Burnout in cancer professionals: a systematic review and meta-analysis

COVID-19 pandemisinin ilk dalgasında sağlık çalışanlarının tükenmişliği: meta analiz

conditions during the COVID-19 pandemic, threaten the lives and physical well-being of healthcare workers (HCWs), and also their mental health, such as burnout, etc. which is often neglected. The aim of this review is to analyze published studies on the proportion of burnout among HCWs during the first wave of the COVID-19. Materials and Methods: We conducted a systematic review of studies that reported burnout (measured by Maslach Burnout Inventory) among HCWs during the COVID-19 pandemic and searched PubMed, PsycINFO, and WOS of relevant articles up to Feb 25th, 2021. Out of 145 non-duplicate studies, 10 were included in the meta-analysis. Results: The overall estimated pooled proportion for emotional exhaustion (EE) was 31% (95% CI: 24%-40%), for depersonalization (DP) was 28% (95% CI: 23%-38%) and 22% (95% CI: 13%-34%) for personal accomplishment (PA). The results show that in countries where the number of cases is high and the number of beds and doctors is low, the level of EE appears to be slightly lower and PA is slightly higher. However, there were no significant differences according to subgroup analyses. Conclusion: Evidence from early studies highlight the fact that a significant proportion of HCWs suffers from burnout during this pandemic. It will be necessary to pay close attention to HCWs' mental health and identify ways to reduce risks and prepare a rehabilitation program for the HCWs during and after the pandemic.

Cross-sectional study to evaluate burnout among pharmacy staff in Saudi Arabia during COVID-19 pandemic

Background

Methods

Results

Conclusions

Issues of mindfulness implementation for oncology caregivers

OBJECTIVES

Burn out is high in oncology. We aim to evaluate the feasibility and identify the barriers for mindfulness implementation in oncology professionals.

METHODS

We conducted a pilot study in which voluntary oncology caregivers entered mindfulness workshops, and complete online questionnaires. We also conducted a qualitative study to better identify the practical reasons which hamper the implementation of mindfulness in oncology caregivers having refused to participate.

RESULTS

83.3% of volunteers for the workshops were women, 60.00% (16/30) of caregivers completed the program. Caregivers' resistances to mindfulness practice were: a lack of availability and information, complex organisation with limited free time, and accept spending time to take care of themselves.

CONCLUSIONS

This work highlights the interest of mindfulness for caregivers in oncology, we have identified specific issues hindering the implementation of such technique which can be further investigated.

Apheresis physician well-being during the COVID-19 pandemic: Results of a survey

Background

The COVID‐19 pandemic has placed additional stressors on physician lives. In this study, we report findings from a survey conducted among attending physician (AP) members of the American Society for Apheresis (ASFA) to elucidate the status of their well‐being during the COVID‐19 pandemic as well as resources provided or actions taken by their institutions and themselves personally to maintain or improve their well‐being.

Study Design and Methods

A 17‐question, voluntary, IRB‐approved survey regarding well‐being was distributed to the ASFA AP members between August 26, 2020 and September 16, 2020. The descriptive analyses were reported as number and frequency of respondents for each question. Non‐parametric chi‐square tests, ANOVA, and paired t‐tests were performed to determine differences in categorical variables, changes in well‐being scores, and compare time points, respectively.

Results

Based on the responses of 70 attending level physicians representing the United States (U.S., 53, 75.7%) and outside the U.S. (17, 24.3%), the following were observed: (1) COVID‐19 negatively affects the well‐being of a sub‐population of APs, (2) neither institutional nor individual measures to improve well‐being completely resolved the problem of decreased AP well‐being during the pandemic, and (3) personal actions may be superior to institutional resources.

Conclusion

There is a widespread decline in AP well‐being during the COVID‐19 pandemic that was not adequately improved by institutional or personal resources/actions taken. Institutions and physicians must work together to implement strategies including resources and actions that could further improve AP physician well‐being during a public health crisis.

The Relationship Between Present-Centered Awareness and Attention, Burnout, and Compassion Fatigue in Oncology Health Professionals

Objectives

Oncology health professionals experience high levels of burnout and compassion fatigue, affecting their health and the care they provide. This study aimed to establish whether present-centered awareness and attention (a component of mindfulness) is uniquely associated with burnout and compassion fatigue in oncology professionals.

Methods

An international sample of oncology professionals (n = 118) completed an online questionnaire with validated measures of present-centered awareness and attention, empathy, compassion fatigue, and burnout. Hierarchical multiple regressions were used to model relations among the independent variable (present-centered awareness and attention) and the criterion variables of burnout (disengagement, exhaustion) and compassion fatigue (compassion satisfaction, compassion burnout, secondary traumatic stress) after statistically controlling for empathy, age, gender, years of experience, and patient contact hours.

Results

Mean hours of patient contact per week was 23.52 (SD = 13.62), with 26 (22.03%) reporting 40 h or more. Higher hours of patient contact per week were positively associated with secondary traumatic stress. Present-centered awareness and attention was associated with lower disengagement, lower emotional exhaustion, higher compassion satisfaction, lower secondary traumatic stress, and lower compassion burnout. In each model, present-centered awareness accounted for unique variance after controlling for age, gender, years of experience, patient contact hours per week, and empathy scores. The amount of unique variance accounted for by present-centered awareness ranged from 4 to 10%.

Conclusions

Oncology professionals reporting higher levels of present-centered awareness and attention reported higher compassion satisfaction and lower secondary traumatic stress, compassion burnout, exhaustion, and disengagement. Promoting present-centered awareness may be a mechanism that contributes to less burnout in oncology professionals.

Prevalence of burnout among healthcare professionals at the Serbian National Cancer Center

OBJECTIVE

The aim of this study was to investigate the level of burnout and identify who is at highest risk among healthcare professionals (HCPs) working at the largest referent national institution.

METHODS

A cross-sectional survey was conducted at the Institute of Oncology and Radiology of Serbia from May 2019 to July 2019, evaluating the level of burnout, depression, fatigue, socio-demographic, behavioral and professional characteristics, and quality of life among healthcare professionals. Of the 576 distributed questionnaires among physicians, nurses/technicians and healthcare coworkers, 432 participants returned their questionnaires (75%). All instruments used in our study had been validated and cross-culturally adapted to Serbian language.

RESULTS

The overall prevalence of burnout was 42.4%, with the greatest proportion of burned out in emotional exhaustion domain (66.9%). The multivariable-adjusted model analysis showed that nurses/technicians had a 1.41 times greater chance of experiencing burnout, compared to physicians (OR = 1.41, 95% CI 1.16-7.10), and that with each year of work experience, the chance of burnout increased by about 2% (OR = 1.02, 95% CI 1.00-1.92). Furthermore, it was shown that, with each point in the PHQ-9 score for depression, probability of burnout increased by 14% (OR = 1.14, 95% CI 1.07-1.94). Finally, after controlling all these potential confounders, the Mental Composite Score of SF-36 score showed an independent prognostic value in exploring the burnout presence among HCPs (OR = 1.17, 95% CI 1.03-2.47).

CONCLUSION

Our research showed a significant level of burnout among healthcare professionals working in oncology, especially among nurses/technicians. The development of effective interventions at both individual and organizational level toward specific risk groups is needed.

Influence of Burnout and Feelings of Guilt on Depression and Health in Anesthesiologists

Background and objective: The WHO has included burnout as an occupational phenomenon in the ICD-11. According to the WHO, burnout is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. The study aimed to evaluate the influence of feelings of guilt and burnout on health in Polish anesthesiologists. Alcohol and tobacco intake, psychosomatic disorders, and depression were assessed. Methods: The study had a non–randomized cross-sectional character. The sample consisted of 372 Polish anesthesiologists. Burnout was measured by the Spanish burnout inventory. Results: Post hoc analysis for burnout consequences: depression (F_(5,366) = 17.51, p < 0.001, η_p² = 0.193), psychosomatic disorders (F_(5,366) = 13.11, p < 0.001, η_p² = 0.152), and tobacco intake (F_(5,366) = 6.23, p < 0.001, η_p² = 0.078), showed significant differences between burnout with and without the highest levels of feelings of guilt. All the instruments applied were reliable. Conclusions: Depression, psychosomatic disorders, and alcohol and tobacco intake are suspected to be consequences of the highest guilt levels related to burnout, i.e., Profile 2 according to the burnout model of Gil-Monte. Participation in prevention programs is recommended for these cases.

Interrelation between defensive mechanisms and coping strategies in psychiatry trainees in Romania: a multicenter study

BACKGROUND

The challenges faced by professionals when working in the field of psychiatry require the development of adequate defensive and coping mechanisms. This study aimed to explore both coping strategies and defense mechanisms and their relationship in psychiatry trainees in Romania.

METHODS

A cross-sectional study was conducted to determine and evaluate both defensive and coping mechanisms of Romanian psychiatry trainees. Defensive Style Questionnaire-60 and COPE scale were applied to psychiatry trainees from five training centers in Romania. By applying structural equation modeling, models that presumed the existence of relationships between coping strategies and defensive mechanisms were analyzed.

RESULTS

Superior defense mechanisms and task-oriented coping strategies were the commonly used approaches by psychiatry trainees. Furthermore, significantly consistent correlations (ranging from 0.2 to 0.5) between adaptive defense mechanisms and coping strategies focused on the problem or emotion were shown. Similarly, avoidant coping strategies correlated with non-adaptive defense mechanisms (correlations between 0.3 and 0.5). Our model presented good fit indices (X 2(34) = 64.324, p < 0.001; GFI = 0.93; root mean square error = 0.08). Moreover, the results indicated a weak association between the two types of adaptive processes (r = 0.07, p < 0.001).

CONCLUSION

Psychiatry trainees present a profile based on two independent groups of adaptation processes, namely, adaptive defenses and problem-oriented coping scales and non-adaptive defenses and avoidant coping scales.

Hospice Employees' Perceptions of Their Work Environment: A Focus Group Perspective

Burnout in healthcare professionals can lead to adverse effects on physical and mental health, lower quality of care, and workforce shortages as employees leave the profession. Hospice professionals are thought to be at particularly high risk for burnout. The purpose of the study was to evaluate workplace perceptions of interdisciplinary hospice care workers who provide care to patients at end of life. Six focus groups and one semi-structured interview were conducted with mixed group of social workers, managers, nurses, hospice aides, chaplains, support staff, and a physician (n = 19). Findings from the groups depicted both rewards and challenges of hospice caregiving. Benefits included intrinsic satisfaction from the work, receiving positive patient and family feedback, and teamwork. Challenges reflected issues with workload, technology issues, administrative demands, travel-related problems, communication and interruptions, difficulties with taking time off from work and maintaining work-life integration, and coping with witnessing grief/loss. Hospice workers glean satisfaction from making meaningful differences in the lives of patients with terminal illness and their family members. It is an expected part of the job that certain patients and situations are particularly distressing; team support and targeted grief support is available for those times. Participants indicated that workload and administrative demands rather than dealing with death and dying were the biggest contributors to burnout. Participants reported episodic symptoms of burnout followed by deliberate steps to alleviate these symptoms. Notably, for all except one of the participants, burnout was cyclical. Symptoms would begin, they would take steps to deal with it (e.g., taking a mental health day), and they recovered. At an organizational level, a multipronged approach that includes both personal and occupational strategies is needed to support professional caregivers and help mitigate the stressors associated with hospice work.

Personalized Nursing: How Life Satisfaction and Occupational Burnout Influence New Competences of Polish Nurses

Nursing around the world is developing very dynamically and nurses are undertaking increasingly complex tasks. The extension of entitlements for nurses in Poland in the area of writing prescriptions and referrals for diagnostic tests seems to be a response to the development and changes occurring in this profession. This will improve the standards of patient care, increase access to medical services and improve the professional status of this group. The aim of this study was to analyze the opinions of nurses regarding their preparedness for administering prescriptions and referrals for diagnostic tests depending on their sense of life satisfaction and the level of occupational burnout. The study was conducted among primary care nurses using a survey technique, using a standardized scale of life satisfaction and a scale to measure burnout. In addition, this study used a proprietary survey questionnaire containing questions regarding the self-assessment of preparedness for new competences. The results showed that nurses do not feel well prepared for new tasks. The levels of life satisfaction and burnout of the nurses surveyed significantly influenced confidence regarding their preparedness for writing prescriptions and referrals for diagnostic tests. Polish nurses have a very cautious attitude towards new competences. However, this is a breakthrough and the first step towards approving the role of an advanced practice nurse in our country.

A critical ethnographic evaluation of pediatric haematology/oncology physicians and burn-out

This qualitative study aims to ascertain what it is that affects pediatric hematology/oncology physicians professional and personal attitudes within their work environment. This research is based in one pediatric oncology unit in western Canada using a critical ethnographic research approach. Critical ethnography was the methodology used to conduct this study. Critical Ethnography (CE) is an interpretative research methodology that allows the researcher to evaluate the cultural aspects of a group, or an organization 'within their setting'; to understand and expose the meaning of the relationships in that environment; without meaning being imposed on them externally. 11 physicians (N = 11) participated in this study, this represents approximately 80% of the physician population in this unit. Semi-structured interviews were conducted which lasted an average of 36 minutes per interview. Physicians described their relationships with colleagues, patients and families as both rewarding but also producing symptoms of burn-out. The majority agreed that they enjoy their job because of the constantly evolving research and scientific updates in oncology research. There is a paradox of conflicting satisfiers and dissatisfiers mainly pertaining to patient, parent, physician relationships. Consideration to offering sabbatical leave should be assessed.

Prevalence and Factors Associated with Burnout among Healthcare Professionals in India: A Systematic Review and Meta-Analysis

BACKGROUND

With increasing workload and dismal working conditions, healthcare professionals (HCPs) in India often suffer from burnout. Understanding the extent of these problems and the contributing factors is necessary to build a healthy workforce capable of serving the society. The purpose of this study was to systematically review and analyze: 1) the prevalence of burnout among HCPs in India and 2) the factors associated with burnout in this population.

METHODS

A systematic search of MEDLINE and EMBASE, from the inception of these databases to October 2019, was conducted using keywords. The search results were screened to identify studies evaluating burnout among HCPs in India using a standard burnout tool. Using a random effect model, the pooled prevalence of burnout was estimated using Maslach Burnout Inventory (MBI) in three domains: emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA). Risk factors for burnout were assessed qualitatively.

RESULTS

A total of 15 studies assessing burnout in 3845 Indian HCPs were identified. The pooled prevalence of burnout was 24% in the EE domain, 27% in the DP domain, and 23% in the PA domain. Younger age, female gender, unmarried status, and difficult working conditions were associated with increased risk of burnout.

CONCLUSION

Burnout is highly prevalent among Indian HCPs, with close to one-fourth of them suffering from burnout. A number of personal and professional factors are associated with burnout, and these should be considered while developing solutions to tackle burnout.

Occupational Burnout Syndrome in Polish Physicians: A Systematic Review

Due to the nature of their work, physicians are exposed to chronic stress. This may potentially lead to the widespread occurrence of occupational burnout syndrome (BS). The aim of this systematic review study was to summarize available published data concerning the prevalence of BS in Polish doctors. The literature search was performed using the following databases: PubMed/MEDLINE, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL) and Google Scholar. The last search was performed on September 27th, 2019. Only articles in English or Polish on graduated doctors practicing in Poland were taken into account. All types of original research were considered eligible. However, review articles, book chapters, case reports, case series, conference papers, study protocols and articles in languages other than English and Polish were excluded. There were no restrictions on age, seniority or specialty of study participants. The literature search revealed a total of 21 studies that met the inclusion criteria. The results of individual studies were very diverse, which makes it difficult to draw specific conclusions. However, the problem of burnout among Polish doctors is valid and worth special attention from society, health policy leaders, and doctors themselves. High-quality research is essential to for a better understanding of this topic.

Burnout among healthcare providers in the complex environment of the Middle East: a systematic review

BACKGROUND

Burnout is a syndrome characterized by emotional exhaustion, increased depersonalization, and a diminished sense of personal accomplishment due to chronic emotional stress at work. Burnout impacts job satisfaction, job performance, vulnerability to illnesses, and interpersonal relationships. There is a gap in the systematic data on the burden of burnout among healthcare professionals from different sectors of healthcare in Middle Eastern countries. Our objective was to examine the burden of burnout among healthcare providers in the Middle East, how it was assessed, which sectors were included, and what interventions have been used.

METHODS

Articles were found through a systematic review of search results including PubMed, Web of Science (Thomson Reuters), and PsycINFO (EBSCO) using search terms reflecting burnout in Middle Eastern countries among populations of healthcare providers. Studies were included if they examined a quantitative measure of burnout among healthcare providers in the Middle East.

RESULTS

There were 138 articles that met our inclusion criteria for this systematic review. Studies focused on burnout in the Middle East among physicians (N = 54 articles), nurses (N = 55), combined populations of healthcare workers (N = 22), and medical students (N = 7). The Maslach Burnout Inventory was the most common tool to measure burnout. Burnout is common among physicians, nurses, and other healthcare professionals, with prevalence estimates predominantly ranging between 40 and 60%. Burnout among healthcare providers in the Middle East is associated with characteristics of their work environments, exposure to violence and terror, and emotional distress and low social support.

CONCLUSIONS

Burnout is highly prevalent among healthcare providers across countries in the Middle East. Previous studies examining burnout in this region have limitations in their methodology. More thoroughly developed epidemiologic studies of burnout are necessary. Health system strengthening is needed in a region that has endured years of ongoing conflict, and there is an urgency to design and implement programs that tackle burnout among health professionals.

The Impact of Fellowship in Dietetics on Clinical Practice

Medical nutrition therapy (MNT) in pediatric cancer treatment is essential. The Nutrition Department and the International Outreach Program at St. Jude Children's Research Hospital in Memphis, TN have worked together from 2005 to 2013 to develop and implement a training program for international dietitians working with pediatric oncology patients. During that time, St. Jude hosted 15 dietitians from various countries for this 3-week-long program. The curriculum provided experience in nutrition risk screening, nutrition care process, nutrition for cancer prevention, palliative care, and exposure to nutrition support. Monthly online meetings were established through the Cure4Kids website to continue collaboration and training. Learning outcomes were developed, and the impact of the program was evaluated based on changes made by former fellows in clinical practice, research, management, and food service upon return to their country. In addition, the program was evaluated based on recognition by the medical team, professional growth/networking, and personal growth. The survey return rate was 100%: responses revealed that 80% of participants continued working in pediatric oncology, 67% participated in monthly meetings, 47% collaborated on research, 100% advanced their competency in clinical practice, 93% broadened their competency in research, 67% became increasingly competent in management, 60% implemented changes in food service, 100% were recognized for participating in the program, and 100 and 93% noted that participation in the fellowship program helped their professional and personal growth, respectively. The psychological impact of the training on healthcare providers was as important as the impact of the program on patient care.

Burnout Syndrome in Physicians-Psychological Assessment and Biomarker Research

Background and objectives: Burnout is a syndrome typically occurring in work environments with continuous and chronic stress. Physicians are at increased risk for burnout, as a result of 24-h work, delayed work–life balance gratification, and the challenges associated with patient care. The aim of the present study was to evaluate the psychological parameters of burnout symptoms in relation to biomarkers of stress among physicians with different medical specialties. Materials and methods: A total of 303 physicians were contacted as potential participants. A comparison group of 111 individuals working outside medicine was used as a control to verify the results. The physicians were specialists in internal medicine, general surgery, pathology, and primary care. Serum cortisol, salivary cortisol, adrenocorticotropic hormone (ACTH), insulin (IRI), and prolactin levels were analyzed by chemiluminescence enzyme immunoassay (Access 2, Beckman Coulter). Fasting glucose in serum and glycated hemoglobin (HbA1C) in whole blood were measured using the automatic analyzer AU 480 Beckman Coulter system. Symptoms of burnout were measured with the Maslach Burnout Inventory (MBI). Results: The group with burnout presented significantly higher levels of serum and saliva cortisol, ACTH, prolactin, fasting glucose, and HbA1C compared with the control group. The correlation analysis between biomarkers showed a positive correlation with moderate strength between serum and saliva cortisol (r = 0.516, p = 0.01),as well as serum and saliva cortisol with ACTH (r = 0.418; r = 0.412, p = 0.01) and HbA1C (r = 0.382; r = 0.395, p = 0.01). A weak positive correlation was found between serum and saliva cortisol with prolactin (r = 0.236; r = 0.267, p < 0.01) and glucose (r = 0.271; r = 0.297, p < 0.01). In the multiple logistic regression model, saliva cortisol, HbA1C, and age were significantly associated with burnout (chi-square = 16.848, p < 0.032). Conclusion: Our findings demonstrated the interest of exploring biomarkers of stress related to burnout in health professionals.

Burnout Syndrome Among Primary Care Physicians in Oman

Objectives

Medical professionals are exposed to many job stressors everyday, which can lead to psychological disturbances as well as burnout syndrome. We sought to assess the level of burnout among primary care physicians (PCPs) in Oman and explore risk factors for its development.

Methods

We conducted a cross-sectional, analytical study among a random cluster sample of 190 PCP working in Muscat, Oman. Indices of burnout (emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA)) were noted using the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). We also used a questionnaire to obtain sociodemographic and job characteristics data. We used a binary logistic regression model and both unadjusted and adjusted odds ratios for statistical analysis.

Results

The prevalence of burnout in all three dimensions was 6.3%. High levels of MBI-HSS subscales were reported on EE, DP and PA with 17.8%, 38.2%, and 21.5%, respectively. Logistic regression analysis revealed that working over 40 hours per week was the most important risk factor for burnout among PCPs.

Conclusions

A total of 6.3% of PCPs working in urban areas in Oman suffered burnout. Long working hours was strongly associated with high occupational burnout. Solutions to eliminate or decrease the rate of burnout involve institutional changes, primarily respecting weekly working hours, and in more severe cases psychotherapy help is very important.

Burnout in oncologists and associated factors: A systematic literature review and meta-analysis

BACKGROUND

Oncologists may be particularly at risk of burnout. This systematic literature review and meta-analysis explores the prevalence of burnout and associated factors in oncologists.

METHODS

The authors assessed 26 studies that utilised the Maslach Burnout Inventory (MBI) tool to measure burnout. Pooled prevalence rates were calculated via meta-analysis (MetaXL) using random effects models.

RESULTS

Approximately 5,768 oncologists provided burnout data. A significant number experience burnout as highlighted by the pooled prevalence rates for MBI subscales of: emotional exhaustion at 32%; depersonalisation at 24%; and low personal accomplishment at 37%. Eighteen of the studies reported factors found to be significantly associated with high levels of burnout in oncology physicians. These were grouped into demographic differences, individual factors and work factors.

CONCLUSION

Burnout was found to affect a significant proportion of oncologists. Burnout was associated with being single, being younger in age, reduced psychological well-being, difficulties outside of work, workplace demands and workplace stress. Burnout has considerable implications for oncology physicians and patient safety. Further insight into individual factors, and factors associated with lower burnout would be beneficial.

An Explanatory Model of Potential Changes in Burnout Diagnosis According to Personality Factors in Oncology Nurses

Burnout in a hospital oncology service takes place when there is a high level of interaction between nurses and patients. The aim of the present study is to identify models that will enable us to accurately classify a person at a given level within each of the three dimensions of burnout, according to the values presented for personality related explanatory variables, for a sample of 96 oncology nurses working in the regional health service of Andalusia (Spain). A quantitative, crosscutting, multicentre, descriptive study was designed, and for this purpose data on sociodemographic and personality variables and on the three dimensions of burnout were compiled. Three categorical-response logit ordinal models were used and the prognostic ratios for each level were obtained, with respect to every other level, according to possible changes in the explanatory variables considered. Certain personality factors are associated with one or more dimensions of burnout syndrome. Thus, nurses are more likely to develop high levels of burnout if they present high levels of neuroticism and low levels of friendliness and responsibility. Further research in this field is needed to confirm and extend these findings.

Readiness of Polish Nurses for Prescribing and the Level of Professional Burnout

Those in the medical profession, due to close contact and the emotional commitment of caring for patients, are particularly vulnerable to the occurrence of a phenomenon known as occupational ‘burnout’. The presented work deals with the problem of burnout and its relationship with new tasks undertaken by nurses. The aim of the study was an analysis of the relationship between the level of professional burnout of the nurses examined and their readiness to take on new duties related to writing prescriptions. The study was conducted among primary health care (PHC) and outpatient specialist care (OSC) nurses. The author’s questionnaire and the standardized Link Burnout Questionnaire (LBQ) were used. The highest level of occupational burnout was related to psychophysical exhaustion (16.00 ± 6.21). Higher results of occupational burnout among the nurses surveyed were matched by the lower readiness of the nurses to administer medicines and write prescriptions.

Can Schwartz Center Rounds support healthcare staff with emotional challenges at work, and how do they compare with other interventions aimed at providing similar support? A systematic review and scoping reviews

OBJECTIVES

(i) To synthesise the evidence-base for Schwartz Center Rounds (Rounds) to assess any impact on healthcare staff and identify key features; (ii) to scope evidence for interventions with similar aims, and compare effectiveness and key features to Rounds.

DESIGN

Systematic review of Rounds literature; scoping reviews of comparator interventions (action learning sets; after action reviews; Balint groups; caregiver support programme; clinical supervision; critical incident stress debriefing; mindfulness-based stress reduction; peer-supported storytelling; psychosocial intervention training; reflective practice groups; resilience training).

DATA SOURCES

PsychINFO, CINAHL, MEDLINE and EMBASE, internet search engines; consultation with experts.

ELIGIBILITY CRITERIA

Empirical evaluations (qualitative or quantitative); any healthcare staff in any healthcare setting; published in English.

RESULTS

The overall evidence base for Rounds is limited. We developed a composite definition to aid comparison with other interventions from 41 documents containing a definition of Rounds. Twelve (10 studies) were empirical evaluations. All were of low/moderate quality (weak study designs including lack of control groups). Findings showed the value of Rounds to attenders, with a self-reported positive impact on individuals, their relationships with colleagues and patients and wider cultural changes. The evidence for the comparative interventions was scant and also low/moderate quality. Some features of Rounds were shared by other interventions, but Rounds offer unique features including being open to all staff and having no expectation for verbal contribution by attenders.

CONCLUSIONS

Evidence of effectiveness for all interventions considered here remains limited. Methods that enable identification of core features related to effectiveness are needed to optimise benefit for individual staff members and organisations as a whole. A systems approach conceptualising workplace well-being arising from both individual and environmental/structural factors, and comprising interventions both for assessing and improving the well-being of healthcare staff, is required. Schwartz Rounds could be considered as one strategy to enhance staff well-being.

Burnout among Lebanese Oncologists: Prevalence and Risk Factors

Background:

Burnout syndrome (BOS) is defined as a work-related psychological state characterized by emotional exhaustion, depersonalization, and low sense of personal accomplishment. Despite the extensive data on physician burnout, studies assessing the prevalence of burnout among oncologists in the Middle East and especially Lebanon are lacking. Our main objective was to determine this prevalence as well as identify potential factors associated with the development of burnout.

Methods:

This was a cross-sectional study conducted among medical, surgical, and radiation oncologists attending several Continuing Medical Education (CME) activities in Lebanon over the course of a three month period. Participants were asked to complete a self-administered questionnaire composed of socio-demographic and work characteristics, as well as the Maslach Burnout Inventory- Human Service Survey (MBI-HSS).

Results:

A total of 51 oncologists completed the survey. Medical oncologists constituted the majority (84.3%), followed by surgical oncologists (9.8%) and radiation oncologists (5.9%). Approximately 47.1% of our sample had a high burnout level in at least one of the domains. 33.3% of oncologists exhibited high emotional exhaustion (EE) scores, 19.6% demonstrated low personal accomplishment (PA) scores, and 13.7% displayed high depersonalization (DP) scores. There was no statistically significant association between overall burnout level and any of the demographic or work characteristics. However, age was significantly associated with EE (p=0.03), while DP scores were significantly associated with the number of patients seen daily (p=0.028).

Conclusion:

Burnout is common among cancer professionals in Lebanon. Future research is needed to explore the problem in depth and suggest effective preventive approaches.

Preventing work-related stress among staff working in children's cancer Principal Treatment Centres in the UK: a brief survey of staff support systems and practices

Growing evidence of the association between health professionals' well-being and patient and organisational outcomes points to the need for effective staff support. This paper reports a brief survey of the UK's children's cancer Principal Treatment Centres (PTCs) regarding staff support systems and practices. A short on-line questionnaire, administered in 2012-2013, collected information about the availability of staff support interventions which seek to prevent work-related stress among different members of the multi-disciplinary team (MDT). It was completed by a member of staff with, where required, assistance from colleagues. All PTCs (n = 19) participated. Debriefs following a patient death was the most frequently reported staff support practice. Support groups were infrequently mentioned. There was wide variability between PTCs, and between professional groups, regarding the number and type of interventions available. Doctors appear to be least likely to have access to support. A few Centres routinely addressed work-related stress in wider staff management strategies. Two Centres had developed a bespoke intervention. Very few Centres were reported to actively raise awareness of support available from their hospital's Occupational Health department. A minority of PTCs had expert input regarding staff support from clinical psychology/liaison psychiatry.

Burnout syndrome and coping strategies in Portuguese oncology health care providers

BACKGROUND

Burnout is a multidimensional syndrome and includes symptoms of emotional exhaustion, depersonalization, and reduced personal accomplishment at work. Oncology health care providers are at high risk to develop symptoms of burnout because of work-related stressors. Adaptive coping strategies adopted to deal with stressors may prevent the development of burnout.

OBJECTIVE

The present study aims to assess the association between burnout, functional coping strategies, and occupational factors in a sample of oncology providers, mostly nurses.

METHODS

Sociodemographic Questionnaire, the Maslach Burnout Inventory, and the Problem Solving Inventory "Inventário de Resolução de Problemas" were administered. Descriptive, correlational, and linear regression analyses were performed.

RESULTS

The study showed that emotional exhaustion correlated with lower levels of adaptive coping, less years of experience in Oncology, and a greater amount of hours worked per week. Personal accomplishment was associated with the adaptive coping strategies. No further statistically significant associations were identified.

DISCUSSION

Our findings support the importance of adaptive coping strategies in order to prevent symptoms of burnout when health professionals face potentially stressful occupational factors. Training aimed at improving adaptive coping skills may prevent burnout syndrome for health care professionals working in Oncology.

Coping and resiliency enhancement program (CARE): a pilot study for interpreters in cancer care

OBJECTIVE

There is a growing demand for interpreters in the cancer setting. Interpreters, the link to quality care for limited English proficiency patients, face many psychosocial stressors in their work. This project assessed interpreters' experiences of stress and piloted a resiliency program to help interpreters cope with stressors.

METHODS

From 2013 to 2014, we pilot tested a targeted resiliency program with interpreters from three Boston-based hospitals. In Phase 1, we conducted five focus groups (n = 31) to identify interpreters' psychosocial needs. In Phase 2, we developed and tested a 4-h group program with 29 interpreters (response rate = 90%; 69% female, 54% Hispanic, 85% born outside of the U.S.).

RESULTS

Phase 1. Stressors were patient-based (seeing young patients decline), interactions with medical team (unsure of role), and systems-based (appointment unpredictability). Phase 2. At baseline interpreters reported low abilities to cope with stress (measured by the Measure of Current Status (MOCS-A)). At 4-week follow-up we found improvements in job satisfaction (p = .02; Cohen's d = .41) and declines in sick days (p = .08; Cohen's d = .38). Stress reactivity (MOCS-A) improved; specifically participants reported feeling more assertive about their needs (p = .10; Cohen's d = .30) and more able to relax at will (p = .10; Cohen's d = .35)-important mechanisms to lower distress.

CONCLUSIONS

We piloted a resiliency program for medical interpreters in cancer care. We found that interpreters experience distress and have low coping skills. This program resulted in improved work factors and stress reactivity. Future research should include further implementation and testing in a larger, randomized trial.Copyright © 2016 John Wiley & Sons, Ltd.

Prevalence of and factors associated with burnout among health care professionals in Arab countries: a systematic review

BACKGROUND

Burnout among healthcare professionals is one of the key challenges affecting health care practice and quality of care. This systematic review aims to (1) estimate the prevalence of burnout among health care professionals (HCP) in Arab countries; and (2) explore individual and work-related factors associated with burnout in this population.

METHODS

Multiple electronic databases were searched for studies published in English or Arabic from January 1980 to November 2014 assessing burnout (using the Maslach Burnout Inventory; MBI) amongst health care professionals (HCP) in Arab countries.

RESULTS

Nineteen studies (N = 4108; 49.3% females) conducted on HCP in Bahrain, Egypt, Jordan, Lebanon, Palestine, Saudi Arabia and Yemen were included in this review. There was a wide range of prevalence estimates for the three MBI subscales, high Emotional Exhaustion (20.0-81.0%), high Depersonalization (9.2-80.0%), and low Personal Accomplishment (13.3-85.8%). Gender, nationality, service duration, working hours, and shift patterns were all significantly associated with burnout.

CONCLUSIONS

Within the constraints of the study and the range of quality papers available, our review revealed moderate-to-high estimates of self-reported burnout among HCP in Arab countries that are similar to prevalence estimates in non-Arabic speaking westernized developed countries. In order to develop culturally appropriate interventions, further research using longitudinal designs is needed to confirm the risk factors for burnout in specific HCP settings and specialties in Arab countries.

Oncologists' negative attitudes towards expressing emotion over patient death and burnout

PURPOSE

The aims of this study were to examine the relationship between negative attitudes towards expressing emotion following patient death and burnout in oncologists and to explore oncologists' preferences for institutional interventions to deal with patient death.

METHODS

The participants included a convenience sample of 177 oncologists from Israel and Canada. Oncologists completed a questionnaire package that included a sociodemographic survey, a burnout measure, a survey assessing negative attitudes towards expressing emotion, and a survey assessing desired interventions to cope with patient death. To examine the association between burnout and negative attitudes while controlling for the effect of sociodemographic variables, a hierarchical linear regression was computed.

RESULTS

Higher burnout scores were related to higher negative attitudes towards perceived expressed emotion (partial r = .25, p < .01) of those who viewed this affect as a weakness and as a sign of unprofessionalism. Approximately half of the oncologists found each of the five categories of institutional interventions (pedagogical strategies, emotional support, group/peer support, taking time off, and research and training) helpful in coping with patient death.

CONCLUSIONS

Our findings suggest that high burnout scores are associated with negative attitudes towards expressing emotion and that there is a wide variation in oncologist preferences in coping with patient death. Institutions should promote interventions that are varied and that focus on the needs of oncologists in order to reduce burnout. Interventions that legitimize expression of emotion about patient death may be useful. Another way to reduce stigma would be to require oncologists to "opt out" rather than "opt in" to accessing a selection of social and/or individual interventions.

Empathy, Burnout, Demographic Variables and their Relationships in Oncology Nurses

INTRODUCTION

Development of nurse-patient empathic communication in the oncology ward is of great importance for the patients to relieve their psychological stress, however, nursing care of cancer patients is accompanied with high stress and burnout. The present study aimed to define the level of empathy and its association with burnout and some demographic characteristics of oncology nurses.

MATERIALS AND METHODS

This descriptive/correlation study was conducted in a professional cancer treatment center in Isfahan. Through census sampling, 67 oncology nurses were selected. The data collection tools were Jefferson Scale of Nursing Empathy, Maslach Burnout Inventory, and demographic characteristics questionnaire.

RESULTS

Mean nurses' empathy and overall burnout scores were 62.28 out of 100 and 38.8 out of 100, respectively. Score of empathy showed an inverse correlation with overall burnout score (r = -0.189, P = 0.04), depersonalization (r = -0.218, P = 0.02), and personal accomplishment (r = -0.265, P = 0.01). Multiple regression test was used to detect which dimension of burnout was a better predictor for the reduction of empathy score. Results showed that the best predictors were lack of personal accomplishment (P = 0.02), depersonalization (P = 0.04), and emotional exhaustion (P = 0.14), respectively. The most influential demographic factor on empathy was work experience (r = 0.304, P = 0.004). One-way analysis of variance showed that official staff had a higher empathy score (f = 2.39, P = 0.045) and their burnout was lower (f = 2.56, P = 0.04).

CONCLUSIONS

Results showed a negative relationship between empathy and burnout in oncology nurses. Therefore, nursing support from managers to reduce burnout increases empathic behavior of nurses.

Resilience and burnout status among nurses working in oncology

BACKGROUND

This study aimed to identify the resilience and burnout status of nurses working in the field of oncology.

METHODS

This descriptive study was conducted with 140 oncology nurses. The data were collected using a socio-demographic attributes form, Resilience Scale for Adults, and the Maslach's Burnout Inventory. Percentage ratios, mean and median values, Kruskal-Wallis test, Mann-Whitney U test, correlation analysis, and multiple stepwise linear regression analysis were used to evaluate the data.

RESULTS

The Maslach's Burnout Inventory total median score was 49.00. The emotional exhaustion median score was 24.00, the depersonalization median score was 9.00, and the personal accomplishment median score was 16.00. The Resilience Scale for Adults total median score was 134.00. The median resilience subscale scores, such as structural style, perception of future, family cohesion, self-perception, social competence, and social resources, were 16.00, 16.00, 24.00, 25, 23, and 31, respectively. A relationship existed between emotional exhaustion and perception of future; depersonalization and structured style and self-perception; and personal accomplishment and structured style, perception of future, and self-perception. Multiple stepwise linear regression analysis revealed a significant relationship between the number of years in the field and emotional exhaustion and depersonalization scores. Moreover, a significant relationship between structured style variables and personal accomplishment scores was observed.

CONCLUSIONS

This study demonstrated the relationship between burnout and resilience situations among the oncology nurses. The results can be used to plan individual and organizational interventions to increase resilience and reduce the experience of burnout by developing measures such as improving communication skills, providing education on stress management and coping strategies, using social resources, and organizing programs that provide psychological support.

Burnout, stress and satisfaction among Australian and New Zealand radiation oncology trainees

Introduction

To evaluate the incidence of burnout among radiation oncology trainees in Australia and New Zealand and the stress and satisfaction factors related to burnout.

Methods

A survey of trainees was conducted in mid‐2015. There were 42 Likert scale questions on stress, 14 Likert scale questions on satisfaction and the Maslach Burnout Inventory‐Human Services Survey assessed burnout. A principal component analysis identified specific stress and satisfaction areas. Categorical variables for the stress and satisfaction factors were computed. Associations between respondent's characteristics and stress and satisfaction subscales were examined by independent sample t‐tests and analysis of variance. Effect sizes were calculated using Cohens's d when significant mean differences were observed. This was also done for respondent characteristics and the three burnout subscales. Multiple regression analyses were performed.

Results

The response rate was 81.5%. The principal component analysis for stress identified five areas: demands on time, professional development/training, delivery demands, interpersonal demands and administration/organizational issues. There were no significant differences by demographic group or area of interest after P‐values were adjusted for the multiple tests conducted. The principal component analysis revealed two satisfaction areas: resources/professional activities and value/delivery of services. There were no significant differences by demographic characteristics or area of interest in the level of satisfaction after P‐values were adjusted for the multiple tests conducted. The burnout results revealed 49.5% of respondents scored highly in emotional exhaustion and/or depersonalization and 13.1% had burnout in all three measures. Multiple regression analysis revealed the stress subscales ‘demands on time’ and ‘interpersonal demands’ were associated with emotional exhaustion. ‘Interpersonal demands’ was also associated with depersonalization and correlated negatively with personal accomplishment. The satisfaction of value/delivery of services subscale was associated with higher levels of personal accomplishment.

Conclusions

There is a significant level of burnout among radiation oncology trainees in Australia and New Zealand. Further work addressing intervention would be appropriate to reduce levels of burnout.

"Burnout in Medical Oncology Fellows: a Prospective Multicenter Cohort Study in Brazilian Institutions"

Burnout syndrome is a common occurrence among oncologists. Doctors enrolled in residency programs in clinical oncology are exposed to similar risk factors; however, few data are available in this population. This study assessed the occurrence of burnout and associated factors among first-year residents at Brazilian institutions. The present prospective, multicenter, cohort study was conducted with doctors enrolled in residency programs in clinical oncology at Brazilian institutions affiliated with the public health system. The participants answered a sociodemographic questionnaire, the Maslach Burnout Inventory (MBI), Lipp's Stress Inventory, and the Beck Depression Inventory (BDI), upon admission to the program and 6 and 12 months later. Of 37 eligible residency programs in 2009, 11 (30.6 %) agreed to participate in the study. Fifty-four residents, representing 100 % of new admissions to the participating institutions, were included. Most of the participants met the criteria for severe burnout upon admission to the residency programs (emotional exhaustion in 49.0 % and depersonalization in 64.7 %). The scores on MBI domains emotional exhaustion and depersonalization increased significantly (p < 0.01) during the first year of residency, and the prevalence of burnout increased to 88 % at the end of that first year. The present study found a high prevalence of burnout among doctors enrolled in residency programs in clinical oncology at Brazilian institutions. A large fraction of the participants met the criteria for burnout syndrome upon admission to the program, which suggests that the problem began during the course of the previous residency program in internal medicine.

An exploration of the prevalence and predictors of work-related well-being among psychosocial oncology professionals: An application of the job demands-resources model

OBJECTIVE

Burnout is reportedly high among oncology healthcare workers. Psychosocial oncologists may be particularly vulnerable to burnout. However, their work engagement may also be high, counteracting stress in the workplace. This study aimed to document the prevalence of both burnout and work engagement, and the predictors of both, utilizing the job demands-resources (JD-R) model, within a sample of psychosocial oncologists.

METHOD

Psychosocial-oncologist (N = 417) clinicians, recruited through 10 international and national psychosocial-oncology societies, completed an online questionnaire. Measures included demographic and work characteristics, burnout (the MBI-HSS Emotional Exhaustion (EE) and Depersonalization (DP) subscales), the Utrecht Work Engagement Scale, and measures of job demands and resources.

RESULTS

High EE and DP was reported by 20.2 and 6.6% of participants, respectively, while 95.3% reported average to high work engagement. Lower levels of job resources and higher levels of job demands predicted greater burnout, as predicted by the JD-R model, but the predicted interaction between these characteristics and burnout was not significant. Higher levels of job resources predicted higher levels of work engagement.

SIGNIFICANCE OF RESULTS

Burnout was surprisingly low and work engagement high in this sample. Nonetheless, one in five psychosocial oncologists have high EE. Our results suggest that both the positive (resources) and negative (demands) aspects of this work environment have an on impact burnout and engagement, offering opportunities for intervention. Theories such as the JD-R model can be useful in guiding research in this area.

Burnout among psychosocial oncologists: an application and extension of the effort-reward imbalance model

OBJECTIVES

Burnout is a significant problem among healthcare professionals working within the oncology setting. This study aimed to investigate predictors of emotional exhaustion (EE) and depersonalisation (DP) in psychosocial oncologists, through the application of the effort-reward imbalance (ERI) model with an additional focus on the role of meaningful work in the burnout process.

METHODS

Psychosocial oncology clinicians (n = 417) in direct patient contact who were proficient in English were recruited from 10 international psychosocial oncology societies. Participants completed an online questionnaire, which included measures of demographic and work characteristics, EE and DP subscales of the Maslach Burnout Inventory-Human Services Survey, the Short Version ERI Questionnaire and the Work and Meaning Inventory.

RESULTS

Higher effort and lower reward were both significantly associated with greater EE, although not DP. The interaction of higher effort and lower reward did not predict greater EE or DP. Overcommitment predicted both EE and DP but did not moderate the impact of effort and reward on burnout. Overall, the ERI model accounted for 33% of the variance in EE. Meaningful work significantly predicted both EE and DP but accounted for only 2% more of the variance in EE above and beyond the ERI model.

CONCLUSIONS

The ERI was only partially supported as a useful framework for investigating burnout in psychosocial oncology professionals. Meaningful work may be a viable extension of the ERI model. Burnout among health professionals may be reduced by interventions aimed at increasing self-efficacy and changes to the supportive work environment.

Understanding individual resilience in the workplace: the international collaboration of workforce resilience model

When not managed effectively, high levels of workplace stress can lead to several negative personal and performance outcomes. Some professional groups work in highly stressful settings and are therefore particularly at risk of conditions such as anxiety, depression, secondary traumatic stress, and burnout. However, some individuals are less affected by workplace stress and the associated negative outcomes. Such individuals have been described as “resilient.” A number of studies have found relationships between levels of individual resilience and specific negative outcomes such as burnout and compassion fatigue. However, because psychological resilience is a multi-dimensional construct it is necessary to more clearly delineate it from other related and overlapping constructs. The creation of a testable theoretical model of individual workforce resilience, which includes both stable traits (e.g., neuroticism) as well as more malleable intrapersonal factors (e.g., coping style), enables information to be derived that can eventually inform interventions aimed at enhancing individual resilience in the workplace. The purpose of this paper is to introduce a new theoretical model of individual workforce resilience that includes several intrapersonal constructs known to be central in the appraisal of and response to stressors and that also overlap with the construct of psychological resilience. We propose a model in which psychological resilience is hypothesized to mediate the relationship between neuroticism, mindfulness, self-efficacy, coping, and psychological adjustment.

Embryologists' health: a nationwide online questionnaire

PURPOSE

The present study evaluates health status and its relation with occupational characteristics and with burnout syndrome among embryologists.

METHODS

A cross-sectional design was used to conduct an online self-assessment survey, sent to all members of the Spanish Association of Clinical Embryologists. The questionnaire contained occupational questions and two standard instruments: 'Short Form-12 Health Survey' as a measure of physical (PCS-12) and mental (MCS-12) health and the Maslach Burnout Inventory-General Survey (MBI-GS) to evaluate the degree of burnout.

RESULTS

The PCS-12 obtained for the Spanish embryologists was higher than that for the reference population. However, the total MCS-12 was significantly lower than that observed in non-institutionalised males and females representative of the general Spanish population aged 35-44 years. In the linear regression model, the dependent variable PCS-12 was related indirectly with the variables number of hours worked per week, BMI, back pain, leg pain and visual discomfort. In the linear regression model, the dependent variable MCS-12 was indirectly related to the gender (male reference; female coefficient regression: -3.23), exhaustion and cynicism dimensions of the MBI-GS. A total of 87 (36.3%) embryologists presented a high score on at least one of the MBI-GS dimensions.

CONCLUSION

In this sample of Spanish embryologists, a norm measure (SF-12) showed their physical health to be better than the average for the general population, but that their mental health was poorer. A significant indirect relation was observed between mental health and burnout syndrome. Strategies to reduce occupational stress and problems should form part of the training provided for clinical embryologists.

Teaching in relationship: the impact on faculty of teaching "the Healer's Art"

BACKGROUND

Medical teachers report both positive and negative experiences, but these impacts are not well understood. In particular, the experience of faculty in relationship-centered education is unknown.

PURPOSES

We sought to assess the benefits to teachers of the Healer's Art, a popular international medical school elective course.

METHODS

We performed quantitative and qualitative analyses of course evaluations completed by 2009-10 Healer's Art faculty from 17 schools.

RESULTS

Ninety-nine of 117 faculty (84.6%) completed the evaluation. No differences in quantitative responses based on gender, specialty, medical school, or year of graduation were observed. Respondents were likely or very likely to agree that the course was useful, positively impacted clinical work and teaching, and increased overall commitment to teaching. In describing the benefits of teaching in the Healer's Art, faculty emphasized four themes: Personal Response to Medicine, Professional Growth, Greater Connection, and Greater Empathy and Respect for Students.

CONCLUSIONS

Healer's Art faculty report personal and professional benefits, as well as increased commitment to teaching and to a relationship-centered educational process.

The "BUONGIORNO" project: burnout syndrome among young Italian radiation oncologists

Few data exist about the prevalence of burnout syndrome among young radiation oncologists. A national survey to assess its prevalence among junior members (under 40 yrs of age) of the Italian Society of Radiation Oncology was conducted. One hundred and twelve young radiation oncologists completed the questionnaire: the prevalence of burnout syndrome was 35%, and it was related to the presence of different personal, organizational, and work-related aspects, with an impact also on the private life (p<.005). Burnout syndrome is relatively common among young Italian radiation oncologists, and specific educational tools to help improve the management of workload and stress are needed.

The psychosocial work environment among physicians employed at Danish oncology departments in 2009. A nationwide cross-sectional study

Working as a physician at an oncology department has some distinctive characteristics that may lead to a stressful work environment. The present study was conducted to provide a nationwide description of the work conditions of all oncologists in Denmark. By comparing the results of the present study with those of a similar study carried out in 2006, the aim was furthermore to elucidate changes in the psychosocial work environment over time.

MATERIAL AND METHODS

From May to September 2009, 330 physicians employed at six oncology centres and seven community based oncology departments were invited to participate in a survey based on the short version of the COPSOQ II questionnaire. The results were compared with data from a representative section of Danish employees and with data from the 2006 survey.

RESULTS

Two hundred and twenty of the 330 invited physicians returned the questionnaire (response rate 67%). Concerning the aspects quantitative demands, work pace, emotional demands, influence, burnout and stress, the oncologists reported worse work conditions than the average Danish employee. However, with regard to possibilities for development, meaning of work and commitment to workplace, the oncologists reported better work conditions. Between 2006 and 2009, substantial improvement was seen concerning several of the assessed work environment aspects within the group of young physicians at the oncology centres.

CONCLUSION

Though substantial improvement of the work conditions has been achieved between 2006 and 2009, certain aspects of the psychosocial work environment at Danish oncology departments still require attention.

Compassion fatigue and burnout amongst clinicians: a medical exploratory study

BACKGROUND

Compassion fatigue is a broad term comprising of two components - burnout and secondary traumatic stress. The current study is aimed at identifying 'burnout' and 'compassion fatigue' among clinicians involved in care of individuals suffering from medical illness.

MATERIALS AND METHODS

A total of 60 clinicians were included in the study. A semi-structured questionnaire was administered to gather information related to personal, professional, anthropometric, and metabolic profile of the study participants. Professional Quality of Life Scale (ProQoL Version V) was used to assess burnout, compassion satisfaction and secondary traumatic stress. Analysis was carried out using the SPSS version 19.0.

RESULTS

The mean age of clinicians was 46.68±11.06 (range 26-67 years). Burnout score was significantly higher in those involved in diabetology practice. Similarly, compassion satisfaction score was greater among those with greater years of practice as well as among those in private practice. Clinicians who reported a poor working condition, as opposed to good, had more burnout and less compassion satisfaction.

CONCLUSION

The current study suggests that it is important to find out ways of decreasing burnout and compassion fatigue among clinicians.

Burden on oncologists when communicating the discontinuation of anticancer treatment

Objective

Communicating the discontinuation of anticancer treatment to patients is a difficult task. The primary aim of this study was to clarify the level of oncologist-reported burden when communicating about discontinuation of an anticancer treatment. The secondary aims were (i) to identify the sources of burden contributing to their levels and (ii) to explore the useful strategies to alleviate their burden.

Methods

A multicenter nationwide questionnaire survey was conducted on 620 oncologists across Japan (response rate, 67%).

Results

High levels of perceived burden were reported by 47% of respondents, and 17% reported that they sometimes, often or always wanted to stop oncology work because of this burden. There was a significant association between high levels of burden and: a feeling that breaking bad news would deprive the patient of hope; concern that the patient's family would blame the oncologist; concern that the patient may lose self-control; and a feeling that there was not enough time to break the bad news. Strategies perceived to be useful by oncologists included training in how to effectively communicate to patients discontinuation of anticancer treatment, a reduction in total workload to allow sufficient time to break bad news, and development of a multidisciplinary model to facilitate cooperation with other professionals and facilities.

Conclusions

Many oncologists reported high levels of burden relating to communication of discontinuation of anticancer treatment. A specific communication skills training program, sufficient time for communication and development of a multidisciplinary model could help alleviate the burden on oncologists.