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Burnout in psychosocial oncology clinicians: A systematic review

Published online by Cambridge University Press:  08 September 2020

Sue E. Morris Open the ORCID record for Sue E. Morris [Opens in a new window] ,
Sarah J. Tarquini ,
Miryam Yusufov ,
Esmeralda Adolf ,
Hermioni L. Amonoo ,
Paul A. Bain Open the ORCID record for Paul A. Bain [Opens in a new window] ,
Nancy A. Borstelmann ,
Ilana M. Braun ,
Tricia Hughes  and
Anna C. Muriel
...Show all authors
Sue E. Morris*
Affiliation:
Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA Department of Psychiatry, Boston Children's Hospital and Brigham and Women's Hospital, and Harvard Medical School, Boston, MA
Sarah J. Tarquini
Affiliation:
Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA Department of Psychiatry, Boston Children's Hospital, and Harvard Medical School, Boston, MA
Miryam Yusufov
Affiliation:
Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA Department of Psychiatry, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA
Esmeralda Adolf
Affiliation:
Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA
Hermioni L. Amonoo
Affiliation:
Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA Department of Psychiatry, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA
Paul A. Bain
Affiliation:
Countway Library of Medicine, Harvard Medical School, Boston, MA
Nancy A. Borstelmann
Affiliation:
Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA
Ilana M. Braun
Affiliation:
Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA Department of Psychiatry, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA
Tricia Hughes
Affiliation:
Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA
Anna C. Muriel
Affiliation:
Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA Department of Psychiatry, Boston Children's Hospital, and Harvard Medical School, Boston, MA
Lisa M. Northman
Affiliation:
Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA Department of Psychiatry, Boston Children's Hospital, and Harvard Medical School, Boston, MA
John R. Peteet
Affiliation:
Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA Department of Psychiatry, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA
Hanneke Poort
Affiliation:
Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA Department of Psychiatry, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA
Angelee Russ-Carbin
Affiliation:
Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA
William F. Pirl
Affiliation:
Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA Department of Psychiatry, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA
*
Author for correspondence: Sue E. Morris, Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, 450 Brookline Avenue, JF8, Boston, MA 02215, USA. E-mail: sue_morris@dfci.harvard.edu
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Abstract

Objective

Few studies have examined burnout in psychosocial oncology clinicians. The aim of this systematic review was to summarize what is known about the prevalence and severity of burnout in psychosocial clinicians who work in oncology settings and the factors that are believed to contribute or protect against it.

Method

Articles on burnout (including compassion fatigue and secondary trauma) in psychosocial oncology clinicians were identified by searching PubMed/MEDLINE, EMBASE, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature, and the Web of Science Core Collection.

Results

Thirty-eight articles were reviewed at the full-text level, and of those, nine met study inclusion criteria. All were published between 2004 and 2018 and included data from 678 psychosocial clinicians. Quality assessment revealed relatively low risk of bias and high methodological quality. Study composition and sample size varied greatly, and the majority of clinicians were aged between 40 and 59 years. Across studies, 10 different measures were used to assess burnout, secondary traumatic stress, and compassion fatigue, in addition to factors that might impact burnout, including work engagement, meaning, and moral distress. When compared with other medical professionals, psychosocial oncology clinicians endorsed lower levels of burnout.

Significance of results

This systematic review suggests that psychosocial clinicians are not at increased risk of burnout compared with other health care professionals working in oncology or in mental health. Although the data are quite limited, several factors appear to be associated with less burnout in psychosocial clinicians, including exposure to patient recovery, discussing traumas, less moral distress, and finding meaning in their work. More research using standardized measures of burnout with larger samples of clinicians is needed to examine both prevalence rates and how the experience of burnout changes over time. By virtue of their training, psychosocial clinicians are well placed to support each other and their nursing and medical colleagues.

Keywords

BurnoutCompassion fatigueOncologyPsychosocial cliniciansSecondary traumaVicarious trauma

Information

Type
Review Article
Information
Palliative & Supportive Care , Volume 19 , Issue 2 , April 2021 , pp. 223 - 234
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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References

REFERENCES

Back, AL, Steinhauser, KE, Kamal, AH, et al. (2016) Building resilience for palliative care clinicians: An approach to burnout prevention based on individual skills and workplace factors. Journal of Pain and Symptom Management 52(2), 284–291. doi: 10.1016/j.jpainsymman.2016.02.002CrossRefGoogle ScholarPubMed
Cañadas-De la Fuente, GA, Gómez-Urquiza, JL, Ortega-Campos, EM, et al. (2018) Prevalence of burnout syndrome in oncology nursing: A meta-analytic study. Psychooncology 27(5), 1426–1433. doi: 10.1002/pon.4632CrossRefGoogle ScholarPubMed
Davis, S, Lind, BK and Sorensen, C (2013) A comparison of burnout among oncology nurses working in adult and pediatric inpatient and outpatient settings. Oncology Nursing Forum 40(4), E303–E311. doi: 10.1188/13.ONF.E303-E311CrossRefGoogle ScholarPubMed
Eelen, S, Bauwens, S, Baillon, C, et al. (2014) The prevalence of burnout among oncology professionals: Oncologists are at risk of developing burnout. Psychooncology 23, 1415–1422. doi: 10.1002/pon.3579CrossRefGoogle ScholarPubMed
Figley, CR (2002) Compassion fatigue: Psychotherapists’ chronic lack of self care. Journal of Clinical Psychology 58, 1433–1441. doi: 10.1002/jclp.10090CrossRefGoogle ScholarPubMed
Fisackerly, BL, Sira, N, Desai, PP, et al. (2016) An examination of compassion fatigue risk in certified child life specialists. Children's Health Care 45(4), 359–375. doi: 10.1080/02739615.2015.1038716CrossRefGoogle Scholar
Gillman, L, Adams, J, Kovac, R, et al. (2015) Strategies to promote coping and resilience in oncology and palliative care nurses caring for adult patients with malignancy: A comprehensive systematic review. JBI Database of Systematic Reviews and Implementation Reports 13(5), 131–204. doi: 10.11124/jbisrir-2015-1898CrossRefGoogle ScholarPubMed
Joubert, L, Hocking, A and Hampson, R (2013) Social work in oncology — managing vicarious trauma — the positive impact of professional supervision. Social Work in Health Care 52(2–3), 296–310.CrossRefGoogle ScholarPubMed
Kadambi, MA and Truscott, D (2004) Vicarious trauma among therapists working with sexual violence, cancer, and general practice. Canadian Journal of Counselling 38, 260–276.Google Scholar
Kearney, MK, Weininger, RB, Vachon, MLS, et al. (2009) Self-care of physicians caring for patients at the end of life: “Being connected…a key to my survival”. Journal of the American Medical Association 301(11), 1155–1164.CrossRefGoogle Scholar
Khamisa, N, Peltzer, K and Oldenburg, B (2013) Burnout in relation to specific contributing factors and health outcomes among nurses: A systematic review. International Journal of Environmental Research and Public Health 10(6), 2214–2240. doi: 10.3390/ijerph10062214CrossRefGoogle ScholarPubMed
Ko, W and Kiser-Larson, N (2016) Stress levels of nurses in oncology outpatient units. Clinical Journal of Oncology Nursing 20(2), 158–164.CrossRefGoogle ScholarPubMed
Maslach, C and Jackson, SE (1981) The measurement of experienced burnout. Journal of Occupational Behavior 2, 99–113.CrossRefGoogle Scholar
Maslach, C and Leiter, MP (2016) Understanding the burnout experience: Recent research and its implications for psychiatry. World Psychiatry 15(2), 103–111. doi: 10.1002/wps.20311CrossRefGoogle ScholarPubMed
Maslach, C, Jackson, SE, and Leiter, MP (1997) Maslach Burnout Inventory, 3rd ed. In Zalaquett, CP and Wood, RJ (eds.), Evaluating Stress: A Book of Resources. Scarecrow Education, pp. 191–218.Google Scholar
Meier, DE, Back, AL and Morrison, RS (2001) The inner life of physicians and care of the seriously ill. Journal of the American Medical Association 286(23), 3007–3014.CrossRefGoogle ScholarPubMed
Merel, SE, Stafford, MM, White, AA, et al. (2015) Providers’ beliefs about expressing condolences to the family of a deceased patient: A qualitative and quantitative analysis. Journal of Palliative Medicine 18(3), 217–224.CrossRefGoogle Scholar
Moher, D, Liberati, A, Tetzlaff, J, et al. (2009) Preferred reporting items for systematic reviews and meta-analyses: The PRISMA Statement. PLoS Medicine 6(7), e1000097. doi: 10.1371/journal.pmed1000097CrossRefGoogle ScholarPubMed
Morris, S and Block, S (2012) Grief and bereavement. In Grassi, L and Riba, M (eds.), Clinical Psycho-Oncology: An International Perspective. London: Wiley-Blackwell, pp. 271–280.CrossRefGoogle Scholar
Morris, SE, Kearns, JP, Moment, A, et al. (2019) “Remembrance”: A self-care tool for clinicians. Journal of Palliative Medicine 22(3), 316–318. doi: 10.1089/jpm.2018.0395CrossRefGoogle ScholarPubMed
Munn, Z, Moola, S, Lisy, K, et al. (2015) Methodological guidance for systematic reviews of observational epidemiological studies reporting prevalence and incidence data. International Journal of Evidence Based Healthcare 13(3), 147–153.CrossRefGoogle ScholarPubMed
Murali, K and Banerjee, S (2018) Burnout in oncologists is a serious issue: What can we do about it? Cancer Treatment Reviews 68, 55–61. doi: 10.1016/j.ctrv.2018.05.009CrossRefGoogle Scholar
Muriel, A, Tarquini, S and Morris, SE (2018) The “liaison” in consultation-liaison psychiatry: Helping medical staff cope with pediatric death. Child and Adolescent Psychiatric Clinics of North America 27(4), 591–598.CrossRefGoogle ScholarPubMed
Neumann, JL, Mau, LW, Virani, S, et al. (2018) Burnout, moral distress, work-Life balance, and career satisfaction among hematopoietic cell transplantation professionals. Biology of Blood and Marrow Transplantation: Journal of the American Society for Blood and Marrow Transplantation 24(4), 849–860. doi: 10.1016/j.bbmt.2017.11.015CrossRefGoogle ScholarPubMed
Nimmo, A and Huggard, P (2013) A systematic review of the measurement of compassion fatigue, vicarious trauma and secondary traumatic stress in physicians. Australasian Journal of Disaster and Trauma Studies 1, 37–44.Google Scholar
Pradas-Hernández, L, Ariza, T, Gómez-Urquiza, JL, et al. (2018) Prevalence of burnout in paediatric nurses: A systematic review and meta-analysis. PLoS One 13(4), e0195039. doi: 10.1371/journal.pone.0195039CrossRefGoogle ScholarPubMed
Rasmussen, V, Turnell, A, Butow, P, et al. (2016) Burnout among psychosocial oncologists: An application and extension of the effort-reward imbalance model. Psychooncology 25(2), 194–202. doi: 10.1002/pon.3902CrossRefGoogle ScholarPubMed
Rotenstein, LS, Torre, M, Ramos, MA, et al. (2018) Prevalence of burnout among physicians: A systematic review. Journal of the American Medical Association 320(11), 1131–1150. doi: 10.1001/jama.2018.12777CrossRefGoogle ScholarPubMed
Sanchez-Reilly, S, Morrison, LJ, Carey, E, et al. (2013) Caring for oneself to care for others: Physicians and their self-care. The Journal of Supportive Oncology 11(2), 75–81. doi: 10.12788/j.suponc.0003CrossRefGoogle ScholarPubMed
Shanafelt, TD, Gradishar, WJ, Kosty, M, et al. (2014a) Burnout and career satisfaction among US oncologists. Journal of Clinical Oncology 32(7), 678–86. doi: 10.1200/JCO.2013.51.8480CrossRefGoogle Scholar
Shanafelt, TD, Raymond, M, Kosty, M, et al. (2014b) Satisfaction with work-life balance and the career and retirement plans of US oncologists. Journal of Clinical Oncology 32(11), 1127–1135. doi: 10.1200/JCO.2013.53.4560CrossRefGoogle Scholar
Shinan-Altman, S, Cohen, M, Rasmussen, V, et al. (2018) Burnout among psychosocial oncologists in Israel: The direct and indirect effects of job demands and job resources. Palliative and Supportive Care 16(6), 677–684. doi: 10.1017/S1478951517001006CrossRefGoogle ScholarPubMed
Simon, CE, Pryce, JD, Roff, LL, et al. (2006) Secondary traumatic stress and oncology social work. Journal of Psychosocial Oncology 23(4), 1–14. doi: 10.1300/J077v23n04_01CrossRefGoogle Scholar
Turnell, A, Rasmussen, V, Butow, P, et al. (2016) An exploration of the prevalence and predictors of work-related well-being among psychosocial oncology professionals: An application of the job demands-resources model. Palliative and Supportive Care 14(1), 33–41. doi: 10.1017/S1478951515000693CrossRefGoogle ScholarPubMed
Worden, JW (1991) Grief Counseling and Grief Therapy: A Handbook for the Mental Health Practitioner. New York, NY: Springer Publishing.Google Scholar
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