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. 2022 Jun;115(6):220-230.
doi: 10.1177/01410768221077366. Epub 2022 Feb 8.

Experiences of staff providing specialist palliative care during COVID-19: a multiple qualitative case study

Andy Bradshaw  1 , Lesley Dunleavy  2 , Ian Garner  2 , Nancy Preston  2 , Sabrina Bajwah  1 , Rachel Cripps  1 , Lorna K Fraser  3 , Matthew Maddocks  1 , Mevhibe Hocaoglu  1 , Fliss Em Murtagh  4 , Adejoke O Oluyase  1 , Katherine E Sleeman  1 , Irene J Higginson  1 , Catherine Walshe  2
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Experiences of staff providing specialist palliative care during COVID-19: a multiple qualitative case study

Andy Bradshaw et al. J R Soc Med. 2022 Jun.

Abstract

Objective: 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.

Keywords: Qualitative research; hospice; palliative care.

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Figures

Figure 1.
Figure 1.
An overview of the themes and sub-themes that represent the processes through which participants in this case study experienced moral distress.
See this image and copyright information in PMC

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