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Distress and self-care among chaplains working in palliative care

Published online by Cambridge University Press:  11 February 2019

Kelsey B. White Open the ORCID record for Kelsey B. White [Opens in a new window] ,
Patricia E. Murphy ,
Jane Jeuland  and
George Fitchett
Kelsey B. White*
Affiliation:
University of Louisville, Louisville, KY
Patricia E. Murphy
Affiliation:
Rush University Medical Center, Chicago, IL
Jane Jeuland
Affiliation:
Yale New Haven Hospital, New Haven, CT
George Fitchett
Affiliation:
Rush University Medical Center, Chicago, IL
*
Author for correspondence: Kelsey B. White, University of Louisville, 6800 Chimney Hill Road, Crestwood, KY 40014. E-mail: kelsey.white@louisville.edu
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Abstract

Background

The prevalence of burnout and distress among palliative care professionals has received much attention since research suggests it negatively impacts the quality of care. Although limited, research suggests low levels of burnout or distress among healthcare chaplains; however, there has been no research among chaplains working in specific clinical contexts, including palliative care.

Objective

This study explored the distress, self-care, and debriefing practices of chaplains working in palliative care.

Method

Exploratory, cross-sectional survey of professional chaplains. Electronic surveys were sent to members of four professional chaplaincy organizations between February and April 2015. Primary measures of interest included Professional Distress, Distress from Theodicy, Informal Self-care, Formal Self-care, and debriefing practices.

Result

More than 60% of chaplains working in palliative care reported feeling worn out in the past 3 months because of their work as a helper; at least 33% practice Informal Self-care weekly. Bivariate analysis suggested significant associations between Informal Self-care and both Professional Distress and Distress from Theodicy. Multivariate analysis also identified that distress decreased as Informal and Formal Self-care increased.

Significance of results

Chaplains working in palliative care appear moderately distressed, possibly more so than chaplains working in other clinical areas. These chaplains also use debriefing, with non-chaplain palliative colleagues, to process clinical experiences. Further research is needed about the role of religious or spiritual beliefs and practices in protecting against stress associated with care for people at the end of life.

Keywords

ChaplainPalliative careDistressSelf-care
Type
Original Article
Information
Palliative & Supportive Care , Volume 17 , Issue 5 , October 2019 , pp. 542 - 549
Copyright
Copyright © Cambridge University Press 2019 

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References

Back, AL, Steinhauser, KE, Kamal, AH, et al. (2016) Building resilience for palliative care clinicians: An approach to burnout prevention based on individual skills and workplace factors. Journal of Pain & Symptom Management 52, 284–91.Google Scholar
Boston, PH and Mount, BM (2006) The caregiver's perspective on existential and spiritual distress in palliative care. Journal of Pain & Symptom Management 32, 13–26.Google Scholar
Carter, JL, Trungale, KR, and Barnes, SA (2013) From bedside to graveside: Increased stress among healthcare chaplains. Journal of Pastoral Care and Counseling 67, 4.Google Scholar
Currier, JM, Drescher, KD, Nieuwsma, JA, et al. (2017) Theodicies and professional quality of life in a nationally representative sample of chaplains in the Veterans' Health Administration. Journal of Prevention & Intervention in the Community 45, 286–96.Google Scholar
Dumanovsky, T, Augustin, R, Rogers, M, et al. (2016) The growth of palliative care in US hospitals: A status report. Journal of Palliative Medicine 19, 8–15.Google Scholar
Ekedahl, M and Wengstrom, Y (2008) Coping processes in a multidisciplinary healthcare team--a comparison of nurses in cancer care and hospital chaplains. European Journal of Cancer Care 17, 42–48.Google Scholar
Flannelly, KJ, Roberts, SB, and Weaver, AJ (2005) Correlates of compassion fatigue and burnout in chaplains and other clergy who responded to the September 11th attacks in New York City. Journal of Pastoral Care & Counseling 59, 213–24.Google Scholar
Galek, K, Flannelly, KJ, Greene, PB, et al. (2011) Burnout, secondary traumatic stress and social support. Pastoral Psychology 60, 633–49.Google Scholar
Handzo, G, Flannelly, KJ, Kudler, T, et al. (2008) What do chaplains really do? II. Interventions in the New York chaplaincy study. Journal of Health Care Chaplaincy 14, 39–56.Google Scholar
Harrison, KL, Dzeng, E, Ritchie, CS, et al. (2017) Addressing palliative care clinician burnout in organizations: A workforce necessity, an ethical imperative. Journal of Pain & Symptom Management 53, 1091–96.Google Scholar
Jankowski, KR, Vanderwerker, LC, Murphy, K.M, et al. (2008) Change in pastoral skills, emotional intelligence, self-reflection, and social desirability across a unit of CPE. Journal of Health Care Chaplaincy 15, 132–48.Google Scholar
Jeuland, J, Fitchett, G, Schulman-Green, D, et al. (2017) Chaplains working in palliative care: Who they are and what they do. Journal of Palliative Medicine 20, 502–08.Google Scholar
Jonas, DF and Bogetz, JF (2016) Identifying the deliberate prevention and intervention strategies of pediatric palliative care teams supporting providers during times of staff distress. Journal of Palliative Medicine 19, 679–83.Google Scholar
Kamal, AH, Bull, JH, Wolf, SP, et al. (2016) Prevalence and predictors of burnout among hospice and palliative care clinicians in the US. Journal of Pain & Symptom Management 51, 690–96.Google Scholar
Kavalieratos, D, Siconolfi, DE, Steinhauser, KE, et al. (2017) “It is like heart failure. It is chronic…and it will kill you”: A qualitative analysis of burnout among hospice and palliative care clinicians. Journal of Pain & Symptom Management 53, 901–10.Google Scholar
Koh, MY, Chong, PH, Neo, PS, et al. (2015) Burnout, psychological morbidity and use of coping mechanisms among palliative care practitioners: A multi-centre cross-sectional study. Journal of Palliative Medicine 29, 633–42.Google Scholar
Massey, K, Barnes, MJ, Villines, D, et al. (2015) What do I do? Developing a taxonomy of chaplaincy activities and interventions for spiritual care in intensive care unit palliative care. BMC Palliative Care 14, 10.Google Scholar
Mills, J, Wand, T, and Fraser, JA (2017) Self-care in palliative care nursing and medical professionals: A cross-sectional survey. Journal of Palliative Medicine 20, 625–30.Google Scholar
Oliver, R, Hughes, B, and Weiss, G (2018) A study of the self-reported resilience of APC chaplains. Journal of Pastoral Care & Counseling 72, 99–103.Google Scholar
Pereira, SM, Fonseca, AM, and Carvalho, AS (2011) Burnout in palliative care: A systematic review. Nursing Ethics 18, 317–26.Google Scholar
Portney, LG and Watkins, MP (2015) Foundations of clinical research, 3rd ed. Philadelphia PA: F.A. Davis Company.Google Scholar
Prin, JT, van der Heijden, FM, Hoekstra-Weebers, JE, et al. (2009) Burnout, engagement and resident physicians' self-reported errors. Psychology, Health, & Medicine 14, 654–66.Google Scholar
Sansó, N, Galiana, L, Oliver, A, et al. (2015) Palliative care professionals' inner life: Exploring the relationships among awareness, self-care, and compassion satisfaction and fatigue, burnout, and coping with death. Journal of Pain & Symptom Management 50, 200–07.Google Scholar
Sinsky, CA, Willard-Grace, R, Schutzbank, AM, et al. (2013) In search of joy in practice: A report of 23 high-functioning primary care practices. Annals of Family Medicine, 11, 272–78.Google Scholar
Spetz, J, Dudley, N, Trupin, L, et al. (2016) Few hospital palliative care programs meet national staffing recommendations. Health Affairs (Millwood) 35, 1690–97.Google Scholar
Taylor, BE, Flannelly, KJ, Weaver, AJ, et al. (2006) Compassion fatigue and burnout among rabbis working as chaplains. Journal of Pastoral Care & Counseling 60, 35–42.Google Scholar
Tei, S, Becker, C, Kawad, R, et al. (2014) Can we predict burnout severity from empathy-related brain activity? Translational Psychiatry 4, e393.Google Scholar
West, CP, Huschka, MM, Novotny, PJ, et al. (2006) Association of perceived medical errors with resident distress and empathy: A prospective longitudinal study. JAMA 296, 1071–78.Google Scholar
Whitebird, RR, Asche, SE, Thompson, GL, et al. (2013) Stress, burnout, compassion fatigue, and mental health in hospice workers in Minnesota. Journal of Palliative Medicine 16, 1534–39.Google Scholar
Williams, ES, Manwell, LB, Konrad, TR, et al. (2007) The relationship of organizational culture, stress, satisfaction, and burnout with physician-reported error and suboptimal patient care: Results from the MEMO study. Health Care Management Review 32, 203–12.Google Scholar
Yan, GW and Beder, J (2013) Professional quality of life and associated factors among VHA chaplains. Military Medicine 178, 638–45.Google Scholar