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The emergence of personal growth amongst healthcare professionals who care for dying children

Published online by Cambridge University Press:  22 May 2017

Laura Beaune*
Affiliation:
Department of Social Work, The Hospital for Sick Children, Toronto, Ontario, Canada Child Health Evaluative Sciences, The Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ontario, Canada
Barbara Muskat
Affiliation:
Department of Social Work, The Hospital for Sick Children, Toronto, Ontario, Canada Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
Samantha J. Anthony
Affiliation:
Department of Social Work, The Hospital for Sick Children, Toronto, Ontario, Canada Child Health Evaluative Sciences, The Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ontario, Canada Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
*
Address correspondence and reprint requests to: Laura Beaune, Department of Social Work, First Floor, Elm Wing, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5 G 1X8, Canada. E-mail: [email protected].

Abstract

Objective:

Compassion fatigue, burnout, and vicarious traumatization are prominent topics in the current literature on the impact of the rewarding but challenging work of healthcare professionals who care for patients with life-limiting illnesses. The positive effects of caregiving constitute a newly emerging outcome that has been relatively unexplored in the pediatric literature, and yet they may play an important role in contributing to the satisfaction and well-being of the healthcare professionals who care for children who have a life-limiting illness.

Method:

This paper reports the results of a secondary analysis of qualitative interview transcripts that explored the experiences of hospital-based pediatric healthcare providers caring for children with varied life-limiting illnesses. In-depth qualitative interviews were conducted with 25 healthcare professionals (9 social workers, 8 nurses, and 8 physicians). The majority of participants were women (80%), with an age range between 20 and 60 years, and most (84%) had the experience of caring for more than 15 dying children. Thematic analysis was conducted using interpretive description and constant comparison.

Results:

Every healthcare professional interviewed experienced personal growth as a result of their providing care for dying children. Three dimensions of personal growth were most consistently reported: (1) new or altered life perspectives, (2) enhanced personal resources, and (3) benevolence.

Significance of results:

A deeper understanding of the phenomenon of personal growth could help healthcare organizations to implement innovative approaches that would counterbalance compassion fatigue, and thereby enhance both healthcare provider well-being and child and family outcomes.

Type
Original Article
Copyright
Copyright © Cambridge University Press 2017 

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References

REFERENCES

Arnold, D., Calhoun, L.G., Tedeschi, R., et al. (2005). Vicarious posttraumatic growth in psychotherapy. Journal of Humanistic Psychology, 45(2), 239263.CrossRefGoogle Scholar
Back, A.L., Young, J.P., McCown, E., et al. (2009). Abandonment at the end of life from patient, caregiver, nurse, and physician perspectives: Loss of continuity and lack of closure. Archives of Internal Medicine, 169(5), 474479. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2918275/.CrossRefGoogle ScholarPubMed
Bance, S. & Stermac, L. (2014). The impact of burnout, secondary traumatic stress and vicarious trauma on job satisfaction in Ontario emergency nurses. Journal of the Emergency Nurses Association of Ontario, 4(2), 16.Google Scholar
Brady, J.L., Guy, J.D., Poelstra, P.L., et al. (1999). Vicarious traumatization, spirituality, and the treatment of sexual abuse survivors: A national survey of women psychotherapists. Professional Psychology: Research and Practice, 30(4), 386393.CrossRefGoogle Scholar
Charmaz, K. (2006). Constructing Grounded Theory: A Practical Guide Through Qualitative Research. London: Sage Publications.Google Scholar
Clarke, J. & Quin, S. (2007). Professional carers' experiences of providing a pediatric palliative care service in Ireland. Qualitative Health Research, 17(9), 12191231.CrossRefGoogle ScholarPubMed
Clarke-Steffen, L. (1998). The meaning of peak and nadir experiences of pediatric oncology nurses: Secondary analysis. Journal of Pediatric Oncology Nursing, 15(1), 2533.CrossRefGoogle ScholarPubMed
Cohen, K. & Collens, P. (2013). The impact of trauma work on trauma workers: A metasynthesis on vicarious trauma and vicarious posttraumatic growth. Psychological Trauma: Theory, Research, Practice, and Policy, 5(6), 570580.CrossRefGoogle Scholar
Conte, T. (2014). The lived experience of work-related loss and grief among pediatric oncology nurses. Journal of Hospice and Palliative Nursing, 16(1), 4046.CrossRefGoogle Scholar
Cook, K.A., Mott, S., Lawrence, P., et al. (2012). Coping while caring for the dying child: Nurses' experiences in an acute care setting. Journal of Pediatric Nursing, 27(4), e11e21. Epub ahead of print Aug 5, 2011.CrossRefGoogle Scholar
Cresswell, J.W. (1988). Qualitative Inquiry and Research Design: Choosing Among Five Traditions. London: Sage Publications.Google Scholar
Davies, B., Clarke, D., Connaughty, S., et al. (1996). Caring for dying children: Nurses' experiences. Pediatric Nursing, 22(6), 500507.Google ScholarPubMed
Doka, K.J. (ed.) (1989). Disenfranchised Grief: Recognizing Hidden Sorrow. Lexington, MA: Lexington Books.Google Scholar
Granek, L. (2015). Confronting oncologists' emotions. The Oncologist, 20(12), 1460. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4679093/.CrossRefGoogle ScholarPubMed
Granek, L., Tozer, R., Maxxotta, P., et al. (2012). Nature and impact of grief over patient loss on oncologists' personal and professional lives. Archives of Internal Medicine, 172(12), 964966. Available from http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1160665.CrossRefGoogle ScholarPubMed
Granek, L., Krzyzanowska, M.K., Tozer, R., et al. (2013). Oncologists' strategies and barriers to effective communication about the end of life. Journal of Oncology Practice, 9(4), e129e135. Epub ahead of print Apr 2. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3710179/.CrossRefGoogle ScholarPubMed
Granek, L., Ariad, S., Shapira, S., et al. (2016). Barriers and facilitators in coping with patient death in clinical oncology. Supportive Care in Cancer, 24(10), 42194227.CrossRefGoogle ScholarPubMed
Hain, R., Devins, M., Hastings, R., et al. (2013). Paediatric palliative care: Development and pilot study of a “directory” of life-limiting conditions. BMC Palliative Care, 12(1), 43. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4029745/.CrossRefGoogle ScholarPubMed
Harrison, R.L. & Westwood, M.J. (2009). Preventing vicarious traumatization of mental health therapists: Identifying protective practices. Psychotherapy, 46(2), 203219.CrossRefGoogle ScholarPubMed
Heller, K.S. & Solomon, M.Z. (2005). Continuity of care and caring: What matters to parents of children with life-threatening conditions. Journal of Pediatric Nursing, 20(5), 335346.CrossRefGoogle ScholarPubMed
Kaplan, L.J. (2000). Toward a model of caregiver grief: Nurses' experiences of treating dying children. Omega, 41(3), 187206.CrossRefGoogle Scholar
Klassen, A., Gulati, S. & Dix, D. (2012). Health care providers' perspectives about working with parents of children with cancer: A qualitative study. Journal of Pediatric Oncology Nursing, 29(2), 9297. Epub ahead of print Mar 13.CrossRefGoogle ScholarPubMed
Korzeniewska-Eksterowicz, A., Przysło, L., Grzelewski, T., et al. (2010). Job satisfaction among health professionals of Home Hospice for Children of the Lodz Region. Advances in Palliative Medicine, 9(3), 6772. Available from https://journals.viamedica.pl/advances_in_palliative_medicine/article/viewFile/29352/24107.Google Scholar
Liben, S, Papadatou, D & Wolfe, J. (2008). Paediatric palliative care: Challenges and emerging tasks. Lancet, 371(9615), 852864.CrossRefGoogle Scholar
Lincoln, Y.S. & Guba, E.G. (1985). Naturalistic Inquiry. London: Sage Publications.CrossRefGoogle Scholar
Macpherson, C.F. (2008). Peer-supported storytelling for grieving pediatric oncology nurses. Journal of Pediatric Oncology Nursing, 25(3), 148163.CrossRefGoogle ScholarPubMed
Maytum, C.J, Heiman, M.B. & Garwick, A.W. (2004). Compassion fatigue and burnout in nurses who work with children with chronic conditions and their families. Journal of Pediatric Health Care, 18(4), 171179.Google ScholarPubMed
McCloskey, S. & Taggart, L. (2010). How much compassion have I left? An exploration of occupational stress among children's palliative care nurses. International Journal of Palliative Nursing, 16(5), 233240.CrossRefGoogle Scholar
McConnell, T., Scott, D. & Porter, S. (2016). Healthcare staff's experience in providing end-of-life care to children: A mixed-method review. Palliative Medicine, 30(10), 905919. Available from http://eprints.bournemouth.ac.uk/26343/1/Porter_Healthcare_Staff_Experience.pdf.CrossRefGoogle ScholarPubMed
Miles, M.B. & Huberman, A.M. (1994). Qualitative Data Analysis: A Sourcebook of New Methods, 2nd ed. Thousand Oaks, CA: Sage Publications.Google Scholar
Mori, M., Shimizu, C., Ogawa, A., et al. (2015). A national survey to systematically identify factors associated with oncologists' attitudes toward end-of-life discussions: What determines timing of end-of-life discussions? The Oncologist, 20(11), 13041311. Epub ahead of print Oct 7. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4718424/.CrossRefGoogle ScholarPubMed
Morgan, D. (2009). Caring for dying children: Assessing the needs of the pediatric palliative care nurse. Pediatric Nursing, 35(2), 8690.Google ScholarPubMed
Morgans, A.K. & Schapira, L. (2015). Confronting therapeutic failure: A conversation guide. The Oncologist, 20(8), 946951.CrossRefGoogle ScholarPubMed
Morrison, C.F. & Morris, E.J. (2017). The Practices and Meanings of Care for Nurses Working on a Pediatric Bone Marrow Transplant Unit. Journal of Pediatric Oncology Nursing, 34(3), 214221. Epub ahead of print Feb 10.CrossRefGoogle ScholarPubMed
Muskat, B., Beaune, L., Anthony, S.J., et al. (2014). The tenuous balance of caring: Narratives from social workers, physicians and nurses who care for dying children in an acute care setting. Journal of Palliative Care, 30(3), 241242.Google Scholar
Papadatou, D., Martinson, I.M. & Chung, P.M. (2001). Caring for dying children: A comparative study of nurses' experiences in Greece and Hong Kong. Cancer Nursing, 24(5), 402412.CrossRefGoogle ScholarPubMed
Plante, J. & Cyr, C. (2011). Health care professionals' grief after the death of a child. Paediatrics & Child Health, 16(4), 213216. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3076172/.CrossRefGoogle ScholarPubMed
QSR International (2007). NVivo Qualitative Data Analysis Software, Version 9. Doncaster, Victoria, Australia: QSR International.Google Scholar
Rapoport, A., Beaune, L., Weingarten, K., et al. (2012). Living life to the fullest: Early integration of palliative care into the lives of children with chronic complex conditions. Current Pediatric Reviews, 8(2), 152165.CrossRefGoogle Scholar
Reid, F.C. (2013). Lived experiences of adult community nurses delivering palliative care to children and young people in rural areas. International Journal of Palliative Nursing, 19(11), 541547.CrossRefGoogle Scholar
Sandelowski, M. (1995). Qualitative analysis: What it is and how to begin? Research in Nursing and Health, 18(4), 371375.CrossRefGoogle ScholarPubMed
Schaefer, J.A. & Moos, R.H. (1992). Life crisis and personal growth. In Personal Coping: Theory, Research and Application. Carpenter, B.N. (ed.), pp.149170. Westport, CT: Praeger.Google Scholar
Sinclair, H.A. & Hamill, C. (2007). Does vicarious traumatization affect oncology nurses? A literature review. European Journal of Oncology Nursing, 11(4), 348356. Epub 2007 May 7.CrossRefGoogle ScholarPubMed
Statistics Canada (2013). National Household Survey Profile, 2011. Ottawa: Statistics Canada. Available from http://www12.statcan.gc.ca/nhs-enm/2011/dp-pd/prof/index.cfm?Lang=E.Google Scholar
Stewart, D.W. & Kamins, M.A. (1993). Secondary Research: Information Sources and Methods, Vol. 4. Thousand Oaks, CA: Sage Publications.CrossRefGoogle Scholar
Strauss, A. & Corbin, J. (1994). Grounded Theory Methodology. Handbook of Qualitative Research. London: Sage Publications.Google Scholar
Taubman-Ben-Ari, O. & Weintroub, A. (2008). Meaning in life and personal growth among pediatric physicians and nurses. Death Studies. 32(7), 621645.CrossRefGoogle ScholarPubMed
Tedeschi, R.G. & Calhoun, L. (2004). Posttraumatic growth: Conceptual foundations and empirical evidence. Psychological Inquiry, 15(1), 118.CrossRefGoogle Scholar
Thorne, S., Reimer Kirkham, S. & O'Flynn-Magee, K. (2004). The analytic challenge in interpretive description. International Journal of Qualitative Methods, 3(1), 111.CrossRefGoogle Scholar
Vachon, M.L., Lyall, W.A. & Freeman, S.J. (1978). Measurement and management of stress in health professionals working with advanced cancer patients. Death Education, 1(4), 365375.CrossRefGoogle ScholarPubMed
Vishnevsky, T., Quinlan, M., Kilmer, R., et al. (2015). “The keepers of stories”: Personal growth and wisdom among oncology nurses. Journal of Holistic Nursing, 33(4), 326344. Epub ahead of print Mar 5.CrossRefGoogle ScholarPubMed
Widger, K., Davies, D., Drouvin, D.J., et al. (2007). Pediatric patients receiving palliative care in Canada: Results of a multicenter review. Archives of Pediatrics & Adolescent Medicine, 161(6), 597602. Available from http://jamanetwork.com/journals/jamapediatrics/fullarticle/570513.CrossRefGoogle ScholarPubMed
Williams, A.M., Donovan, R., Stajduhar, K., et al. (2015). Cultural influences on palliative family caregiving: Service recommendations specific to the Vietnamese in Canada. BMC Research Notes, 8(1), 280. Available from https://bmcresnotes.biomedcentral.com/articles/10.1186/s13104-015-1252-3.CrossRefGoogle Scholar
Woolley, H., Stein, A., Forrest, G.C., et al. (1989). Staff stress and job satisfaction at a children's hospice. Archives of Disease in Childhood, 64(1), 114118. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1791797/.CrossRefGoogle Scholar