Resilience and well-being in palliative care staff
Although working with cancer patients is considered inherently stressful, palliative care staff experience similar levels of psychological distress and lower levels of burnout than staff working in other specialties. There are few empirical studies in palliative care to explain this. Since working in a stressful job does not inevitably lead to psychological distress, the antecedent factors that promote resilience and maintain a sense of well-being are worthy of study. This thesis reviews two theoretical perspectives from the broader psychological literature, the personality constructs of hardiness and sense of coherence, which may promote resilience. It then outlines a qualitative study that used interpretative phenomenological analysis (IPA) to describe hospice nurses' experiences of work. During the analysis, themes emerged relating to the underlying interpersonal factors that influenced the nurses' decisions to begin and continue working in palliative care, and their attitudes towards life and work. These themes were compared with the theoretical personality constructs of hardiness and sense of coherence, and this comparison highlighted many similarities. The nurses showed high levels of commitment, and imputed a sense of meaning and purpose to their work. An area of divergence was their response to change, and this is discussed in relation to hardiness and sense of coherence. It is suggested that increasing our understanding of resilience in palliative care has implications for individual staff wellbeing, and for staff training and support, which, in turn, may also impact on the quality of patient care provided.