Presence and the paradox of time for palliative care clinicians: a phenomenological study
Bibliographic record
Abstract
Background: A presence of quality is recognized as a central competence for palliative care clinicians in their mission to accompany patients and families in their end-of-life journey. However, PC clinicians’ capacity for presence may be affected by the increasing emotional, professional and organizational demands of their working environment. Those demands may, in turn, affect quality of care and clinicians’ health. To our knowledge, no previous study has aimed at a better understanding of how PC clinicians view and experience presence in their day-to-day work, although this holds the potential of generating insights to help clinicians develop and cultivate a high-quality presence towards dying patients.Methods: We conducted in-depth qualitative semi-structured interviews with 10 PC clinicians working on a specialized PC ward, later analyzed using Interpretative Phenomenological Analysis.Results: Results account for three essential themes describing the experience of presence; connection to the self, to the other and to the meaning of care. Results also suggest that presence was lived and experienced within a very particular relation to time, which appeared to our participants as a significant challenge in achieving high-quality presence.Conclusion: The stressful working environment in which PC clinicians daily evolve appeared as a threat to presence for our participants. Paradoxically, cultivating presence with mindfulness may be a promising tool to better cope with the competing demands of work and to foster clinicians’ resilience to stress.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.020 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.012 | 0.016 |
| Scholarly communication | 0.007 | 0.007 |
| Open science | 0.002 | 0.008 |
| Research integrity | 0.002 | 0.004 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".