Metamorphosis: The transformation process for palliative care professionals – or how to work in palliative care and not die trying

Rafael Mota Vargas and Vinita Mahtani-Chugani, palliative care physicians from Spain, explain the background to their longer research article selected as ‘Editor’s choice’ in the February issue of Palliative Medicine.

‘How do you manage to do this for a living?’

Dr Rafael Mota Vargas

Dr Rafael Mota Vargas

Palliative care professionals are frequently faced with this question. Are professionals expected to achieve particular abilities for palliative care? Or are they expected to demonstrate a kind of ‘Palliative Profile’?

Also, are professionals actually aware of the associated risks they are actively undertaking? Are they able to identify the emotions arising from their daily routine as related to suffering and death? And, if so, are they trained to handle them appropriately, and are they provided with effective self-care strategies?

These were the key questions that led our group of palliative care professionals in Extremadura (Spain) to carry out a research study on the emotional impact on practitioners through daily contact with suffering, as well as the self-care strategies they employ in order to conduct their work satisfactorily. At the same time, we have tried to describe the trajectory of these practitioners and the factors that influence this process.

For this purpose, we worked closely with a qualitative research expert, Dr Vinita Mahtani from the Canary Islands, who supported us with the methodological procedure.


Dr Vinita Mahtani-Chugani

Dr Vinita Mahtani-Chugani

Dr Mahtani-Chugani comments:


“When you asked me to contribute to this blog it brought up all the memories of how we began to work together.

Once upon a time . . . life decided to put into my path a wonderful multidisciplinary team of professionals. We created an intense interaction based on a shared curiosity to reflect on who we are, where we come from and where we are headed.

I had the opportunity to guide you in the use of qualitative methodology and analyze together what exactly was taking place in your lives. I am grateful to life for all the learning we have shared.”

The analysis revealed a common trajectory followed by participants in their working lives: Pre-palliative care/Honeymoon/Frustration/Maturation. These phases, depending on the relationship between the cost of caring and the satisfaction of caring, can influence both the care provided to patients and families and their own personal circumstances. Being aware of this risk, and implementing self-care strategies, can protect and enable us to conduct our work in an optimal manner. The result of this process, which we have metaphorically termed ‘metamorphosis’, is the transformation of a professional who can work satisfactorily within a palliative care context. Based on the arts- based research framework we have transformed the results into a documentary called ‘Metamorphosis’.

We hope that experienced professionals working in palliative care can somehow feel involved by the scope of our study, that beginners will find it a useful tool to foresee further feelings, and that it can also help professionals from other disciplines and our loved ones to have a better understanding of the particular environment that we face.

More about the authors . . .
Rafael Mota Vargas is a physician in the Palliative Care Team at the Infanta Cristina Hospital Complex, Badajoz and part of the Extremadura Health Service (Servicio Extremeño de Salud – SES), Spain.
Vinita Mahtani-Chugani is a physician in the Research Unit Hospital, Nuestra Señora de la Candelaria, Canary Islands Health Care Services, Tenerife, Spain. 

2.coverDownload a free copy of the full article
This blog post relates to the longer article, ‘The transformation process for palliative care professionals: the metamorphosis, a qualitative research study’, by Rafael Mota Vargas, Vinita Mahtani-Chugani, María Solano Pallero, Borja Rivero Jiménez, Raquel Cabo Domínguez, and Vicente Robles Alonso published in Palliative Medicine February 2016 vol. 30: 161-170, first published on 20 April 2015, doi 10.1177/0269216315583434.

EAPC members and registered users of the EAPC website can download a free copy of this article and other ‘Editor’s choice’ papers from the EAPC website. (If you need to register or login to download this paper please follow the instructions in the top right-hand corner of EAPC home page and scroll down to the article). Click here to view other EAPC-originated papers.





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2 Responses to Metamorphosis: The transformation process for palliative care professionals – or how to work in palliative care and not die trying

  1. Pingback: Self Care in Palliative Care |

  2. Mary Tehan says:

    Thank you for this article. I am wondering if you could also do a study on the after-effects/after-life issues and needs of having worked in palliative care? Leaving the ‘palliative care bubble’ may be just as painful and distressing as other professional disciplines find (e.g. top-class athletes; footballers etc). Is there a need to offer post-palliative care support for people who have devoted much of their professional life to end-of-life care?

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