Experiences of staff providing specialist palliative care during COVID-19: a multiple qualitative case study
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Abstract
Summary
To explore the experiences of, and impact on, staff working in palliative care during the COVID-19 pandemic.
Design
Qualitative multiple case study using semi-structured interviews between November 2020 and April 2021 as part of the CovPall study. Data were analysed using thematic framework analysis.
Setting
Organisations providing specialist palliative services in any setting.
Participants
Staff working in specialist palliative care, purposefully sampled by the criteria of role, care setting and COVID-19 experience.
Main outcome measures
Experiences of working in palliative care during the COVID-19 pandemic.
Results
Five cases and 24 participants were recruited (n = 12 nurses, 4 clinical managers, 4 doctors, 2 senior managers, 1 healthcare assistant, 1 allied healthcare professional). Central themes demonstrate how infection control constraints prohibited and diluted participants’ ability to provide care that reflected their core values, resulting in experiences of moral distress. Despite organisational, team and individual support strategies, continually managing these constraints led to a ‘crescendo effect’ in which the impacts of moral distress accumulated over time, sometimes leading to burnout. Solidarity with colleagues and making a valued contribution provided ‘moral comfort’ for some.
Conclusions
This study provides a unique insight into why and how healthcare staff have experienced moral distress during the pandemic, and how organisations have responded. Despite their experience of dealing with death and dying, the mental health and well-being of palliative care staff was affected by the pandemic. Organisational, structural and policy changes are urgently required to mitigate and manage these impacts.
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SciScore for 10.1101/2021.11.17.21266437: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:13, 63 A limitation of this study, however, is that it relied on single individual interviews collected at only one timepoint. Whilst these provide a snapshot in which participants could retrospectively reflect on the impact of COVID-19, the long-term impact of COVID-19 on staff, alongside the sustainability/effectiveness of …
SciScore for 10.1101/2021.11.17.21266437: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:13, 63 A limitation of this study, however, is that it relied on single individual interviews collected at only one timepoint. Whilst these provide a snapshot in which participants could retrospectively reflect on the impact of COVID-19, the long-term impact of COVID-19 on staff, alongside the sustainability/effectiveness of organisational responses, is not clear. Further longitudinal work that addresses these gaps will be a useful addition to the literature. Moreover, these data represent staff experiences of responding to COVID-19 from within a particular sector, and whilst there is likely to be overlap in experiences between healthcare settings, the nuances in experiences across other healthcare contexts (e.g., the public and private sectors) is not captured.
Results from TrialIdentifier: We found the following clinical trial numbers in your paper:
Identifier Status Title ISRCTN16561225 NA NA Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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