Institute on Aging and Lifelong Health, University of Victoria, 3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada.
Institute on Aging and Lifelong Health, University of Victoria, 3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada; School of Nursing, University of Victoria, 3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada.
Soc Sci Med. 2021 Mar;272:113749. doi: 10.1016/j.socscimed.2021.113749. Epub 2021 Feb 6.
The end-of-life context is imbued with emotions, with death and dying transforming everyday places, like long-term care facilities, into entirely new emotional topographies that can evoke profound effects on those who live and work within these settings. Despite their significant role, healthcare providers' emotions and their interconnections with 'place' have received relatively little attention from researchers, including geographers of care and caregiving. This secondary thematic analysis attempts to address this notable gap by exploring the emotional geographies of healthcare providers caring for dying residents in four long-term care facilities in western Canada. By drawing upon interview and focus group data with administrators (n = 12) and direct care provider (n = 80) participants, findings reveal that experiences of caring for dying residents were often charged with negative emotions (e.g., distress, frustration, grief). These emotions were not only influenced by social and physical aspects of 'place', but the temporal process of caring for a dying resident, which included: (1) Identifying a resident as in need of a palliative approach to care; (2) Actively dying; and (3) Following a resident's death. Findings indicate that providers' emotions shifted in scale at each of these temporal phases, ranging from association with the facility as a whole to the micro-scale of the body. Broader structural forces that influence the physical and social place of long-term care facilities were also found to shape experiences of emotional labor among staff. With an increasing number of deaths occurring within long-term care facilities throughout the Global North, such findings contribute critical experiential knowledge that can inform policy and programs on ways to help combat staff burnout, facilitate worker satisfaction, and foster resilience among long-term care providers, ensuring they receive the necessary supports to continue fulfilling this valuable caring role.
临终关怀环境充满了情感，死亡和濒死将长期护理设施等日常场所转变为全新的情感地形，这些场所会对居住和工作在这些环境中的人产生深远的影响。尽管医护人员的情感及其与“场所”的相互联系在研究中扮演着重要的角色，但包括护理和照护地理学在内的研究人员对其关注相对较少。这项二次主题分析试图通过探索加拿大西部四家长期护理机构中照顾临终居民的医护人员的情感地理来解决这一显著差距。通过对管理人员（n=12）和直接护理提供者（n=80）的访谈和焦点小组数据进行分析，研究结果表明，照顾临终居民的经历常常充满了负面情绪（例如，痛苦、沮丧、悲伤）。这些情绪不仅受到“场所”的社会和物理方面的影响，还受到照顾临终居民的时间过程的影响，包括：（1）确定居民需要姑息治疗方法；（2）处于积极死亡阶段；（3）居民死亡后。研究结果表明，提供者的情绪在这些时间阶段都发生了变化，从与整个设施的关联到身体的微观层面。影响长期护理设施的物理和社会场所的更广泛结构力量也被发现会影响工作人员的情感劳动体验。随着全球北方的长期护理机构中死亡人数的增加，这些发现提供了重要的经验知识，可以为政策和项目提供信息，帮助对抗员工倦怠、提高员工满意度，并培养长期护理提供者的适应力，确保他们获得必要的支持，继续履行这一有价值的护理角色。
