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Osei HV, Arthur J, Aseibu F, Osei-Kwame D, Fiakeye R, Abama C. The joint impact of burnout and neurotic personality on career satisfaction and intention to leave among health workers during the first 2 years of COVID-19. J Health Organ Manag 2024; ahead-of-print. [PMID: 38888569 DOI: 10.1108/jhom-03-2023-0089] [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] [Indexed: 06/20/2024]
Abstract
PURPOSE The purpose of the study is to examine the psychological impact of COVID-19 on health workers' career satisfaction and intention to leave the health profession, with neurotic personality type as a moderator. DESIGN/METHODOLOGY/APPROACH A total of 277 health workers in two public hospitals in Ghana were included in this study. Purposive and convenience sampling techniques were adopted for the study, focusing on eight departments that were involved in the management of COVID-19 cases. Validated instruments were used to measure burnout, intention to leave, neurotic personality and career satisfaction. Using AMOS and partial least squares structural equation modeling (PLS-SEM), various techniques were employed to analyze mediating and moderating mechanisms. FINDINGS The departments had staff sizes ranging from 19 to 40, with 67% female and 33% male, with an average age of 31. Nurses accounted for the majority of responses (67.8%), followed by physicians (13.9%), sonographers (0.9%), lab technicians (0.9%) and other respondents (16.5%). The study found that health workers' level of burnout during COVID-19 had a positive effect on their intention to leave the health profession. Career satisfaction does not mediate this relationship; however, career satisfaction negatively influences the intention to leave the health profession. A neurotic personality does not moderate this relationship. ORIGINALITY/VALUE This study provides validation of burnout and intention to leave among health workers in Ghana during COVID-19 and supports the proposition that threats to resources (burnout) and having a resource (career satisfaction) have effects on the intention to leave one's profession.
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Affiliation(s)
- Hannah Vivian Osei
- Department of Human Resource and Organisational Development, KNUST School of Business, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Justice Arthur
- Department of Human Resource and Organisational Development, KNUST School of Business, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Francis Aseibu
- Department of Human Resource and Organisational Development, KNUST School of Business, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Daniel Osei-Kwame
- Department of Emergency Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Rita Fiakeye
- Department of Human Resource and Organisational Development, KNUST School of Business, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Charity Abama
- Department of Human Resource and Organisational Development, KNUST School of Business, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Bernard KS, Bostain N. The opportunity to lead facilitates PA professional well-being. JAAPA 2024; 37:1-10. [PMID: 38747902 DOI: 10.1097/01.jaa.0000000000000022] [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: 07/11/2024]
Abstract
OBJECTIVE Physician associates/assistants (PAs) with mature careers represent an important leadership resource for healthcare employers. This study sought to determine whether PA leadership task responsibility interacted with experience level to predict professional well-being. METHODS This quantitative study used an archival dataset from a national sample of PAs. The Professional Fulfillment Index was used to measure well-being and career length was used to represent experience level. PA leadership task responsibility was calculated as an aggregate score. Bivariate linear regression with mediation analysis was conducted to determine the relationship between variables. RESULTS An increase in PA experience level predicted higher professional fulfillment and lower burnout, and aggregate leadership task score partially mediated this relationship. CONCLUSIONS Granting leadership task responsibility compatible with experience level may enhance PA professional fulfillment, mitigate burnout, and increase PA usefulness for healthcare employers.
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Affiliation(s)
- Kari Sue Bernard
- Kari Sue Bernard is associate director of research and capstone in the Doctor of Medical Science program at A.T. Still University's Arizona School of Health Sciences in Mesa, Ariz., and practices in psychiatry at Orion Behavioral Health Network in Eagle River, Alaska. Nancy Bostain is an adjunct faculty member at Walden University in Minneapolis, Minn. Dr. Bernard discloses that she owns and operates Bernard Wellness Initiative, LLC, a professional well-being business that provides continuing medical education, coaching, and workplace assessments to healthcare providers and organizations. The authors have disclosed no other potential conflicts of interest, financial or otherwise
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Kim M, Oh Y, Lee JY, Lee E. Job satisfaction and moral distress of nurses working as physician assistants: focusing on moderating role of moral distress in effects of professional identity and work environment on job satisfaction. BMC Nurs 2023; 22:267. [PMID: 37580762 PMCID: PMC10424341 DOI: 10.1186/s12912-023-01427-1] [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: 04/26/2023] [Accepted: 07/31/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Physician assistant was created in response to a shortage of physicians. However, this profession is not officially recognized in Korea. Many nurses are working as physician assistants. Their job satisfaction was low due to role conflict. Job satisfaction plays a major role in providing high quality nursing. This study aimed to investigate effects of work environment and professional identity on job satisfaction and identify the mediating role of moral distress in such effects. METHODS Participants were 112 nurses working as physician assistants. They were recruited from three General Hospitals. A questionnaire scale was used to collect data. Data were analyzed using frequency, descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation, and Macro Model 4 with SPSS Statistics. RESULTS Job satisfaction of nurses working as physician assistants had a score of 3.08 out of 5. It showed significant associations with work environment and professional identity. Moral distress had a partial mediating role in relationships of job satisfaction with work environment and professional identity. CONCLUSION Many nurses are working as physician assistants, although physician assistant as a profession is not officially recognized in Korea. Nurses working as physician assistants experience confusion about their professional identity and moral distress. For better nursing outcomes, physician assistant policy should be improved, and various strategies should be provided to improve their job satisfaction.
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Affiliation(s)
- Minsub Kim
- School of Nursing, Research Institute of Nursing Science, Hallym University, 1 Hallymdaehak-gil, Chuncheon, 24252, Gangwon-do, Republic of Korea
| | - Younjae Oh
- School of Nursing, Research Institute of Nursing Science, Hallym University, 1 Hallymdaehak-gil, Chuncheon, 24252, Gangwon-do, Republic of Korea
| | - Joo Yun Lee
- College of Nursing, Gachon University, Incheon, Korea
| | - Eunhee Lee
- School of Nursing, Research Institute of Nursing Science, Hallym University, 1 Hallymdaehak-gil, Chuncheon, 24252, Gangwon-do, Republic of Korea.
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Pickard T, Williams S, Tetzlaff E, Petraitis C, Hylton H. Team-Based Care in Oncology: The Impact of the Advanced Practice Provider. Am Soc Clin Oncol Educ Book 2023; 43:e390572. [PMID: 37279437 DOI: 10.1200/edbk_390572] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Integration of APPs into care teams affects quality and safety for the oncology patient. Learn the best practices and understand the concepts of onboarding, orientation, mentorship, scope of practice, and top of license. Review how productivity and other incentive programs can be adapted to integrate APPs and focus on team-based metrics.
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Affiliation(s)
- Todd Pickard
- University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Eric Tetzlaff
- Levine Cancer Institute Within Atrium Health, Charlotte, NC
- Department of Hematology Oncology, the Fox Chase Cancer Center, Philadelphia, PA
| | - Camille Petraitis
- Department of Hematology Oncology, the Fox Chase Cancer Center, Philadelphia, PA
| | - Heather Hylton
- Quality Assurance and Patient Safety at K Health, New York, NY
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Call M, Qeadan F, Tingey B, Morrow E, Webber D, Hamilton B, Locke A. Measuring provider well-being: initial validation of a brief engagement survey. BMC Health Serv Res 2023; 23:432. [PMID: 37138346 PMCID: PMC10157943 DOI: 10.1186/s12913-023-09449-w] [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: 06/14/2022] [Accepted: 04/25/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Measurement is one of the critical ingredients to addressing the well-being of health care professionals. However, administering an organization-wide well-being survey can be challenging due to constraints like survey fatigue, financial limitations, and other system priorities. One way to address these issues is to embed well-being items into already existing assessment tools that are administered on a regular basis, such as an employee engagement survey. The objective of this study was to assess the utility of a brief engagement survey, that included a small subset of well-being items, among health care providers working in an academic medical center. METHODS In this cross-sectional study, health care providers, including physicians and advanced clinical practitioners, employed at an academic medical center completed a brief, digital engagement survey consisting of 11 quantitative items and 1 qualitative item administered by Dialogue™. The emphasis of this study was on the quantitative responses. Item responses were compared by sex and degree, domains were identified via exploratory factor analysis (EFA), and internal consistency of item responses was assessed via McDonald's omega. Sample burnout was compared against national burnout. RESULTS Of the 791 respondents, 158 (20.0%) were Advanced Practice Clinicians (APCs), and 633 (80.0%) were Medical Doctors (MDs). The engagement survey, with 11 items, had a high internal consistency with an omega ranging from 0.80-0.93 and was shown, via EFA, to have three domains including communication, well-being, and engagement. Significant differences for some of the 11 items, by sex and degree, in the odds of their agreement responses were found. In this study, 31.5% reported experiencing burnout, which was significantly lower than the national average of 38.2%. CONCLUSION Our findings indicate initial reliability, validity, and utility of a brief, digital engagement survey among health care professionals. This may be particularly useful for medical groups or health care organizations who are unable to administer their own discrete well-being survey to employees.
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Affiliation(s)
- Megan Call
- Department of Psychiatry, University of Utah Health, 501 Chipeta Way, UT, 84108, Salt Lake City, USA.
- Resiliency Center, University of Utah Health, 26 S 2000 E, Salt Lake City, UT, 5775A84112, USA.
| | - Fares Qeadan
- Parkinson School of Health Sciences and Public Health, Loyola University Chicago, 2160 S. First Avenue, Maywood, IL, 60153, USA
| | - Benjamin Tingey
- Parkinson School of Health Sciences and Public Health, Loyola University Chicago, 2160 S. First Avenue, Maywood, IL, 60153, USA
| | - Ellen Morrow
- Resiliency Center, University of Utah Health, 26 S 2000 E, Salt Lake City, UT, 5775A84112, USA
- Department of Surgery, University of Utah Health, 30 N 1900 E, Salt Lake City, UT, 84132, USA
| | - David Webber
- University of Utah Health, Medical Group, 50 N. Medical Drive, Salt Lake City, UT, 84132, USA
| | - Blake Hamilton
- Department of Surgery, University of Utah Health, 30 N 1900 E, Salt Lake City, UT, 84132, USA
| | - Amy Locke
- Resiliency Center, University of Utah Health, 26 S 2000 E, Salt Lake City, UT, 5775A84112, USA
- Department of Family & Preventive Medicine, University of Utah Health, 375 Chipeta Way Ste A, UT, 84108, Salt Lake City, USA
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Paz M, Galdi R, Staller K, Thurler A, Vélez C. The Role of the Advanced Practice Provider in a Subspecialty Practice: Satisfaction and Professionalism, Including COVID-19 Impacts. Gastroenterol Nurs 2023; 46:232-242. [PMID: 37074979 PMCID: PMC10238553 DOI: 10.1097/sga.0000000000000713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/20/2022] [Indexed: 04/20/2023] Open
Abstract
The advanced practice provider collaborates with other clinicians and works to educate, advocate, and increase access for patients in the clinical setting. Research has shown that advanced practice providers working collaboratively with physicians yield improved quality of care and outcomes; however, the current level of understanding of this role in gastroenterology has not been explored in detail. Across two academic institutions, we conducted 16 semi-structured interviews to examine how the environment of the gastroenterology department aligns with the professional satisfaction of its advanced practice providers. Thematic saturation was achieved, revealing four themes: (1) productivity of the working relationship; (2) inconsistent understandings of the advanced practice provider role in clinical care; (3) mixed advanced practice provider experience relating to colleague support; and (4) autonomy impacts satisfaction. These themes highlight not only a reasonable degree of advanced practice provider satisfaction, but also the need to engage with colleagues regarding the advanced practice provider role in care to allow for better integration into the overall gastroenterology healthcare team. The results from different institutions suggest the need to interview gastroenterology advanced practice providers in different settings to better understand whether similar themes exist.
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Affiliation(s)
- Mary Paz
- School of Nursing, Massachusetts General Hospital Institute of Health Professions, Boston, MA 02114
| | - Riya Galdi
- School of Nursing, Massachusetts General Hospital Institute of Health Professions, Boston, MA 02114
| | - Kyle Staller
- Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114
| | - Andrea Thurler
- Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114
| | - Christopher Vélez
- Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114
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Tetzlaff ED, Hylton HM, Ruth KJ, Hasse Z, Hall MJ. Moral Distress, Organizational Climate, and the Risk of Burnout Among Physician Assistants in Oncology. JCO Oncol Pract 2023; 19:e639-e649. [PMID: 36780593 PMCID: PMC10414748 DOI: 10.1200/op.22.00641] [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] [Received: 09/13/2022] [Revised: 11/09/2022] [Accepted: 01/06/2023] [Indexed: 02/15/2023] Open
Abstract
PURPOSE Moral distress (MD) is the result of barriers or constraints that prevent providers from carrying out what they believe to be ethically appropriate care. This study was initiated to explore associations between MD, burnout, and the organizational climate (OC) for oncology physician assistants (PAs). METHODS A national survey of oncology PAs was conducted to explore the associations between MD, OC, and burnout. The Nurse Practitioner-Primary Care OC Questionnaire was revised for oncology PAs to assess OC for PA practice. MD and burnout were assessed using the Measure of MD-Healthcare Professionals (MMD-HP) and the Maslach Burnout Inventory. RESULTS One hundred forty-six oncology PAs are included in the analysis. PAs were mostly female (90%), White/Caucasian (84%), married/partnered (78%), and in medical oncology (73%), with mean age 41.0 years. The mean MMD-HP score for oncology PAs was 71.5 and there was no difference in MD scores on the basis of oncology subspecialty, practice setting, practice type, or hours worked per week. PAs currently considering leaving their position because of MD had significantly higher mean scores on the MMD-HP compared with those not considering leaving their position (108.2 v 64.8; P = .001). PAs with burnout also had significantly higher mean scores for MD compared with PAs without burnout (97.6 v 54.3; P < .001). A negative relationship between OC for PA practice and MD was only found for the PA-administration relations subscale, whereas all subscales were negatively associated with burnout. CONCLUSION This study demonstrates that the risk of professional burnout increases significantly with increasing levels of MD. Additional research exploring the relationship between MD and burnout is needed.
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Affiliation(s)
| | - Heather M. Hylton
- Association of Physician Assistants in Oncology, Altamonte Springs, FL
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Abstract
OBJECTIVE Recent updates to physician associate/assistant (PA) laws reflect less mandated supervision. Although greater autonomy may inspire experienced PAs, newer PAs may struggle with less required oversight. This study examined the influence of autonomy, career length, and the quality of the collaborative physician (CP) relationship on PA well-being. METHODS A secondary analysis of data gathered in 2018 by the American Academy of Physician Associates was conducted using bivariate and multiple linear regression with moderated mediation. RESULTS Years of experience positively predicted PA well-being and negatively predicted the percentage of time spent consulting with a CP. The interaction of the percentage of time spent consulting with a CP and the quality of the CP relationship mediated the relationship between years of experience and well-being. CONCLUSIONS Findings demonstrate that the quality of the CP relationship is most salient to the well-being of early-career PAs who spend more time in consultation with CPs.
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Norful AA, Brewer KC, Adler M, Dierkes A. Initial psychometric properties of the provider-co-management index-RN to scale registered nurse-physician co-management: Implications for burnout, job satisfaction, and intention to leave current position. J Interprof Care 2023:1-10. [PMID: 36688514 DOI: 10.1080/13561820.2022.2164563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Team-based care has become a cornerstone of care delivery to meet the demands of high-quality patient care. Yet, there is a lack of valid and reliable instruments to measure the effectiveness of co-management between clinician dyads, particularly physicians and registered nurses (RNs). The purpose of this study was to adapt an existing instrument, Provider Co-Management Index (PCMI), previously used among primary care providers into a new version to scale RN-physician co-management (called PCMI-RN). We also aimed to explore preliminary associations between RN-physician co-management and burnout, job satisfaction, and intention to leave current job. Face, cognitive, and content validity testing, using mixed methods approaches, were preceded by initial pilot testing (n = 122 physicians and nurses) in an acute care facility. The internal consistency reliability (α=.83) was high. One-quarter of participants reported burnout, 27% were dissatisfied with their job, and 20% reported intention to leave their job. There was a weak significant correlation between co-management and burnout (p = .010), and co-management and job satisfaction (p = .009), but not intention to leave current position. Construct validity testing is recommended. Future research using PCMI-RN may help to isolate factors that support or inhibit effective physician-nurse co-management.
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Affiliation(s)
- Allison A Norful
- School of Nursing, Columbia University School of Nursing, New York, NY, USA
| | | | - Margaret Adler
- Department of Nursing Quality, NewYork-Presbyterian Hudson Valley Hospital, Cortlandt, NY, USA
| | - Andrew Dierkes
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
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Jackson H, West O, Austin A, Peal K. Interventions to Improve Advanced Practitioner Work-Related Quality of Life and Patient Satisfaction. J Adv Pract Oncol 2023; 14:49-53. [PMID: 36741211 PMCID: PMC9894207 DOI: 10.6004/jadpro.2023.14.1.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Background Across the United States, an incremental need for cancer care continues to emerge. Specialty nurse practitioners and physician assistant teams have helped in meeting this demand. However, there is a need for evidence-based recommendations to inform appropriate provider-patient staffing ratios that encompass complex cancer treatments and ensure optimal care. Methods A literature review identified a gap in existing research with regard to recommended inpatient provider-patient ratios for hematology and oncology services. The conceptual framework of ICU nursing workload was utilized to ensure a comprehensive understanding of an inpatient specialty cancer provider's duties. Results Within the unit, job, patient, and situation workload levels, there were multiple interventions implemented to streamline systems and improve workplace conditions for providers, as measured by the work-related quality of life (WRQoL) scale. Patient satisfaction scores improved an average of 4% across multiple criteria and exceeded benchmark rankings by 10.7% surrounding communication with nurses and physicians (a 6.3% increase). Discharge efficiency improved, with 6.1% more discharges occurring by 11:00 am, and length of stay was noted to be 8.8 days fewer than teaching services treating the same cancer diagnosis. Finally, additional shift pay was greatly reduced and turnover decreased by 17%. Conclusion Application of the conceptual framework of ICU nursing workload provided a scientific assessment of specialty inpatient cancer services within one institution. Interventions resulted in improved working conditions, patient satisfaction, discharge efficiency, and reduced turnover, ultimately ensuring the provision of high-quality cancer care.
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Affiliation(s)
- Heather Jackson
- From Vanderbilt University Medical Center, Nashville, Tennessee
| | - Olivia West
- From Vanderbilt University Medical Center, Nashville, Tennessee
| | - Annie Austin
- From Vanderbilt University Medical Center, Nashville, Tennessee
| | - Karline Peal
- From Vanderbilt University Medical Center, Nashville, Tennessee
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Factors Affecting Turnover of Advanced Practice Providers: A University Teaching Hospital Review. J Healthc Manag 2023; 68:15-24. [PMID: 36602452 DOI: 10.1097/jhm-d-21-00279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
GOAL Retention of advanced practice providers (APPs) is an issue of critical importance to healthcare leaders. High APP turnover negatively affects an organization's ability to meet patient needs, maintain quality of care, and control costs. Our goal was to identify any association between intent to leave and specific survey factors; analyze the distribution of scale factors from the survey; and describe differences among the APP roles, specialties, and length of employment. METHODS This study used a self-administered questionnaire for APPs at a large university medical center to determine job satisfaction rates and intent to resign. The survey used a modified Misener Nurse Practitioner Job Satisfaction Scale and Anticipated Turnover Scale. PRINCIPAL FINDINGS We received surveys from 102 providers (for a 38.9% response rate). Results were used to determine the correlation between job satisfaction and intent to leave and to identify possible factors involved in APP commitment to the hospital and intent to stay. We found that APPs reported the most satisfaction in benefits, followed by time (i.e., time available for answering messages, reviewing laboratory and other test results, seeing patients, scheduling work). Intrapractice partnership/collegiality received the lowest satisfaction score. Extrinsic factors such as monetary bonuses available in addition to salary, reward distribution, involvement in research, conflict resolution, and opportunity to receive compensation for services performed outside normal duties were common dissatisfiers. PRACTICAL APPLICATIONS This survey may help hospitals identify in real time the triggers of APP dissatisfaction and intent to resign. In addition, the results may guide possible revisions to hospital policies and practice procedures to improve APP commitment and decrease turnover intent. Additional surveys in similar university teaching hospital systems could confirm comparable intrinsic and extrinsic factors that are relevant to the satisfaction and turnover of APPs.
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Cunningham R, Westover J, Harvey J. Drivers of job satisfaction among healthcare professionals: a quantitative review. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2022. [DOI: 10.1080/20479700.2022.2126671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
| | | | - Jaron Harvey
- Organizational Leadership, Utah Valley University, Orem, UT, USA
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KAMA BAŞCI Ö, EKİNCİ F, ERDOĞAN AP, ESER E. Tıbbi Onkoloji Çalışanlarında Tükenmişlik: Ulusal Gerçeklerle Yüzleşmek. KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNIVERSITESI TIP FAKÜLTESI DERGISI 2022. [DOI: 10.17517/ksutfd.1151313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Objectives: This study aimed to reveal the prevalence of burnout syndrome among physicians, nurses and biologists working in oncology clinics in Turkey. Sociodemographic factors affecting burnout were revealed . The adequacy of institutional measures was questioned and their participation in solution proposals was examined.
Material and Methods: This cross-sectionally designed study aimed to reach all actively working medical oncology staff in Turkey. 323 of them agreed to participate in the study. Maslach Burnout Inventory (MBI) was used to measure the burnout status of the participants. Clinical burnout reduction solutions were also questioned. The burnout prevention questions were prepared. Statistical significance was considered, and all statistical tests were two-sided (p < 0.05).
Results: Of 323 participants, 38% were medical oncologists, 58% were nurses and 4% were biologists. The median age was 37±9. According to the MBI subscales, the mean±SD burnout levels of the oncology staff are 19.7±7.8 (high) for EE, 6±4.3 (moderate) for DP and 20.9±5.1 (high) for PA. Respondents under 41 age has higher risk. The participants who are having a hobby, good sleep pattern, making regular exercises has significantly lower burnout scores.
Conclusion: Burnout syndrome was detected in more than half of oncology workers. Personal factors such as young age, family type, sleep, exercise and having a hobby affect burnout. preventive measures and interventions are required for health workers
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Affiliation(s)
| | | | - Atike Pinar ERDOĞAN
- MANISA CELAL BAYAR UNIVERSITY, SCHOOL OF MEDICINE, DEPARTMENT OF INTERNAL MEDICINE, DEPARTMENT OF INTERNAL MEDICINE (MEDICINE), MEDICAL ONCOLOGY
| | - Erhan ESER
- MANİSA CELÂL BAYAR ÜNİVERSİTESİ, TIP FAKÜLTESİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, HALK SAĞLIĞI ANABİLİM DALI
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Arem H, Moses J, Nekhlyudov L, Killackey M, Sieloff B, Cisneros C, Pratt-Chapman ML. Oncology provider experiences during the COVID-19 pandemic. PLoS One 2022; 17:e0270651. [PMID: 35881586 PMCID: PMC9321423 DOI: 10.1371/journal.pone.0270651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 06/14/2022] [Indexed: 11/19/2022] Open
Abstract
PURPOSE The COVID-19 pandemic upended nearly all aspects of daily life and of medical care, placing a double burden of professional and personal concerns on those who provide medical care. We set out to assess the burden of the pandemic on provider outlook and understand how cancer survivorship providers experienced rapid changes to practice. METHODS We distributed a survey through the American College of Surgeons Commission on Cancer (CoC) to its accredited organizations in mid-October 2020. We included questions on provider characteristics, changes in patient care practices resulting from the pandemic, worry about COVID-19, and concern about impact on cancer survivors. RESULTS Of the n = 607 participants, three-quarters were female and three-quarters were White. Only 2.1% of participants reported having had COVID-19, but 43% reported anxiety about getting COVID-19 and over a quarter experienced sadness or depression, anxiety about the future, changes to sleep, difficulty concentrating, or social isolation. Approximately half of providers also expressed significant concern about progression of cancer in patients who experienced care delays or were afraid of accessing in-person care. In terms of changes to survivorship care, respondents reported changes to visitor policies, delays or cancellations, and efforts to reduce in-person visits. CONCLUSIONS COVID-19 has taken a significant toll on front-line healthcare professionals, including oncologists and cancer care allied health professionals. Findings support proactive mental health support of healthcare professionals as well as emergency preparedness to manage delays to care for cancer patients in the event of future unexpected pandemics.
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Affiliation(s)
- Hannah Arem
- Healthcare Delivery Research, Medstar Health Research Institute, Washington, DC, United States of America
| | - Jenna Moses
- Department of Epidemiology, George Washington University Milken Institute School of Public Health, Washington, DC, United States of America
| | - Larissa Nekhlyudov
- George Washington University Cancer Center, Community Advisory Board, Washington, DC, United States of America
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Maureen Killackey
- George Washington University Cancer Center, Community Advisory Board, Washington, DC, United States of America
- American College of Surgeons’ Commission on Cancer Site Reviewer, NYS Cancer Advisory Council, NY, United States of America
| | - Beth Sieloff
- George Washington University Cancer Center, Community Advisory Board, Washington, DC, United States of America
- Inter-Tribal Council of Michigan, Sault Ste, MI, United States of America
| | - Cindy Cisneros
- George Washington University Cancer Center, Community Advisory Board, Washington, DC, United States of America
| | - Mandi L. Pratt-Chapman
- School of Medicine and Health Sciences, George Washington University, Washington, DC, United States of America
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Turchi GP, Salvalaggio I, Croce C, Dalla Riva MS, Orrù L, Iudici A. The Health of Healthcare Professionals in Italian Oncology: An Analysis of Narrations through the M.A.D.I.T. Methodology. Behav Sci (Basel) 2022; 12:bs12050134. [PMID: 35621431 PMCID: PMC9137842 DOI: 10.3390/bs12050134] [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: 02/16/2022] [Revised: 04/21/2022] [Accepted: 04/26/2022] [Indexed: 01/23/2023] Open
Abstract
From the analysis of the scientific literature relating to the health of oncological patients, the need to consider the global dimension of health of individuals emerges, which subsumes the bodily dimension and involves all the actors who offer their contribution to it in different ways. In this direction, the state of the art of the health construct offered by healthcare professionals highlights a lack of scientific contributions to the specific subject although these professionals are fundamental figures in oncological diagnosis setups. Considering, therefore, the healthcare roles as an integral part of the interactive framework where the oncological patient is placed, this paper offers the results of an Italian study relating to the health of healthcare professionals who take charge of patients with a neoplasia diagnosis. In particular, through an analysis of the discursive productions of 61 participants (healthcare workers, oncological patients and citizens) by the M.A.D.I.T. methodology (Methodology for the Analysis of Computerized Textual Data), this study aimed at observing the discursive reality of health offered by healthcare workers. The collected data highlight a low degree of health expressed by the healthcare professionals, who are strongly typified by rhetoric such as “the one who is destined to suffer psychologically”. These narrations limit the possibilities of development of different narrations in depicting these professionals: critical repercussions in the interaction with the oncological patients emerged, as well as in their global health degree. In conclusion, the results show the need for deep investigation into the impact that the health degree of health professionals can have on the patients they take charge of.
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Tetzlaff ED, Hylton HM, Ruth KJ, Hasse Z, Hall MJ. Association of Organizational Context, Collaborative Practice Models, and Burnout Among Physician Assistants in Oncology. JCO Oncol Pract 2022; 18:e1306-e1319. [PMID: 35061507 PMCID: PMC9377690 DOI: 10.1200/op.21.00627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE: Despite an increase in the number of physician assistants (PAs) in the oncology workforce, their potential to meet anticipated demand for oncology services may be hindered by high rates of burnout. The aim of this study was to examine the association between organizational context (OC) and burnout among oncology PAs to better understand factors associated with burnout. METHODS: A national survey of oncology PAs was conducted to explore relationships between burnout and the OC in which the PA practiced. The Areas of Worklife Survey (AWS) assessed OC by examining six key workplace qualities (workload, control, reward, community, fairness, and values). Burnout was assessed using the Maslach Burnout Inventory. RESULTS: PAs demonstrating burnout scored significantly lower across all domains of the AWS than those without burnout ( P < .001 for each AWS subscale). The median score for each domain of the AWS and burnout (No v Yes) were as follows: workload (3.33 v 2.67), control (3.67 v 3.00), reward (4.00 v 3.67), community (4.00 v 3.67), fairness (3.33 v 2.67), and values (4.00 v 3.33). Multivariable analysis found that mismatches between the PA and their work environment in workload (odds ratio [OR] = 1.99; 95% CI, 1.32 to 3.02; P = .001), reward (OR = 1.89, 95% CI, 1.18 to 3.02; P = .008), and values (OR = 2.25; 95% CI, 1.31 to 3.88; P = .003) were more likely to report burnout. Differences in burnout in the context of workload were not explained by patient volume, practice structure, or professional autonomy. CONCLUSION: Workload, reward, and values were associated with greater odds of burnout, with workload being the most common mismatch in job fit. Sustainable workloads and consistency in rewards (financial, institutional, and social) for oncology PAs should be an employer's focus to help mitigate their risk of burnout.
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Affiliation(s)
| | - Heather M. Hylton
- Association of Physician Assistants in Oncology, Altamonte Springs, FL
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Tetzlaff ED, Hylton HM, Ruth KJ, Hasse Z, Hall MJ. Changes in Burnout Among Oncology Physician Assistants Between 2015 and 2019. JCO Oncol Pract 2022; 18:e47-e59. [PMID: 34292762 PMCID: PMC8757962 DOI: 10.1200/op.21.00051] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
PURPOSE Burnout has significant implications for the individual provider, the oncology workforce, and the quality of care for patients with cancer. The primary aim of this study was to explore temporal changes in burnout among physician assistants (PAs) in oncology in 2019 compared with 2015. METHODS Oncology PAs were surveyed to assess for burnout using the Maslach Burnout Inventory according to the same cross-sectional design of the study performed in 2015. Comparison between oncology PAs in 2015 and 2019 in the prevalence of burnout and personal and professional characteristics was performed. RESULTS Two hundred thirty-four participants completed the full-length survey. The participants in 2015 and 2019 were similar in age (41.8 v 40.3 years), sex (88.8% v 86.3% female), number of years as a PA in oncology (9.6 v 10), and percentage involved in academic practice (55.2% v 59.2%). There was a significant increase in burnout in 2019 compared with 2015 with 48.7% of PAs reporting at least one symptom of burnout compared with 34.8% (odds ratio for burnout, 2019 v 2015 = 1.92 [95% CI, 1.40 to 2.65], P < 0.001). The odds of burnout remained higher in 2019 compared with 2015 when adjusted for age, sex, relationship status, practice setting, subspecialty, practice type, and hours worked. Factors associated with burnout in both 2015 and 2019 include the percentage of time spent on patient care, collaborative physician relationship, number of hours worked, and satisfaction with compensation. No new factors associated with burnout emerged in 2019 that were not identified in 2015. CONCLUSION The rate of burnout of oncology PAs has significantly increased. Burnout in oncology PAs is multifactorial, and the increase cannot be easily explained. Additional research is needed to better define the drivers of PA burnout.
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Affiliation(s)
- Eric D. Tetzlaff
- Fox Chase Cancer Center, Philadelphia, PA,Eric D. Tetzlaff, MHS, Fox Chase Cancer Center, 333 Cottman Ave, Philadelphia, PA 19111; e-mail:
| | - Heather M. Hylton
- Association of Physician Assistants in Oncology, Altamonte Springs, FL
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Smith JL, Allen JW, Haack CI, Wehrmeyer KL, Alden KG, Lund MB, Mascaro JS. Impact of App-Delivered Mindfulness Meditation on Functional Connectivity, Mental Health, and Sleep Disturbances Among Physician Assistant Students: Randomized, Wait-list Controlled Pilot Study. JMIR Form Res 2021; 5:e24208. [PMID: 34665153 PMCID: PMC8564666 DOI: 10.2196/24208] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 04/23/2021] [Accepted: 07/23/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Health care provider and trainee burnout results in substantial national and institutional costs and profound social effects. Identifying effective solutions and interventions to cultivate resilience among health care trainees is critical. Although less is known about the mental health needs of physician assistants (PAs) or PA students, accumulating research indicates that they experience similarly alarming rates of burnout, depression, and emotional exhaustion. Mobile app-delivered mindfulness meditation may be an effective part of salubrious programming to bolster long-term resilience and health among PA students. OBJECTIVE This study aims to examine the impact of app-delivered mindfulness meditation on self-reported mental health symptoms among PA students. A secondary aim is to investigate changes in brain connectivity to identify neurobiological changes related to changes in mental health symptoms. METHODS We recruited PA students enrolled in their third semester of PA school and used a longitudinal, randomized, wait-list-controlled design. Participants randomized to the mindfulness group were provided 1-year subscriptions to the 10% Happier app, a consumer-based meditation app, and asked to practice every day for 8 weeks. Before randomization and again after completion of the 8-week program, all participants completed resting-state functional magnetic resonance imaging as well as self-report assessments of burnout, depression, anxiety, and sleep impairment. App use was acquired as a measure of mindfulness practice time. RESULTS PA students randomized to the mindfulness group reported improvements in sleep impairment compared with those randomized to the wait-list control group (ηp2=0.42; P=.01). Sleep impairment decreased significantly in the mindfulness group (19% reduction; P=.006) but not in the control group (1% reduction; P=.71). There were no other significant changes in mental health for those randomized to app-delivered mindfulness. Across all students, changes in sleep impairment were associated with increased resting-state functional connectivity between the medial prefrontal cortex (a component of the default mode network) and the superior temporal gyrus, as well as between areas important for working memory. Changes in connectivity predicted categorical conversion from impaired to nonimpaired sleep in the mindfulness group. CONCLUSIONS This pilot study is the first to examine app-based mindfulness for PA students' mental health and investigate the impact of mindfulness on PA students' brain function. These findings suggest that app-delivered mindfulness may be an effective tool to improve sleep dysfunction and that it may be an important part of the programming necessary to reduce the epidemic of suffering among health profession trainees.
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Affiliation(s)
- Jeremy L Smith
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA, United States
| | - Jason W Allen
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA, United States
- Department of Neurology, Emory University, Atlanta, GA, United States
| | - Carla I Haack
- Department of Surgery, Emory University, Atlanta, GA, United States
| | - Kathryn L Wehrmeyer
- Department of Family and Preventative Medicine, Emory University, Atlanta, GA, United States
| | - Kayley G Alden
- Department of Family and Preventative Medicine, Emory University, Atlanta, GA, United States
| | - Maha B Lund
- Physician Assistant Program, Department of Family and Preventative Medicine, Emory University, Atlanta, GA, United States
| | - Jennifer S Mascaro
- Department of Family and Preventative Medicine, Emory University, Atlanta, GA, United States
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Neary S, Ruggeri M, Roman C. Assessing Trends in Physician Assistant Student Depression Risk, Suicidal Ideation, and Mental Health Help-Seeking Behavior. J Physician Assist Educ 2021; 32:138-142. [PMID: 34293797 DOI: 10.1097/jpa.0000000000000369] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this study was to assess how physician assistant (PA) student depression risk, suicidal ideation, and mental health help-seeking behaviors change during didactic training and the relationship between depression risk and demographic factors. METHODS Data were obtained through an anonymous online survey sent to didactic students in 7 PA programs during orientation and again at midpoint of the didactic year. Descriptive statistics, independent samples t-testing, and one-way ANOVA analyses were used to assess trends in patient health questionnaire (PHQ-9) scores over the 6-month time period. The PHQ-9 is the module of the PHQ that measures severity of depression risk. RESULTS The orientation survey response rate was 82.7% (287/347) and the midpoint survey response rate was 62% (217/350). Analysis revealed that mean PHQ-9 scores increased significantly from 2.49 to 6.42 (p < 0.001) from orientation to midpoint of the didactic year, with 18.9% of students having scores of 10 or greater at midpoint compared to 4.5% at orientation. Thoughts of self-harm and/or suicidal ideation in the past 2 weeks also increased from 3.5% to 7.4% during the same time frame. Additionally, students' likelihood of seeking mental health help decreased between orientation and midpoint despite the concurrent increases in depression risk and suicidal ideation. CONCLUSION Rising PHQ-9 scores indicated an increased risk of major depression among didactic-year PA students. Further research on early screening methods and factors that encourage help-seeking behaviors may serve to inform programs about how to create learning environments that mitigate depression risk and promote wellbeing during professional training.
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Affiliation(s)
- Stephanie Neary
- Stephanie Neary, MPA, MMS, PA-C, is an adjunct assistant professor and the director of didactic in Department of General Internal Medicine at for the Yale University Physician Assistant Online Program, New Haven, Connecticut
- Mary Ruggeri, MEd, MMSc, PA-C, is a recent graduate in Department of General Internal Medicine at the Yale University Physician Assistant Online Program, New Haven, Connecticut
- Christopher Roman, MA, MMS, PA-C, is an associate professor for the Butler University Department of Physician Assistant Studies, Indianapolis, Indiana
| | - Mary Ruggeri
- Stephanie Neary, MPA, MMS, PA-C, is an adjunct assistant professor and the director of didactic in Department of General Internal Medicine at for the Yale University Physician Assistant Online Program, New Haven, Connecticut
- Mary Ruggeri, MEd, MMSc, PA-C, is a recent graduate in Department of General Internal Medicine at the Yale University Physician Assistant Online Program, New Haven, Connecticut
- Christopher Roman, MA, MMS, PA-C, is an associate professor for the Butler University Department of Physician Assistant Studies, Indianapolis, Indiana
| | - Christopher Roman
- Stephanie Neary, MPA, MMS, PA-C, is an adjunct assistant professor and the director of didactic in Department of General Internal Medicine at for the Yale University Physician Assistant Online Program, New Haven, Connecticut
- Mary Ruggeri, MEd, MMSc, PA-C, is a recent graduate in Department of General Internal Medicine at the Yale University Physician Assistant Online Program, New Haven, Connecticut
- Christopher Roman, MA, MMS, PA-C, is an associate professor for the Butler University Department of Physician Assistant Studies, Indianapolis, Indiana
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Hlubocky FJ, Shanafelt TD, Back AL, Paice JA, Tetzlaff ED, Friese CR, Kamal AH, McFarland DC, Lyckholm L, Gallagher CM, Chatwal M, Saltzman J, Dudzinski D, Burke JM, James TA, Page RD, Boyle DA, Gonzalez MM, Srivastava P. Creating a Blueprint of Well-Being in Oncology: An Approach for Addressing Burnout From ASCO's Clinician Well-Being Taskforce. Am Soc Clin Oncol Educ Book 2021; 41:e339-e353. [PMID: 34061565 DOI: 10.1200/edbk_320873] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Optimizing the well-being of the oncology clinician has never been more important. Well-being is a critical priority for the cancer organization because burnout adversely impacts the quality of care, patient satisfaction, the workforce, and overall practice success. To date, 45% of U.S. ASCO member medical oncologists report experiencing burnout symptoms of emotional exhaustion and depersonalization. As the COVID-19 pandemic remains widespread with periods of outbreaks, recovery, and response with substantial personal and professional consequences for the clinician, it is imperative that the oncologist, team, and organization gain direct access to resources addressing burnout. In response, the Clinician Well-Being Task Force was created to improve the quality, safety, and value of cancer care by enhancing oncology clinician well-being and practice sustainability. Well-being is an integrative concept that characterizes quality of life and encompasses an individual's work- and personal health-related environmental, organizational, and psychosocial factors. These resources can be useful for the cancer organization to develop a well-being blueprint: a detailed start plan with recognized strategies and interventions targeting all oncology stakeholders to support a culture of community in oncology.
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Affiliation(s)
- Fay J Hlubocky
- Department of Medicine, Section of Hematology/Oncology, University of Chicago Medicine, Chicago, IL
| | | | - Anthony L Back
- Seattle Cancer Care, University of Washington, Seattle, WA
| | - Judith A Paice
- Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Eric D Tetzlaff
- Department of Hematology Oncology, Fox Chase Cancer Center, Philadelphia, PA
| | | | | | | | - Laurie Lyckholm
- Division of Hematology Oncology, University of Iowa, Iowa City, IA
| | | | | | - Joel Saltzman
- Lake Health, University Hospitals, Seidman Cancer Center, Mentor, OH
| | | | | | - Ted A James
- Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA
| | - Ray D Page
- The Center for Cancer and Blood Disorders, Fort Worth, TX
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Abstract
OBJECTIVE To understand the relationships between burnout, job satisfaction, and career plans among physician assistants in the United States. METHODS The authors surveyed PAs in 2016. The survey included the Maslach Burnout Inventory and items on job satisfaction and career plans. RESULTS Overall 82.7% of PAs were satisfied with their job, 32.2% indicated intent to leave their current position, and 19.5% reported intent to reduce work hours. On multivariate analysis, burnout increased the odds of job dissatisfaction, intent to reduce work hours within the next year, and intent to leave the current practice in the next 2 years. CONCLUSIONS About a third of PAs indicated intent to leave their current practice and one in five indicated intent to reduce their clinical hours. Burnout was an independent predictor of job satisfaction and career plans.
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Affiliation(s)
- Michael P Halasy
- Michael P. Halasy is an assistant professor in health care administration at the Mayo Clinic in Rochester, Minn. Colin P. West is a professor of medicine, medical education, and biostatistics and codirector of the Mayo Clinic Program on Physician Well-Being. Tait Shanafelt is a professor of medicine and associate dean of the Stanford (Calif.) University School of Medicine. Danielle J. O'Laughlin is an assistant professor in the Division of Community Internal Medicine, Department of Medicine at the Mayo Clinic. Daniel Satele is a statistician in the Department of Health Sciences Research at the Mayo Clinic. Liselotte N. Dyrbye is a professor of medicine and medical education and codirector of the Mayo Clinic Program on Physician Well-Being. Funding for this study was provided by the Mayo Clinic Program on Physician Well-Being. Funding sources had no role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for publication. The authors have disclosed no other potential conflicts of interest, financial or otherwise
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Abstract
OBJECTIVES This study explores associations between job satisfaction, career flexibility, and burnout among physician assistants (PAs) in Minnesota. METHODS A survey comprising the Maslach Burnout Inventory (a validated burnout tool) and original questions was emailed to PAs practicing in Minnesota. Spearman rank correlation coefficients were used to assess associations between variables and burnout. RESULTS PAs (response rate = 31.4%, N = 312) reported moderate levels of burnout. Working in primary care and being female were independently associated with higher rates of burnout. Satisfaction with one's career and one's current position were both high (95.9% and 87.8%, respectively) and independently associated with lower rates of burnout. CONCLUSIONS Despite high levels of career and job satisfaction, PAs in Minnesota report moderate levels of burnout, particularly women in primary care. Further research should examine a broader population and the effect of burnout on patient care.
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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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Bourdeanu L, Pearl Zhou Q, DeSamper M, Pericak KA, Pericak A. Burnout, Workplace Factors, and Intent to Leave Among Hematology/Oncology Nurse Practitioners. J Adv Pract Oncol 2020; 11:141-148. [PMID: 33532113 PMCID: PMC7848810 DOI: 10.6004/jadpro.2020.11.2.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Burnout and intent to leave have been well documented in oncology/hematology health-care professionals, with a potentially detrimental effect on the patient-provider relationship and job satisfaction. With the recommended changes in the nurse practitioner (NP) role to accommodate for the physician shortage, it is important to determine the burnout and intent to leave of hematology/oncology NPs. Purpose To examine the association between burnout, workplace factors, and intent to leave among hematology/oncology NPs. Methods In this cross-sectional survey, a convenience sample of 201 hematology/oncology NPs was recruited to assess their burnout levels using the Maslach Burnout Inventory, workplace factors using the Areas of Worklife survey (AWS), and intent to leave. Descriptive, correlational, and logistic regression analyses were performed to examine the relationships among variables. Results 44 (21.9%) participants reported intention to leave the profession or hematology/oncology. 30.8% of the sample reported a high level of emotional exhaustion, 9.0% reported high depersonalization, and 21.0% reported low personal accomplishment. Emotional exhaustion was related to increased likelihood of intent to leave in regression model (adjusted odds ratio [OR] = 1.10, 95% confidence interval [CI] = 1.05–1.17, p < .001). Workplace reward (adjusted OR = 0.4, 95% CI = 0.17–0.93, p < .05) and value (adjusted OR = 0.52, 95% CI = 0.28–0.99, p < .05) were negatively associated with intent to leave. Conclusion Hematology/oncology NPs experience high emotional exhaustion, with over 20% indicating intent to leave their job or the nursing profession. Some workplace factors may play protective roles to reduce the intent to leave. Interventions are needed to enhance these workplace factors to decrease burnout.
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Affiliation(s)
| | | | | | | | - Arlene Pericak
- George Washington University School of Nursing, Washington, DC
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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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Professionalism for Physician Assistants. PHYSICIAN ASSISTANT CLINICS 2020. [DOI: 10.1016/j.cpha.2019.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Abstract
Physician assistants (PAs) have historically reported high levels of professional satisfaction, but emerging research indicates increasing levels of professional burnout. This article explores burnout interventions in the literature and their usefulness to PAs. We propose that PAs and leaders of the profession must acknowledge and assess the phenomenon of burnout through standardized measurement at the population level, be mindful of personal boundaries in order to maintain a healthy work life balance, and commit to creating an organizational culture that sustains overall clinician well-being and fosters PA engagement.
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Let's not abandon the idea of burnout before we know how to prevent it. JAAPA 2019; 32:1-2. [DOI: 10.1097/01.jaa.0000553389.05755.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Essary AC, Bernard KS, Coplan B, Dehn R, Forister JG, Smith NE, Valentin VL. Burnout and Job and Career Satisfaction in the Physician Assistant Profession: A Review of the Literature. NAM Perspect 2018. [DOI: 10.31478/201812b] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
| | - Kari S. Bernard
- University of Washington MEDEX Northwest Physician Assistant Training Program
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Commentaries on health services research. JAAPA 2018. [DOI: 10.1097/01.jaa.0000545075.94096.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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