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Title
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June 2018 List
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
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Citation List Month
June 2018 List
URL Address
<a href="http://doi.org/10.1136/archdischild-2018-rcpch.459" target="_blank" rel="noreferrer noopener">http://doi.org/10.1136/archdischild-2018-rcpch.459</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Moral distress, trauma and burnout in staff in relation to changes in picu outcomes, challenging cases and media involvement in disagreements about end-of-life care
Publisher
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Archives of Disease in Childhood
Date
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2018
Subject
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burnout; emotional stress; morality; posttraumatic stress disorder; staff; terminal care; adult; awareness; child; conference abstract; controlled study; court; death; depersonalization; disability; human; life sustaining treatment; nurse; questionnaire; wellbeing
Creator
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Colville G; Rutt M; Berger Z; Titman P; Brierley J
Description
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Background Technological advances have decreased PICU mortality but increased the number of children surviving with disability or technologically-dependent. Death in PICU most frequently follows withdrawal of life-sustaining therapy (LST), increasingly after prolonged admissions for invasive organ support. Disagreements with families about cessation of life-sustaining therapy (LST) can be protracted, distressing for everyone, harmful to the child and ultimately require court adjudication. Little is known about the impact of this, or of that of social/other media campaigns when families decides to involve the press, as is increasingly the case Method 50 staff (39 nurses; 9 doctors and 2 AHPs) were surveyed using the Moral Distress Scale-Revised (MD-R) ques-tionnaire; Trauma Screening Questionnaire (TSQ) and abbreviated Maslach Burnout Inventory (aMBI) together with several open-ended questions about their experiences and what they felt had been learned 3 months after the final court decision following one such high profile case. Results Mean moral distress score (MDS-R) was 96, consistent with recent Canadian multi-centre PICU study and higher than average Adult ICU scores (57-83 in the literature). Specifically, in relation to the recent high profile case 15% scored in the clinically significant range for post-traumatic stress symptoms (TSQ); a significant number reported a number of sub-clinical symptoms; 68% reported being 'upset by reminders of the event' and 53% reported 'heightened awareness of potential danger' to themselves and others at least twice in the previous week. Burnout symptoms (aMBI): 44% reported emotional exhaustion at a high level; 17% reported a high level of depersonalization. The 25% of staff considering leaving PICU reported higher burnout (emotional exhaustion) scores (p=0.001); higher post-traumatic stress scores (p=0.04) and were also less likely to feel supported in relation to moral distress (p=0.010). Conclusions These findings highlight the impact of changing PICU outcomes on staff, with increased survival of children with severe disability or technologically-dependent; and death following prolonged PICU admission sometimes after disagreements about cessation of LST, occasionally with public campaigns. They illustrate that the dimension of moral distress is one which needs to be acknowledged, along with burnout and post-traumatic stressĀ² in a comprehensive assessment of staff well-being.
Identifier
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<a href="http://doi.org/10.1136/archdischild-2018-rcpch.459" target="_blank" rel="noreferrer noopener">10.1136/archdischild-2018-rcpch.459</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2018
Adult
Archives of Disease in Childhood
Awareness
Berger Z
Brierley J
Burnout
Child
Colville G
conference abstract
Controlled Study
court
Death
depersonalization
Disability
Emotional Stress
Human
June 2018 List
Life Sustaining Treatment
Morality
Nurse
PostTraumatic Stress Disorder
Questionnaire
Rutt M
Staff
Terminal Care
Titman P
Wellbeing