Personal Growth and Well-Being in the Time of COVID: An Exploratory Mixed-Methods Analysis.

The physical distancing measures necessitated by COVID-19 have resulted in a severe withdrawal from the patterns of daily life, necessitating significantly reduced contact with other people. To many, such withdrawal can be a major cause of distress. But, to some, this sort of withdrawal is an integral part of growth, a pathway to a more enriching life. The present study uses a sequential explanatory QUAN-qual design to investigate whether people who felt that their lives had changed for the better after being forced to engage in physical distancing, what factors predicted such well-being, and how they spent their time to generate this sense of well-being. We invited 614 participants who reported closely following physical distancing recommendations to complete a survey exploring this topic. Our analyses, after controlling for all other variables in the regression model, found a greater positive association between presence of meaning in life, coping style, and self-transcendent wisdom and residualized current well-being accounting for retrospective assessments of well-being prior to physical distancing. An extreme-case content analysis of participants' personal projects found that participants with low self-transcendent wisdom reported more survival-oriented projects (e.g., acquiring groceries or engaging in distracting entertainments), while participants reporting high self-transcendent wisdom reported more projects involving deepening interactions with other people, especially family. Our findings suggest a more nuanced pathway from adversity to a deeper sense of well-being by showing the importance of not merely coping with adversity, but truly transcending it.

Hospice Palliative Care (HPC) and Medical Assistance in Dying (MAiD): Results From a Canada-Wide Survey.

BACKGROUND: With the legalization of medical assistance in dying (MAiD) in Canada, physicians and nurse practitioners now have another option within their scope of practice to consider alongside hospice palliative care (HPC) to support the patient and family regardless of their choice toward natural or medically assisted death. To elucidate insights and experiences with MAiD since its inception and to help adjust to this new end-of-life care environment, the membership of the Canadian Hospice Palliative Care Association (CHPCA) was surveyed. METHODS: The CHPCA developed and distributed a 16-item survey to its membership in June 2017, one year following the legalization of MAiD. Data were arranged in Microsoft® Excel and open-ended responses were analyzed thematically using NVivo 12 software. RESULTS: From across Canada, 452 responses were received (response rate: 15%). The majority of individuals worked as nurses (n = 161, 33%), administrators (n = 79, 16%), volunteers (n = 76, 16%) and physicians (n = 56, 11%). Almost 75% (n = 320) of all respondents indicated that they had experienced a patient in their program who had requested MAiD. Participants expressed dissatisfaction with the current psychological and professional support being provided by their health care organization and Ministry of Health - during and after the MAiD procedure. CONCLUSION: The new complexities of MAiD present unique challenges to those working in the health-care field. There needs to be an increased focus on educating/training providers as without proper support, health-care workers will be unable to perform to their full potential/scope of practice while also providing patients with holistic and accessible care.

Gaps in Hospice and Palliative Care Research: A Scoping Review of the North American Literature.

BACKGROUND: The demand for hospice and palliative care is growing as a result of the increase of an aging population, which is most prominent in North America. Despite the importance of the topic and an increase in hospice and palliative care utilization, there still are gaps in research and evidence within the field. AIM: To determine what gaps currently exist in hospice and palliative/end-of-life care research within the context of a North American setting to ensure that future directions are grounded in appropriate evidence. METHODS: Using Arksey and O'Malley's scoping review framework, six peer-reviewed, and four grey electronic literature databases in healthcare and the social sciences were searched in mid-2019. 111 full-text articles were retrieved, with 25 articles and reports meeting the inclusion criteria. Major themes were identified through thematic context analysis: (1) clinical, (2) system access to care, (3) research methodology, and (4) caregiving-related research gaps. RESULTS: Findings include strategies for engaging stakeholder organizations and funding agencies, implications for other stakeholder groups such as clinicians and researchers, and highlight implications for policy (e.g., national framework discussion) and practice (e.g., healthcare provider education and training and public awareness). CONCLUSION: Reviewing and addressing targeted research gaps is essential to inform future directions in Canada and beyond.