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. 2024 May 9:18:26323524241247857.
doi: 10.1177/26323524241247857. eCollection 2024.

Work-related quality of life in professionals involved in pediatric palliative care: a repeated cross-sectional comparative effectiveness study

Anne-Kathrin Gerber  1 , Ursula Feuz  1   2 , Karin Zimmermann  3   4 , Stefan Mitterer  1 , Michael Simon  1 , Nicolas von der Weid  5 , Eva Bergsträsser  4
Affiliations

Work-related quality of life in professionals involved in pediatric palliative care: a repeated cross-sectional comparative effectiveness study

Anne-Kathrin Gerber et al. Palliat Care Soc Pract. .

Abstract

Background: Working in pediatric palliative care (PPC) impacts healthcare and allied professionals' work-related quality of life (QoL). Professionals who lack specific PPC training but who regularly provide services to the affected children have articulated their need for support from specialized PPC (SPPC) teams.

Objectives: This study had two objectives: (1) to evaluate whether the availability of a SPPC team impacted the work-related QoL of professionals not specialized in PPC; and (2) to explore the work-related QoL of professionals working in PPC without specialized training.

Design: Repeated cross-sectional comparative effectiveness design.

Methods: One hospital with an established SPPC program and affiliated institutions provided the intervention group (IG). Three hospitals and affiliated institutions where generalist PPC was offered provided the comparison group (CG). Data were collected by paper-pencil questionnaire in 2021 and 2022. The Professional Quality of Life (ProQOL 5) questionnaire was used to assess work-related QoL, yielding separate scores for burnout (BO), secondary traumatic stress (STS) and compassion satisfaction (CS). A descriptive statistical analysis was performed and general estimation equations were modelled. To increase the comparability of the IG and CG, participants were matched by propensity scores.

Results: The 301 participating non-PPC-specialized professionals had overall low to moderate levels of BO and STS and moderate to high levels of CS. However, none of these scores (BO: p = 0.36; STS: p = 0.20; CS: p = 0.65) correlated significantly with support from an SPPC team. Compared to nurses, physicians showed higher levels of BO (1.70; p = 0.02) and STS (2.69; p ⩽ 0.001).

Conclusion: Although the study sample's overall work-related QoL was satisfactory, it showed a considerable proportion of moderate BO and STS, as well as moderate CS. To provide tailored support to professionals working in PPC, evidence regarding key SPPC support elements and their effectiveness is needed.

Trial registration: ClinicalTrials.gov ID, NCT04236180.

Keywords: compassion fatigue; compassion satisfaction; health personnel; palliative care; pediatrics; quality of life.

Plain language summary

Work-related quality of life in professionals involved in pediatric palliative care - Why was this study done? Caring for children suffering from life-limiting conditions and their families impacts professionals’ work-related Quality of Life (QoL). Professionals without specific training often provide pediatric palliative care (PPC) to children and their families. - What did the researchers do? We aimed to determine whether the work-related the QoL of professionals without specialised PPC training would be positively influenced when they were supported by PPC specialists. We also wanted to explore what person-specific factors might correspond with higher or lower work-related QoL. Work-related QoL was analysed in relation to burnout (BO), secondary traumatic stress (STS), and compassion satisfaction (CS). These variables’ levels were assessed with a questionnaire survey in 2021 and 2022. - What did the researchers find? The 301 participating professionals had overall low to moderate levels of BO and STS and moderate to high levels of CS. There was no substantial difference in work-related QoL in the professionals supported by PPC specialists compared to those who did not receive specialist support. Physicians showed higher levels of BO and STS than nurses. - What do the findings mean? Although the studied professionals’ overall work-related QoL was satisfactory, there is a considerable proportion of moderate BO and STS scores in professionals working with children suffering from life-limiting conditions. Further research should explore the specific needs of professionals not specialised in PPC.

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Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
PPC versus SPPC. (a) Generalized PPC is provided by specialists of a given discipline and setting in a fragmented manner, as displayed by the separate pieces. Professionals engaging in generalized PPC have basic PPC training and experience without working fully engaged and dedicated in PPC. (b) SPPC is provided by professionals specialized in and working dedicatedly in PPC. SPPC teams are composed of professionals with various backgrounds, for example, medicine, nursing, psychology and are characterized by providing interprofessional consultative services, adding an extra layer of care. PPC, pediatric palliative care; SPPC, specialized pediatric palliative care.
Figure 2.
Figure 2.
Flow diagram of participants for the years 2021 and 2022. (a) SPhAERA professionals – flow diagram 2021. (b) SPhAERA Professionals – flow diagram 2022. SPhAERA, Specialized Pediatric PAlliativE CaRe: Assessing family, healthcare professional and health system outcomes in a multi-site context of various care settings.
Figure 3.
Figure 3.
BO, STS and CS scores of professionals involved in PPC. BO, STS and CS scores for the intervention and comparison group are displayed as boxplots. The ProQOL score levels are embedded in the background and allow the classification of BO, STS and CS scores into the levels: low (score ⩽ 22), moderate (23 ⩽ score ⩾ 41) and high (score ⩾ 42). Participants who participated in both survey rounds (2021 and 2022) were counted twice. BO, burnout; CS, compassion satisfaction; PPC, pediatric palliative care; ProQOL, Professional Quality of Life; STS, secondary traumatic stress.
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