How individuals living with myeloma experience an end of life phase during covid-19: An interpretative phenomenological analysis

<p>Systematic Literature Review</p> <p>Breaking bad news is an occupational hazard for healthcare practitioners. Fourteen papers pertaining to practitioner experience of breaking bad news were identified during a systematic search of the literature and a conceptual overview is provided in this critical interpretative meta synthesis. Analysis elicited four themes: (1) Discomfort, particularly difficult emotional and physical responses to breaking bad news; (2) Relational distress, connected to attachment and identification with patients; (3) Bad clinician, indicating the fear of doing it badly or being bad; and (4) Only human, highlighting a culture of invulnerability where practitioner self-care is deprioritised. Recommendations include reflective practice to support staff, normalisation of difficult experiences around bad news conversations, and inclusion of practitioner needs within breaking bad news protocols.</p> <p>Research Project</p> <p>Interpretative Phenomenological Analysis was used to explore six myeloma patient’s experiences of an end of life phase during the COVID-19 pandemic. Three super ordinate themes were identified: (1) Threat is all around, captured an intensified sense uncertainty and risk from others brought about by the pandemic; (2) My world became smaller, illuminated cumulative losses experienced and the adjustment to shielding including reduced social contact, which for some was experienced as an unexpected benefit; and (3) Outside I’m a swan, reflected the pressure participants felt to maintain prior roles and responsibilities and ‘just get on with it’. Findings emphasised the amplification of pre-existing challenges for those with myeloma as a result of the pandemic and the importance of practitioner understanding of patient values and support systems in order to best provide person-centred care.</p>