Scientific Programme
Year 2021
October 2021


Abstract Title
Challenges and Resiliences of Non-Palliative Care Professionals Caring for End-of-Life Patients: A Qualitative Study on Health Profession Education



Nanyang Technological University1

Background & Hypothesis

High prevalence of death occurs outside of palliative care settings, and Non-Palliative Care Professionals (NPCPs) who regularly care for end-of-life (EoL) patients often struggle with burnout and poor mental health that negatively impact care quality and safety. This qualitative phenomenological study critically examines the challenges and resilience of NPCPs for informing health profession education.


105 NPCPs (35 physicians, 35 nurses, 35 medical social workers) from 9 major medical disciplines (Cardiology, Geriatric, Intensive Care Medicine, Internal Medicine, Nephrology, Neurology, Oncology, Respiratory Medicine, Surgery) who tend to EoL patients regularly were recruited form 3 major public healthcare institutions in Singapore. In-depth lived experience interviews were conducted, recorded, transcribed verbatim, and analyzed using Framework Analysis.


10 themes with 33 sub-themes emerged from the analysis and were organized into 2 major theme categories. First, ‘Challenges in the Provision and Assurance of EoL Care Excellence’ comprises: (1) emotional labours of EoL Care, (2) poor death literacy, (3) barriers to effective care partnership, (4) workplace hindrance to professional competency, and (5) systemic predicaments to quality care. Second, ‘Resilience Strategies for managing EoL Care Complexity’ comprises: (6) meaning-making with loss, (7) building fortitude through adversity, (8) nurturing grit and inner strengths, (9) enriching interpersonal connections, and (10) strengthening organizational support.

Discussion & Conclusion

Study findings form the Challenges and Resilience in EoL (CaRE) Empowerment Framework for informing and advancing education programmes, training initiatives, and institutional changes to better support NPCPs in rendering quality EoL care. Practice and policy recommendations to promote emotional, psychological, spiritual, social and organizational resilience are discussed.