The burden in palliative care assistance: A comparison of psychosocial risks and burnout between inpatient hospice and home care services workers

Fattori, Alice; Pedruzzi, Matilde; Cantarella, Carlo; Bonzini, Matteo

doi:10.1017/s1478951521001887

Cited by 7 publications

(11 citation statements)

References 45 publications

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“…According to PSC Benchmark Standards, the mean PSC value found in our study suggests a high-risk level ( Dollard and Bailey, 2019 ). Although none of these studies concerned the Italian context, making comparison difficult, it is noteworthy that the mean PSC score in our sample was also lower than those found in previous Italian studies among workers involved in palliative cares ( Fattori et al, 2022 ) and healthcare workers facing COVID-19 ( Fattori et al, 2021 ).…”

Section: Discussioncontrasting

confidence: 84%

Psychosocial safety climate (PSC) at middle management level in the healthcare sector: A contribution to the Italian validation of psychosocial safety climate-4

et al. 2022

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IntroductionPsychosocial safety climate (PSC) refers to workers’ shared perceptions of organizational policies, practices and procedures for the protection of psychological health and safety. PSC offers a multilevel organizational approach that expands traditional models of workplace stress, giving a more comprehensive understanding of occupational health and safety issues. Although considerable research on psychosocial risks in the healthcare sector has been conducted, few studies have explored the role of PSC among healthcare workers at middle management level. Additionally, no validated version of PSC is available in Italian language. The aim of this study is to contribute to the validation of the Italian 4-item version of the PSC and to explore this theory within the Job Demands-Resources model (JD-R) among a sample of Italian healthcare workers by testing PSC at the middle management level.MethodsWe used cross-sectional data from 276 employees working in 17 different wards in a large Italian hospital. Intra-class coefficient (ICC) coefficient and agreement index were used to test PSC as a climate construct (data nested to hospital ward level). We performed hierarchical linear models to test mediation and moderation effects.ResultsThe Italian version of PSC-4 proved to have good psychometric properties and confirmed its role as a group-level construct (α = 0.84; ICC = 0.16). Multilevel random coefficient models showed PSC was associated with Job demands (Effort: B = −0.36, SE = 0.07; Emotional demands: B = −0.03, SE = 0.01) and Job resources (Reward: B = 1.16, SE = 0.01; Physical work environment: B = 0.06, SE = 0.01). Results confirmed the indirect effect of PSC on Psychological (Burnout) and Occupational health (Job satisfaction) outcomes supporting the role of Job resources and Job demands as mediators. The multilevel analysis did not find a significant interaction terms between PSC and Job demands on Burnout therefore the moderation hypothesis was not supported.DiscussionThe Italian version of PSC-4 is a valid tool to evaluate PSC. These findings sustain the multilevel framework of PSC and the significant role played by mid-leaders in both the health impairment and motivational path. Further studies should explore the buffering effect of PSC at higher baseline levels as well as the adoption of PSC as a target for occupational health intervention the Italian context.

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Section: Discussioncontrasting

confidence: 84%

Psychosocial safety climate (PSC) at middle management level in the healthcare sector: A contribution to the Italian validation of psychosocial safety climate-4

et al. 2022

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“…There was one study that compared palliative healthcare professionals with other healthcare professionals: Yildrim et al [40] performed a comparison study between hematology, oncology, and palliative care nurses. The study of Diehl and colleagues made a comparison between different types of palliative nurses: those providing specialized palliative care compared with those providing general palliative care; Fattori et al [18] compared inpatient hospice and home care service workers.…”

Section: Resultsmentioning

confidence: 99%

Burnout of healthcare professionals in supportive and palliative care: a summary of recent literature

Roo

2023

Current Opinion in Supportive &Amp; Palliative Care

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Purpose of review Burnout is a complex phenomenon where several personal and work-related factors interact with each other. Palliative care is a challenging branch of healthcare, which can be especially demanding for the professionals providing it. This review presents an overview of the most recent literature on causes, identification, and consequences of burnout as well as articles on interventions to reduce burnout in the professional palliative healthcare provider setting. Recent findings With a few exceptions, research on burnout in the palliative care provider setting is focused on further insight on the different aspects that cause burnout on an individual, social, and organizational level. Unfortunately, only a few studies were found on interventions to prevent burnout. While the results of these interventions were promising, long-term results or data on how these diminish actual healthcare provider dropout were not available. Summary Research on burnout faced by palliative healthcare professionals seems to focus mainly on gaining further insight of different aspects of the complex syndrome that is burnout and how different individual, social, and organizational factors interact with each other. Further research on the prevention and treatment of burnout is necessary.

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“…There was strong evidence (five high-quality studies2 7 61 63 65) showing that factors such as change management and the overall organisational culture in a hospice are associated with poorer psychological well-being. For example, one study reported that how organisational change is managed and communicated in the organisation was a significant predictor of depression (n=91, beta=−2.684, p≤0.01) 66…”

Section: Resultsmentioning

confidence: 99%

“…There was insufficient evidence suggesting that hospice workers’ psychological well-being is affected by ‘work intrusiveness’, the extent to which their work intrudes into their private life 65…”

Section: Resultsmentioning

confidence: 99%

“…Exploring the role of place of work in relation to staff well-being included comparisons between working in a hospice and working in other healthcare settings, and comparisons between working in an inpatient setting with working in the community. There was strong evidence (five high-quality studies2 7 62 65 67) that working in a hospice environment protected against poor psychological well-being, but mixed evidence on whether well-being was better for those staff who worked in inpatient settings versus community settings (and vice versa). For example, one study reported that elements of the hospice environment, such as having supportive work colleagues and having more time to listen and talk to patients, were resources not found in other similar roles 7…”

Section: Resultsmentioning

confidence: 99%

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Psychological well-being of hospice staff: systematic review

Papworth

Ziegler

Beresford

et al. 2023

BMJ Support Palliat Care

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BackgroundPoor psychological well-being among healthcare staff has implications for staff sickness and absence rates, and impacts on the quality, cost and safety of patient care. Although numerous studies have explored the well-being of hospice staff, study findings vary and the evidence has not yet been reviewed and synthesised. Using job demands-resources (JD-R) theory, this review aimed to investigate what factors are associated with the well-being of hospice staff.MethodsWe searched MEDLINE, CINAHL and PsycINFO for peer-reviewed quantitative, qualitative or mixed-methods studies focused on understanding what contributes to the well-being of hospice staff who provide care to patients (adults and children). The date of the last search was 11 March 2022. Studies were published from 2000 onwards in the English language and conducted in Organisation for Economic Co-operation and Development countries. Study quality was assessed using the Mixed Methods Appraisal Tool. Data synthesis was conducted using a result-based convergent design, which involved an iterative, thematic approach of collating data into distinct factors and mapping these to the JD-R theory.ResultsA total of 4016 unique records were screened by title and abstract, 115 full-text articles were retrieved and reviewed and 27 articles describing 23 studies were included in the review. The majority of the evidence came from studies of staff working with adult patients. Twenty-seven individual factors were identified in the included studies. There is a strong and moderate evidence that 21 of the 27 identified factors can influence hospice staff well-being. These 21 factors can be grouped into three categories: (1) those that are specific to the hospice environment and role, such as the complexity and diversity of the hospice role; (2) those that have been found to be associated with well-being in other similar settings, such as relationships with patients and their families; and (3) those that affect workers regardless of their role and work environment, that is, that are not unique to working in a healthcare role, such as workload and working relationships. There was strong evidence that neither staff demographic characteristics nor education level can influence well-being.DiscussionThe factors identified in this review highlight the importance of assessing both positive and negative domains of experience to determine coping interventions. Hospice organisations should aim to offer a wide range of interventions to ensure their staff have access to something that works for them. These should involve continuing or commencing initiatives to protect the factors that make hospices good environments in which to work, as well as recognising that hospice staff are also subject to many of the same factors that affect psychological well-being in all work environments. Only two studies included in the review were set in children’s hospices, suggesting that more research is needed in these settings.PROSPERO registration numberCRD42019136721 (Deviations from the protocol are noted in Table 8, Supplementary material).

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The burden in palliative care assistance: A comparison of psychosocial risks and burnout between inpatient hospice and home care services workers

Cited by 7 publications

References 45 publications

Psychosocial safety climate (PSC) at middle management level in the healthcare sector: A contribution to the Italian validation of psychosocial safety climate-4

Psychosocial safety climate (PSC) at middle management level in the healthcare sector: A contribution to the Italian validation of psychosocial safety climate-4

Burnout of healthcare professionals in supportive and palliative care: a summary of recent literature

Psychological well-being of hospice staff: systematic review

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