Experiences of work-related stress and coping among palliative care staff in South Africa: a qualitative study

Palliative care staff are exposed to a plethora of work-related stressors that negatively affect their psychological well-being and work engagement. Using qualitative interviews, this study sought to explore the experiences of work-related stress and coping among a multidisciplinary group of 12 palliative care staff employed by a non-governmental hospice in South Africa. Data were analysed using the principles of thematic analysis. Four domains of stressors were implicated in the experience of work-related stress: stressors accruing from the nature of work and were specific to palliative care; stressors relating to working in the community; those deriving from certain encounters with patients and families; and organisational stressors. Broader structural factors pertinent to the socio-political and economic context in South Africa and the perception of palliative care were interwoven with the experience of work-related stress. Receiving social support from co-workers, professionals, and family and friends; accepting limits; setting work-life boundaries; relying on personal resources and reconstructing the hospice in positive ways were coping strategies deployed by staff to manage stress. Arguably much of the experience of work-related stress and coping among palliative care staff in South Africa is similar to that reported in resource-rich contexts. However, the particularities of the broader socio-political and economic environment and its subsequent impact on palliative care organisations appear to augment and expand work-related stress for these practitioners. Deployment of intra-individual and interpersonal coping resources could be supplemented with efforts to address structural factors contributing to the subjective experience of stress.