Drutchas Alexis, Rusch Rachel, Leiter Richard
Division of Palliative Care and Geriatric Medicine, Massachusetts General Hospital, Boston, MA, USA.
Division of Comfort and Palliative Care, Children's Hospital Los Angeles, Boston, MA, USA.
Palliat Support Care. 2024 Sep 30:1-8. doi: 10.1017/S1478951524001226.
Palliative care (PC) faces a workforce crisis. Seriously ill patients surpass the supply of PC cliniciansin their work clinicians face repeated loss and extreme suffering which can have deleterious consequences, such as burnout and attrition. We urgently need interventions that foster thriving communities in this emotionally complex environment. Storytelling represents a promising path forward. In response to widespread loneliness and moral distress among PC clinicians before, during, and after the early months of the COVID-19 pandemic, we created the Palliative Story Exchange (PSE), a storytelling intervention to build community, decrease isolation, and help clinicians rediscover the shared meaning in their work. This paper discusses this novel intervention and initial program evaluation data demonstrating the PSE's impact thus far.
Participants voluntarily complete a post-then-pre wellness survey reflecting on their experience.
Thus far, over 1,000 participants have attended a PSE. In the fall of 2022, we began distributing a post-then-pre-evaluation survey. To date, 130 interprofessional participants from practice locations across 10 different countries completed the survey. Responses demonstrate an increase in the connection that participants felt toward their work and the larger palliative care community after attending a PSE. Further, more than half of all free-text responses include terms such as, "meaningful," "healing," "powerful," and "universal," to describe their participation.
Training programs and healthcare organizations use the humanities to support clinician wellness and improve patient care. The PSE builds upon this work through a novel combination of storytelling, community co-creation using reflection, and shared meaning making. Initial survey data demonstrates that after attending a PSE, participants feel increased meaning in their work, in the significance of their own stories, and connection with the PC community. Moving forward, we seek to expand our community of practice, host a facilitator leadership course, and rigorously study the PSE's impact on clinician wellness outcomes.
姑息治疗（PC）面临劳动力危机。重症患者数量超过了姑息治疗临床医生的供给，临床医生在工作中面临反复的损失和极端的痛苦，这可能会产生有害后果，如职业倦怠和人员流失。在这个情感复杂的环境中，我们迫切需要能够促进形成繁荣社区的干预措施。讲故事是一条很有前景的前进道路。为应对新冠疫情最初几个月期间及前后姑息治疗临床医生普遍存在的孤独感和道德困扰，我们创建了姑息故事交流（PSE）项目，这是一种通过讲故事来建立社区、减少孤立感并帮助临床医生重新发现其工作中共同意义的干预措施。本文讨论了这一新颖的干预措施以及展示PSE迄今为止影响的初步项目评估数据。
参与者自愿完成一份事后-事前健康状况调查问卷，以反思他们的经历。
到目前为止，已有超过1000名参与者参加了PSE。2022年秋季，我们开始分发事后-事前评估调查问卷。截至目前，来自10个不同国家的实践地点的130名跨专业参与者完成了该调查。调查结果显示，参与者在参加PSE后，对工作和更大的姑息治疗社区的联系感有所增强。此外，超过一半的自由文本回复中使用了“有意义”“治愈”“有力”和“普遍”等词汇来描述他们的参与感受。
培训项目和医疗保健组织利用人文学科来支持临床医生的健康状况并改善患者护理。PSE通过讲故事、利用反思进行社区共同创作以及共同意义构建的新颖组合，在此基础上开展工作。初步调查数据表明，参加PSE后，参与者在工作中感受到的意义、自身故事的重要性以及与姑息治疗社区的联系都有所增加。展望未来，我们寻求扩大我们的实践社区，举办一次促进者领导力课程，并严格研究PSE对临床医生健康状况结果的影响。
