A research on palliative caregivers' change of mental state

This research will study how palliative care staff’s mental state changes after their assigned patients' death under the setting of long-term care. Its results could be constructive to medical organizations either having provided or planing to provide palliative care in any country on the globe.

The mental state of healthcare workers has often been disregarded despite its importance. Among the very few studies associated with this topic, some have investigated the grief symptoms of direct care staff who has established close relationship with and were not prepared for patients’ death (Boerner, Burback, Jopp, Mock, 2015) while the others examined levels of burnout and compassion fatigue among hospice care professionals (Alkema, Linton, Davies, 2008) . However, no previous research has been conducted to study the mental state of palliative caregivers who may have equally significant relationship with their patients and not be prepared for their patients’ death. Neither is there any research that investigates the association among previous study on this topic. Therefore, research for identifying the factors that may produce negative outcome on their mental state including grief, burnout, and compassion fatigue is important for palliative caregivers to provide optimal support for patients and for researchers to determine the correlation among grief symptoms, burnout, and compassion fatigue.

Building on previous studies related to grief for death, burnout and compassion fatigue among direct care staff, the aim of the following research is to identify the variables contributing to the change of mental state of palliative care staff and the correlation among grief, burnout, and compassion fatigue. Under the setting of long-term care, staff characteristics (age range and whether caregivers have lost someone important), attributes related to patients (the length of time assigned to patients, relationship quality, and months since patient death), and care context (support availability) will be examined as potential factors to the change of mental status. Also, level of grief, burnout, and compassion fatigue will be compared to determine their correlation with each other.

Psychological support for patients who are under mental stress of the terminal diagnosis has been one primary goal of palliative care. However, care providers who have established close relationship with their patients after long-term care and have been completely unprepared for patients' death are subjected to high level of grief. Because of a lack of psychological support, burnout and compassion fatigue, two of the most frequently reported negative mental conditions in the helping professions, may impede them from providing the optimal support to other patients.

Scales employed to measure variables in this research have been used by previous studies which may include the same variables but different participants who are also professional caregivers and have similar challenges compared to those of palliative care providers. Therefore, validity and reliability of the results can be ensured. Also, variables that are either under debate or neglected despite their significance will be added to the research. The integration will provide researchers with a more comprehensive understanding of the problem proposed and enable them to determine and manipulate the associated variables to solve the problem.

Research for identifying the factors that may produce the negative conditions of  mental state including grief, burnout, and compassion fatigue is important for palliative caregivers to provide optimal support to patients and for researchers to determine the correlation among grief symptoms, burnout, and compassion fatigue. Therefore, its results could be of value to not only medical organizations which provide palliative care but also research that tries to make a further step on this problem.

To collect data, the researchers will visit interdisciplinary team meetings at each of the medical organizations and those in attendance will be then given information about the research and asked whether they are interested in participating. Trained interviewers with a Bachelor's degree will conduct the in-person interviews at a place and time of the participant's convenience. Interviews will last on average 30 minutes. Prior to all interviews, written informed consent will be obtained. Interviews will not occur during work hours. There will not be any more sessions of interview for the participants after this one.

1) Sample size - more patients’ deaths than the researchers can follow within the designated timeframe

2) Correlational research design - only tentative predictions can be made ; no definitive conclusions regarding causations

3) Participants resillience - significant to mental state but hard to measure

4) Retrospective assessments of participants grief symptoms biased by the adjustment to the loss or other current events

Palliative care itself is a highly human-centered program established primarily in developed countries. Despite its humanitarian nature and common need across the world, palliative care's novelty decides its limitations. Introduced by an educational article on palliative care, I found that the value of palliative care empathizes with mine and have since motivated to overcoming its limitations, one of which is my research topic here. I finished the research proposal in a psychology program that I attended in Stanford University and am still looking for more expertise and resources to make it practical when I initiate it in college.