Resilience in palliative healthcare professionals: a systematic review

Francesco Zanatta, Marina Maffoni, Anna Giardini, Francesco Zanatta, Marina Maffoni, Anna Giardini

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.

Keywords: Burnout; Chronicity; End-of-life; Healthcare professionals; Palliative care; Resilience.

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Flow diagram of records identified, screened and included in the systematic review, according to PRISMA reporting guidelines
Fig. 2
Fig. 2
Palliative care providers’ experience and the role of resilience

References

    1. Chmitorz A, Kunzler A, Helmreich I, Tuscher O, Kalisch R, Kubiak T, et al. Intervention studies to foster resilience - a systematic review and proposal for a resilience framework in future intervention studies. Clin Psychol Rev. 2018;59:78–100.
    1. Block JH, Block J (1980) The role of ego-control and ego-resiliency in the organization of behavior. In: W A Collins (Ed) The Minnesota symposia on child psychology: development of cognition, affect, and social relations, Vol 13, pp 39–101
    1. Connor KM, Davidson JR, Lee LC. Spirituality, resilience, and anger in survivors of violent trauma: a community survey. J Trauma Stress. 2003;16:487–494.
    1. Ong AD, Bergeman CS, Bisconti TL, Wallace KA. Psychological resilience, positive emotions, and successful adaptation to stress in later life. J Pers Soc Psychol. 2006;91:730–749.
    1. Hu T, Zhang D, Wang J. A meta-analysis of the trait resilience and mental health. Personal Individ Differ. 2015;76:18–27.
    1. Fletcher D, Sarkar M. Psychological resilience: a review and critique of definitions, concepts, and theory. Eur Psychol. 2013;18:12–23.
    1. Reivich K, Shatté A. The resilience factor: 7 essential skills for overcoming life’s inevitable obstacles. New York: Broadway Books; 2002.
    1. Southwick SM, Litz BT, Charney D, Friedman MJ. Resilience and mental health: challenges across the lifespan. Cambridge: Cambridge University Press; 2011.
    1. Southwick SM, Charney DS. Resilience: the science of mastering life’s greatest challenges. Cambridge: Cambridge University Press; 2012.
    1. Hobfoll SE, Stevens NR, Zalta AK. Expanding the science of resilience: conserving resources in the aid of adaptation. Psychol Inq. 2015;26:174–180.
    1. Bonanno GA, Diminich ED. Annual research review: positive adjustment to adversity--trajectories of minimal-impact resilience and emergent resilience. J Child Psychol Psychiatry. 2013;54:378–401.
    1. Bonanno GA, Romero SA, Klein SI. The temporal elements of psychological resilience: an integrative framework for the study of individuals, families, and communities. Psychol Inq. 2015;26:139–169.
    1. Aburn G, Gott M, Hoare K. What is resilience? An integrative review of the empirical literature. J Adv Nurs. 2016;72:980–1000.
    1. Connor KM, Davidson JR. Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC) Depress Anxiety. 2003;18(2):76–82.
    1. Bonanno GA. Loss, trauma, and human resilience: have we underestimated the human capacity to thrive after extremely aversive events? Am Psychol. 2004;59(1):20–28.
    1. Kralik D, van Loon A, Visentin K. Resilience in the chronic illness experience. Educ Action Res. 2006;14(2):187–201.
    1. Ungar M. Resilience across cultures. Br J Soc Work. 2008;38:218–235.
    1. Easterbrooks MA, Drisoll JR, Barlett JD. Resilience in infancy: relational approach. Res Hum Dev. 2008;5(3):139–152.
    1. Montepetit MA, Bergeman CS, Deoboeck PR, Tiberio SS, Boker SM. Resilience-as-process: negative affect, stress and coupled dynamical systems. Psychol Aging. 2010;25(3):631–640.
    1. Wingo AP, Fani N, Bradley B, Ressler KJ. Psychological resilience and neurocognitive performance in a traumatized community sample. Depress Anxiety. 2010;27(8):768–774.
    1. Dowrick C, Kokanovic R, Hegarty K, Griffith F, Gunn J. Resilience and depression: perspectives from primary care. Health (London) 2008;12(4):439–452.
    1. Canvin K, Marttila A, Burstrom B, Whitehead M. Tales of the unexpected? Hidden resilience in poor households in Britain. Soc Sci Med. 2009;69(2):238–245.
    1. Theron LC, Malindi MJ. Resilient street youth: a qualitative South African study. J Youth Stud. 2010;13(6):717–736.
    1. Janssen BM, Van Regenmortel T, Abma TA. Identifying sources of strength: resilience from the perspective older people receiving long-term community care. Eur J Ageing. 2011;8(3):145–156.
    1. Burns RA, Anstey KJ. The Connor-Davidson Resilience Scale (CD-RISC): testing the invariance of a uni-dimensional resilience measure that is independent of positive and negative affect. Personal Individ Differ. 2010;48(5):527–531.
    1. Southwick SM, Bonanno GA, Masten AS, Panter-Brick C, Yehuda R. Resilience definitions, theory, and challenges: interdisciplinary perspectives. Eur J Psychotraumatol. 2014;5(1):25338.
    1. Edward KL, Welch A, Chater K. The phenomenon of resilience as described by adults who have experienced mental illness. J Adv Nurs. 2009;65(3):587–595.
    1. American Psychological Association . The road to resilience: American Psychological Association. DC: Washington; 2014.
    1. Robertson HD, Elliott AM, Burton C, Iversen L, Murchie P, Porteous T, et al. Resilience of primary healthcare professionals: a systematic review. Br J Gen Pract. 2016;66:e423–e433.
    1. Jackson D, Firtko A, Edenborough M. Personal resilience as a strategy for surviving and thriving in the face of workplace adversity: a literature review. J Adv Nurs. 2007;60:1–9.
    1. Stevenson AD, Phillips CB, Anderson KJ. Resilience among doctors who work in challenging areas: a qualitative study. Br J Gen Pract. 2011;61:e404–e410.
    1. Zwack J, Schweitzer J. If every fifth physician is affected by burnout, what about the other four? Resilience strategies of experienced physicians. Acad Med. 2013;88:382–389.
    1. Cooke GP, Doust JA, Steele MC. A survey of resilience, burnout, and tolerance of uncertainty in Australian general practice registrars. BMC Med Educ. 2013;13:2.
    1. Keeton K, Fenner DE, Johnson TR, Hayward RA. Predictors of physician career satisfaction, work-life balance, and burnout. Obstet Gynecol. 2007;109:949–955.
    1. Arrogante O, Aparicio-Zaldivar E. Burnout and health among critical care professionals: the mediational role of resilience. Intensive Crit Care Nurs. 2017;42:110–115.
    1. Colville GA, Smith JG, Brierley J, Citron K, Nguru NM, Shaunak PD, Tam O, Perkins-Porras L. Coping with staff burnout and work-related posttraumatic stress in intensive care. Pediatr Crit Care Med. 2017;18(7):e267–e273.
    1. Maffoni M, Argentero P, Giorgi I, Hynes J, Giardini A (2019) Healthcare professionals’ moral distress in adult palliative care: a systematic review. BMJ Support Palliat Care:1–10
    1. Maffoni M, Argentero P, Giorgi I, Giardini A (2019) Healthcare professionals’ perceptions about the Italian law on advance directives. Nurs Ethics. 10.1177/0969733019878831
    1. Hynes J, Maffoni M, Argentero P, Giorgi I, Giardini A. Palliative medicine physicians: doomed to burn? BMJ Support Palliat Care. 2019;9:45–46.
    1. Samson T, Shvartzman P. Association between level of exposure to death and dying and professional quality of life among palliative care workers. Palliat Support Care. 2018;16:442–451.
    1. Powell MJ, Froggatt K, Giga S (2019) Resilience in inpatient palliative care nursing: a qualitative systematic review. BMJ Support Palliat Care:1–12
    1. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol. 2009;62:1006–1012.
    1. Human Development Report (2016) Human Development Index and its components. http:// hdr. undp. org/ en/composite/ HDI. Accessed 18 Mar 2019
    1. Rushton CH, Batcheller J, Schroeder K, Donohue P. Burnout and resilience among nurses practicing in high-intensity settings. Am J Crit Care. 2015;24:412–420.
    1. Mehta DH, Perez GK, Traeger L, Park ER, Goldman RE, Haime V, et al. Building resiliency in a palliative care team: a pilot study. J Pain Symptom Manag. 2016;51:604–608.
    1. Klein CJ, Riggenbach-Hays JJ, Sollenberger LM, Harney DM, McGarvey JS. Quality of life and compassion satisfaction in clinicians: a pilot intervention study for reducing compassion fatigue. Am J Hosp Palliat Care. 2018;35:882–888.
    1. Edo-Gual M, Monforte-Royo C, Aradilla-Herrero A, Tomas-Sabado J. Death attitudes and positive coping in Spanish nursing undergraduates: a cross-sectional and correlational study. J Clin Nurs. 2015;24:2429–2438.
    1. Pangallo A, Zibarras L, Patterson F. Measuring resilience in palliative care workers using the situational judgement test methodology. Med Educ. 2016;50:1131–1142.
    1. Oginska-Bulik N. Secondary traumatic stress and vicarious posttraumatic growth in nurses working in palliative care - the role of psychological resilience. Advances in Psychiatry and Neurology. 2018;27:196–210.
    1. de Araújo MMT, da Silva MJP, Francisco MCPB. Nursing the dying: essential elements in the care of terminally ill patients. Int Nurs Rev. 2004;51:149–158.
    1. Bride BE, Robinson MM, Yegidis B, Figley CR. Development and validation of the secondary traumatic stress scale. Res Soc Work Pract. 2004;14:27–35.
    1. Manning-Jones S, de Terte I, Stephens C. The relationship between vicarious posttraumatic growth and secondary traumatic stress among health professionals. J Loss Trauma. 2017;22:256–270.
    1. Kamal AH, Bull J, Kavalieratos D, Taylor DH, Jr, Downey W, Abernethy AP. Palliative care needs of patients with cancer living in the community. J Oncol Pract. 2011;7:382–388.
    1. Maslach C, Jackson SE, Leiter MP. Maslach burnout inventory manual. 4. Menlo Park: Mind Garden Inc; 2016.
    1. Cordes CL, Dougherty TW. A review and an integration of research on job burnout. Acad Manag Rev. 1993;18:621–656.

Source: PubMed

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