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Burnout among physicians in palliative care: Impact of clinical settings

Published online by Cambridge University Press:  14 October 2015

Soazic Dréano-Hartz ,
Wadih Rhondali Open the ORCID record for Wadih Rhondali [Opens in a new window] ,
Mathilde Ledoux ,
Murielle Ruer ,
Julien Berthiller ,
Anne-Marie Schott ,
Léa Monsarrat  and
Marilène Filbet
Soazic Dréano-Hartz
Affiliation:
Department of Palliative Care, Centre Hospitalier de Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France
Wadih Rhondali
Affiliation:
Department of Palliative Care, Centre Hospitalier de Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France
Mathilde Ledoux
Affiliation:
Department of Palliative Care, Centre Hospitalier de Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France
Murielle Ruer
Affiliation:
Department of Palliative Care, Centre Hospitalier de Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France
Julien Berthiller
Affiliation:
Pôle IMER (Information Médicale Evaluation Recherche), Hospices Civils de Lyon, Lyon, France
Anne-Marie Schott
Affiliation:
Pôle IMER (Information Médicale Evaluation Recherche), Hospices Civils de Lyon, Lyon, France
Léa Monsarrat
Affiliation:
Department of Palliative Care, Centre Hospitalier de Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France
Marilène Filbet*
Affiliation:
Department of Palliative Care, Centre Hospitalier de Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France
*
Address correspondence and reprint request to: Marilène Filbet, Department of Palliative Care, Centre Hospitalier de Lyon-Sud, Hospices Civils de Lyon, 165 Chemin du Grand Revoyet, 69310 Pierre-Bénite, France. E-mail: marilene.filbet@chu-lyon.fr.
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Abstract

Objective:

Burnout syndrome is a work-related professional distress. Palliative care physicians often have to deal with complex end-of-life situations and are at risk of presenting with burnout syndrome, which has been little studied in this population. Our study aims to identify the impact of clinical settings (in a palliative care unit (PCU) or on a palliative care mobile team (PCMT)) on palliative care physicians.

Method:

We undertook a cross-sectional study using a questionnaire that included the Maslach Burnout Inventory (MBI), and we gathered sociodemographic and professional data. The questionnaire was sent to all 590 physicians working in palliative care in France between July of 2012 and February of 2013.

Results:

The response rate was 61, 8% after three reminders. Some 27 (9%) participants showed high emotional exhaustion, 12 (4%) suffered from a high degree of depersonalization, and 71 (18%) had feelings of low personal accomplishment. Physicians working on a PCMT tended (p = 0.051) to be more likely to suffer from emotional exhaustion than their colleagues. Physicians working on a PCMT worked on smaller teams (fewer physicians, p < 0.001; fewer nonphysicians, p < 0.001). They spent less time doing research (p = 0.019), had fewer resources (p = 0.004), and their expertise seemed to be underrecognized by their colleagues (p = 0.023).

Significance of Results:

The prevalence of burnout in palliative care physicians was low and in fact lower than that reported in other populations (e.g., oncologists). Working on a palliative care mobile team can be a more risky situation, associated with a lack of medical and paramedical staff.

Keywords

BurnoutPalliative care physiciansClinical settingsMaslach Burnout Inventory
Type
Original Articles
Information
Palliative & Supportive Care , Volume 14 , Issue 4 , August 2016 , pp. 402 - 410
Copyright
Copyright © Cambridge University Press 2015 

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References

REFERENCES

Asai, M., Morita, T., Akechi, T., et al. (2007). Burnout and psychiatric morbidity among physicians engaged in end-of-life care for cancer patients: A cross-sectional nationwide survey in Japan. Psycho-Oncology, 16(5), 421–428.CrossRefGoogle ScholarPubMed
Aubry, R. (2011). État des lieux du développement des soins palliatifs en France en 2010: Rapport du comité national de suivi du développement des soins palliatifs. Paris: Ministère des Affaires sociales, de la Santé et des Droits des femmes.Google Scholar
Bressi, C. & Manenti, S. (2008). Haemato-oncology and burnout: An Italian survey. British Journal of Cancer, 98, 1046–1052.CrossRefGoogle ScholarPubMed
Catalan, J., Burgess, A., Pergami, A., et al. (1996). The psychological impact on staff of caring for people with serious diseases: The case of HIV infection and oncology. Journal of Psychosomatic Research, 40(4), 425–435.CrossRefGoogle ScholarPubMed
Catt, S., Fallowfield, L., Jenkins, V., et al. (2005). The informational roles and psychological health of members of 10 oncology multidisciplinary teams in the UK. British Journal of Cancer, 93, 1092–1097.CrossRefGoogle ScholarPubMed
Coulon, A. & Filbet, M. (1995). Le syndrome de burnout chez les médecins s'occupant de patients en soins palliatifs. Info Kara, 40, 5–15.Google Scholar
Dion, G. & Tessier, R. (1994). Validation de la traduction de l'inventaire d'épuisement professionnel de Maslach et Jackson. Revue Canadienne des Sciences du Comportement, 26, 210–227.CrossRefGoogle Scholar
Elit, L., Trim, K., Mand-Bains, I.H., et al. (2004). Job satisfaction, stress and burnout among Canadian gynaecologic oncologists. Gynecologic Oncology, 94, 134–139.CrossRefGoogle Scholar
Estryn-Behar, M., Lassaunière, J.M., Fry, C., et al. (2011). L'interdisciplinarité diminue-t-elle la souffrance au travail? Comparaison entre soignants de toutes spécialités (médecins et infirmiers) avec ceux exerçant en soins palliatifs, en onco-hématologie et en gériatrie. Médecine Palliative: Soins de support — Accompagnement — Équipe, 11, 65–89.Google Scholar
Finlay, I. (1989). Sources of stress in hospice medical directors and matrons. Palliative Medicine, 4, 5–9.CrossRefGoogle Scholar
Freudenberger, H.J. (1974). Staff burnout. Journal of Social Issues, 30, 159–165.CrossRefGoogle Scholar
Galam, E. & Mouriès, R. (2007). L'épuisement professionnel des médecins libéraux franciliens: Témoignages, analyses et perspectives. Paris: URML IDF/commission prévention et santé publique.Google Scholar
Glasberg, J., Horiuti, L., Novais, M.A., et al. (2007). Prevalence of the burnout syndrome among Brazilian medical oncologists. Revista da Associação Médica Brasileira, 53(1), 85–89.Google Scholar
Graham, J., Ramirez, A.J., Cull, A., et al. (1996). Job stress and satisfaction among palliative physicians. Palliative Medicine, 10(3), 185–194.CrossRefGoogle ScholarPubMed
Grunfeld, E., Whelan, T.J., Zitzelsberger, L., et al. (2000). Cancer care workers in Ontario: Prevalence of burnout, job stress and job satisfaction. CMAJ, 163(2), 166–169.Google Scholar
Guex, P. & Stiefel, F. (2010). De la souffrance du patient à celle des équipes. Médecine Palliative: Soins de Support — Accompagnement — Équipe, 9, 32–35.CrossRefGoogle Scholar
Hill, A., Roberts, J., Ewings, P., et al. (1997). Non-response bias in a lifestyle survey. Journal of Public Health Medicine, 19(2), 203–207.CrossRefGoogle Scholar
Hudson, P.L., Remedios, C. & Thomas, K. (2010). A systematic review of psychological interventions for family carers of palliative care patients. BMC Palliative Care, 9, 17.CrossRefGoogle ScholarPubMed
Johnson, T.P. & Owens, L. (2003). Survey response rate reporting in the professional literature. Paper presented at the 58th Annual Meeting of the American Association for Public Opinion Research, Nashville, May 2003. Available from http://www.srl.uic.edu/publist/Conference/rr_reporting.pdf.Google Scholar
Kearney, M.K., Weininger, R.B., Vachon, M.L., et al. (2009). Self-care of physicians caring for patients at the end of life: “Being connected … A key to my survival,” The Journal of the American Medical Association, 301(11), 1155–1164.CrossRefGoogle Scholar
Maslach, C. & Jackson, S.E. (1981). The measurement of experienced burnout. Journal of Organizational Behavior, 2(2), 99–113.CrossRefGoogle Scholar
Maslach, C., Schaufeli, W. & Leiter, M. (2001). Job burnout. Annual Review of Psychology, 52, 397–422.Google Scholar
Meier, D.E., Back, A.L. & Morrison, R.S. (2001). The inner life of physicians and care of the seriously ill. The Journal of the American Medical Association, 286, 3007–3014.CrossRefGoogle ScholarPubMed
Ministère de la Santé, de la Jeunesse, des Sports et de la Vie Associative (2008). Circulaire n° DHOS/02/2008/99 du 25 mars 2008 relative à l'organisation des soins palliatifs.Google Scholar
Peterson, J., Johnson, M.A., Halvorsen, B., et al. (2010). What is it so stressful about caring for dying patient? A qualitative study of nurses' experiences. International Journal of Palliative Nursing, 16, 181–187.CrossRefGoogle Scholar
Ramirez, A.J., Graham, J., Richards, M.A., et al. (1995). Burnout and psychiatric disorder among cancer clinicians. British Journal of Cancer, 71, 1263–1269.CrossRefGoogle ScholarPubMed
Ramirez, A.J., Graham, J., Richards, M.A., et al. (1996). Mental health of hospital consultants: The effects of stress and satisfaction at work. Lancet, 347, 724–728.CrossRefGoogle ScholarPubMed
Rhondali, W., Filbet, M. & Bruera, E. (2012). La médecine palliative dans les dix prochaines années. Médecine Palliative: Soins de Support — Accompagnement — Équipe, 11(5), 233–245.CrossRefGoogle Scholar
Swetz, K.M., Harrington, S.E., Matsuyama, R.K., et al. (2009). Strategies for avoiding burnout in hospice and palliative medicine: Peer advice for physicians on achieving longevity and fulfillment. Journal of Palliative Medicine, 12(9), 773–777.CrossRefGoogle ScholarPubMed
Trufelli, D.C., Bensi, C.G., Garcia, J.B., et al. (2008). Burnout in cancer professionals: A systematic review and meta-analysis. European Journal of Cancer Care, 17, 524–531.Google ScholarPubMed
Tucunduva, L.T., Garcia, A.P., Prudente, F.V., et al. (2006). Incidence of burnout syndrome among Brazilian cancer physicians. Revista da Associação Médica Brasileira, 52, 108–112.CrossRefGoogle ScholarPubMed
Vachon, M.L. (1995). Staff stress in hospice/palliative care: A review. Palliative Medicine, 9, 91–122.CrossRefGoogle ScholarPubMed
Wu, H., Liu, L., Wang, Y., et al. (2013). Factors associated with burnout among Chinese hospital doctors: A cross-sectional study. BMC Public Health, 13, 786.CrossRefGoogle ScholarPubMed