Views on death and dying among health care workers in an Indian cancer care hospice: balancing individual and collective perspectives.

In providing palliative and end-of-life care, professional and lay hospice workers alike attend to patient and family needs to encourage a dignified death. However, there are few comparative inquiries documenting how differential workplace preparation affects the processes and outcomes related to being confronted to death and dying. This qualitative study explores and compares these experiences among a diverse sample of health workers (N = 25) in a grassroots cancer care hospice in Bangalore, India. Our findings underscore how personal views, socio-economic status, beliefs and values, occupational experience, and workplace interventions interact to shape 'worldviews' about death and dying. Whereas health workers report conflicting feelings of relief and sadness when confronted with the death of their patients, these mixed emotions are often lessened through open dialogue among newly trained and more experienced health workers. Moreover, experienced hospice workers wished to ensure that less experienced ones are provided with the necessary workplace support to lessen psychological 'hardening' that may occur with repeated exposure to death. In dealing with the diverse needs of hospice workers, both individual and collective needs must be considered to ensure an optimal workplace climate. Future work should study how hospice workers' views on death and dying evolve with time and experience.