What keeps you up at night? Genetics professionals' distressing experiences in patient care

被引:26
作者
Bernhardt, Barbara A. [1 ,2 ]
Silver, Rachel [3 ]
Rushton, Cynda Hylton [4 ,5 ,6 ,7 ]
Micco, Ellyn [8 ]
Geller, Gail [4 ,5 ,9 ,10 ]
机构
[1] Univ Penn, Dept Med, Philadelphia, PA 19104 USA
[2] Univ Penn, Penn Ctr Integrat Genet Healthcare Technol, Philadelphia, PA 19104 USA
[3] Mt Sinai Hosp, Prenatal Diag & Med Genet Program, Toronto, ON M5G 1X5, Canada
[4] Johns Hopkins Berman Inst Bioeth, Baltimore, MD USA
[5] Johns Hopkins Univ, Sch Med, Dept Pediat, Baltimore, MD 21205 USA
[6] Johns Hopkins Univ, Sch Nursing, Baltimore, MD USA
[7] Johns Hopkins Children Ctr, Baltimore, MD USA
[8] Fox Chase Canc Ctr, Dept Populat Sci, Philadelphia, PA 19111 USA
[9] Johns Hopkins Univ Bloomberg Sch Publ Hlth, Dept Hlth Behav & Soc, Baltimore, MD USA
[10] Johns Hopkins Univ, Sch Med, Dept Med, Baltimore, MD 21205 USA
关键词
burnout; genetic service providers; distress; countertransference; training; MORAL DISTRESS; INFORMED-CONSENT; DECISION-MAKING; DIFFICULT NEWS; SELF-CARE; PHYSICIANS; BURNOUT; COMMUNICATION; EMPATHY; INTERVENTIONS;
D O I
10.1097/GIM.0b013e3181db82d9
中图分类号
Q3 [遗传学];
学科分类号
071007 ; 090102 ;
摘要
Purpose: To explore specific patient care experiences that genetics professionals associate with distress and the emotions engendered by those experiences. Methods: We conducted semistructured telephone interviews with clinical geneticists, genetic counselors, and genetic nurses that focused on a single distressing experience. Results: Fourteen clinical geneticists, 25 genetic counselors, and 14 nurses were interviewed. We categorized the situations that interviewees associated with distressing patient care experiences into seven major types: patient/family decisions (27% of total situations), giving bad news (17%), colleague behavior (15%), end-of-life issues (12%), unintended outcomes (12%), difficult patients (8%), and injustice/inhumanity (8%). Interviewees reported experiencing a variety of negative emotions during these situations, including anger, guilt, helplessness, and inadequacy. Conclusions: The distress and resulting emotions experienced by genetic service providers must be acknowledged. Interventions are needed to assist the clinician in becoming self-aware by reflecting on experienced emotions, examining belief systems and values, and understanding the connection between their emotions and behavior. Involvement in mindfulness meditation, reflective writing, peer support groups or additional communication skill-based training could address this need. In addition, clinicians should seek ways to increase personal meaning derived from providing patient care. Genet Med 2010:12(5):289-297.
引用
收藏
页码:289 / 297
页数:9
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