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      Resilience in palliative healthcare professionals: a systematic review

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          Abstract

          Purpose

          Exposure to end-of-life and chronic illness on a daily basis may put palliative healthcare professionals’ well-being at risk. Resilience may represent a protective factor against stressful and demanding challenges. Therefore, the aim is to systematically review the quantitative studies on resilience in healthcare professionals providing palliative care to adult patients.

          Methods

          A literature search on PubMed, Scopus, Web of Science and PsycINFO databases was performed. The review process has followed the international PRISMA statement guidelines.

          Results

          At the initial search, a total of 381 records were identified. Twelve articles were assessed for eligibility and, finally, 6 studies met all the inclusion criteria. Of these, four researches were observational and two interventional pilot studies. From the systematic synthesis, palliative care providers’ resilience revealed to be related to other psychological constructs, including secondary traumatic stress, vicarious posttraumatic growth, death anxiety, burnout, compassion satisfaction, hope and perspective taking.

          Conclusions

          The current systematic review reported informative data leading to consider resilience as a process modulator and facilitator among palliative care professionals. A model on palliative healthcare providers’ experience and the role of resilience was proposed. Further studies may lead to its validation and implementation in assessment and intervention contributing to foster palliative healthcare professionals’ well-being.

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          Most cited references27

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          Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC).

          Kathryn M Connor, Jonathan Davidson (2003)
          Resilience may be viewed as a measure of stress coping ability and, as such, could be an important target of treatment in anxiety, depression, and stress reactions. We describe a new rating scale to assess resilience. The Connor-Davidson Resilience scale (CD-RISC) comprises of 25 items, each rated on a 5-point scale (0-4), with higher scores reflecting greater resilience. The scale was administered to subjects in the following groups: community sample, primary care outpatients, general psychiatric outpatients, clinical trial of generalized anxiety disorder, and two clinical trials of PTSD. The reliability, validity, and factor analytic structure of the scale were evaluated, and reference scores for study samples were calculated. Sensitivity to treatment effects was examined in subjects from the PTSD clinical trials. The scale demonstrated good psychometric properties and factor analysis yielded five factors. A repeated measures ANOVA showed that an increase in CD-RISC score was associated with greater improvement during treatment. Improvement in CD-RISC score was noted in proportion to overall clinical global improvement, with greatest increase noted in subjects with the highest global improvement and deterioration in CD-RISC score in those with minimal or no global improvement. The CD-RISC has sound psychometric properties and distinguishes between those with greater and lesser resilience. The scale demonstrates that resilience is modifiable and can improve with treatment, with greater improvement corresponding to higher levels of global improvement. Copyright 2003 Wiley-Liss, Inc.
          Article 0 comments Cited 2615 times – based on 0 reviews     Review now
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            Intervention studies to foster resilience - A systematic review and proposal for a resilience framework in future intervention studies.

            A Chmitorz, A Kunzler, I Helmreich … (2018)
            Psychological resilience refers to the phenomenon that many people are able to adapt to the challenges of life and maintain mental health despite exposure to adversity. This has stimulated research on training programs to foster psychological resilience. We evaluated concepts, methods and designs of 43 randomized controlled trials published between 1979 and 2014 which assessed the efficacy of such training programs and propose standards for future intervention research based on recent developments in the field. We found that concepts, methods and designs in current resilience intervention studies are of limited use to properly assess efficacy of interventions to foster resilience. Major problems are the use of definitions of resilience as trait or a composite of resilience factors, the use of unsuited assessment instruments, and inappropriate study designs. To overcome these challenges, we propose 1) an outcome-oriented definition of resilience, 2) an outcome-oriented assessment of resilience as change in mental health in relation to stressor load, and 3) methodological standards for suitable study designs of future intervention studies. Our proposals may contribute to an improved quality of resilience intervention studies and may stimulate further progress in this growing research field.
            Article 0 comments Cited 157 times – based on 0 reviews     Review now
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              Predictors of physician career satisfaction, work-life balance, and burnout.

              Kristie Keeton, D Fenner, Philip Hayward … (2007)
              To explore factors associated with physician career satisfaction, work-life balance, and burnout focusing on differences across age, gender, and specialty. A cross-sectional, mailed, self-administered survey was sent to a national sample of 2,000 randomly-selected physicians, stratified by specialty, age, and gender (response rate 48%). Main outcome measures included career satisfaction, burnout, and work-life balance. Scales ranged from 1 to 100. Both women and men report being highly satisfied with their careers (79% compared with 76%, P<.01), having moderate levels of satisfaction with work-life balance (48% compared with 49%, P=.24), and having moderate levels of emotional resilience (51% compared with 53%, P=.09). Measures of burnout strongly predicted career satisfaction (standardized beta 0.36-0.60, P<.001). The strongest predictor of work-life balance and burnout was having some control over schedule and hours worked (standardized beta 0.28, P<.001, and 0.20-0.32, P<.001, respectively). Physician gender, age, and specialty were not strong independent predictors of career satisfaction, work-life balance, or burnout. This national physician survey suggests that physicians can struggle with work-life balance yet remain highly satisfied with their career. Burnout is an important predictor of career satisfaction, and control over schedule and work hours are the most important predictors of work-life balance and burnout. II.
              Article 0 comments Cited 93 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Anna Giardini:
                ORCID: http://orcid.org/0000-0002-2845-347X
                anna.giardini@icsmaugeri.it
                Journal
                Journal ID (nlm-ta): Support Care Cancer
                Journal ID (iso-abbrev): Support Care Cancer
                Title: Supportive Care in Cancer
                Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )
                ISSN (Print): 0941-4355
                ISSN (Electronic): 1433-7339
                Publication date (Electronic): 6 December 2019
                Publication date (Print): 2020
                Volume: 28
                Issue: 3
                Pages: 971-978
                Affiliations
                [1 ]GRID grid.8982.b, ISNI 0000 0004 1762 5736, Department of Brain and Behavioral Sciences, , University of Pavia, ; Pavia, Italy
                [2 ]Psychology Unit – Institute of Montescano, Istituti Clinici Scientifici Maugeri IRCCS, 27040 Montescano, PV Italy
                Author information
                http://orcid.org/0000-0002-2845-347X
                Article
                Publisher ID: 5194
                DOI: 10.1007/s00520-019-05194-1
                PMC ID: 7223999
                PubMed ID: 31811483
                SO-VID: 84ad2769-07d9-403f-8b77-1c3817c0112c
                Copyright © © Springer-Verlag GmbH Germany, part of Springer Nature 2019
                License:

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                Date received : 14 June 2019
                Date accepted : 20 November 2019
                Funding
                Funded by: “Ricerca Corrente” Funding scheme of the Ministry of Health, Italy.
                Award ID: /
                Categories
                Subject: Review Article
                Custom metadata
                issue-copyright-statement © Springer-Verlag GmbH Germany, part of Springer Nature 2020

                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: resilience,palliative care,burnout,end-of-life,chronicity,healthcare professionals
                Data availability:
                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: resilience, palliative care, burnout, end-of-life, chronicity, healthcare professionals

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