Staying Positive in a Negative situation:Applying the positive health strategy in preventing distress in lung cancer patients

Background Timely signaling of distress in cancer patients is important. Due to the focus on medical treatment, patients and healthcare providers often overlook other options for leading a higher quality, meaningful life with this critical illness. By shifting the emphasis to resilience and well-being (rather than ill-health), the patient can be empowered and distress may be prevented. Aims To compare the Distress Thermometer and the spider-web diagram, a visualization tool that represents patients’ assessments of different aspects of their lifes. Method A quantitative study was carried out among lung cancer patients (n=112) at the Albert Schweitzer hospital in the Netherlands. They all completed the Distress Thermometer as well as the Spider-Web diagram (Dialogue tool 1.0 of the Institute for Positive Health), and a satisfaction questionnaire (min 1 to max 10). Results The spider-web does not represent an external norm, it reflects the personal evaluation of the situation. Patients' satisfaction scores of the Spider Web exceeded the distress thermometer (8.0 ± 1.3 vs 6.9 ± 1.2). More specifically, they felt more able to state problems and concerns (t (- .67), p Conclusion Satisfaction and preference among patients was in favor of the Spider Web. It is recommended that oncology teams start a conversation about deploying the most appropriate instrument for prevention of distress, preferably aimed at mapping mental well-being and enhancing positive qualities

Using an intervention mapping approach to develop a discharge protocol for intensive care patients

Background: Admission into an intensive care unit (ICU) may result in long-term physical, cognitive, and emotional consequences for patients and their relatives. The care of the critically ill patient does not end upon ICU discharge; therefore, integrated and ongoing care during and after transition to the follow-up ward is pivotal. This study described the development of an intervention that responds to this need. Methods: Intervention Mapping (IM), a six-step theory- and evidence-based approach, was used to guide intervention development. The first step, a problem analysis, comprised a literature review, six semi-structured telephone interviews with former ICU-patients and their relatives, and seven qualitative roundtable meetings for all eligible nurses (i.e., 135 specialized and 105 general ward nurses). Performance and change objectives were formulated in step two. In step three, theory-

The prevalence of compassion fatigue and burnout among healthcare professionals in intensive care units: A systematic review

Background: Working in the stressful environment of the Intensive Care Unit (ICU) is an emotionally charged challenge that might affect the emotional stability of medical staff. The quality of care for ICU patients and their relatives might be threatened through long-term absenteeism or a brain and skill drain if the healthcare professionals leave their jobs prematurely in order to preserve their own health. Purpose: The purpose of this review is to evaluate the literature related to emotional distress among healthcare professionals in the ICU, with an emphasis on the prevalence of burnout and compassion fatigue and the available preventive strategies. Methods: A systematic literature review was conducted, using Embase, Medline Ovid SP, Cinahl, Web-of-science, PsychINFO, PubMed publisher, Cochrane and Google Scholar for articles published between 1992 and June, 2014. Studies reporting the prevalence of burnout, compassion fatigue, secondary traumatic stress and vicarious trauma in ICU healthcare professionals were included, as well as related intervention studies. Results: Forty of the 1623 identified publications, which included 14,770 respondents, met the selection criteria. Two studies reported the prevalence of compassion fatigue as 7.3% and 40%; five studies described the prevalence of secondary traumatic stress ranging from 0% to 38.5%. The reported prevalence of burnout in the ICU varied from 0% to 70.1%. A wide range of intervention strategies emerged from the recent literature search, such as different intensivist work schedules, educational programs on coping with emotional distress, improving communication skills, and relaxation methods. Conclusions: The true prevalence of burnout, compassion fatigue, secondary traumatic stress and vicarious trauma in ICU healthcare professionals remains open for discussion. A thorough exploration of emotional distress in relation to communication skills, ethical rounds, and mindfulness might provide an appropriate starting point for the development of further preventive strategies