34 The education and practice of self-care in palliative medicine trainees, a qualitative study

Context The emotional burden of regularly confronting suffering when caring for dying patients can affect the well-being of palliative care clinicians. Experienced clinicians recommend self-care strategies as a way of sustaining this work. There is increasing evidence for the effective use of self-care strategies in other caring professions who face similar challenges. Little is known about how doctors-in-training learn such skills. The aim of this study was to explore how trainees in palliative medicine learn and practice self-care strategies. Methods Eight palliative trainees in one region in England participated in a qualitative study using semi-structured interviews. An inductive thematic approach was used to analyse the data. Results Five closely linked themes are described detailing the perspectives of the trainees. Self-care was recognised as being integral to their identity as a palliative medicine clinician, even though it was not openly discussed. Trainees were keen for self-care to be recognised as an accepted part of providing holistic patient care in a sustainable manner. Strategies needed to be integrated into the working day to be most useful and were mostly learnt through personal experience. Explicit training or guidance from seniors on self-care strategies was rare but non-hierarchical relationships with peers enabled and motivated shared learning. Training in communication skills and Psychosocial care were also identified as important in improving their sense of work-related competency and hence well-being...