{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T06:18:02Z","timestamp":1791353882969,"version":"4.3.1"},"reference-count":60,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Sage Open Nursing"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Palliative care nurse practitioners work in sustained proximity to death, grief, and end-of-life decision, yet relatively little is known about how this role relates to psychological well-being and depressive symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective(s)<\/jats:title>\n                    <jats:p>To examine subjective happiness, mental well-being, and depressive symptoms among palliative care nurse practitioners in Israel, and to explore how clinicians interpret repeated exposure to death in relation to these experiences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An explanatory sequential mixed-methods study was conducted among certified palliative care nurse practitioners in Israel. In the quantitative phase, participants completed the Subjective Happiness Scale, the Mental Health Continuum-Short Form, and the Center for Epidemiologic Studies Depression Scale. In the qualitative phase, a focus group was conducted with survey respondents to explore meaning, coping, and death-related experiences. Descriptive statistics, internal consistency estimates, and Pearson correlations were used for the quantitative analysis. Qualitative data were analyzed using reflexive thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty-six nurse practitioners completed the survey and ten participated in the focus group. Participants reported moderate subjective happiness and mental well-being, while 44.4% scored above the threshold for elevated depressive symptoms on the depression screening measure. Qualitative analysis generated four themes: temporal reflections on death, cultural and societal meaning, existential struggle, and professional-personal identity intersections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Palliative care nurse practitioners may sustain professional meaning while also carrying substantial depressive symptom burden. Institutional responses should move beyond informal self-care and include structured reflective support, mental health monitoring, and workforce policies that acknowledge the emotional consequences of repeated exposure to dying.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23779608261459577","type":"journal-article","created":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:04:17Z","timestamp":1780963457000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Psychological Well-Being, Depressive Symptoms, and Death-Related Meaning Among Palliative Care Nurse Practitioners in Israel: A Mixed-Methods Study"],"prefix":"10.1177","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8470-8710","authenticated-orcid":false,"given":"Anat","family":"Romem","sequence":"first","affiliation":[{"name":"Hadassah, The Hebrew University of Jerusalem"},{"name":"Complex care unit, Herzog Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilly","family":"Pelleg","sequence":"additional","affiliation":[{"name":"Health Systems Management, The Max Stern Yezreel Valley College, Mizra, D.N. 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