Ethical decisions in palliative care: interprofessional relations as a burnout protective factor? Results from a mixed-methods multicenter study in Portugal

DELiCaSP, Pablo Hernández-Marrero, Sandra Martins Pereira*, Ana Sofia Carvalho

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

28 Citations (Scopus)

Abstract

Background: Ethical decisions are part of contemporary practices in palliative care. The need of making such decisions is associated to higher burnout levels and other work related problems among healthcare professionals. Aims: As part of the project entitled “Decisions in End-of-Life Care in Spain and Portugal” (DELiCaSP), this study aims to (i) identify the most common ethical decisions made by Portuguese palliative care teams and (ii) understand how the making of such decisions relates to burnout. Methods: A mixed methods study was conducted with 9 palliative care teams, using (i) questionnaires of socio-demographic and professional variables, work-related experiences, (ii) the Maslach Burnout Inventory, (iii) interviews and (iv) observations. These teams were geographically dispersed across the country, covering the North, Centrum and South regions, and heterogeneous: Five palliative care units for inpatients; three home care teams; and one hospital support team. A total of 20 interviews and 240 hours of observations were completed until reaching saturation. Results: The most common ethical decisions were related to communication issues (information disclosure of the diagnosis and prognosis), forgoing treatment and sedation. Although perceived as stressful, emotionally demanding and challenging, ethical decisions were not significantly associated with burnout. Conclusions: Making ethical decisions is not associated with higher burnout levels among professionals working in Portuguese palliative care teams. This can be explained by the interprofessional decision-making process followed by these teams, which promotes a sense of shared-decision and team-based empowerment; and by the advanced level of interdisciplinary education in palliative care that these professionals have.

Original languageEnglish
Pages (from-to)723-732
Number of pages10
JournalAmerican Journal of Hospice and Palliative Medicine
Volume33
Issue number8
DOIs
Publication statusPublished - 1 Sep 2016

Keywords

  • Burnout
  • End-of-life care
  • Ethical decisions
  • Ethical issues
  • Interprofessional relations
  • Mixed-methods
  • Palliative care
  • Shared decision making

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