Self-care of Physicians Caring for Patients at the End of Life "Being Connected ... A Key to My Survival"

被引：272

作者：

Kearney, Michael K. ^{[1
,2
]}

Weininger, Radhule B. ^{[3
]}

Vachon, Mary L. S. ^{[4
,5
]}

Harrison, Richard L. ^{[6
]}

Mount, Balfour M. ^{[7
]}

机构：

[1] Santa Barbara Cottage Hosp, Palliat Care Serv, Santa Barbara, CA 93102 USA

[2] Visiting Nurse & Hosp Care Santa Barbara, Santa Barbara, CA USA

[3] La Casa de Maria Retreat & Conf Ctr, Santa Barbara, CA USA

[4] Univ Toronto, Dept Psychiat, Toronto, ON, Canada

[5] Univ Toronto, Dalla Lana Sch Publ Hlth, Toronto, ON, Canada

[6] Univ British Columbia, Counseling Psychol Program, Vancouver, BC V5Z 1M9, Canada

[7] McGill Univ, Dept Med, Montreal, PQ, Canada

来源：

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION | 2009年 / 301卷 / 11期

关键词：

WRITTEN EMOTIONAL EXPRESSION; STRESS REDUCTION; MENTAL-HEALTH; OF-LIFE; SURGICAL ONCOLOGISTS; HOSPITAL CONSULTANTS; PERSONAL WELLNESS; CONTROLLED-TRIAL; PALLIATIVE CARE; IMMUNE FUNCTION;

D O I：

10.1001/jama.2009.352

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Physicians providing end-of-life care are subject to a variety of stresses that may lead to burnout and compassion fatigue at both individual and team levels. Through the story of an oncologist, we discuss the prodromal symptoms and signs leading to burnout and compassion fatigue and present the evidence for prevention. We define and discuss factors that contribute to burnout and compassion fatigue and consider factors that may mitigate burnout. We explore the practice of empathy and discuss an approach for physicians to maximize wellness through self-awareness in the setting of caring for patients with end-stage illness. Finally, we discuss some practical applications of self-care in the workplace.

引用

页码：1155 / 1164

页数：10

共 111 条

[1] Prevalence of Burnout in the U.S. Oncology Community: Results of a 2003 Survey [J].

Allegra, Carmen J. ;

Hall, Ray ;

Yothers, Greg .

JOURNAL OF ONCOLOGY PRACTICE, 2005, 1 (04) :140-147

[2]

[Anonymous], 1995, Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized, DOI [10.1007/BF00733425, DOI 10.1007/BF00733425]

[3] Fellow suffering [J].

Armstrong, J .

JOURNAL OF CLINICAL ONCOLOGY, 2004, 22 (21) :4425-4427

[4] Vicarious posttraumatic growth in psychotherapy [J].

Arnold, D ;

Calhoun, LG ;

Tedeschi, R ;

Cann, A .

JOURNAL OF HUMANISTIC PSYCHOLOGY, 2005, 45 (02) :239-263

[5] Burnout and psychiatric morbidity among physicians engaged in end-of-life care for cancer patients: A cross-sectional nationwide survey in Japan [J].

Asai, Mako ;

Morita, Tatsuya ;

Akechi, Tatsuo ;

Sugawara, Yuriko ;

Fujimori, Malko ;

Akizuki, Nobuya ;

Nakano, Tomohito ;

Uchitomi, Yosuke .

PSYCHO-ONCOLOGY, 2007, 16 (05) :421-428

[6] Stress and burnout among surgical oncologists: A call for personal wellness and a supportive workplace environment [J].

Balch, Charles M. ;

Copeland, Edward .

ANNALS OF SURGICAL ONCOLOGY, 2007, 14 (11) :3029-3032

[7]

BARNARD D, 2000, CROSSING OVER NARRAT

[8]

Beddoe AE, 2004, J NURS EDUC, V43, P305

[9] The caregiver's perspective on existential and spiritual distress in palliative care [J].

Boston, Patricia H. ;

Mount, Balfour M. .

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 2006, 32 (01) :13-26

[10] What's important to you?: The use of narratives to promote self-reflection and to understand the experiences of medical residents [J].

Brady, DW ;

Corbie-Smith, G ;

Branch, WT .

ANNALS OF INTERNAL MEDICINE, 2002, 137 (03) :220-223

← 1 2 3 4 5 6 7 8 9 10 →