Attitudes towards death and the quality of life in the structure of resilience among palliative care providers

Abstract

Introduction: Mental health protection of medical workers is one of the priority tasks of healthcare. In this regard, in modern psychological research, there is an increasing interest in studying human viability as an integral phenomenon that allows an individual to realize a metavital goal (E.A. Rylskaya) through life tasks closely related to social roles and profession. Professional realization is a factor that increases a person's vitality. However, the process of becoming a personal news professional is influenced by many factors, including environmental ones. Palliative medicine staff regularly come into contact with dying patients and their relatives, while they themselves experience the fear of death as one of the basic existential problems (S.L. Rubinstein). Aims: To study the features of the professional context of viability and the attitude to the topic of death of palliative care providers. Materials and methods: 60 female respondents participated in the study (mean age = 37.7 years; mean medical experience = 12.5 years). The sample was divided into two groups: Group 1 (n = 30; 22 nurses, 5 physicians, 3 nursing assistants) consisted of staff from a palliative care department (Lobnya Hospital) regularly engaging with terminally ill patients and their families. Group 2 (n = 30; 20 laboratory assistants, 10 physicians) consisted of staff from clinical diagnostic, bacteriological, and radiology departments (Lobnya Hospital) with minimal patient contact. All participants provided voluntary informed consent. A battery of tests included:1) The Human Resilience Test (E.A. Rylskaya); 2) The Professional Quality of Life (ProQOL) Scale (B. Stamm), as adapted by A.A. Pankratov and M. E. Nikolaeva; 3) The Death Attitude Profile-Revised (DAP-R), as adapted by T.A. Gavrilova. Results: The analysis revealed correlations between components of resilience, attitudes toward death, and indicators of professional quality of life among palliative care providers and medical workers with different intensities of patient contact. A comparative analysis established that meaning in life and capacity for self-development were found to be negatively correlated with fear of death and death avoidance. Palliative care providers exhibited a more complex and contradictory conception of death compared to the control group, as opposed to a more homogeneous death attitude structure among the controls. Meaning in life functioning as an attractor for the development of resilience was positively associated with job satisfaction among palliative care providers and served as a protective factor against compassion fatigue, which encompasses burnout and secondary traumatic stress. Conclusion: These findings demonstrate a critical need to routinely assess death attitudes among palliative care providers to facilitate the timely correction of maladaptive psychological strategies. The formation of such strategies may diminish professional resilience and compromise the quality of patient care.