Crape Byron, Akhmetniyaz Pana, Akhmetova Makpal, Foster Faye, Dauyey Kaisar, Clementi Alessandra, Toleubekova Lyazzat
Department of Biomedical Sciences, Nazarbayev University School of Medicine, Astana, Kazakhstan.
Department of Medicine, Nazarbayev University School of Medicine, Kerey-Zhanibek Khan Street 5/1, Office 924, Astana city, Kazakhstan.
BMC Palliat Care. 2025 Jun 7;24(1):161. doi: 10.1186/s12904-025-01798-z.
This exploratory study investigates the emotional impact of palliative care provision among healthcare professionals in resource-limited settings, specifically in Kazakhstan. As a middle-income country with a growing burden of chronic diseases, the palliative care sector in Kazakhstan faces increasing challenges to address burnout.
Due to limited existing knowledge, an exploratory design was adopted, employing grounded theory approach to discover professionals' understanding of their experiences, emotional stressors, and burnout development. In-depth qualitative interviews were conducted with 60 palliative care professionals (41 nurses, 19 physicians) from 4 hospices, 2 PCUs of cancer centers, and 1 nursing department from diverse geographical locations within Kazakhstan. The data collection phase was carried out between May 2021 and July 2022. Analysis focused on identifying stressors leading to burnout and coping mechanisms used by palliative care professionals.
The study identifies key stressors, including emotional involvement with patients, communication challenges with relatives, witnessing patient frailty and death, lack of personal accomplishment, and emotional labor. A unique finding is the widespread denial of emotional impact among participants, expressed through normalization of work-related stress and suppression of emotions. Through analysis, four key themes were identified as central to the findings: (1) stressors contributing to burnout, (2) denial of emotional impact, (3) coping mechanisms, and (4) attitudes towards seeking psychological help.
The present study has revealed that the denial of emotional impact, along with the downplaying or dismissal of the impact of stress, is a recurring pattern among healthcare workers providing palliative care to terminally ill patients in Kazakhstan. The findings of this study underscore the need for tailored training to address the specific emotional needs of palliative care workers, focusing on effective communication, techniques for emotional regulation, stress management, and self-care practices to help professionals cope with the emotional demands of their work.
本探索性研究调查了资源有限环境下，特别是哈萨克斯坦的医疗保健专业人员提供姑息治疗的情感影响。作为一个慢性病负担日益加重的中等收入国家，哈萨克斯坦的姑息治疗部门在应对职业倦怠方面面临着越来越大的挑战。
由于现有知识有限，采用了探索性设计，运用扎根理论方法来发现专业人员对其经历、情感压力源和职业倦怠发展的理解。对来自哈萨克斯坦不同地理位置的4家临终关怀机构、2个癌症中心的姑息治疗单元和1个护理部门的60名姑息治疗专业人员（41名护士、19名医生）进行了深入的定性访谈。数据收集阶段于2021年5月至2022年7月进行。分析重点在于确定导致职业倦怠的压力源以及姑息治疗专业人员所采用的应对机制。
该研究确定了关键压力源，包括与患者的情感投入、与亲属的沟通挑战、目睹患者的脆弱和死亡、缺乏个人成就感以及情感劳动。一个独特的发现是参与者中普遍否认情感影响，表现为将与工作相关的压力正常化以及压抑情绪。通过分析，确定了四个关键主题作为研究结果的核心：（1）导致职业倦怠的压力源，（2）否认情感影响，（3）应对机制，以及（4）寻求心理帮助的态度。
本研究表明，在哈萨克斯坦为绝症患者提供姑息治疗的医护人员中，否认情感影响以及淡化或忽视压力影响是一种反复出现的模式。本研究结果强调需要进行针对性培训，以满足姑息治疗工作者的特定情感需求，重点是有效沟通、情绪调节技巧、压力管理和自我护理实践，以帮助专业人员应对工作中的情感需求。
