TY - JOUR
T1 - Ethical decisions in palliative care
T2 - interprofessional relations as a burnout protective factor? Results from a mixed-methods multicenter study in Portugal
AU - DELiCaSP
AU - Hernández-Marrero, Pablo
AU - Pereira, Sandra Martins
AU - Carvalho, Ana Sofia
PY - 2016/9/1
Y1 - 2016/9/1
N2 - 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.
AB - 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.
KW - Burnout
KW - End-of-life care
KW - Ethical decisions
KW - Ethical issues
KW - Interprofessional relations
KW - Mixed-methods
KW - Palliative care
KW - Shared decision making
UR - http://www.scopus.com/inward/record.url?scp=84981268327&partnerID=8YFLogxK
U2 - 10.1177/1049909115583486
DO - 10.1177/1049909115583486
M3 - Article
C2 - 25926435
AN - SCOPUS:84981268327
SN - 1049-9091
VL - 33
SP - 723
EP - 732
JO - American Journal of Hospice and Palliative Medicine
JF - American Journal of Hospice and Palliative Medicine
IS - 8
ER -