Table 1.

Study descriptions and details.

Author(s)	Year of publication	Aim of Study	Methodology	Findings summary
Back et al.	2016	Examine the approaches to building resilience in palliative care physicians—clinician resilience skills & workplace factors	Literature review and stakeholder interviews	Introduced a structural model of individual skills and system construction that support professional resilience
Cortezzo et al.	2019	Study of birth planning for life-limiting fetal diagnosis from both the patient and parents' perspectives	Mixed methods, quantitative-descriptive & univariate analysis; qualitative-thematic analysis	Proposed eliciting parental preferences for greater participation and decision making. Physician comfort levels were adequate, but found that time limitations made communication aspects with birth planning was most unfeasible aspect
Cortezzo et al.	2015	Explore the practices and perceptions of end-of-life care in NICU—examined patient and provider experiences	Survey study- explorative, description cross-sectional evaluation	Found debriefing/closure conferences, bereavement support, and education provision was variable and suboptimal at times. Value of formal palliative care teams rather than individual consultants ascertained.
Forster and Hafiz	2015	Explore the coping strategies and perceptions of support available to professionals encountering pediatric death	Qualitative: multidisciplinary professional interviews	Personal coping strategies, peer support, family support, spiritual beliefs, relational efficacy when caring for the dying child and family all improved coping
Hamric	2014	Illustrate ethical issues and moral distress associated with end-of-life issues that occur in the NICU which impact perinatal palliative care provision.	Case study	Expounded ethical climate building with debriefing, improving communication, multidisciplinary care conferences, and resilience factors
Hutti et al.	2016	Evaluate nurses reactions to caregiving for patient experiencing fetal demise	Recorded group discussions structured by Swanson's Theory of Caring was analyzed	Risks for compassion fatigue were revealed. Coping strategies and interventions based on latest research was presented which included debriefing, mentoring, more perinatal bereavement education, and self-care practices were implicated.
Jonas-Simpson et al.	2016	Explore thematic patterns of obstetrical or neonatal nurse's grief experiences to perinatal death	Qualitative study: interpretive phenomenology	Thematic patterns included: Growth and transformation emerging with anguish and grief, collegial supports, education, aspects of reciprocal mentorship, the intrinsic value of compassionate caregiving
Kamal et al.	2016	Examine the prevalence and predicting factors associated with burnout rates in hospital and palliative care clinicians in the U.S.	Quantitative: Survey study and statistical analysis	Higher rates of burnout correlated with emotional exhaustion and depersonalization, working at smaller organizations, extended work hours, age < 50, and working weekends. Activities related to interpersonal relationships and vacation use were associated with less burnout rates.
Klein	2009	Study issues of ethical dilemma and moral distress in pediatric palliative care—infants born with severe life-limiting anomalies	Case studies	Prognostication challenges, cultural, and social factors can cause moral distress in parents and palliative staff. Beliefs and aspects regarding the suffering of the infant can create emotional dilemma. Ethics and palliative care collaboration can be supportive to staff and caregivers.
Kilcullen and Ireland	2017	Present facilitators and barriers to palliative care provision in an Australian NICU	Qualitative: Thematic analysis of semi-structured interviews	Facilitators of the provision of palliative care included: cultural awareness, experienced and proficient mentors and supportive staff, clinical skills and knowledge, personal knowledge of one's own values, morals, & beliefs, emotional & communication skills, and knowledge of bereavement practices. Barriers to the provision of palliative care included: lack of education/inservices, workspace environment, parents' inaccessibility to infant, nurses' own grief, and included input into development of policies and procedures.
McCloskey and Taggart	2010	Probe the occupational stressors of pediatric palliative care nurses	Qualitative focus group discussions: thematic content analysis	Workload demands included: emotional, ethical, constraints to care delivery, lack of resources, documentation, community misconceptions, maintaining relationships with patient & family, and cultivating autonomy within the profession
Mehta et al.	2016	Study aspects of palliative care teams- pilot study of model for team resilience	Quantitative- Resiliency model testing with physicians	Team building measured a feasible reduction in perceived stress, and improved the perspective taking of the others in the team
Mills et al.	2017	Evaluate perceptions, education, and practices related to self-care in palliative nurses and medical professionals in Australia	Survey studies	Self-care was regarded as important by most. Many had not practiced self-care and also denied having any education on self-care. A large portion of those reported that self-care plans would be considered if training was provided.
Mills et al.	2018	Explore the meaning and practice of self-care in palliative nurses and physicians	Qualitative content analysis of semi-structured interviews	A practice of self-care contributed to a better capacity to care for others. Self-care practices in both occupational and personal settings is necessary.
				Facilitators of self-care practices included supportive environments, self-assessment, prioritization, and an ongoing planning process. Barriers included overwhelming workload & excessive busyness, stigma against self-care at the workplace, low self-worth or self-criticism, and lack of planning.
Perez et al.	2015	Examine the barriers and facilitators of resiliency in palliative care clinicians	Qualitative: content analysis of semi-structured interviews	Identified stressors, coping strategies, and training needs. Stressors included limited resources & cost-cutting, conflicting interdisciplinary expectations, increased caseloads, intensity of the cases, boundary setting, personal & professional limitations, competing demands from administrative & documentation activities, patients, & staff. Coping strategies included personal self-care, emotional & physical distancing from work off the clock, and social & emotional supports. Training needs included mind-body skills, stress education, cognitive stress management skills, and brief coping strategies to implement in real time.
Profit et al.	2014	Explore aspects of burnout and resilience in NICU	Cross-sectional surveys	NICUs with higher levels of burnout were correlated with a reduced teamwork climate, safety climate, job satisfaction, perceptions of management, and working conditions. A resilient culture was show to enhance safety and quality of care.
Sanso et al.	2015	Determine the relationship between self-care & awareness and development of burnout, compassion fatigue, and coping with death in palliative care professionals	Quantitative- survey study	Self-care and self-awareness improved coping with death and compassion satisfaction, less burnout and compassion fatigue. The data collection after the spiritual training exercises did not have those desired effects.
Dev et al.	2018	Evaluate the relationship between barriers to compassion and burnout in nurses.	Quantitative study: survey	Barriers to compassion, contributors to burnout included workload, clinical barriers, practice of self-compassion, encounters with patient and families
Weitraub et al.	2016	Contrast physician burnout, compassion fatigue, and compassion satisfaction	Quantitative study: linear regression analysis	Overlapping of burnout and compassion fatigue found. Impacts emotional well-being and professional performance of neonatologists. Self-identifying as being Hispanic debriefing and utilization of pediatric palliative care services resulted in compassion satisfaction.
Wright et al.	2011	Examine the facilitators and barriers to the provision of end-of-life care in the NICU settings from the perspectives of neonatal nurses.	Quantitative: Questionnaire survey study	Five barriers were identified as: inability to express values and beliefs regarding palliative care, environmental constraints, engagement in technology, demands from parents, and lack of education. Eight facilitators identified as: staff support, involvement of parents in decision making, support from medical team when palliative care was implemented, parents informed of options, staffing, time allotment with dying baby, policies/guidelines that supported palliative care, and available counseling.
Zwack and Schweitzer	2013	Analyze stakeholder interviews regarding aspects of burnout and resilience	Qualitative study: Concept analysis	Both attitudes and strategies (social, mental, and physical) assisted physicians' success to augment decision making, coping, and promoting resilience in others.