Background Ethical decision making in intensive care is a demanding task. The need to proceed to ethical decision is considered to be a stress factor that may lead to burnout. The aim of this study is to explore the ethical problems that may increase burnout levels among physicians and nurses working in Portuguese intensive care units . A quantitative, multicentre, correlational study was conducted among 300 professionals.Results The most crucial ethical decisions made by professionals working in ICU were related to (...) communication, withholding or withdrawing treatments and terminal sedation. A positive relation was found between ethical decision making and burnout in nurses, namely, between burnout and the need to withdraw treatments , to withhold treatments and to proceed to terminal sedation . This did not apply to physicians. Emotional exhaustion was the burnout subdimension most affected by the ethical decision. The nurses' lack of involvement in ethical decision making was identified as a risk factor. Nevertheless, in comparison with nurses , it was the physicians who more keenly felt the need to proceed to ethical decisions in ICU.Conclusions Ethical problems were reported at different levels by physicians and nurses. The type of ethical decisions made by nurses working in Portuguese ICUs had an impact on burnout levels. This did not apply to physicians. This study highlights the need for education in the field of ethics in ICUs and the need to foster inter-disciplinary discussion so as to encourage ethical team deliberation in order to prevent burnout. (shrink)

Burnout is a phenomenon characterized by fatigue and frustration, usually related to work stress and dedication to a cause, a way of life that does not match the person’s expectations. Although it seems to be associated with risk factors stemming from a professional environment, this problem may affect any person. Palliative care is provided in a challenging environment, where professionals often have to make demanding ethical decisions and deal with death and dying. This article reports on the findings of a (...) systematic review aimed at identifying described burnout levels in palliative care nurses and physicians, and the related risks and protective factors. The main findings indicate that burnout levels in palliative care, or in health care settings related to this field, do not seem to be higher than in other contexts. (shrink)

The purpose of this study was to understand the perceptions of highly skilled and less skilled volleyball players about the influences that parents, coaches, and peers had on their sport development and performance achievement. Highly skilled (n= 30) and less skilled (n= 30) volleyball players participated in semi-structured retrospective interviews to explain how parents, coaches and peers may have influenced their sport participation. Data was analyzed through a process of content analysis. Results indicated that parents, coaches, and peers had an (...) important influence in player's sport development but differing according to players' expertise level. Concerning to parental influences, tangible support during the early years of development was mentioned by all players. However, parents' level of involvement and parenting styles revealed interesting differences between highly skilled and less skilled players. Highly skilled players perceived a moderate parental involvement and an autonomy-supportive parenting style, while less skilled players referred a excessive parental involvement in players' sport participation. Coaches influences showed to have some similarities in the early years with all players mentioning coaches as caring and recognizing their value as an athlete. However, highly skilled players described a different training environment characterized by a demanding coach, individualized instruction, and specific goal setting. Regarding peers' influence, all players recognized that friends were not only one of the main reasons to start playing volleyball, but also an important source of support to remain engaged and staying motivated to do sport. Highly skilled players, however, mentioned the importance of teammates' positive push and critiques during practice for enhancing their motivation, team cohesion and friendship. They also highlighted the importance of friends outside of sport in the later years of their career by acting as an escape from all the pressure that emerged from volleyball training and competition demands. Overall, these findings highlight different social influences according to the players' expertise level suggesting the need to examine more extensively the nature of significant others' support on athlete and talent development. (shrink)