Death Anxiety and Caregiver Burnout

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Introduction: The nature of working in healthcare entails exposure to death. Death anxiety, according to Doenges (2016) is a nursing diagnosis defined as a Vague uneasy feeling of discomfort or dread generated by perceptions of a real or imagined threat to one’s existence (p 219-222). Lee & King (2014) add that Caregivers who experience death anxiety have anxious thoughts or feelings when thinking about or talking about death and/or the dying process, or when interacting with someone who is dying (p 480).

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Healthcare workers, including nurses, report feeling unconfident in their ability to talk about death, much less to provide talk therapy to dying patients, and are at greater risk of experiencing burnout (Lee & King, 2014, p 480). As this writer struggles with work-related death anxiety, with respect to self and patients, an article (Exploring Death Anxiety and Burnout Among Staff Members Who Work In Outpatient Hemodialysis Units) on the subject of death anxiety specific to nurses was located in the ProQuest database. The article was analyzed so that possible solutions for death anxiety might be undertaken to prevent death anxiety-induced burnout.

Summary: Lee and King (2014), the authors of the article, assert that caregiver death anxiety is positively correlated with burnout. They hypothesize that education on EOL care might serve as a treatment for death anxiety and burnout. They point out that both death anxiety and burnout can negatively impact the quality of care that caregivers provide, as well as their job satisfaction and increases job turnover (p 479-480).

They found numerous studies that validate their assertions: that patient mortality is positively correlated with unresolved grieving (Gerow et al., 2010, as cited in Lee & King, 2014), that these can lead to frustration, moral distress, compassion fatigue, depression, and burnout (Ashker, Penprase, & Salman, 2012; Dermody & Bennett, 2008; Hayes & Bonner, 2010, as cited in Lee & King, 2014), that turnover was positively correlated with psychological stress (Argentero, Dell’Olivio, & Ferretti, 2008; Hayes & Bonner, 2010, as cited in Lee & King, 2014) and many more; a total of 33 scholarly resources were cited by the authors to validate their points. To test their hypothesis, they sampled fifteen nurses working in hemodialysis units and provided four classes on EOL care, each two hours long and one week apart from the others. To assess the efficacy of their program, they used the Revised Collet-Lester Fear of Death and Dying Scale and the Maslach’s Burnout Inventory; both tools were administered before the program and after. The conclusion of the program was that it was successful, but with several limitations. All of the participants were female, the sample size was small, and not all of the participants finished the program. Because of these limitations, the authors admitted that results may not be generalizable to other [hemodialysis] units.

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