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'Not a panacea' - Expert perspectives on the concept of resilience and its potential for palliative care

  • BACKGROUND Resilience is an increasingly used term in medicine and subject to various definitions, often not easy to grasp. There are established core concepts for patients receiving palliative care, for example, meaning in life, that have already been researched a lot. Resilience, relative to these concepts, is a new object of research in palliative care, where it has so far been used predominantly with regard to the well-being of teams. AIM To explore how experts in palliative care define the concept of resilience and its suitability for patients, significant others, and professionals. DESIGN Qualitative study using summarizing content analysis according to Mayring. SETTING/PARTICIPANTS Twenty-one health and social care professionals with expertise caring for persons with life-threatening/limiting illnesses and their relatives were interviewed in three individual interviews and four focus groups. All conversations were recorded, transcribed, coded via MAXQDA, and validated by another researcher. RESULTS Resilience has been described as something procedural, dynamic, individual, and flexible. In connection with well-known concepts such as posttraumatic growth or terms from the field of mindfulness, social environment or personal factors have also been linked to resilience. Resources such as spirituality can contribute to resilience, and resilience itself can function as a resource, for example, by contributing to quality of life. An active use of the term in practical work with patients or relatives is rare, but it is used in education or team measures. Limited lifespan can pose a challenge to an active use of the concept of resilience. CONCLUSION Resilience as a very individual approach provides added value to other core concepts of palliative care. Within the palliative context, the normative dimension of resilience must be well reflected. A broader definition of resilience is recommended, leaving room for everyone to find their own form of resilience. The concept of resilience in palliative care includes opportunities as well as risks and should, therefore, be implemented carefully, requiring specific training. What experts think about resilience in palliative care Why was this study done? Resilience is described as a process of coping with stress or adversity while remaining physically and mentally functional. Resilience is subject to a range of definitions. In the context of palliative care, where many other concepts, such as meaning in life, are already used, the definition of resilience also represents a challenge. We wanted to learn how people working in palliative care, defined by us as experts, understand and use the concept of resilience. In addition, there are three different target groups for resilience: patients, significant others and professionals. We wanted to learn about the differences in the application of resilience to these groups. What did the researchers do? We conducted interviews with a total of 21 experts in individual and group settings (so-called focus groups). All interviews and focus groups were audiotaped and transcribed verbatim to analyse them precisely using qualitative methods. What did the researchers find? This study shows how resilience is understood in the work field of the participants: namely as something procedural, dynamic, individual and flexible but normative at the same time. Factors such as the social environment, the number and intensity of crises already experienced (known as the idea of posttraumatic growth), aspects from the field of mindfulness or spirituality can contribute to developing resilience, which is why we call these things resources for resilience. Experts use the term resilience less in their daily work with patients or significant others, but more in education. What do the findings mean? The concept of resilience in palliative care involves both risks and opportunities. Practical work with the concept has to be well reflected and must be applied sensitively. Therefore, it is essential that professional as well as informal caregivers receive specific training that also includes respect for each individual’s personal concept of resilience.

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Metadaten
Document Type:Article
Language:English
Author:Katja MausORCiD, Frank Peusquens, Milena Kriegsmann-Rabe, Julia-Katharina Matthias, Gülay AteşORCiD, Birgit Jaspers, Franziska Geiser, Lukas Radbruch
Parent Title (English):Palliative Care and Social Practice
Volume:18
Article Number:26323524241254839
Number of pages:15
First Page:1
Last Page:15
ISSN:2632-3524
URN:urn:nbn:de:hbz:1044-opus-83644
DOI:https://doi.org/10.1177/26323524241254839
PMID:https://pubmed.ncbi.nlm.nih.gov/38807748
Publisher:SAGE Publications
Publishing Institution:Hochschule Bonn-Rhein-Sieg
Date of first publication:2024/05/27
Copyright:© The Author(s), 2024. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License.
Funding:The project is part of the DFG-funded research group 2686 ‘Resilience in Religion and Spirituality: Endurance and the Formation of Powerlessness, Fear and Anxiety’ (grant number: 348851031).
Keyword:mindfulness; qualitative research; resilience; sense of coherence; spirituality
Departments, institutes and facilities:Centrum für Entrepreneurship, Innovation und Mittelstand (CENTIM)
Dewey Decimal Classification (DDC):6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Entry in this database:2024/06/06
Licence (German):License LogoCreative Commons - CC BY-NC - Namensnennung - Nicht kommerziell 4.0 International