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Singh AP, Balogh EP, Carlson RW, Huizinga MM, Malin BA, Melamed A, Meropol NJ, Pisano ED, Winn RA, Yabroff KR, Shulman LN. Re-Envisioning Electronic Health Records to Optimize Patient-Centered Cancer Care, Quality, Surveillance, and Research. JCO Oncol Pract 2024:OP2400260. [PMID: 39102623 DOI: 10.1200/op.24.00260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 04/24/2024] [Accepted: 05/02/2024] [Indexed: 08/07/2024] Open
Abstract
Electronic health records (EHRs) are a significant advancement over paper records. However, the full potential of EHRs for improving care quality, patient outcomes, surveillance, and research in cancer care is yet to be realized. The organic evolution of EHRs has resulted in a number of unanticipated consequences including increased time spent by clinicians interfacing with the EHR for daily workflows. Patient access to clinicians and their records has been an important advancement in patient-centered care; however, this has brought to light additional gaps and challenges in EHRs meeting these needs. A significant challenge for EHR design and physician workflows is how best to meet the complex goals and priorities of various stakeholders including providers, researchers, patients, health systems, payors, and regulatory agencies. The National Cancer Policy Forum convened a 2022 workshop, "Innovations in Electronic Health Records for Oncology Care, Research and Surveillance," to address these challenges and to facilitate collaboration across all user groups with the goal of re-envisioning EHRs that will better support shared goals of improving patient outcomes and advancing cancer care and research without overburdening clinicians with administrative tasks. Here, we summarize the current EHR ecosystem as discussed at the workshop and highlight opportunities to improve EHR contributions to oncology evidence and care.
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Affiliation(s)
| | - Erin P Balogh
- American Society of Clinical Oncology, Alexandria, VA
| | | | | | | | | | | | - Etta D Pisano
- American College of Radiology, University of Pennsylvania, Philadelphia, PA
| | - Robert A Winn
- Massey Comprehensive Cancer Center, Virginia Commonwealth University, Richmond, VA
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Szmaglinska M, Andrew L, Massey D, Kirk D. Beyond standard treatment: A qualitative descriptive study of cancer patients' perceptions of hypnotherapy in cancer care. Complement Ther Clin Pract 2024; 56:101861. [PMID: 38820657 DOI: 10.1016/j.ctcp.2024.101861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 05/12/2024] [Accepted: 05/13/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND AND PURPOSE Cancer remains a leading cause of death in Australia. The number of new cancer cases diagnosed each year is expected to surpass 200,000 by 2033. This marks a significant increase from about 88,000 cases in 2000 to an estimated 165,000 cases in 2023. Despite advancements in treatment, emotional and psychological challenges in cancer care are often overlooked. This study focuses on hypnotherapy, a complementary therapy recognized for its efficacy for physical and emotional symptoms, yet underutilized in Australian cancer care. The research aims to explore patients' perceptions of hypnotherapy and identify barriers to its integration, contributing to the development of holistic, patient-centered cancer care models. MATERIALS AND METHODS A qualitative study employing semi-structured interviews was conducted with 14 adult cancer patients (breast, lung, and colorectal) undergoing active treatment, selected through convenience sampling. The interviews were carried out from May 2022 to August 2023, focusing on participants' experiences and attitudes toward hypnotherapy among other complementary and alternative medicine (CAM) therapies. Thematic analysis using Braun and Clarke's six-step framework was applied to the data. RESULTS Five themes were developed following analysis: 1) emotional roller coaster of cancer diagnosis, 2) participants' perspectives on hypnotherapy among other CAM modalities, 3) hypnotherapy as a psychological vs physiological support, 4) fringe benefits of hypnosis, and 5) the main hurdles: cost and lack of information. Participants expressed a diverse range of experiences and attitudes towards hypnotherapy and CAM, with a strong emphasis on the need for emotional support in cancer care. Although hypnotherapy was recognized for its potential to address both emotional and physical symptoms, its predominant use was for emotional well-being. Participants also highlighted the importance of attitudes and endorsements from healthcare providers in their decision-making process about CAM therapies. CONCLUSION The study findings emphasize the need for a more integrative and patient-centered approach in cancer care that includes hypnotherapy as a non-pharmacological intervention for physical and particularly emotional support. Healthcare providers should be aware of the potential value of hypnotherapy and consider patient preferences in their recommendations. In addition, addressing the identified barriers could improve the accessibility and integration of hypnotherapy into cancer care protocols in Australia.
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Affiliation(s)
- Malwina Szmaglinska
- School of Nursing and Midwifery, Edith Cowan University, Western Australia, Australia.
| | - Lesley Andrew
- School of Nursing and Midwifery, Edith Cowan University, Western Australia, Australia.
| | - Debbie Massey
- School of Nursing and Midwifery, Edith Cowan University, Western Australia, Australia.
| | - Deborah Kirk
- School of Nursing and Midwifery, Edith Cowan University, Western Australia, Australia; La Trobe University, School of Nursing and Midwifery, Victoria, Australia.
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Chatwal MS, Camacho P, Symington B, Rosenberg A, Hinyard L, Chavez Mac Gregor M, Gallagher C, El-Jawahri A, McGinnis M, Lee RT. Ethics of Patient-Clinician Boundaries in Oncology: Communication Strategies for Promoting Clinician Well-Being and Quality Patient Care. JCO Oncol Pract 2024; 20:1016-1020. [PMID: 38484207 DOI: 10.1200/op.23.00650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 02/07/2024] [Accepted: 02/15/2024] [Indexed: 07/18/2024] Open
Affiliation(s)
| | - Polo Camacho
- American Society of Clinical Oncology, Alexandria, VA
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Shi L, Ren F, Xin S, Sun Q, Li DN, Li K, Wang Y. Prevalence of burnout among military personnel in the plateau region of China: a cross-sectional survey. BMC Public Health 2024; 24:1897. [PMID: 39014372 PMCID: PMC11251340 DOI: 10.1186/s12889-024-19340-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 07/02/2024] [Indexed: 07/18/2024] Open
Abstract
OBJECTIVES The geographical environment and military activities in the plateau area pose potential work-related stressors for military personnel, leading to burnout which is an external manifestation of internal energy exhaustion caused by stress. Without countermeasures, this can result in serious military problems. This study aims to examine the association between burnout and occupational stressors among military personnel stationed in the plateau area of China. MATERIAL AND METHODS A stratified randomized cluster sampling survey was conducted among 2026 military personnel from 6 different troops stationed in the plateau area of China. The Chinese Maslach Burnout Inventory-General Survey(MBI-GS in Chinese) was administered from March 2022 to December 2023, and data were analyzed using SPSS version 25. RESULTS A total of 2026 military personnel participated in the survey. The mean overall burnout score was 3.37 ± 0.73, with emotional exhaustion at 2.69 ± 0.89, depersonalization at 3.58 ± 0.92, and professional achievement at 3.81 ± 0.85 levels respectively reported by participants on average scale scores ranging from zero to six. Severe level of burnout was reported by 43.2% of participants while medium level of burnout was reported by 54 .3%. Age, education level, length of military service, and household income were identified as important factors influencing burnout. CONCLUSION This study highlights a relatively high prevalence of burnout among military personnel stationed in plateau areas necessitating attention towards their occupational health particularly focusing on working hours and economic aspects so as to formulate effective policies and implement intervention measures that strengthen career development for soldiers deployed in such regions.
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Affiliation(s)
- Lei Shi
- Department of Medical Research, The Ninth Medical Center, Chinese PLA General Hospital, Beijing, 100101, China
| | - Fei Ren
- Department of Medical Research, The Ninth Medical Center, Chinese PLA General Hospital, Beijing, 100101, China
| | - Shen Xin
- Department of Medical Research, The Ninth Medical Center, Chinese PLA General Hospital, Beijing, 100101, China
| | - Qin Sun
- Department of Medical Research, The Ninth Medical Center, Chinese PLA General Hospital, Beijing, 100101, China
| | - Dan-Ni Li
- Department of Medical Research, The Ninth Medical Center, Chinese PLA General Hospital, Beijing, 100101, China
| | - Ke Li
- Department of Medical Research, The Ninth Medical Center, Chinese PLA General Hospital, Beijing, 100101, China.
| | - Yuan Wang
- Department of Medical Research, The Ninth Medical Center, Chinese PLA General Hospital, Beijing, 100101, China.
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Walsh K, Manochakian R, Schwartz J, Brondfield S. Launching an International Community of Practice in Hematology/Oncology Medical Education. Am Soc Clin Oncol Educ Book 2024; 44:e100046. [PMID: 38776483 DOI: 10.1200/edbk_100046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
A community of practice (CoP) is a group of people who share a concern or a passion for something they do and learn how to do it better as they interact regularly. While the field of hematology/oncology has historically prioritized clinical care and biomedical research, medical education has received increasing attention within hematology/oncology in recent years. In 2018, ASCO launched the Education Scholars Program to train hematology/oncology clinicians in the science of teaching and learning. However, the number of hematology/oncology educators nationally and internationally far exceeds the capacity of the Education Scholars Program to train them. In addition, hematology/oncology educators often lack sufficient mentorship and guidance at their own institutions to pursue their chosen career path effectively. To ensure high-quality clinical care and research for generations to come, attention must be paid to improving support for hematology/oncology educators. Therefore, supported by ASCO, we developed an international medical education (Med Ed) CoP for hematology/oncology educators with the purpose of providing them with support, community, mentorship, resources, and scholarly opportunities in medical education. In this article, we describe the development of the Med Ed CoP using a three-stage framework (Establish-Grow-Sustain) including successes, challenges, and reflections. By supporting the needs of hematology/oncology educators, the Med Ed CoP will serve as a home for all who contribute to the field of hematology/oncology.
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Affiliation(s)
- Katherine Walsh
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | | | - Jennifer Schwartz
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Sam Brondfield
- Department of Medicine, University of California, San Francisco, San Francisco, CA
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Jacobson JO, Brooks GA. Unspoken Risks of Cancer Care. JCO Oncol Pract 2024; 20:617-620. [PMID: 38382006 DOI: 10.1200/op.23.00795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/03/2024] [Accepted: 01/22/2024] [Indexed: 02/23/2024] Open
Affiliation(s)
- Joseph O Jacobson
- Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
| | - Gabriel A Brooks
- Dartmouth Cancer Center/Dartmouth Hitchcock Medical Center, Lebanon, NH
- Dartmouth Geisel School of Medicine, Hanover, NH
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Paul TK, Reddy Y, Gnanakumar A, England R, Superdock A, Malipeddi D, Wrigley J, Reardon E, Weaver MS, Kaye EC. Narrative medicine interventions for oncology clinicians: a systematic review. Support Care Cancer 2024; 32:241. [PMID: 38512594 DOI: 10.1007/s00520-024-08434-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 03/11/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE As narrative medicine interventions are integrated increasingly into medical practice, growing evidence indicates benefits for healthcare professionals. Presently, the prevalence and impact of narrative medicine interventions in the field of oncology remain unknown. This systematic review synthesizes published data on narrative medicine interventions in oncology and reports current knowledge on feasibility, acceptability, and impact on cancer care professionals. METHODS Following PRISMA guidelines, we searched Ovid Medline, Embase, Scopus, Web of Science, Cochrane, and ClinicalTrials.gov databases from inception through February 2024. Eligible articles were published in English and contained original data on feasibility, acceptability, and/or impact of a narrative medicine intervention for oncology professionals. Database searches identified 2614 deduplicated articles, from which 50 articles were identified for full-text assessment and 11 articles met inclusion criteria. Two additional articles were identified through manual review of references. RESULTS Thirteen articles described 12 unique narrative medicine interventions targeting cancer care professionals. All studies described their respective interventions as feasible, acceptable, and impactful for participants. Interventions involved writing, reading, reflection, and other narrative-based strategies. Standardized validated tools evaluated outcomes including burnout, empathy expression, secondary trauma, quality of humanistic care, and well-being. Participants reported appreciation of opportunities for reflection, perspective sharing, and bearing witness, which they perceived to strengthen wellness and community. CONCLUSION Narrative medicine interventions are feasible and acceptable and may bolster oncology clinicians' functioning across domains. Multi-site, prospective, randomized studies are needed to investigate the broader impact of narrative medicine interventions and advance the science of narrative medicine in oncology. TRIAL REGISTRATION ClinicalTrials.gov Identifier: CRD42022369432.
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Affiliation(s)
- Trisha K Paul
- Department of Oncology, Division of Quality of Life and Palliative Care, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail Stop 260, Memphis, TN, USA.
| | | | | | - Rebecca England
- University of Tennessee Health Science Center, Memphis, TN, USA
| | - Alexandra Superdock
- Department of Oncology, Division of Quality of Life and Palliative Care, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail Stop 260, Memphis, TN, USA
| | | | - Jordan Wrigley
- Department of Oncology, Division of Quality of Life and Palliative Care, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail Stop 260, Memphis, TN, USA
| | | | | | - Erica C Kaye
- Department of Oncology, Division of Quality of Life and Palliative Care, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail Stop 260, Memphis, TN, USA
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Sobczuk P, Gawlik-Urban A, Sigorski D, Kiszka J, Osmola M, Machulska-Ciuraj K, Wilk M, Brodziak A. Prevalence and factors associated with professional burnout in Polish oncologists-results of a nationwide survey. ESMO Open 2024; 9:102230. [PMID: 38266421 PMCID: PMC10937194 DOI: 10.1016/j.esmoop.2023.102230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 12/03/2023] [Accepted: 12/21/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND High rates of burnout are observed among health care professionals worldwide, which could have negative consequences on personal and organizational levels. We aimed to evaluate the burnout prevalence and factors associated with burnout among oncologists in Poland. MATERIALS AND METHODS An online survey was conducted using the validated Maslach Burnout Inventory-Human Services Survey (MBI-HSS) and additional work/lifestyle questions. Descriptive statistics, parametric and nonparametric tests, and multivariate logistic regression were used to identify factors associated with burnout. RESULTS A total of 228 physicians participated in the survey, including 168 medical oncologists, 43 radiation oncologists, and 17 from other specialties. Data collected from 211 medical and radiation oncologists were included in the final analyses. Most participants were female (71.6%) and ≤40 years of age (70.1%). A self-reported feeling of burnout was present in 65.9% of participants. Based on the MBI-HSS, 74.9% showed evidence of burnout with burnout subdomains as follows: depersonalization 37.0%; emotional exhaustion 64.5%; low accomplishment 43.1%. There were no differences in burnout rates based on specialization (oncology/haematology-75.6%, radiotherapy-72.1%), career stage, gender, or age groups. Lack of work-life balance was the only significant factor associated with the risk of burnout in the logistic regression (relative risk 2.6, 95% confidence interval 1.3-5.4). Only 20.9% of physicians had access to psychological support in their workplace; however, 70.1% desired such support. Three main factors impacting burnout in cancer care workers were: bureaucracy and administrative duties overload, admissions of many patients, and poor work culture. CONCLUSIONS Burnout is common among medical and radiation oncologists in Poland. There is a high demand for psychological support and organizational changes in the workplace to reduce risk and mitigate the adverse effects of burnout among health care professionals.
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Affiliation(s)
- P Sobczuk
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw.
| | - A Gawlik-Urban
- Clinical Oncology Department with Chemotherapy Subunit, Provincial Hospital Saint Luke, Tarnów; Faculty of Health Sciences, University of Applied Sciences in Tarnów, Tarnów
| | - D Sigorski
- Department of Oncology, University of Warmia and Mazury, Olsztyn; Department of Oncology and Immuno-Oncology, Warmian-Masurian Cancer Center of the Ministry of the Interior and Administration's Hospital, Olsztyn
| | - J Kiszka
- Department of Clinical Oncology, Subcarpathian Cancer Center, Brzozów
| | - M Osmola
- Department of Hematology, Oncology and Internal Medicine, Medical University of Warsaw, Warsaw
| | - K Machulska-Ciuraj
- Department of Clinical Oncology and Chemotherapy, Independent Public Clinical Hospital No. 4, Lublin
| | - M Wilk
- Oncology Department, ECZ-Postgraduate Medical Center European Health Center, Otwock
| | - A Brodziak
- Department of Oncology and Radiotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw; Laboratory of Centre for Preclinical Research, Department of Experimental and Clinical Physiology, Medical University of Warsaw, Warsaw, Poland
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Fernandez Montes A, Elez E, de la Haba-Rodriguez J, Paez D, Mendez-Vidal MJ, Felip E, Rodriguez-Lescure A. Medical oncology workload, workforce census, and needs in Spain: two nationwide studies by the Spanish Society of medical oncology. Clin Transl Oncol 2024; 26:98-108. [PMID: 37316754 PMCID: PMC10266958 DOI: 10.1007/s12094-023-03225-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 05/22/2023] [Indexed: 06/16/2023]
Abstract
PURPOSE Growing complexity and demand for cancer care entail increased challenges for Medical Oncology (MO). The Spanish Society of Medical Oncology (SEOM) has promoted studies to provide updated data to estimate the need for medical oncologists in 2040 and to analyse current professional standing of young medical oncologists. METHODS Two national, online surveys were conducted. The first (2021) targeted 146 Heads of MO Departments, and the second (2022), 775 young medical oncologists who had completed their MO residency between 2014 and 2021. Participants were contacted individually, and data were processed anonymously. RESULTS Participation rates reached 78.8% and 48.8%, respectively. The updated data suggest that 87-110 new medical oncologist full-time equivalents (FTEs) should be recruited each year to achieve an optimal ratio of 110-130 new cases per medical oncologist FTE by 2040. The professional standing analysis reveals that 9.1% of medical oncologists trained in Spain do not work in clinical care in the country, with tremendous employment instability (only 15.2% have a permanent contract). A high percentage of young medical oncologists have contemplated career paths other than clinical care (64.5%) or working in other countries (51.7%). CONCLUSIONS Optimal ratios of medical oncologists must be achieved to tackle the evolution of MO workloads and challenges in comprehensive cancer care. However, the incorporation and permanence of medical oncologists in the national healthcare system in Spain could be compromised by their current sub-optimal professional standing.
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Affiliation(s)
- Ana Fernandez Montes
- Department of Medical Oncology, University Hospital Complex of Ourense (CHUO), Ourense, Galicia, Spain.
| | - Elena Elez
- Medical Oncology Department, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Univesitat Autònoma de Barcelona (UAB), Barcelona, Catalunya, Spain
| | - Juan de la Haba-Rodriguez
- Medical Oncology Department, Reina Sofia University Hospital, Maimonides Institute for Biomedical Research in Cordoba, Córdoba, Spain
| | - David Paez
- Department of Medical Oncology, Santa Creu I Sant Pau University Hospital, U705, ISCIII Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Catalunya, Spain
| | - Maria Jose Mendez-Vidal
- Medical Oncology Department, Maimonides Institute for Biomedical Research in Cordoba, Reina Sofia University Hospital, Córdoba, Spain
| | - Enriqueta Felip
- Medical Oncology Department, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Catalunya, Spain
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Ilbawi A, Casolino R. Training cancer workforce to be fit-for-purpose and practice in 2024 and beyond. Cancer 2023; 129:3360-3362. [PMID: 37650868 DOI: 10.1002/cncr.34998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
To achieve an oncology workforce that is fit for purpose and sufficient in number, more holistic workforce planning is needed, focusing on educational sector and labor market dynamics. Oncology professionals must be trained and enabled to influence factors affecting their clinical practice including by developing competencies to redesign clinical practice, reduce burnout, and improve productivity and care.
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Affiliation(s)
- André Ilbawi
- Department of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
| | - Raffaella Casolino
- Department of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
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Hlubocky FJ, McFarland DC, Back AL, Friese CR, Lyckholm L, Gallagher CM, McGinnis M, Spence R, Lynch L, Tomkins J, Shanafelt T, Srivastava P. Development, Feasibility, and Acceptability of an Oncologist Group Peer Support Program From ASCO's Clinician Well-Being Task Force. JCO Oncol Pract 2023; 19:669-675. [PMID: 37327462 DOI: 10.1200/op.23.00068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 04/05/2023] [Accepted: 05/08/2023] [Indexed: 06/18/2023] Open
Abstract
PURPOSE The COVID-19 pandemic has had deleterious effects on oncologist professional and personal well-being, the optimal delivery of quality cancer care, and the future cancer care workforce, with many departing the field. Hence, the identification of evidence-based approaches to sustain oncologists is essential to promote well-being. MATERIALS AND METHODS We developed a brief, oncologist-centered, virtual group peer support program and tested its feasibility, acceptability, and preliminary impact on well-being. Trained facilitators provided support to peers on the basis of burnout research in oncology with available resources to enhance oncologist resilience. Peers completed pre- and postsurvey assessment of well-being and satisfaction. RESULTS From April to May 2022, 11 of 15 (73%) oncologists participated in its entirety: mean age 51.1 years (range, 33-70), 55% female, 81.8% Ca, 82% medical oncologists, 63.6% trained ≥15 years, average 30.3 patients/wk (range, 5-60), and 90.9% employed in hospital/health system practice. There was a statistically significant difference in pre- and postintervention well-being (7.0 ± 3.6 v 8.2 ± 3.0, P = .03) with high satisfaction with postgroup experience (9.1 ± 2.5). These quantitative improvements were affirmed by qualitative feedback. These themes included (1) an enhanced understanding of burnout in oncology, (2) shared experience in practice of oncology, and (3) fostering connections with diverse colleagues. Future recommendations proposed included (1) restructuring group format and (2) tailoring groups according to practice setting (academic v community). CONCLUSION Preliminary results suggest that a brief, innovative oncologist-tailored group peer support program is feasible, acceptable, and beneficial for enhancing well-being dimensions including burnout, engagement, and satisfaction. Additional study is required to refine program components (optimal timing, format) to support oncologist well-being, now during the pandemic and well into recovery.
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Affiliation(s)
- Fay J Hlubocky
- Department of Medicine, Section Hematology/Oncology, Maclean Center for Clinical Medical Ethics, Supportive Oncology Program, University of Chicago Medicine, Chicago, IL
| | - Daniel C McFarland
- Department of Psychiatry, Wilmot Cancer Center, University of Rochester, Rochester, NY
| | - Anthony L Back
- Department of Medicine/Oncology, University of Washington, Seattle, WA
| | - Christopher R Friese
- Health Management and Policy, University of Michigan School of Nursing, Ann Arbor, MI
| | - Laurel Lyckholm
- Department of Medicine, Section of Hematology/Oncology, WVU Cancer Institute, West Virginia University, Morgantown, WV
| | - Colleen M Gallagher
- Section of Integrated Ethics in Cancer Care, University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | - Laura Lynch
- American Society of Clinical Oncology, Alexandria, VA
| | - Julia Tomkins
- American Society of Clinical Oncology, Alexandria, VA
| | - Tait Shanafelt
- VA Palo Alto Health Care System, Stanford University, Palo Alto, CA
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Tremblay D, Beaupère S, Biaudet J, Castel P, Fervers B, Galvez C, Sontag P, Usher S, Wilhelmy C. Resilience at Work among Healthcare Professionals in Oncology during and beyond the Pandemic: Report from A Deliberative Multi-Stakeholder Reflexive Symposium. Curr Oncol 2023; 30:6986-6995. [PMID: 37504366 PMCID: PMC10377963 DOI: 10.3390/curroncol30070506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/10/2023] [Accepted: 07/18/2023] [Indexed: 07/29/2023] Open
Abstract
The chronic distress faced by healthcare professionals (HCPs) in oncology was exacerbated by the COVID-19 pandemic, heightening the need to improve their resilience. The Entretiens Jacques Cartier symposium provided an opportunity for participants from France and Quebec to share perspectives on resilience at work and discuss interventions at individual and organizational levels to support HCP health and well-being. Fifty-eight stakeholders were invited to the symposium, including HCPs, government decision-makers, researchers, and patient representatives. The symposium began with presentations on the nature of professional resilience at work in oncology and promising interventions developed in France and Quebec. Participants were then engaged in deliberation on how evidence and experiential knowledge could contribute to workplace strategies to strengthen resilience. Small-group reflexive sessions using the photovoice method, and an intersectoral roundtable, elicited the expression and deliberation of multiple perspectives on the nature and building blocks of resilience. Four main themes emerged from the discussions: (1) that resilience remains a muddy concept and can be associated pejoratively with "happycracy"; (2) that resilience must contend with bounded autonomy and captors; (3) that it relies on a sense of coherence at work; and (4) that patients play a role in improving HCP resilience. Stakeholders from healthcare systems in different countries view resilience at work as a means of equipping teams to handle chronic and punctual stresses in cancer care. The symposium emphasized the importance of better defining what resilience at work means and pursuing explorations of multicomponent interventions to support oncology HCPs and the patients they care for. The themes raised by participants at the symposium suggest pathways for furthering this exploration.
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Affiliation(s)
- Dominique Tremblay
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, QC J4K 0A8, Canada
- Centre de Recherche Charles-Le Moyne, Longueuil, QC J4K 0A8, Canada
| | | | - Julien Biaudet
- Cancéropôle Lyon Auvergne Rhône-Alpes, 69007 Lyon, France
| | - Patrick Castel
- Sciences Po, Centre de Sociologie des Organisations (CSO), CNRS, 75007 Paris, France
| | - Béatrice Fervers
- Département Prévention Cancer Environnement, Centre Léon Bérard, 69008 Lyon, France
| | | | | | - Susan Usher
- Commissaire à la Santé et au Bien-Être, Quebec, QC G1S 2L2, Canada
| | - Catherine Wilhelmy
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada
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Martinez DAS, Quilez-Cutillas A, Jimenez-Labaig P, Sesma A, Tarazona N, Pacheco-Barcia V, Obispo B, Paez D, Quintanar T, Sanchez-Canovas M, Montes AF, Felip E, Rodriguez-Lescure A, Elez E. Current professional standing of young medical oncologists in Spain: a nationwide survey by the Spanish Society of Medical Oncology + MIR section. Clin Transl Oncol 2023; 25:796-802. [PMID: 36418642 PMCID: PMC9685015 DOI: 10.1007/s12094-022-02989-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 10/18/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND There is a lack of knowledge about the career paths and employment situation of young medical oncologists. The aim of our study was to evaluate the current professional standing of these professionals in Spain. METHODS The Spanish Society of Medical Oncology + MIR section conducted a national online survey in May 2021 of young medical oncology consultants (< 6 years of expertise) and final year medical oncology residents. RESULTS A total of 162 responses were eligible for analysis and included participants from 16 autonomous communities; 64% were women, 80% were consultants, and 20% were residents. More than half of the participants performed routine healthcare activity and only 7% research activity. Almost three quarters (73%) were subspecialized in a main area of interest and almost half of these chose this area because it was the only option available after residency. Half of the respondents (51%) considered working abroad and 81% believed the professional standing in Spain was worse than in other countries. After finishing their residency, only 22 were offered a job at their training hospital. Just 16% of participants had a permanent employment contract and 87% were concerned (score of ≥ 5 on a scale of 1-10) about their job stability. In addition, one quarter of the participants in our study showed an interest in increasing their research activity. CONCLUSIONS The choice of subspecialty in medical oncology may depend on job opportunities after residency rather than personal interest. The abundance of temporary contracts may have influenced the job stability concerns observed. Future mentoring strategies should engage in building a long-term career path for young medical oncologists.
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Affiliation(s)
- Domingo Antonio Sanchez Martinez
- grid.411372.20000 0001 0534 3000Department of Medical Oncology, IMIB, Virgen de La Arrixaca University Hospital, Murcia, Región de Murcia Spain
| | - Aliica Quilez-Cutillas
- Department of Medical Oncology, Can Misses Hospital, Área de Salud de Ibiza y Formentera (ASEF), Ibiza, Illes Balears Spain
| | - Pablo Jimenez-Labaig
- grid.411232.70000 0004 1767 5135Department of Medical Oncology, Cruces University Hospital, Barakaldo, Bizkaia Spain
| | - Andrea Sesma
- grid.411050.10000 0004 1767 4212Department of Medical Oncology, Lozano Blesa University Clinical Hospital, Zaragossa, Aragón Spain
| | - Noelia Tarazona
- grid.429003.c0000 0004 7413 8491Department of Medical Oncology, INCLIVA Biomedical Research Institute, Comunitat Valenciana, Spain ,grid.510933.d0000 0004 8339 0058Instituto de Salud Carlos III, CIBERONC, Madrid, Spain
| | - Vilma Pacheco-Barcia
- grid.411171.30000 0004 0425 3881Department of Medical Oncology, Torrejón University Hospital, Madrid, Spain
| | - Berta Obispo
- grid.414761.1Department of Medical Oncology, Infanta Leonor University Hospital, Madrid, Spain
| | - David Paez
- grid.410458.c0000 0000 9635 9413Department of Medical Oncology, Santa Creu i Sant Pau University Hospital, Barcelona, Catalunya Spain
| | - Teresa Quintanar
- grid.411089.50000 0004 1768 5165Department of Medical Oncology, Elche University General Hospital, Elche, Comunitat Valenciana Spain
| | - Manuel Sanchez-Canovas
- grid.411089.50000 0004 1768 5165Department of Hematology and Medical Oncology, Morales Meseguer University General Hospital, Murcia, Región de Murcia Spain
| | - Ana Fernandez Montes
- grid.418883.e0000 0000 9242 242XDepartment of Medical Oncology, University Hospital Complex of Ourense (CHUO), Ourense, Galicia Spain
| | - Enriqueta Felip
- grid.411083.f0000 0001 0675 8654Vall d’Hebron Institute of Oncology (VHIO), Medical Oncology Department, Vall d’Hebron University Hospital, Univesitat Autònoma de Barcelona (UAB), 119-129, 08035 Barcelona, Catalunya Spain
| | - Alvaro Rodriguez-Lescure
- grid.411089.50000 0004 1768 5165Department of Medical Oncology, Elche University General Hospital, Elche, Comunitat Valenciana Spain
| | - Elena Elez
- Vall d'Hebron Institute of Oncology (VHIO), Medical Oncology Department, Vall d'Hebron University Hospital, Univesitat Autònoma de Barcelona (UAB), 119-129, 08035, Barcelona, Catalunya, Spain.
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14
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Barry A, Elliott M, Loewen S, Alfieri J, Bowes D, Croke J, Debenham B, Keyes M, Papadakos J, Quartey NK, Stuckless T, Lajkosv K, Weiss J, Giuliani M. The Impact of Parent and Family Caregiver Roles Among Canadian Radiation Oncologists. Int J Radiat Oncol Biol Phys 2022; 116:280-289. [PMID: 36563908 DOI: 10.1016/j.ijrobp.2022.12.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 11/15/2022] [Accepted: 12/11/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Working parents, and a rising number of adults delivering care for aging relatives, experience numerous challenges in their personal, family, professional, and financial lives owing to multiple responsibilities. This study describes the experiences of Canadian radiation oncologist (RO) parents and family caregivers, reporting challenges that may exist in providing family care with clinical and academic work commitments. METHODS AND MATERIALS Canadian ROs, via RO heads of departments in cancer centers across Canada, and physician members of the Canadian Association of Radiation Oncology were invited to participate in an anonymous online survey between November 2021 and January 2022. The survey focused on demographics, experiences of pregnancy and leave, parenting and adult caregiving responsibilities, and self-care. RESULTS A total of 103 staff ROs (38%) completed the survey and 78 (75.7%) identified as having a parental (76 [89.7%]) and/or other family caregiver (8 [10.3%]) role; 41% were female and 59% were male, with no difference between genders in the number of children (median, 2; interquartile range, 1-3; P = .17). More female respondents took parental leave for their first child compared with male respondents (mean, 29 vs 6 weeks; P < .001). Of male respondents who started caring for their first child during residency, 27% took parental leave, compared with 77% who started caring for their first child as a staff member (P = .003). The majority of respondents described "always/usually" having collegial support for each pregnancy and parental leave. Both genders described parental responsibilities as negatively affecting attendance at conferences (male, 65%; female, 77%; P = .31) and early or late work-related meetings (male, 76%; female, 79%; P = 1.0). More female respondents described parental responsibilities as negatively affecting their career (50% vs 29%; P = .085). Of female respondents, 52% (vs 26% of male respondents; P = .044) identified a physician mentor or positive role model around parenting issues. CONCLUSIONS Parental and other family caregiving responsibilities are not gender unique in Canadian ROs, but competing work and family roles may affect genders differently.
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Affiliation(s)
- Aisling Barry
- Princess Margaret Cancer Centre, University Health Network, and Department of Radiation Oncology, University of Toronto, Toronto, Canada.
| | - Mary Elliott
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Shaun Loewen
- Division of Radiation Oncology, University of Calgary, Calgary, Alberta, Canada
| | - Joanna Alfieri
- Division of Radiation Oncology, McGill University Health Centre, Montreal, Québec, Canada
| | - David Bowes
- Department of Radiation Oncology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jennifer Croke
- Princess Margaret Cancer Centre, University Health Network, and Department of Radiation Oncology, University of Toronto, Toronto, Canada
| | - Brock Debenham
- Department of Oncology, University of Alberta, Edmonton, Alberta, Canada
| | - Mira Keyes
- Department of Radiation Oncology, British Columbia Cancer Agency Vancouver Centre, and Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Janet Papadakos
- Cancer Health Literacy Research Centre, Cancer Education, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Naa Kwarley Quartey
- Cancer Health Literacy Research Centre, Cancer Education, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Teri Stuckless
- Department of Radiation Oncology, Cancer Care Program of Eastern Health, St. John's, Newfoundland and Labrador, Canada
| | - Katherine Lajkosv
- Department of Biostatistics, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Jessica Weiss
- Department of Biostatistics, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Meredith Giuliani
- Princess Margaret Cancer Centre, University Health Network, and Department of Radiation Oncology, University of Toronto, Toronto, Canada
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15
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Alpert JM, Hampton CN, Raisa A, Markham MJ, Bylund CL. Integrating patient-centeredness into online patient-clinician communication: a qualitative analysis of clinicians' secure messaging usage. Support Care Cancer 2022; 30:9851-9857. [PMID: 36260178 PMCID: PMC9580446 DOI: 10.1007/s00520-022-07408-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 10/11/2022] [Indexed: 11/28/2022]
Abstract
Purpose Patient-centered communication (PCC) in cancer care is helpful to nurture the patient-clinician relationship and respond to patients’ emotions. However, it is unknown how PCC is incorporated into electronic patient-clinician communication. Methods In-depth, semi-structured qualitative interviews with clinicians were conducted to understand how PCC was integrated into asynchronous communication between patients and clinicians; otherwise, known as secure messaging. The constant comparative method was used to develop a codebook and formulate themes. Results Twenty clinicians in medical and radiation oncology participated in audio-recorded interviews. Three main themes addressed how clinicians incorporate PCC within messages: (1) being mindful of the patient-clinician relationship, (2) encouraging participation and partnership, and (3) responding promptly suggests accessibility and approachability. Clinicians recommended that patients could craft more effective messages by being specific, expressing concern, needs, and directness, summarized by the acronym S.E.N.D. Conclusions Clinicians value secure messaging to connect with patients and demonstrate their accessibility. They acknowledge that secure messaging can influence the patient-clinician relationship and make efforts to include considerate and supportive language. As secure messaging is increasingly relied upon for patient-clinician communication, patients’ message quality must improve to assist clinicians in being able to provide prompt responses inclusive of PCC.
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Affiliation(s)
- Jordan M Alpert
- Center for Value-Based Care Research, Internal Medicine and Geriatrics, Cleveland Clinic, Cleveland, OH, USA.
| | - Chelsea N Hampton
- College of Journalism and Communications, University of Florida, 2093 Weimer Hall, Gainesville, FL, 32611, USA
| | - Aantaki Raisa
- College of Journalism and Communications, University of Florida, 2093 Weimer Hall, Gainesville, FL, 32611, USA
| | | | - Carma L Bylund
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
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16
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Krieger T, Salm S, Dresen A, Cecon N. Cancer patients' experiences and preferences when receiving bad news: a qualitative study. J Cancer Res Clin Oncol 2022:10.1007/s00432-022-04311-8. [PMID: 35999331 PMCID: PMC9398052 DOI: 10.1007/s00432-022-04311-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 08/15/2022] [Indexed: 12/01/2022]
Abstract
PURPOSE Receiving a cancer diagnosis significantly impacts patients' lives, and how the bad news is delivered influences patients' trajectory, psychosocial adjustment and openness to psycho-oncological support. We explored how patients' experiences, reactions and preferences were when receiving the news and which optimization recommendations can be made. METHODS We conducted an exploratory qualitative study with patients who enrolled in the new integrated cross-sectoral psycho-oncological care programme 'isPO', being enrolled 12 months post-diagnosis. Data on the main issue (i.e. perception of the moment when the diagnosis is received) were collected via telephone interviews that were fully audiotaped and transcribed. Two independent coders conducted inductive content analyses using MAXQDA. RESULTS Out of 38 approached patients, 23 cancer patients with 13 different tumour entities participated. They had a mean age of 54.2 (SD 16.2); n = 17 (74%) were female. Three major themes with 14 corresponding subthemes emerged: (1) patients' experiences with the bad news delivery, including setting, mode, preparation and perceived needs; (2) patients' reactions to the bad news, such as shock, fear and helplessness, disbelief and denial, anger and feeling of injustice, thankfulness and depression; and (3) patients' receiving preferences, including psycho-oncological support, addressing informational needs, needs-driven comprehensive support and a competent multidisciplinary support team. CONCLUSIONS The quality of bad news delivery and addressing patients' needs should be strongly considered by physicians. We recommend integrating patients' perspective on the quality management processes of breaking bad news. For providing needs-centred high-quality care, applying existing guidelines and acquiring patient-centred communication skills are central.
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Affiliation(s)
- Theresia Krieger
- Faculty of Medicine and University Hospital Cologne, Faculty of Human Sciences, Institute for Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), University of Cologne, Eupener Str. 129, 50933, Cologne, Germany.
| | - Sandra Salm
- Faculty of Medicine and University Hospital Cologne, Faculty of Human Sciences, Institute for Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), University of Cologne, Eupener Str. 129, 50933, Cologne, Germany
| | - Antje Dresen
- Faculty of Medicine and University Hospital Cologne, Faculty of Human Sciences, Institute for Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), University of Cologne, Eupener Str. 129, 50933, Cologne, Germany
| | - Natalia Cecon
- Faculty of Medicine and University Hospital Cologne, Faculty of Human Sciences, Institute for Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), University of Cologne, Eupener Str. 129, 50933, Cologne, Germany
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17
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Granek L, Nakash O. Oncology Healthcare Professionals’ Mental Health during the COVID-19 Pandemic. Curr Oncol 2022; 29:4054-4067. [PMID: 35735432 PMCID: PMC9222050 DOI: 10.3390/curroncol29060323] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 05/26/2022] [Accepted: 05/31/2022] [Indexed: 11/16/2022] Open
Abstract
The paper begins by reviewing the literature on oncology healthcare professionals’ (HCP) mental health. We summarize and present the current data on HCP mental health in order to understand the baseline state of oncology HCPs’ mental health status prior to the COVID-19 pandemic. At each juncture, we will discuss the implications of these mental health variables on the personal lives of HCPs, the healthcare system, and patient care. We follow by reviewing the literature on these parameters during the COVID-19 pandemic in order to better understand the impact of COVID-19 on the overall mental health of HCPs working in oncology. By reviewing and summarizing the data before and after the start of the pandemic, we will get a fuller picture of the pre-existing stressors facing oncology HCPs and the added burden caused by pandemic-related stresses. The second part of this review paper will discuss the implications for the oncology workforce and offer recommendations based on the research literature in order to improve the lives of HCPs, and in the process, improve patient care.
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Affiliation(s)
- Leeat Granek
- School of Health Policy and Management and Department of Psychology, Faculty of Health, York University, 4700 Keele Street, Toronto, ON M3J 1P3, Canada
- Correspondence: ; Tel.: +1-416-736-2100
| | - Ora Nakash
- School for Social Work, Smith College, Northampton, MA 01063, USA;
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18
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How Much Burnout and Coping Influence Quality of Life among Young Oncology Providers in Romania during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095508. [PMID: 35564906 PMCID: PMC9102177 DOI: 10.3390/ijerph19095508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 04/26/2022] [Accepted: 04/28/2022] [Indexed: 12/10/2022]
Abstract
This study aims to investigate the correlations between burnout, coping strategies, and quality of life among young oncology healthcare workers in Romania during the COVID-19 pandemic. We collected the data using an online questionnaire consisting of sociodemographic questions, the Maslach Burnout Inventory, the COPE questionnaire, and the 15D instrument. A total of 122 healthcare providers responded to our survey. We evaluated the differences in the scores among the three groups of healthcare workers in oncology under 40 years old: medical oncologists (n = 87), radiation oncologists (n = 11), and oncology nurses (n = 24). Finally, we conducted a correlation analysis between the dimensions of burnout, coping, and quality of life. Overall, the medical oncologists exhibited much higher burnout levels than nurses in the COVID-19 pandemic outbreak, having statistically significant higher levels of emotional exhaustion, depersonalization, and lack of personal achievement. Some factors were inversely associated with burnout: active approach, planning, positive interpretation and growth, and acceptance. Our findings illustrated a very good level of health-related quality of life (average = 0.93, SD = 0.06), and no statistically significant differences were found in the quality of life between the three groups. This study was the first to identify the profile of young oncology providers in Romania. Our findings may be relevant in creating preventive strategies for burnout and increasing the quality of life in Romanian young oncology providers in future crises.
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19
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Huilgol YS, Adler‐Milstein J, Ivey SL, Hong JC. Opportunities to use electronic health record audit logs to improve cancer care. Cancer Med 2022; 11:3296-3303. [PMID: 35348298 PMCID: PMC9468426 DOI: 10.1002/cam4.4690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 01/21/2022] [Accepted: 03/10/2022] [Indexed: 12/11/2022] Open
Abstract
The rapid adoption of electronic health records (EHRs) has created extensive repositories of digitized data that can be used to inform improvements in care delivery, processes, and patient outcomes. While the clinical data captured in EHRs are widely used for such efforts, EHRs also capture audit log data that reflect how users interact with the EHR to deliver care. Automatically collected audit log data provide a unique opportunity for new insights into EHR user behavior and decision‐making processes. Here, we provide an overview of audit log data and examples that could be used to improve oncology care and outcomes in four domains: diagnostic reasoning and consumption, care team collaboration and communication, patient outcomes and experience, and provider burnout/fatigue. This data source could identify gaps in performance and care, physician uptake of EHR features that enhance decision‐making, and integration of data trends for oncology. Ensuring researchers and oncologists are familiar with the data's potential and developing the data engineering capacity to utilize this rich data source, will expand the breadth of research to improve cancer care.
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Affiliation(s)
- Yash S. Huilgol
- UC Berkeley‐UCSF Joint Medical Program University of California Berkeley California USA
- School of Medicine University of California San Francisco California USA
| | - Julia Adler‐Milstein
- School of Medicine University of California San Francisco California USA
- Center for Clinical Informatics and Improvement Research (CLIIR) University of California San Francisco California USA
| | - Susan L. Ivey
- UC Berkeley‐UCSF Joint Medical Program University of California Berkeley California USA
- School of Public Health University of California Berkeley California USA
| | - Julian C. Hong
- Bakar Computational Health Sciences Institute University of California San Francisco California USA
- Department of Radiation Oncology University of California San Francisco California USA
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20
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Braun M, Naor L, Hasson-Ohayon I, Goldzweig G. Oncologists’ Locus of Control, Compassion Fatigue, Compassion Satisfaction, and the Mediating Role of Helplessness. Curr Oncol 2022; 29:1634-1644. [PMID: 35323337 PMCID: PMC8947102 DOI: 10.3390/curroncol29030137] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 02/18/2022] [Accepted: 03/01/2022] [Indexed: 01/22/2023] Open
Abstract
The oncology setting may give rise to significant feelings of helplessness among oncologists via patients’ inevitable deaths or suffering. The current study examines whether and how oncologists’ sense of control (locus of control; LOC) influences their compassion fatigue and satisfaction. Methods: Seventy-three oncologists completed the following questionnaires: the Professional Quality of Life scale; Levenson’s Internal, Powerful Others, and Chance scale; the Guilt Inventory, State Guilt subscale; and the Learned Helplessness scale. Results: Oncologists reported high levels of secondary traumatic stress and burnout and moderate levels of compassion satisfaction. A positive association between oncologists’ external LOC and compassion fatigue, and a negative association between oncologists’ internal LOC and compassion fatigue, were found. Helplessness, but not guilt, had a mediating role in these associations. Internal LOC was also positively associated with compassion satisfaction. Conclusions: The current study highlights oncologists as a population at risk of experiencing compassion fatigue and emphasizes oncologists’ locus of control as a predisposition that plays a role in the development of this phenomenon. Additionally, the cognitive as well as the emotional aspects of control were found to be important factors associated with compassion fatigue.
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Affiliation(s)
- Michal Braun
- Oncology Breast Unit, Sharett Institute of Oncology, Hadassah Medical Center, Jerusalem 9574401, Israel
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Yaffo 6818211, Israel; (L.N.); (G.G.)
- Correspondence:
| | - Lee Naor
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Yaffo 6818211, Israel; (L.N.); (G.G.)
| | | | - Gil Goldzweig
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Yaffo 6818211, Israel; (L.N.); (G.G.)
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21
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Alpert JM, Hampton CN, Markham MJ, Bylund CL. Clinicians' Attitudes and Behaviors Towards Communicating Electronically with Patients: A Grounded Practical Theory Approach. JOURNAL OF HEALTH COMMUNICATION 2022; 27:103-114. [PMID: 35380099 DOI: 10.1080/10810730.2022.2059723] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Secure messaging (SM), asynchronous communication between patients and clinicians, is an increasingly popular tool among patients to contact clinicians about their care. Despite patients' enthusiasm, clinicians have been hesitant to embrace the technology to communicate with patients. Using the theoretical and methodological framework of Grounded Practical Theory (GPT), we analyzed and interpreted clinicians' perceptions, attitudes, and approaches toward SM to communicate with patients. Twenty clinicians in medical oncology and radiation oncology participated in audio-recorded, semi-structured interviews. Findings revealed the problems with using SM, such as difficulty interpreting low-quality messages, the amount of time needed to devote to responding, and its potential to negatively affect the patient-clinician relationship. Techniques employed to manage such problems consisted of using different forms of communication and utilizing messaging to expedite workloads. The philosophical rationale of clinicians toward SM was that it can improve patient care and this form of communication is already embedded within existing patient care. Overall, this article clarifies how clinicians can re-conceptualize how they think about SM so that it becomes a productive, informative, and useful aspect of patient care.
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Affiliation(s)
- Jordan M Alpert
- Department of Advertising, University of Florida, Gainesville, Florida, USA
| | - Chelsea N Hampton
- Department of Advertising, University of Florida, Gainesville, Florida, USA
| | | | - Carma L Bylund
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA
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22
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Alabi RO, Hietanen P, Elmusrati M, Youssef O, Almangush A, Mäkitie AA. Mitigating Burnout in an Oncological Unit: A Scoping Review. Front Public Health 2021; 9:677915. [PMID: 34660505 PMCID: PMC8517258 DOI: 10.3389/fpubh.2021.677915] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 08/24/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: The purpose of this study was to provide a scoping review on how to address and mitigate burnout in the profession of clinical oncology. Also, it examines how artificial intelligence (AI) can mitigate burnout in oncology. Methods: We searched Ovid Medline, PubMed, Scopus, and Web of Science, for articles that examine how to address burnout in oncology. Results: A total of 17 studies were found to examine how burnout in oncology can be mitigated. These interventions were either targeted at individuals (oncologists) or organizations where the oncologists work. The organizational interventions include educational (psychosocial and mindfulness-based course), art therapies and entertainment, team-based training, group meetings, motivational package and reward, effective leadership and policy change, and staff support. The individual interventions include equipping the oncologists with adequate training that include-communication skills, well-being and stress management, burnout education, financial independence, relaxation, self-efficacy, resilience, hobby adoption, and work-life balance for the oncologists. Similarly, AI is thought to be poised to offer the potential to mitigate burnout in oncology by enhancing the productivity and performance of the oncologists, reduce the workload and provide job satisfaction, and foster teamwork between the caregivers of patients with cancer. Discussion: Burnout is common among oncologists and can be elicited from different types of situations encountered in the process of caring for patients with cancer. Therefore, for these interventions to achieve the touted benefits, combinatorial strategies that combine other interventions may be viable for mitigating burnout in oncology. With the potential of AI to mitigate burnout, it is important for healthcare providers to facilitate its use in daily clinical practices. Conclusion: These combinatorial interventions can ensure job satisfaction, a supportive working environment, job retention for oncologists, and improved patient care. These interventions could be integrated systematically into routine cancer care for a positive impact on quality care, patient satisfaction, the overall success of the oncological ward, and the health organizations at large.
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Affiliation(s)
- Rasheed Omobolaji Alabi
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Industrial Digitalization, School of Technology and Innovations, University of Vaasa, Vaasa, Finland
| | | | - Mohammed Elmusrati
- Department of Industrial Digitalization, School of Technology and Innovations, University of Vaasa, Vaasa, Finland
| | - Omar Youssef
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Pathology, University of Helsinki, Helsinki, Finland
| | - Alhadi Almangush
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Pathology, University of Helsinki, Helsinki, Finland.,University of Turku, Institute of Biomedicine, Pathology, Turku, Finland
| | - Antti A Mäkitie
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden
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23
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Jiménez-Labaig P, Pacheco-Barcia V, Cebrià A, Gálvez F, Obispo B, Páez D, Quílez A, Quintanar T, Ramchandani A, Remon J, Rogado J, Sánchez DA, Sánchez-Cánovas M, Sanz-García E, Sesma A, Tarazona N, Cotés A, González E, Bosch-Barrera J, Fernández A, Felip E, Vera R, Rodríguez-Lescure Á, Élez E. Identifying and preventing burnout in young oncologists, an overwhelming challenge in the COVID-19 era: a study of the Spanish Society of Medical Oncology (SEOM). ESMO Open 2021; 6:100215. [PMID: 34325108 PMCID: PMC8332651 DOI: 10.1016/j.esmoop.2021.100215] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/07/2021] [Accepted: 06/25/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Young oncologists are at particular risk of professional burnout, and this could have a significant impact on their health and care of their patients. The coronavirus disease 2019 (COVID-19) pandemic has forced rapid changes in professionals' jobs and training, with the consequent physical and psychological effects. We aimed to characterize burnout levels and determinants in young oncologists, and the effects of the pandemic on their training and health. METHODS Two online surveys were conducted among oncology residents and young oncology specialists in Spain. The first addressed professional burnout and its determinants before the COVID-19 pandemic, while the second analyzed the impact of the pandemic on health care organization, training, and physical and psychological health in the same population. RESULTS In total, 243 respondents completed the first survey, and 263 the second; 25.1% reported significant levels of professional burnout. Burnout was more common among medical oncology residents (28.2%), mainly in their second year of training. It was significantly associated with a poor work-life balance, inadequate vacation time, and the burnout score. Nearly three-quarters of respondents (72%) were reassigned to COVID-19 care and 84.3% of residents missed part of their training rotations. Overall, 17.2% of this population reported that they had contracted COVID-19, 37.3% had scores indicating anxiety, and 30.4% moderate to severe depression. Almost a quarter of young oncologists (23.3%) had doubts about their medical vocation. CONCLUSIONS Burnout affects a considerable number of young oncologists. The COVID-19 pandemic has had a profound impact on causes of burnout, making it even more necessary to periodically monitor it to define appropriate detection and prevention strategies.
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Affiliation(s)
- P Jiménez-Labaig
- Department of Medical Oncology, Cruces University Hospital, Barakaldo, Bizkaia, Spain
| | - V Pacheco-Barcia
- Department of Medical Oncology, Gómez Ulla Military Hospital, Madrid, Spain
| | - A Cebrià
- Department of Mental Health, Parc Taulí University Hospital, Sabadell, Catalunya, Spain
| | - F Gálvez
- Department of Medical Oncology, Jaén University Hospital, Jaén, Andalucía, Spain
| | - B Obispo
- Department of Medical Oncology, Infanta Leonor University Hospital, Madrid, Spain
| | - D Páez
- Department of Medical Oncology, Santa Creu i Sant Pau University Hospital, Barcelona, Catalunya, Spain
| | - A Quílez
- Department of Medical Oncology, Can Misses Hospital, Área de salud de Ibiza y Formentera (ASEF), Ibiza, Illes Balears, Spain
| | - T Quintanar
- Department of Medical Oncology, Elche University General Hospital, Elche, Comunitat Valenciana, Spain
| | - A Ramchandani
- Department of Medical Oncology, University Hospital Complex, Insular-Materno Infantil de Gran Canaria, Las Palmas de Gran Canaria, Islas Canarias, Spain
| | - J Remon
- Department of Medical Oncology, HM Delfos Hospital, Barcelona, Catalunya, Spain
| | - J Rogado
- Department of Medical Oncology, Infanta Leonor University Hospital, Madrid, Spain
| | - D A Sánchez
- Department of Medical Oncology, Virgen de La Arrixaca University Hospital, Murcia, Región de Murcia, Spain
| | - M Sánchez-Cánovas
- Department of Hematology and Medical Oncology, Morales Meseguer University General Hospital, Murcia, Región de Murcia, Spain
| | - E Sanz-García
- Department of Medical Oncology, HM Sanchinarro Hospital-Centro Integral Oncológico Clara Campal (CIOOC), Madrid, Spain
| | - A Sesma
- Department of Medical Oncology, Lozano Blesa University Clinical Hospital, Zaragoza, Aragón, Spain
| | - N Tarazona
- Department of Medical Oncology, INCLIVA Biomedical Research Institute, Comunitat Valenciana, Spain; Instituto de Salud Carlos III, CIBERONC, Madrid, Spain
| | - A Cotés
- Department of Medical Oncology, Elda General Hospital, Elda, Comunitat Valenciana, Spain
| | - E González
- Department of Medical Oncology, Virgen de las Nieves University Hospital, Granada, Andalucía, Spain
| | - J Bosch-Barrera
- Department of Medical Oncology, Dr. Josep Trueta University Hospital, Institut Català d'Oncologia (ICO), Girona, Catalunya, Spain
| | - A Fernández
- Department of Medical Oncology, University Hospital Complex of Ourense (CHUO), Ourense, Galicia, Spain
| | - E Felip
- Department of Medical Oncology, Vall d'Hebron University Hospital & Institute of Oncology (VHIO), Vall d'Hebron Hospital Campus, Barcelona, Catalunya, Spain
| | - R Vera
- Department of Medical Oncology, University Hospital Complex of Navarra, Pamplona, Navarra, Spain
| | - Á Rodríguez-Lescure
- Department of Medical Oncology, Elche University General Hospital, Elche, Comunitat Valenciana, Spain
| | - E Élez
- Department of Medical Oncology, Vall d'Hebron University Hospital & Institute of Oncology (VHIO), Vall d'Hebron Hospital Campus, Barcelona, Catalunya, Spain.
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Alcaraz-Mor R, Urcun A, Vigouroux A, Boyer L, Villa A, Lehucher-Michel MP. Contraintes psychosociales et organisationnelles : analyse qualitative auprès de 52 médecins hospitaliers. ARCH MAL PROF ENVIRO 2021. [DOI: 10.1016/j.admp.2021.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Bui S, Pelosi A, Mazzaschi G, Tommasi C, Rapacchi E, Camisa R, Binovi C, Leonardi F. Burnout and Oncology: an irreparable paradigm or a manageable condition? Prevention strategies to reduce Burnout in Oncology Health Care Professionals. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021091. [PMID: 34212933 PMCID: PMC8343755 DOI: 10.23750/abm.v92i3.9738] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 05/11/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Burnout is a stress-induced occupational related syndrome, characterized by Emotional Exhaustion (EE), feeling of depersonalization (DP) and low sense of professional accomplishment (PA). The aim of this study is to analyse the effectiveness of interventions in decreasing health professionals Burnout as well as work and life-style risk factors. Methods: A survey in Medical Oncology Department in the University Hospital of Parma was conducted using the validated Maslach Burnout Inventory (MBI) and two additional questionnaires exploring lifestyle and work factors. An 8-months intervention involved fortnight meetings by facilitators, incorporated elements of reflection, shared experiences and managing emotions. Six months after the end of the intervention a second survey was performed among the participants using MBI and the same questionnaires mentioned above. Results: EE resulted the most problematic score in Day Hospital: after the 8-month intervention we described a significant decreasing in EE score especially for Day Hospital operators (from 16.7 to 10.9) and a considerable reduction in DP score. In the Oncology Ward a correlation between lack of collaboration among different health categories and DE score was detected; in the Day Hospital the absence of solid working teams was related to higher EE scores. Conclusion: The Oncology professional health care personnel are at the greatest risk of Burnout. Our study in Oncology Department shows that specific intervention should be used to prevent and reduce Burnout. Effective personal health care strategies should be incorporated into routine oncology care to prevent and treat Burnout.
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Affiliation(s)
- Simona Bui
- azienda ospedaliero universitario di Parma.
| | | | | | | | | | | | - Cinzia Binovi
- Medical Oncology Unit, University Hospital of Parma.
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James TA, Zhang JQ. ASO Author Reflections: Addressing the Early Onset of Clinical Practice Distress in Breast Surgery. Ann Surg Oncol 2021; 28:850-851. [PMID: 34110526 DOI: 10.1245/s10434-021-10114-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 04/21/2021] [Indexed: 11/18/2022]
Affiliation(s)
- T A James
- Department of Surgery, Breast Surgical Oncology Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | - J Q Zhang
- Department of Surgery, Breast Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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27
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Alpert JM, Wang S, Bylund CL, Markham MJ, Bjarnadottir RI, Lee JH, Lafata JE, Salloum RG. Improving secure messaging: A framework for support, partnership & information-giving communicating electronically (SPICE). PATIENT EDUCATION AND COUNSELING 2021; 104:1380-1386. [PMID: 33280967 DOI: 10.1016/j.pec.2020.11.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 10/19/2020] [Accepted: 11/17/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Patient-centered communication benefits patients and is widely endorsed. However, it is primarily associated with face-to-face contexts, although patients are increasingly using electronic platforms, such as secure messaging in patient portals, to communicate with providers. PURPOSE Given the popularity of secure messaging and its ability to impact the patient-provider relationship, this study aimed to determine which attributes of patient-centered communication are most desired by cancer patients using secure messaging. METHODS A 26 balanced incomplete block design discrete choice experiment was conducted using the best-worst scaling technique. Respondents were asked to select their most and least preferred attributes of two simulated patient-provider exchanges within each of eight choice sets. RESULTS 210 respondents indicated that either level of partnership (high and low) and either level of information-giving (high and low) were most preferred, while response times greater than 24 hours and low levels of support were least favored. CONCLUSIONS Similar to face-to-face communication, patients value aspects of patient-centered communication in the secure messaging setting and desire them to be included in provider replies. PRACTICE IMPLICATIONS Patient-centered communication is important to patients using secure messaging. Providers should incorporate SPICE (Support, Partnership, and Information-giving while Communicating Electronically).
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Affiliation(s)
- Jordan M Alpert
- Department of Advertising, University of Florida, Gainesville, FL, USA.
| | - Shu Wang
- Department of Biostatistics, University of Florida, Gainesville, FL, USA
| | - Carma L Bylund
- Department of Public Relations, Division of Hematology & Oncology, University of Florida, Gainesville, FL, USA
| | - Merry Jennifer Markham
- Department of Medicine, Division of Hematology & Oncology, University of Florida, Gainesville, FL, USA
| | | | - Ji-Hyun Lee
- Department of Biostatistics, University of Florida, Gainesville, FL, USA
| | - Jennifer Elston Lafata
- UNC Eshelman School of Pharmacy and UNC Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Ramzi G Salloum
- Department of Health Outcomes & Biomedical Informatics, University of Florida, Gainesville, FL, USA
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28
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Zhang JQ, Dong J, Pardo J, Emhoff I, Serres S, Shanafelt T, James T. Burnout and Professional Fulfillment in Early and Early-Mid-Career Breast Surgeons. Ann Surg Oncol 2021; 28:6051-6057. [PMID: 33876361 DOI: 10.1245/s10434-021-09940-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 03/08/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Prior work has shown that burnout among breast surgeons is prevalent and highest in those earlier in their clinical practice career. Therefore, we sought to better understand and identify specific contributors to early-career breast surgeon burnout. METHODS We analyzed data from our 2017 survey of members of the American Society of Breast Surgeons. The 16-items of the Professional Fulfillment Index were used in determining overall burnout and professional fulfillment scores. Multivariable regressions were performed to evaluate factors related to overall burnout and professional fulfillment. RESULTS The mean overall burnout score was 1.23 (0-4 scale; higher score unfavorable) for surgeons in practice < 5 years, compared with 1.39 for surgeons in practice 5-9 years and 1.22 for those in practice ≥ 10 years. The mean professional fulfillment score was 2.71 (0-4 scale; higher score favorable) for surgeons in practice < 5 years, 2.66 for surgeons in practice 5-9 years, and 2.67 for surgeons in practice ≥ 10 years. Multivariable analysis showed that burnout was positively correlated with ≥ 60 work hours per week in the group practicing for < 5 years, and dedicating less than full time to breast surgery in the group in practice 5-9 years. Professional fulfillment was negatively associated with single relationship status in surgeons practicing < 5 years, and dedicating less than full time to breast surgery for those in practice 5-9 years. CONCLUSION Our study suggests that breast surgeons who have been in practice for 5-9 years have particularly high overall burnout rates and additional support focused on this group of breast surgeons may be needed.
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Affiliation(s)
- Jennifer Q Zhang
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Joe Dong
- OpenNotes, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Jaime Pardo
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Isha Emhoff
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Stephanie Serres
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Tait Shanafelt
- Stanford University School of Medicine, Stanford, CA, USA
| | - Ted James
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA. .,BreastCare Center, Beth Israel Deaconess Medical Center, Boston, MA, USA.
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Lichtner V, Baysari M. Electronic display of a patient treatment over time: a perspective on clinicians' burn-out. BMJ Health Care Inform 2021; 28:bmjhci-2020-100281. [PMID: 33853861 PMCID: PMC8054091 DOI: 10.1136/bmjhci-2020-100281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 02/03/2021] [Indexed: 01/08/2023] Open
Affiliation(s)
- Valentina Lichtner
- UCL School of Pharmacy, University College London, London, UK
- Leeds University Business School, University of Leeds, Leeds, UK
| | - Melissa Baysari
- Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
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30
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Avcı O, İriağaç Y, Çavdar E, Şeber ES. Mindfulness Among Medical Oncology Doctors and Its Relation With Burnout: Turkish Oncology Group (TOG) Study. JCO Oncol Pract 2021; 17:e917-e924. [PMID: 33835862 DOI: 10.1200/op.20.01037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Medical oncology physicians have been identified as one of the main risk groups for the development of burnout. Mindfulness as being aware of the moment nonjudgmentally seems to be a protective factor against burnout. We aimed to reveal mindfulness levels among medical oncology doctors and the potential impact of mindfulness on burnout syndrome. METHODS In this cross-sectional study, the data of 285 medical oncology doctors were analyzed. The Mindful Attention Awareness Scale was used for mindfulness evaluation, and the Maslach Burnout Inventory was used for burnout assessment. After defining mindfulness levels among medical oncology doctors, the relationship between mindfulness and burnout was analyzed by the Pearson correlation and bivariate logistic regression tests. RESULTS The mean Mindful Attention Awareness Scale score of participants was 54.52 ± 13.77. Mindfulness was associated with age (P < .001), having a hobby (P = .008), regular exercise (P = .001), professional title (P = .02), and professional experience (P = .02). As the level of mindfulness increased, emotional exhaustion and depersonalization decreased, whereas personal accomplishment increased significantly (all P < .001). In the regression analysis, mindfulness was significantly associated with all three subscales of burnout (all P < .01). CONCLUSION We have demonstrated for the first time on such a large scale that higher levels of mindfulness were related with lower burnout among medical oncology physicians. These findings suggest the potential benefits of mindfulness-based interventions in reducing burnout levels in medical oncologists.
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Affiliation(s)
- Okan Avcı
- Department of Medical Oncology, Namık Kemal University, Tekirdağ, Turkey
| | - Yakup İriağaç
- Department of Medical Oncology, Namık Kemal University, Tekirdağ, Turkey
| | - Eyyüp Çavdar
- Department of Medical Oncology, Namık Kemal University, Tekirdağ, Turkey
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Hawari FI, Obeidat NA, Dodin YI, Albtoosh AS, Manasrah RM, Alaqeel IO, Mansour AH. The inevitability of Covid-19 related distress among healthcare workers: Findings from a low caseload country under lockdown. PLoS One 2021; 16:e0248741. [PMID: 33793579 PMCID: PMC8016221 DOI: 10.1371/journal.pone.0248741] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 03/04/2021] [Indexed: 11/18/2022] Open
Abstract
Objectives To characterize psychological distress and factors associated with distress in healthcare practitioners working during a stringent lockdown in a country (Jordan) that had exhibited one of the lowest incidence rates of Covid-19 globally at the time of the survey. Methods A cross-sectional online survey sent to healthcare practitioners working in various hospitals and community pharmacies. Demographic, professional and psychological characteristics (distress using Kessler-6 questionnaire, anxiety, depression, burnout, sleep issues, exhaustion) were measured as were sources of fear. Descriptive and multivariable statistics were performed using level of distress as the outcome. Results We surveyed 937 practitioners (56.1% females). Approximately 68%, 14%, and 18% were nurses/technicians, physicians, and pharmacists (respectively). 32% suffered from high distress while 20% suffered from severe distress. Exhaustion, anxiety, depression, and sleep disturbances were reported (in past seven days) by approximately 34%, 34%, 19%, and 29% of subjects (respectively). Being older or male, a positive perception of communications with peers, and being satisfied at work, were significantly associated with lower distress. Conversely, suffering burnout; reporting sleep-related functional problems; exhaustion; being a pharmacist (relative to a physician); working in a cancer center; harboring fear about virus spreading; fear that the virus threatened life; fear of alienation from family/friends; and fear of workload increases, were significantly associated with higher distress. Conclusion Despite low caseloads, Jordanian practitioners still experienced high levels of distress. Identified demographic, professional and psychological factors influencing distress should inform interventions to improve medical professionals’ resilience and distress likelihood, regardless of the variable Covid-19 situation.
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Affiliation(s)
- Feras I. Hawari
- Section of Pulmonary and Critical Care, Department of Internal Medicine, King Hussein Cancer Center and University of Jordan, Amman, Jordan
- Cancer Control Office, King Hussein Cancer Center, Amman, Jordan
- * E-mail:
| | - Nour A. Obeidat
- Cancer Control Office, King Hussein Cancer Center, Amman, Jordan
| | - Yasmeen I. Dodin
- Cancer Control Office, King Hussein Cancer Center, Amman, Jordan
| | - Asma S. Albtoosh
- Respiratory Division, Internal Medicine Department, University of Jordan, Amman, Jordan
| | | | | | - Asem H. Mansour
- Director General Office, King Hussein Cancer Center, Amman, Jordan
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Guercovich A, Piazzioni G, Waisberg F, Mandó P, Angel M. Burnout syndrome in medical oncologists during the COVID-19 pandemic: Argentinian national survey. Ecancermedicalscience 2021; 15:1213. [PMID: 33912238 PMCID: PMC8057778 DOI: 10.3332/ecancer.2021.1213] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Indexed: 11/16/2022] Open
Abstract
Burnout (BO) syndrome is a condition that results in physical and mental distress. The current COVID-19 pandemic is strongly affecting the mental health of the general population. We aimed to assess the incidence of BO among medical oncologists and determine factors associated with burnout levels during the current pandemic. METHODS A digital survey was created for this study. The Spanish-validated version of Maslach BO Inventory was incorporated to define BO. Social and demographic information was analysed to remove duplicated answers. RESULTS A total of 188 Argentinian medical oncologists from 16 cities participated in the survey. The median age of the participants was 43 years (IQR 38-50) and a similar distribution between male and female was observed. At the time of the survey, Argentina was in the third month of strict lockdown. Most of the participants practiced in both public and private practice facilities (55.3%) and the majority reported more than 10 years of experience (53.2%). Twenty-five percent (43) of subjects reported high levels of DP, 39.9% (75) reported high levels of EE and 53.7% (101) reported low levels of PA. BO Maslach criteria were fulfilled by 14.9% (28). We compared this result with other burnout assessment tools. Using the Gil-Monte and Neira tool, BO-associated domains were altered in 77.1%, 42% and 42% for EE, DP, and PA domains, respectively. Concomitantly, under Neira assessment a domain impairment was appreciated in 77.1%, 76% and 54% respectively. BO criteria were met by 30.3% (57) according to Gil-Monte and 47.9% (90) to Neira. CONCLUSION BO is a multifaceted issue with a negative impact on physicians, patients, and institutions. During the COVID-19 pandemic, BO criteria was met in a considerable proportion of survey respondents using MBI, and Peiro and Neiro tools and younger age, use of antidepressants and psychological medications and income reduction arose as statistically significant factors after multivariate analysis.
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Affiliation(s)
- Andres Guercovich
- Centro Oncológico Integral (COI), Neuquén Q8300XAC, Argentina
- Member of Asociación Argentina de Oncología Clínica (AAOC)
| | - Gonzalo Piazzioni
- Psychologist, Instituto Austral de Salud Mental, Neuquén Q8300XAC, Argentina
| | - Federico Waisberg
- Instituto Alexander Fleming, CABA, Buenos Aires C1426ANZ, Argentina
- Member of Asociación Argentina de Oncología Clínica (AAOC)
| | - Pablo Mandó
- Breast and Gynecological Tumor Unit, Centro Universitario CEMIC, CABA, Buenos Aires C1431FWN, Argentina
- Member of Asociación Argentina de Oncología Clínica (AAOC)
| | - Martín Angel
- Clinical Oncologist, GenitoUrinary Tumor Unit, Instituto Alexander Fleming, CABA, Buenos Aires C1426ANZ, Argentina
- Member of Asociación Argentina de Oncología Clínica (AAOC)
- https://orcid.org/0000-0002-1463-8887
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Zucker J, Peterson GJ, Falco A, Casselberry J. A Role to Alleviate Burnout and Maintain Quality of Care. J Adv Pract Oncol 2021; 12:203-208. [PMID: 34109051 PMCID: PMC8017797 DOI: 10.6004/jadpro.2021.12.2.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Health care in acute care settings has become increasingly complex and stressful with rapidly evolving treatment options, a growing aging population with multiple comorbidities, and expectations to deliver high-quality care with less resources to curb rising costs. Numerous studies have documented the ever-growing problem of burnout in health-care providers working in acute care settings and increased provider interruptions leading to medical errors. From 2018 to 2019, a new advanced practice provider (APP) role was tested on a 36-bed inpatient bone marrow transplant unit at the University of Colorado to address these issues. The goal of this role was to alleviate stressors and minimize interruptions that could otherwise contribute to compromised patient care and safety. In addition to improving patient care, the goal of the role is to improve job satisfaction. A description of the role and its development and implementation at the University of Colorado Hospital, Anschutz Medical Campus, is highlighted in this article.
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Affiliation(s)
| | | | - Angela Falco
- University of Colorado Medicine, Aurora, Colorado
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34
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Hlubocky FJ, Symington BE, McFarland DC, Gallagher CM, Dragnev KH, Burke JM, Lee RT, El-Jawahri A, Popp B, Rosenberg AR, Thompson MA, Dizon DS, Srivastava P, Patel MI, Kamal AH, Daugherty CK, Back AL, Dokucu ME, Shanafelt TD. Impact of the COVID-19 Pandemic on Oncologist Burnout, Emotional Well-Being, and Moral Distress: Considerations for the Cancer Organization's Response for Readiness, Mitigation, and Resilience. JCO Oncol Pract 2021; 17:365-374. [PMID: 33555934 DOI: 10.1200/op.20.00937] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Fay J Hlubocky
- University of Chicago Medicine, Maclean Center for Clinical Medical Ethics, Chicago, IL
| | | | - Daniel C McFarland
- Memorial Sloan Kettering Cancer Center, Department of Psychiatry, New York, NY
| | - Colleen M Gallagher
- MD Anderson Cancer Center, Section of Integrated Ethics in Cancer Care, Houston, TX
| | | | | | - Richard T Lee
- Case Comprehensive Cancer Center, Department of Medicine, Division of Hematology/Oncology, School of Medicine, Cleveland OH
| | - Areej El-Jawahri
- Massachusetts General Hospital, Cancer Center, Harvard Medical School, Boston MA
| | - Beth Popp
- Ichan School of Medicine, Geriatrics and Palliative Medicine, Mount Sinai, New York, NY
| | - Abby R Rosenberg
- Division of Hematology/Oncology, Department of Pediatrics, University of Washington School of Medicine; Seattle WA; Seattle Children's Research Institute, Seattle, WA
| | | | - Don S Dizon
- Lifespan Cancer Institute, Rhode Island Hospital, Brown University Providence, RI
| | | | - Manali I Patel
- Stanford University, VA Palo Alto Health Care System, Palo Alto, CA
| | - Arif H Kamal
- Duke University, Duke Cancer Institute, Population Health Sciences, Durham, NC
| | - Christopher K Daugherty
- University of Chicago Medicine, Department of Medicine, Section Hematology/Oncology, Maclean Center for Clinical Medical Ethics, Chicago, IL Chicago, IL
| | - Anthony L Back
- University of Washington, Department of Medicine/Oncology, Seattle, WA
| | - Mehmet E Dokucu
- Northwestern University, Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences, Chicago, IL
| | - Tait D Shanafelt
- Stanford University, Department of Medicine, Med/Hematology, Chief Wellness Officer, Palo Alto, CA
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Prevalence of burnout among healthcare professionals at the Serbian National Cancer Center. Int Arch Occup Environ Health 2021; 94:669-677. [PMID: 33387030 DOI: 10.1007/s00420-020-01621-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 11/26/2020] [Indexed: 10/22/2022]
Abstract
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.
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Pilar A, Gravel SB, Croke J, Soliman H, Chung P, Wong RK. Coronavirus Disease 2019's (COVID-19's) Silver Lining-Through the Eyes of Radiation Oncology Fellows. Adv Radiat Oncol 2021; 6:100527. [PMID: 32838070 PMCID: PMC7377812 DOI: 10.1016/j.adro.2020.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 11/05/2022] Open
Abstract
PURPOSE The coronavirus disease 2019 (COVID-19) pandemic has propelled health care workers to the front lines against the pandemic. In addition to anxiety related to infection risks, trainees have the additional burden of learning and career planning while providing care in an uncertain and rapidly changing environment. We conducted a survey to evaluate the practical and psychosocial impact on radiation oncology fellows during the first month of the pandemic. METHODS AND MATERIALS A 4-part survey was designed and distributed to the fellows in our program. The survey was designed to evaluate the impact of the pandemic on scope of activity and well-being ("Impact on You") and to identify key lessons learned and social factors ("About You") using Likert scales and open-ended response options. The survey included items from the Oldenburg Burnout questionnaire. RESULTS A total of 17 participants (71%) responded to the survey. Although there was a significant reduction in the mean time spent on in-person clinics (13.5 h/wk [pre-COVID] vs 9.3 h/wk [3 weeks into the COVID emergency response]; P = .002), this was replaced by virtual consults and other COVID-related activities. The proportion of respondents demonstrating features of burnout in the domains of "disengagement" and "exhaustion" was 71% and 64%, respectively. However, there was also evidence of resilience, with 47% respondents "feeling energized." Top "concerns" and "negative changes" identified related to learning, infection risk and safety, patient care, coping, and concerns about their home country. Top "positive changes" highlighted include work culture, appreciation for leadership caring for the team, the insistence on evidence to guide change, and the implementation of virtual health care. CONCLUSIONS Negative impact needs to be anticipated, acknowledged, and managed. We anticipate understanding the positives that have emerged under these extraordinary circumstances is the "silver lining" of the pandemic, giving us tools and the best leverage to plan for the future.
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Affiliation(s)
- Avinash Pilar
- Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
- Radiation Medicine Program, Princess Margaret Cancer Center, Toronto, Ontario, Canada
| | - Samuel Bergeron Gravel
- Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
- Radiation Medicine Program, Princess Margaret Cancer Center, Toronto, Ontario, Canada
| | - Jennifer Croke
- Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
- Radiation Medicine Program, Princess Margaret Cancer Center, Toronto, Ontario, Canada
| | - Hany Soliman
- Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
- Department of Radiation Oncology, Odette Cancer Center, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Peter Chung
- Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
- Radiation Medicine Program, Princess Margaret Cancer Center, Toronto, Ontario, Canada
| | - Rebecca K.S. Wong
- Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
- Radiation Medicine Program, Princess Margaret Cancer Center, Toronto, Ontario, Canada
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Franceschi E, Brandes AA. Burnout in medical oncology during the COVID-19 pandemic. Expert Rev Anticancer Ther 2020; 21:351-353. [PMID: 33353446 DOI: 10.1080/14737140.2021.1866549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Enrico Franceschi
- Medical Oncology Department, Azienda USL/IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Bologna, Italia
| | - Alba A Brandes
- Medical Oncology Department, Azienda USL/IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Bologna, Italia
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Thomaier L, Teoh D, Jewett P, Beckwith H, Parsons H, Yuan J, Blaes AH, Lou E, Hui JYC, Vogel RI. Emotional health concerns of oncology physicians in the United States: Fallout during the COVID-19 pandemic. PLoS One 2020; 15:e0242767. [PMID: 33232377 PMCID: PMC7685431 DOI: 10.1371/journal.pone.0242767] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 11/09/2020] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Cancer care is significantly impacted by the Coronavirus Disease 2019 (COVID-19) pandemic. Our objective was to evaluate the early effects of the pandemic on the emotional well-being of oncology providers across the United States and explore factors associated with anxiety and depression symptoms. MATERIALS AND METHODS A cross-sectional survey was administered to United States cancer-care physicians recruited over a two-week period (3/27/2020-4/10/2020) using snowball-convenience sampling through social media. Symptoms of anxiety and depression were measured using the Patient Health Questionnaire (PHQ-4). RESULTS Of 486 participants, 374 (77.0%) completed the PHQ-4: median age was 43 years; 63.2% female; all oncologic specialties were represented. The rates of anxiety and depression symptoms were 62.0% and 23.5%, respectively. Demographic factors associated with anxiety included female sex, younger age, and less time in clinical practice. Perception of inadequate personal protective equipment (68.6% vs. 57.4%, p = 0.03) and practicing in a state with more COVID-19 cases (65.8% vs. 51.1%, p = 0.01) were associated with anxiety symptoms. Factors significantly associated with both anxiety and depression included the degree to which COVID-19 has interfered with the ability to provide treatment to cancer patients and concern that patients will not receive the level of care needed for non-COVID-19 illness (all p-values <0.01). CONCLUSION The perceived degree of interference with clinical practice along with personal concerns about COVID-19 were significantly associated with both anxiety and depression among oncology physicians in the United States during the COVID-19 pandemic. Our findings highlight factors associated with and sources of psychological distress to be addressed to protect the well-being of oncology physicians.
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Affiliation(s)
- Lauren Thomaier
- Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, United States of America
| | - Deanna Teoh
- Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, United States of America
| | - Patricia Jewett
- Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN, United States of America
| | - Heather Beckwith
- Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN, United States of America
| | - Helen Parsons
- Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, United States of America
| | - Jianling Yuan
- Department of Radiation Oncology, University of Minnesota, Minneapolis, MN, United States of America
| | - Anne H. Blaes
- Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN, United States of America
| | - Emil Lou
- Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN, United States of America
| | - Jane Yuet Ching Hui
- Department of Surgery, University of Minnesota, Minneapolis, MN, United States of America
| | - Rachel I. Vogel
- Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, United States of America
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Davis A, Bell JF, Reed SC, Kim KK, Stacey D, Joseph JG. Nurse-Led Telephonic Symptom Support for Patients Receiving Chemotherapy. Oncol Nurs Forum 2020; 47:E199-E210. [PMID: 33063775 DOI: 10.1188/20.onf.e199-e210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PROBLEM STATEMENT The use of evidence-informed symptom guides has not been widely adopted in telephonic support. DESIGN This is a descriptive study of nurse-led support using evidence-based symptom guides during telephone outreach. DATA SOURCES Documentation quantified telephone encounters by frequency, length, and type of patient-reported symptoms. Nurse interviews examined perceptions of their role and the use of symptom guides. ANALYSIS Quantitative data were summarized using univariate descriptive statistics, and interviews were analyzed using directed descriptive content analysis. FINDINGS Symptom guides were viewed as trusted evidence-based resources, suitable to address common treatment-related symptoms. A threshold effect was a reported barrier of the guides, such that the benefit diminished over time for managing recurring symptoms. IMPLICATIONS FOR PRACTICE Telephone outreach using evidence-based symptom guides can contribute to early symptom identification while engaging patients in decision making. Understanding nurse activities aids in developing an economical and high-quality model for symptom support, as well as in encouraging nurses to practice at the highest level of preparation.
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De Clercq E, Rost M, von der Weid N, Ansari M, Elger BS. To be or not to be in the social media arena? The perspective of healthcare providers working within adolescent and young adult oncology in Switzerland. Int J Adolesc Med Health 2020; 34:417-429. [PMID: 32860667 DOI: 10.1515/ijamh-2020-0137] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 07/28/2020] [Indexed: 12/23/2022]
Abstract
Background Given that social media is quickly penetrating clinical practice, it is essential to explore how these technologies can be used to improve patient-centered care. This is particularly important for healthcare professionals caring for adolescents and young adults (AYA), amid whom the use of social media is nearly universal and whose medical and psychosocial needs are often underestimated by the pediatric or adult oncology settings in which they are treated. Objectives To examine the perspectives of various medical professionals on the emerging role of social media in AYA oncology. Methods Three focus groups were performed with Swiss healthcare professionals involved in the care of AYA patients with cancer. The focus groups were analyzed using thematic coding. Results Healthcare professionals caring for AYA cancer patients in Switzerland are reluctant to step into the social media sphere because they find it difficult to navigate professional boundaries in an unfamiliar space where different contexts collapse. Nurses and younger healthcare professionals who tend to have a more intimate relationship with AYA, often lack virtual mentorship to know how to maintain online professionalism. Adolescents and young adults cancer-related social media presence was unknown to our participants which resulted in missed occasions to inform, educate and care for this often underserved population of cancer patients. Conclusions More practical guidance is needed to help healthcare professionals with how to integrate social media into clinical practice. Setting up fruitful collaborations between medical institutions and existing AYA support groups online might be the best way forward.
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Affiliation(s)
- Eva De Clercq
- University of Basel, Institute for Biomedical Ethics, Basel, Switzerland
| | - Michael Rost
- University of Basel, Institute for Biomedical Ethics, Basel, Switzerland
| | | | - Marc Ansari
- Hôpitaux Universitaires de Genève, Département de l'Enfant et de l'Adolescent, Onco-hématologie pédiatrique, Genève, Switzerland
| | - Bernice S Elger
- University of Basel, Institute for Biomedical Ethics, Basel, Switzerland
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Messerotti A, Banchelli F, Ferrari S, Barbieri E, Bettelli F, Bandieri E, Giusti D, Catellani H, Borelli E, Colaci E, Pioli V, Morselli M, Forghieri F, Galeazzi GM, Marasca R, Bigi S, D'Amico R, Martin P, Efficace F, Luppi M, Potenza L. Investigating the association between physicians self-efficacy regarding communication skills and risk of "burnout". Health Qual Life Outcomes 2020; 18:271. [PMID: 32762755 PMCID: PMC7409639 DOI: 10.1186/s12955-020-01504-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 07/21/2020] [Indexed: 11/10/2022] Open
Abstract
Background Breaking bad news (BBN) may be associated with increasing risk of burnout in practising physicians. However, there is little research on the association between the way bad news is broken and burnout. We investigated the association between physicians’ self-efficacy regarding communication to patients and risk of burnout. Methods We performed a cross-sectional study by proposing an ad-hoc survey exploring attitudes and practice regarding BBN and the Maslach Burnout Inventory - Human Service Survey to 379 physicians from two University Hospitals in Italy. Associations were assessed by multivariable logistic regression models. Results Two-hundred twenty-six (60%) physicians returned the questionnaires. 76% of physicians acquired communication skills by observing mentors or colleagues, 64% considered BBN as discussing a poor prognosis, 56% reported discussing prognosis as the most difficult task, 38 and 37% did not plan a BBN encounter and considered it stressful. The overall burnout rate was 59%. Considering BBN a stressful task was independently associated with high risk of burnout (OR 3.01; p = 0.013). Planning the encounter (OR = 0.43, p = 0.037), mastering communication skills (OR = 0.19, p = 0.034) and the self-evaluation as good or very good at BBN (OR 0.32; 0.15 to 0.71; p = 0.0) were associated with low risk of burnout. Conclusions Our findings suggest that some physicians’ BBN attitudes and knowledge of conceptual frameworks may influence the risk of burnout and support the notion that increasing knowledge about communication skills may protect clinicians from burnout. Further research is needed in this area.
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Affiliation(s)
- Andrea Messerotti
- Hematology Unit and Chair, Azienda Ospedaliera Universitaria di Modena and Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Federico Banchelli
- Department of Medical and Surgical Sciencesm, Statistic Unit, University of Modena and Reggio Emilia, Modena, Italy
| | - Silvia Ferrari
- Department of Biomedic and Metabolic Science and Neuroscience, section of Psychiatry, University of Modena and Reggio Emilia, Modena, Italy
| | - Emiliano Barbieri
- Hematology Unit and Chair, Azienda Ospedaliera Universitaria di Modena and Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Francesca Bettelli
- Hematology Unit and Chair, Azienda Ospedaliera Universitaria di Modena and Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Elena Bandieri
- Oncology and Palliative Care Units, Civil Hospital Carpi, Local Health Agency, Carpi (Modena), Italy
| | - Davide Giusti
- Hematology Unit and Chair, Azienda Ospedaliera Universitaria di Modena and Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Hillary Catellani
- Hematology Unit and Chair, Azienda Ospedaliera Universitaria di Modena and Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Eleonora Borelli
- Department of Biomedic and Metabolic Science and Neuroscience, University of Modena and Reggio Emilia, Modena, Italy
| | - Elisabetta Colaci
- Hematology Unit and Chair, Azienda Ospedaliera Universitaria di Modena and Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Valeria Pioli
- Hematology Unit and Chair, Azienda Ospedaliera Universitaria di Modena and Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Monica Morselli
- Hematology Unit and Chair, Azienda Ospedaliera Universitaria di Modena and Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Fabio Forghieri
- Hematology Unit and Chair, Azienda Ospedaliera Universitaria di Modena and Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Gian Maria Galeazzi
- Department of Biomedic and Metabolic Science and Neuroscience, section of Psychiatry, University of Modena and Reggio Emilia, Modena, Italy
| | - Roberto Marasca
- Hematology Unit and Chair, Azienda Ospedaliera Universitaria di Modena and Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Sarah Bigi
- Department of Linguistic Sciences and Foreign Literatures, Catholic University of the Sacred Heart, Milan, Italy
| | - Roberto D'Amico
- Department of Medical and Surgical Sciencesm, Statistic Unit, University of Modena and Reggio Emilia, Modena, Italy
| | - Peter Martin
- Centre for Organisational Change in Person-Centred Healthcare, Faculty of Health, Deakin University, Melbourne, Australia
| | - Fabio Efficace
- Italian Group for Adult Hematologic Disease (GIMEMA), Health Outcomes Research Unit, Rome, Italy
| | - Mario Luppi
- Hematology Unit and Chair, Azienda Ospedaliera Universitaria di Modena and Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Leonardo Potenza
- Hematology Unit and Chair, Azienda Ospedaliera Universitaria di Modena and Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy.
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Nadler MB, Barry A, Murphy T, Prince R, Elliott M. Strategies to support health care providers during the COVID-19 pandemic. CMAJ 2020; 192:E522. [PMID: 32575044 DOI: 10.1503/cmaj.75499] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Michelle B Nadler
- Medical oncology fellow, Department of Medical Oncology and Haematology, Princess Margaret Cancer Centre, Toronto, Canada and University of Toronto, Toronto, Ont
| | - Aisling Barry
- Radiation oncologist, Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Canada and University of Toronto, Toronto, Ont
| | - Tracy Murphy
- Hematologist, Department of Medical Oncology and Haematology, Princess Margaret Cancer Centre, Toronto, Canada and University of Toronto, Toronto, Ont
| | - Rebecca Prince
- Medical oncologist, Department of Medical Oncology and Haematology, Princess Margaret Cancer Centre, Toronto, Canada and University of Toronto, Toronto, Ont
| | - Mary Elliott
- Psychiatrist, Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Canada and University of Toronto, Toronto, Ont
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Barry A, Murphy T, Prince R, May T, Zimmermann C, Elliott M. Time to "Buddy Up"-Simple Strategies to Support Oncologists During the Coronavirus Disease 2019 Pandemic. Adv Radiat Oncol 2020; 5:601-602. [PMID: 32313847 PMCID: PMC7167586 DOI: 10.1016/j.adro.2020.04.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 04/02/2020] [Indexed: 11/28/2022] Open
Affiliation(s)
- Aisling Barry
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Canada.,University of Toronto, Department of Radiation Oncology, Toronto, Canada
| | - Tracy Murphy
- Department of Medical Oncology and Haematology, Princess Margaret Cancer Centre, Toronto, Canada
| | - Rebecca Prince
- Department of Medical Oncology and Haematology, Princess Margaret Cancer Centre, Toronto, Canada
| | - Taymaa May
- Department of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, Canada
| | - Camilla Zimmermann
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Canada
| | - Mary Elliott
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Canada
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Shanafelt TD, Kamal AH, Hlubocky FJ. Promoting Oncologist Well-Being to Foster Delivery of Ethical, High-Quality Cancer Care: Priorities for 2020 and Beyond. JCO Oncol Pract 2020; 16:188-190. [DOI: 10.1200/op.20.00069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Arif H. Kamal
- Duke Cancer Institute and Duke Fuqua School of Business, Durham, NC
| | - Fay J. Hlubocky
- The University of Chicago Medicine, Department of Medicine, Section of Hematology/Oncology, MacLean Center for Clinical Medical Ethics, Cancer Research Center, Supportive Oncology Program, Chicago, IL,
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Richardson DR, Tan X, Winzelberg G, Rosenstein DL, Collichio FA. Development of an Art of Oncology Curriculum to Mitigate Burnout and Foster Solidarity Among Hematology/Oncology Fellows. JCO Oncol Pract 2020; 16:e384-e394. [PMID: 32101489 DOI: 10.1200/jop.19.00529] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2020] [Indexed: 04/03/2024] Open
Abstract
PURPOSE Oncologists and fellows in hematology/oncology (HO) training programs report high levels of burnout. The Accreditation Council for Graduate Medical Education requires accredited programs to have a mechanism to foster well-being among fellows. METHODS Through an iterative process involving a multidisciplinary committee, we created a 3-year longitudinal Art of Oncology (AOO) curriculum intended to address burnout and foster solidary among HO fellows. Sessions used narratives to promote the formation of a shared mental model through discussion of the mutual experience of caring for patients with cancer. We tested the feasibility, acceptability, and initial effectiveness of implementing the curriculum into traditional didactic lectures as a pilot intervention from 2018 to 2019. Eight sessions were completed. RESULTS Sixteen fellows participated. Most were married (63%) and planned on pursuing careers in academic medicine (75%). The sample was racially and ethnically diverse (31% minority representation). Thirty-eight percent of fellows reported burnout symptoms. AOO sessions had higher attendance than didactic lectures (P = .04). Of 14 fellows who completed all follow-up assessments (87.5% response rate), 93% (13 of 14 fellows) felt the sessions were very or somewhat helpful and that sessions improved solidarity. Preparedness in managing work-life balance significantly improved (paired t test, mean difference, 0.53; P = .04). Measured levels of burnout did not significantly improve from baseline (mean difference, -0.133; P = .67). Work-life balance was associated with burnout on multivariable analysis (coefficient, 0.40; P = .03). CONCLUSION The implementation of a dedicated AOO curriculum is feasible and viewed as helpful by HO fellows. Larger studies are needed to assess the efficacy of this curricular intervention.
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Affiliation(s)
- Daniel R Richardson
- UNC Lineberger Comprehensive Cancer Center, Division of Hematology/Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC
- The Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Xianming Tan
- UNC Lineberger Comprehensive Cancer Center, Division of Hematology/Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC
- UNC Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Gary Winzelberg
- UNC School of Medicine, UNC Palliative Care Program, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Donald L Rosenstein
- UNC School of Medicine, Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Frances A Collichio
- UNC Lineberger Comprehensive Cancer Center, Division of Hematology/Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Hlubocky FJ, Taylor LP, Marron JM, Spence RA, McGinnis MM, Brown RF, McFarland DC, Tetzlaff ED, Gallagher CM, Rosenberg AR, Popp B, Dragnev K, Bosserman LD, Dudzinski DM, Smith S, Chatwal M, Patel MI, Markham MJ, Levit K, Bruera E, Epstein RM, Brown M, Back AL, Shanafelt TD, Kamal AH. A Call to Action: Ethics Committee Roundtable Recommendations for Addressing Burnout and Moral Distress in Oncology. JCO Oncol Pract 2020; 16:191-199. [PMID: 32223701 DOI: 10.1200/jop.19.00806] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Oncologist well-being is critical to initiating and maintaining the physician-patient relationship, yet many oncologists suffer from symptoms of burnout. Burnout has been linked to poor physical and mental health, as well as increased medical errors, patient dissatisfaction, and workforce attrition. In this Call to Action article, we discuss causes of and interventions for burnout and moral distress in oncology, highlight existing interventions, and provide recommendations for addressing burnout and improving well-being at the individual and organizational levels to deliver ethical, quality cancer care.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Abby R Rosenberg
- University of Washington School of Medicine, Department of Pediatrics, Seattle, WA
| | - Beth Popp
- Icahn School of Medicine at Mount Sinai, New York, NY
| | | | | | | | | | | | | | | | | | - Eduardo Bruera
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Marie Brown
- American Medical Association and Rush University, Chicago, IL
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Hlubocky FJ, Spence R, McGinnis M, Taylor L, Kamal AH. Burnout and Moral Distress in Oncology: Taking a Deliberate Ethical Step Forward to Optimize Oncologist Well-Being. JCO Oncol Pract 2020; 16:185-186. [PMID: 32134705 DOI: 10.1200/op.20.00030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Fay J Hlubocky
- Department of Medicine, Section of Hematology/Oncology, MacLean Center for Clinical Medical Ethics, Cancer Research Center, Supportive Oncology Program, The University of Chicago Medicine, Chicago, IL
| | - Rebecca Spence
- American Society of Clinical Oncology, Ethics Committee, Alexandria, VA
| | - Molly McGinnis
- American Society of Clinical Oncology, Ethics Committee, Alexandria, VA
| | - Lynne Taylor
- Departments of Neurology and Neurologic Surgery, University of Washington, and Seattle Cancer Care Alliance, Seattle, WA
| | - Arif H Kamal
- Duke Cancer Institute and Duke Fuqua School of Business, Durham, NC
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LeNoble CA, Pegram R, Shuffler ML, Fuqua T, Wiper DW. To Address Burnout in Oncology, We Must Look to Teams: Reflections on an Organizational Science Approach. JCO Oncol Pract 2020; 16:e377-e383. [PMID: 32074017 DOI: 10.1200/jop.19.00631] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Despite decades of effort, burnout among physicians remains elevated compared with that of other working populations, and it yields catastrophic consequences, including medical errors and physician suicide. Burnout leaves oncologists feeling like they are alone, but this is not the case-it affects everyone. To effectively address burnout, it is not enough to look only at oncologists; instead, we must include all those involved in the delivery of cancer care. With this aim, we present an overview of the organizational science strategies and initial evidence for the value of a comprehensive, team-focused approach to addressing oncology provider burnout. METHODS We describe the development of a team-focused burnout intervention approach, implemented for oncology providers, which focuses on the importance of encouraging communication and psychological safety to reduce feelings of isolation and fragmentation. We discuss the initial findings from 1 such team-based initiative currently underway within an academic medical center, presenting data from 409 cancer care providers embedded in 30 oncology units participating in this intervention approach. RESULTS Preliminary results demonstrate that units that integrated a team-focused intervention for burnout reported significantly higher levels of teamwork and lower levels of burnout. We also describe lessons learned and recommendations for implementing this type of intervention on the basis of best practices from organizational science. CONCLUSION This approach can positively affect the delivery of cancer care, interprofessional relationships among oncology staff, and the well-being of both patients and providers. Treating physician burnout alone will treat 1 symptom of the overall issue of burnout in oncology. As burnout pulls oncology clinicians apart, our solution must be to bring them together.
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Kust D, Murgic J, Vukovic P, Kruljac I, Prpic M, Zilic A, Lengyel C, Wdowiak K, Simaskaite L, Mutlu Gunaydin U, Tica Sedlar I, Fountzilas E, Janzic U, Coroian I, Durutovic I, Pellegrino B, Petrova M, Huti E, Napolskaia E, Seruga B, Balenovic A, Frobe A, Luetic K. Oncologist Burnout Syndrome in Eastern Europe: Results of the Multinational Survey. JCO Oncol Pract 2020; 16:e366-e376. [PMID: 32048930 DOI: 10.1200/jop.19.00470] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Burnout is defined as a three-dimensional syndrome-emotional exhaustion (EE), depersonalization (DP), and reduced personal accomplishment (PA)-caused by chronic occupational stress. The aim of the current study was to investigate the prevalence of burnout among oncologists in Eastern Europe and to identify the contributing factors. METHODS The study was conducted as an online survey between October 2017 and March 2018. Oncologists (including medical, radiation, clinical, and surgical oncologists) from 19 countries were invited to participate. The survey consisted of 30 questions, including the standardized burnout instrument, Maslach Burnout Inventory, and eight demographic questions. Burnout risk was scored according to the scoring manual for health care workers. RESULTS The study included 637 oncologists. Overall, 28% were at low or intermediate risk and 72% were at high risk for burnout. Forty-four percent of participants were at high risk for EE, 28.7% for DP, and 47.3% for PA. EE risk was associated with female sex. DP risk was highest among clinical and radiation oncologists, whereas PA risk was positively correlated with years of service, percentage of cancer deaths, and availability of the number of oncologists. In multivariate logistic regression analysis, burnout was significantly associated with standardized cancer mortality and fewer years of practice. CONCLUSION Burnout among oncologists in Eastern Europe is high, and younger oncologists are the most vulnerable group. Preventive measures should be taken to address this issue, which negatively affects optimal care delivery and poses a threat to oncologists' health and well-being.
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Affiliation(s)
- Davor Kust
- Department of Oncology and Nuclear Medicine, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia
| | - Jure Murgic
- Department of Oncology and Nuclear Medicine, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia
| | - Petra Vukovic
- Department of Medical Oncology, University Hospital for Tumors, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia
| | - Ivan Kruljac
- Department of Internal Medicine, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia
| | - Marin Prpic
- Department of Oncology and Nuclear Medicine, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia.,School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Ana Zilic
- Intensive Oncology and Supportive Care Department, Clinic For Medical Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | | | - Kamil Wdowiak
- Department of Internal Medicine and Oncological Chemotherapy, Medical University of Silesia, Katowice, Poland
| | - Lina Simaskaite
- Department of Oncology and Hematology, Hospital of Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Ulug Mutlu Gunaydin
- Department of Medical Oncology, Istanbul Medeniyet University, Istanbul, Turkey
| | - Ivana Tica Sedlar
- Clinic of Oncology, University Hospital Mostar, Mostar, Bosnia and Herzegovina
| | - Elena Fountzilas
- Department of Medical Oncology, Euromedica General Clinic, Thessaloniki, Greece
| | - Urska Janzic
- Medical Oncology Unit, University Clinic Golnik, Golnik, Slovenia
| | - Iulia Coroian
- Medical Oncology Department, Oncology Institute Prof. Dr. I. Chiricuta, Cluj-Napoca, Romania
| | - Ivana Durutovic
- Clinic for Oncology and Radiotherapy, Clinical Center of Montenegro, Podgorica, Montenegro
| | | | - Mila Petrova
- Department of Medical Oncology, Multi Profile Hospital for Active Treatment Nadezhda, Sofia, Bulgaria
| | - Emiljana Huti
- Department of Oncology, American Hospital Tirana II, Tirana, Albania
| | - Elena Napolskaia
- Outpatient Department, Clinical Scientifical Practical Center of Specialized Kinds of Medical Care (Oncology), Saint Petersburg, Russia
| | - Bostjan Seruga
- Division of Medical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | | | - Ana Frobe
- Department of Oncology and Nuclear Medicine, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia.,School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Kresimir Luetic
- Department of Gastroenterology and Hepatology, Clinical Hospital "Sveti Duh," Zagreb, Croatia
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A Cross-sectional Analysis of Compassion Fatigue, Burnout, and Compassion Satisfaction in Pediatric Hematology-Oncology Physicians in the United States. J Pediatr Hematol Oncol 2020; 42:e50-e55. [PMID: 31259831 DOI: 10.1097/mph.0000000000001548] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Compassion fatigue (CF), burnout (BO), and compassion satisfaction (CS) are interrelated phenomena that impact personal and professional performance. The CF and Satisfaction Self-Test and a demographic questionnaire were distributed electronically to pediatric hematology-oncology physicians nationally. Linear regression models for CF, BO, and CS as a function of potential predictors were constructed. Survey response rate was 28%. Female sex, BO score, distress about a "clinical situation," and "teaching" were associated with higher CF scores. "Administrative activities" were associated with lower CF scores. CF score, and distress about "administrative burden/academic stress" and "coworkers" were associated with higher BO scores. CS score and "socializing" were associated with lower BO scores. "Exercise," "socializing," and "talking with partner" were associated with higher CS scores. CF and BO scores, emotional depletion, and distress about the "work environment" and "administrative/academic burden" were associated with lower CS scores. Our data highlights the importance of strong social connections at work and at home to decrease BO and enhance CS. Professional development in leadership, communication, and conflict resolution, as well as "team building" events may perpetuate coworker relationships. Education about the importance of connectedness and self-care should begin early in medical education to cultivate robust coping mechanisms in trainees.
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