Caring for terminally Ill patients: the impact on oncologists.

Humans Male Female Middle Aged Adult Singapore Qualitative Research Oncologists / psychology Terminally Ill / psychology Interviews as Topic / methods Palliative Care / methods Adaptation, Psychological
Death Doctor-patient relationship Dying Oncology Palliative care Professional identity formation Professionalism

Journal

BMC palliative care
ISSN: 1472-684X
Titre abrégé: BMC Palliat Care
Pays: England
ID NLM: 101088685

Informations de publication

Date de publication:
28 Sep 2024
Historique:
received: 27 06 2024
accepted: 13 09 2024
medline: 29 9 2024
pubmed: 29 9 2024
entrez: 28 9 2024
Statut: epublish

Résumé

Journeying with patients throughout their cancer trajectory and caring for them at the end of life can lead to emotional and moral distress in oncologists, negatively impacting their personal and professional identities. A better understanding of how transitions in care goals affect oncologists can shed light on the challenges faced and the support required. This study explored the impact of care transitions on oncologists' professional identity formation (PIF). From September to December 2023, semi-structured interviews were conducted with oncologists in a palliative care center in Singapore. The Ring Theory of Personhood (RToP) was used as a framework to capture the effects of experiences with patients transitioning from curative to palliative care on the oncologists' sense of self and identity. Data were analyzed using both inductive and deductive qualitative analysis. Participants included six female and six male physicians, aged 30 to 53 years (mean 38 years), with an average of 9.75 years of experience as oncologists. The main domains identified were 1) challenges faced in transitioning patients to palliative care, 2) the impact of dealing with dying patients on oncologists, and 3) coping mechanisms. Oncologists experience self-doubt and moral distress as they manage transitions in care. The PIF of oncologists can be supported through reflection and introspection, peer support, and interventions to promote self-care - ultimately enabling them to make meaning of their experiences, renew family ties, and reaffirm their commitment to the profession.

Sections du résumé

BACKGROUND BACKGROUND
Journeying with patients throughout their cancer trajectory and caring for them at the end of life can lead to emotional and moral distress in oncologists, negatively impacting their personal and professional identities. A better understanding of how transitions in care goals affect oncologists can shed light on the challenges faced and the support required. This study explored the impact of care transitions on oncologists' professional identity formation (PIF).
METHODS METHODS
From September to December 2023, semi-structured interviews were conducted with oncologists in a palliative care center in Singapore. The Ring Theory of Personhood (RToP) was used as a framework to capture the effects of experiences with patients transitioning from curative to palliative care on the oncologists' sense of self and identity. Data were analyzed using both inductive and deductive qualitative analysis.
RESULTS RESULTS
Participants included six female and six male physicians, aged 30 to 53 years (mean 38 years), with an average of 9.75 years of experience as oncologists. The main domains identified were 1) challenges faced in transitioning patients to palliative care, 2) the impact of dealing with dying patients on oncologists, and 3) coping mechanisms.
CONCLUSION CONCLUSIONS
Oncologists experience self-doubt and moral distress as they manage transitions in care. The PIF of oncologists can be supported through reflection and introspection, peer support, and interventions to promote self-care - ultimately enabling them to make meaning of their experiences, renew family ties, and reaffirm their commitment to the profession.

Identifiants

DOI: 10.1186/s12904-024-01562-9 PMID: 39342162
pubmed: 39342162
doi: 10.1186/s12904-024-01562-9
pii: 10.1186/s12904-024-01562-9
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

231

Informations de copyright

© 2024. The Author(s).

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Auteurs

Nagavalli Somasundaram (N)

Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore.
Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore, 169857, Singapore.
Division of Medical Oncology, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore.

Halah Ibrahim (H)

Department of Medical Sciences, Khalifa University College of Medicine and Health Sciences, Abu Dhabi, United Arab Emirates.

Ranitha Govindasamy (R)

Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore.
Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore.
Centre for Biomedical Ethics, National University of Singapore, Block MD11, 10 Medical Drive #02-03, Singapore, 117597, Singapore.

Nur Amira Binte Abdul Hamid (NABA)

Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore.

Simon Yew Kuang Ong (SYK)

Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore.
Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore, 169857, Singapore.
Division of Medical Oncology, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore.

Lalit Kumar Radha Krishna (LKR)

Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore. lalit.radha-krishna@liverpool.ac.uk.
Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore, 169857, Singapore. lalit.radha-krishna@liverpool.ac.uk.
Division of Palliative and Supportive Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore. lalit.radha-krishna@liverpool.ac.uk.
Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore. lalit.radha-krishna@liverpool.ac.uk.
Centre for Biomedical Ethics, National University of Singapore, Block MD11, 10 Medical Drive #02-03, Singapore, 117597, Singapore. lalit.radha-krishna@liverpool.ac.uk.
End of Life Care Centre, Cancer Research Centre, Palliative Care Institute Liverpool, University of Liverpool, Academic Palliative &200 London Road, Liverpool , Liverpool, L3 9TA, UK. lalit.radha-krishna@liverpool.ac.uk.
PalC, The Palliative Care Centre for Excellence in Research and Education, Dover Park Hospice, 10 Jalan Tan Tock Seng, Singapore, 308436, Singapore. lalit.radha-krishna@liverpool.ac.uk.
Health Data Science, University of Liverpool, Whelan Building, The Quadrangle, Brownlow Hill, Liverpool, Liverpool, L69 3GB, UK. lalit.radha-krishna@liverpool.ac.uk.

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