title: The transformation process for palliative care professionals: The metamorphosis, a qualitative research study.
abstract: BACKGROUND
  Palliative care professionals are exposed daily to high levels of suffering. This makes them particularly vulnerable to suffering from stress, which can lead to burnout and/or compassion fatigue.
  
  
  OBJECTIVE
  To analyse the professional trajectory of palliative care workers over time and the factors which influence this trajectory.
  
  
  METHODS
  A qualitative study was designed based on the Grounded Theory approach, using semi-structured individual interviews. Interviews were recorded audio-visually and transcribed verbatim for subsequent analysis using the procedure described by Miles and Huberman. This process was supported using ATLAS.ti 6 software.
  
  
  METHODS
  A total of 10 palliative care professionals from Extremadura (Spain) took part in the study.
  
  
  RESULTS
  The analysis revealed a common trajectory followed by participants in their working lives: pre-palliative care/honeymoon/frustration/maturation. In addition, factors which influence this trajectory were identified. Details of the self-care strategies that these professionals have developed are described. The result of this process, which we have metaphorically termed 'metamorphosis', is the formation of a professional who can work satisfactorily within a palliative care context.
  
  
  CONCLUSIONS
  During their professional activity, palliative care professionals go through a series of phases, depending on the relationship between the cost of caring and the satisfaction of caring, which can influence both the care provided to patients and families and their own personal circumstances. Being aware of this risk, and implementing self-care strategies, can protect professionals and enable them to conduct their work in an optimal manner. Reflecting on the experiences of these professionals could be useful for other health professionals.
authors.affiliation: Palliative Care Team, Infanta Cristina Hospital Complex, Extremadura Health Service (Servicio Extremeño de Salud - SES), Badajoz, Spain rafael.mota44@gmail.com.
authors.forename: Rafael
authors.initials: R
authors.lastname: Mota Vargas
authors.affiliation: Research Unit Hospital Nuestra Señora de la Candelaria, Canary Islands Health Care Services, Tenerife, Spain.
authors.forename: Vinita
authors.initials: V
authors.lastname: Mahtani-Chugani
authors.affiliation: Palliative Care Regional Observatory, Fundación para la Formación e Investigación de los Profesionales de la Salud de Extremadura (FUNDESALUD), Mérida, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Solano Pallero
authors.affiliation: Researcher in Social Science, Cáceres, Spain.
authors.forename: Borja
authors.initials: B
authors.lastname: Rivero Jiménez
authors.affiliation: Palliative Care Team, Asociación Española contra el Cáncer (AECC) (Spanish Anti-Cancer Association), Badajoz, Spain.
authors.forename: Raquel
authors.initials: R
authors.lastname: Cabo Domínguez
authors.affiliation: Palliative Care Team, Virgen del Puerto Hospital, Extremadura Health Service (Servicio Extremeño de Salud - SES), Plasencia, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Robles Alonso
mesh_terms: D000328:Adult; D000068376:Compassion Fatigue / Q000523:psychology*; D004645:Empathy; D005260:Female; D066296:Grounded Theory; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D010166:Palliative Care / Q000379:methods / Q000523:psychology*; D011361:Professional Competence; D036301:Qualitative Research; D013315:Stress, Psychological / Q000523:psychology
keywords: Palliative care; burnout; compassion; emotional stress; qualitative research; self-care; trajectory professional