Are Career Termination Concerns Only for Athletes? A Case Study of the Career Termination of an Elite Female Coach

This paper presents a case study of an elite female coach and her career termination from a 20+ year career following a critical life incident. A novel autobiographical approach was adopted whereby the participant undertook expressive writing to describe her experiences prior to, during, and following coaching an athlete at the 2012 Summer Olympic Games. Thematic analysis indicated seven phases related to the participant’s experiences of the critical incident: Build up to the event, the event, the aftermath, recovery and reflection on the event, sampling of new avenues, enlightenment, and career re-birth. The findings reinforce the high demands placed upon elite coaches, the subsequent threats to physical and mental well-being, and the importance of having robust psychological skills and suitable social support to cope with these demands. Implications for preparing and supporting coaches for successful career transition are discussed.

Caring for Children Dying from Cancer at Home: a Qualitative Study of the Experience of Primary Care Practitioners

Background. The rarity of childhood cancers makes providing palliative care in the community an unusual event for primary care practitioners. Providing this care requires effective interprofessional collaboration with the team that forms to provide the care often working together for the first and only time. Objective. To explore the experiences of primary care practitioners following their involvement in the palliative care of a child with cancer at home. Methods. The study design was a community-based qualitative study. The study location was the West Midlands region. Purposeful sample of GPs and community nurses involved in providing palliative care to 12 children. One-to-one in-depth interviews with 47 primary care professionals (10 GPs and 37 community nurses) and 5 facilitated case discussions were undertaken. Field notes were documented and grounded theory data analysis undertaken: chronological comparative data analysis identifying generated themes. Results. GPs had minimal input into the preceding care of children undergoing treatment for cancer but sought to re-establish their role at the child’s transition to palliative care. GPs felt they had a role to play and could add value to this phase of care, highlighted their continuing role with the child’s family and acknowledged that they had gained from the experience of contributing. However, lack of specialist knowledge and uncertainty about their role within the team made this more challenging. In contrast, community nurses were routinely involved in both active treatment and palliation care phases. There was little evidence of collaboration between the specialist and primary care professionals involved. There was considerable variation in out of hours provision across cases. Conclusions. Engaging primary care practitioners needs to be more actively anticipated and negotiated at the transition to palliation. Variation in out of hours care is another cause for concern. Enhancing inter-professional collaboration and planning during both active and palliative care phases may help. Keywords. Cancer, family medicine, palliative care, paediatric.