Emotional labour in palliative and end-of-life care communication: A qualitative study with generalist palliative care providers
Emotional labour in palliative and end-of-life care communication: A qualitative study with generalist palliative care providers
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DOI：
10.1016/j.pec.2018.10.013
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发表时间：
2019-03-01
影响因子：
3.5
通讯作者：
Evans, Catherine J.
中科院分区：
文献类型：
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作者：
Brighton, Lisa Jane;Selman, Lucy Ellen;Evans, Catherine J.
目的：探讨全科姑息治疗提供者在与患者和家属进行有关姑息治疗和临终关怀的对话时的情绪劳动经验，为支持策略提供信息。方法：对参加交流研讨会的全科医生（提供“初级”或“一般”姑息治疗的人员，而不是姑息治疗专家）进行半结构化访谈。抽样是有目的的（按性别、职业、经验）。使用框架方法分析数据；为了严格起见，抄本样本被双重编码。数据收集和分析以情绪劳动、应对和沟通理论为依据。结果：对4名救护人员、3名护士、2名语言治疗师和1名治疗助理进行了访谈。出现了五个主题：情感体验；情感“表现规则”；情绪管理;支持需求;以及情绪劳动的感知影响。参与者报告了平衡“人性”和“专业”情感表达的能力。支持需求包括情绪管理的时间，使情绪体验正常化的工作场所文化，正式的情感支持，以及姑息治疗和临终关怀技能培训。结论：支持多面手员工情感需求的多样化策略对于确保高质量的临终关怀和沟通以及支持员工幸福感至关重要。实践启示：需要正式和非正式的支持，以及技能培训，以实现支持性的工作场所文化和个人发展。(C) 2018 Elsevier B.V.版权所有
Objective: To explore generalist palliative care providers' experiences of emotional labour when undertaking conversations around palliative and end-of-life care with patients and families, to inform supportive strategies.Methods: Semi-structured interviews conducted with generalist staff (those providing 'primary' or 'general' palliative care, not palliative care specialists) who had attended a communication workshop. Sampling was purposive (by gender, profession, experience). Data were analysed using a framework approach; a sample of transcripts were double-coded for rigour. Data collection and analysis were informed by theories of emotional labour, coping, and communication.Results: Four ambulance staff, three nurses, two speech and language therapists, and one therapy assistant were interviewed. Five themes emerged: emotions experienced; emotion 'display rules'; emotion management; support needs; and perceived impact of emotional labour. Participants reported balancing 'human' and 'professional' expressions of emotion. Support needs included time for emotion management, workplace cultures that normalise emotional experiences, formal emotional support, and palliative and end-of-life care skills training.Conclusion: Diverse strategies to support the emotional needs of generalist staff are crucial to ensure high-quality end-of-life care and communication, and to support staff well-being.Practice implications: Both formal and informal support is required, alongside skills training, to enable a supportive workplace culture and individual development. (C) 2018 Elsevier B.V. All rights reserved.