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‘Now I can train myself to be with death’: a phenomenological study with young doctors in care homes supported by a palliative care unit during the second wave of the pandemic in Italy

OBJECTIVE: During the second wave of the COVID-19 pandemic, one of the organisational strategies established by the Italian National Health System was the special units for continuity of care (SUCCs). In the province of Ravenna, those units enrolled novice doctors to care for elderly patients with C...

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Autores principales: Moroni, Matteo, Díaz Crescitelli, Matías Eduardo, Capuccini, Jenny, Pedroni, Cristina, Bianco, Mattia, Montanari, Luigi, Ghirotto, Luca
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10105916/
https://www.ncbi.nlm.nih.gov/pubmed/37041055
http://dx.doi.org/10.1136/bmjopen-2022-065458
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author Moroni, Matteo
Díaz Crescitelli, Matías Eduardo
Capuccini, Jenny
Pedroni, Cristina
Bianco, Mattia
Montanari, Luigi
Ghirotto, Luca
author_facet Moroni, Matteo
Díaz Crescitelli, Matías Eduardo
Capuccini, Jenny
Pedroni, Cristina
Bianco, Mattia
Montanari, Luigi
Ghirotto, Luca
author_sort Moroni, Matteo
collection PubMed
description OBJECTIVE: During the second wave of the COVID-19 pandemic, one of the organisational strategies established by the Italian National Health System was the special units for continuity of care (SUCCs). In the province of Ravenna, those units enrolled novice doctors to care for elderly patients with COVID-19 in care homes (CHs). The local palliative care (PC) unit decided to offer consultations and support to them. This study aimed to comprehend the experience of young doctors who asked for consultations when facing, during their first early years of practice, complex situations. DESIGN: We conducted a qualitative study employing a phenomenological approach and in-depth interviews. PARTICIPANTS: We involved 10 young doctors who worked in Italian SUCC during the pandemic and used a PC consultation support service. RESULTS: What describes our participants’ experience is related to four main themes: (1) reducing distances, (2) perceiving medical futility and improvising, (3) being supported to learn how to be with death and (4) narrowed timing to humanise care. The pandemic was, for our participants, a moment of reflection and critique on the skills acquired during the university course. It was a strong experience of human and professional growth that helped them reshape and deepen their role and skills, incorporating the approach of PC into their professional identity. CONCLUSIONS: Integration between specialists and young doctors with an early entry into the workforce during the pandemic in CHs set out a ‘shift’ to a proactive and creative approach through a new awareness of professional and personal roles in doctor–patient relations. The continuity of care models should be rethought by integrating CHs and PC. Adequate PC training for young doctors (at pregraduate and postgraduate levels) can change doctors’ vision and daily practice in assisting patients at the end of life.
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spelling pubmed-101059162023-04-17 ‘Now I can train myself to be with death’: a phenomenological study with young doctors in care homes supported by a palliative care unit during the second wave of the pandemic in Italy Moroni, Matteo Díaz Crescitelli, Matías Eduardo Capuccini, Jenny Pedroni, Cristina Bianco, Mattia Montanari, Luigi Ghirotto, Luca BMJ Open Palliative Care OBJECTIVE: During the second wave of the COVID-19 pandemic, one of the organisational strategies established by the Italian National Health System was the special units for continuity of care (SUCCs). In the province of Ravenna, those units enrolled novice doctors to care for elderly patients with COVID-19 in care homes (CHs). The local palliative care (PC) unit decided to offer consultations and support to them. This study aimed to comprehend the experience of young doctors who asked for consultations when facing, during their first early years of practice, complex situations. DESIGN: We conducted a qualitative study employing a phenomenological approach and in-depth interviews. PARTICIPANTS: We involved 10 young doctors who worked in Italian SUCC during the pandemic and used a PC consultation support service. RESULTS: What describes our participants’ experience is related to four main themes: (1) reducing distances, (2) perceiving medical futility and improvising, (3) being supported to learn how to be with death and (4) narrowed timing to humanise care. The pandemic was, for our participants, a moment of reflection and critique on the skills acquired during the university course. It was a strong experience of human and professional growth that helped them reshape and deepen their role and skills, incorporating the approach of PC into their professional identity. CONCLUSIONS: Integration between specialists and young doctors with an early entry into the workforce during the pandemic in CHs set out a ‘shift’ to a proactive and creative approach through a new awareness of professional and personal roles in doctor–patient relations. The continuity of care models should be rethought by integrating CHs and PC. Adequate PC training for young doctors (at pregraduate and postgraduate levels) can change doctors’ vision and daily practice in assisting patients at the end of life. BMJ Publishing Group 2023-04-11 /pmc/articles/PMC10105916/ /pubmed/37041055 http://dx.doi.org/10.1136/bmjopen-2022-065458 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Palliative Care
Moroni, Matteo
Díaz Crescitelli, Matías Eduardo
Capuccini, Jenny
Pedroni, Cristina
Bianco, Mattia
Montanari, Luigi
Ghirotto, Luca
‘Now I can train myself to be with death’: a phenomenological study with young doctors in care homes supported by a palliative care unit during the second wave of the pandemic in Italy
title ‘Now I can train myself to be with death’: a phenomenological study with young doctors in care homes supported by a palliative care unit during the second wave of the pandemic in Italy
title_full ‘Now I can train myself to be with death’: a phenomenological study with young doctors in care homes supported by a palliative care unit during the second wave of the pandemic in Italy
title_fullStr ‘Now I can train myself to be with death’: a phenomenological study with young doctors in care homes supported by a palliative care unit during the second wave of the pandemic in Italy
title_full_unstemmed ‘Now I can train myself to be with death’: a phenomenological study with young doctors in care homes supported by a palliative care unit during the second wave of the pandemic in Italy
title_short ‘Now I can train myself to be with death’: a phenomenological study with young doctors in care homes supported by a palliative care unit during the second wave of the pandemic in Italy
title_sort ‘now i can train myself to be with death’: a phenomenological study with young doctors in care homes supported by a palliative care unit during the second wave of the pandemic in italy
topic Palliative Care
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10105916/
https://www.ncbi.nlm.nih.gov/pubmed/37041055
http://dx.doi.org/10.1136/bmjopen-2022-065458
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