A pilot study exploring interventions for physician distress in pediatric subspecialists

Kase, Samuel M.; Gribben, Jeanie L.; Waldman, Elisha; Weintraub, Andrea S.

doi:10.1038/s41390-020-0805-x

Cited by 8 publications

(9 citation statements)

References 31 publications

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“…40 In the current study, only 10% of respondents reported participation in hospital-based wellness initiatives, which is discrepant when compared to a national survey of pediatric subspecialists noting 60% participation. 42 The low participation rate in hospital wellness programming among our study respondents may be secondary to time constraints and heavy workloads in the field of organ transplantation which may make participation in self-care initiatives challenging. Also, while many hospitals offer mental health services, participation rates are noted to be quite low.…”

Section: Discussionmentioning

confidence: 96%

“…Also, while many hospitals offer mental health services, participation rates are noted to be quite low. 42 Other programmatic interventions to consider include peer-debriefing sessions and workshops to promote emotional processing during distressing patient care scenarios. 43,44 Additional interventions that may reduce burnout include improving communication and workflow within the team and initiating quality improvement projects that are targeted at addressing clinician concerns.…”

Section: Discussionmentioning

confidence: 99%

“…The low participation rate in hospital wellness programming among our study respondents may be secondary to time constraints and heavy workloads in the field of organ transplantation which may make participation in self‐care initiatives challenging. Also, while many hospitals offer mental health services, participation rates are noted to be quite low 42 . Other programmatic interventions to consider include peer‐debriefing sessions and workshops to promote emotional processing during distressing patient care scenarios 43,44 .…”

Section: Discussionmentioning

confidence: 99%

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Burnout, professional fulfillment, and post‐traumatic stress among pediatric solid organ transplant teams

Cousino

Bogle

Lim

et al. 2021

Pediatric Transplantation

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Background: Adverse effects of clinician burnout have been studied across multiple specialties; however, there have been no studies examining rates of burnout among pediatric solid organ transplant teams. This study aimed to measure burnout, work exhaustion, professional fulfillment, and post-traumatic stress symptoms among clinicians and administrators practicing in this high-stress field. Methods:This cross-sectional study utilized a 50 item web-based survey that included the Personal Fulfillment Index and the IES-R. This survey was distributed across four pediatric solid organ transplant centers in North America. Basic demographics, clinician characteristics, and information regarding wellness and self-care activities were collected. Descriptive and correlational analyses were performed.Results: One hundred and thirty five participants completed the survey, 76% were female and 78% were Caucasian. One-third (34%) of participants endorsed burnout, while 43% reported professional fulfillment. Approximately 15% of respondents endorsed clinically significant levels of post-traumatic stress symptoms related to patient deaths, with female clinicians more likely to endorse symptoms (p = .01). Nearly 80% of participants reported engaging in self-care activities outside of work and only 10% of participants reported participation in hospital-sponsored wellness programs. Conclusions: Pediatric solid organ transplant team members exhibited moderate levels of burnout, professional fulfillment, and post-traumatic stress. Female clinicians were the most likely to experience both work exhaustion and post-traumatic stress symptoms. Transplant centers are encouraged to consider interventions and programming to improve clinician wellness.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Burnout, professional fulfillment, and post‐traumatic stress among pediatric solid organ transplant teams

Cousino

Bogle

Lim

et al. 2021

Pediatric Transplantation

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“…This is an important finding for institutional leadership, as interventions aimed at making physicians feel valued can have a far-reaching impact. 28 How institutional leadership expresses employee value and shows appreciation is not “one-size-fits-all” and requires meticulous attention. 1 , 18 Prior to the pandemic, pediatric subspecialists reported wanting more social and emotional support from their institutions.…”

Section: Discussionmentioning

confidence: 99%

Compassion fatigue, burnout, and compassion satisfaction in pediatric subspecialists during the SARS-CoV-2 pandemic

et al. 2021

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Background The aim of this study was to explore factors contributing to compassion fatigue (CF), burnout (BO), and compassion satisfaction (CS) during the severe acute respiratory syndrome coronavirus-2 pandemic in pediatric subspecialists. Methods The Compassion Fatigue and Satisfaction Self-Test (CFST) and a questionnaire of personal/professional characteristics were distributed electronically to pediatric subspecialists. Results There were no significant differences in pre- and early-pandemic CF, BO, and CS scores. Nearly 40% of respondents felt their contributions to the pandemic were not valued by their institutions. Higher CF scores were significantly associated with: higher BO score; “I have put myself at increased risk through my work”; working in one’s specialty >50% of time; distress about mental health and/or future uncertainty. Higher BO scores were significantly associated with: higher CF score; “Self-care is not a priority”; emotional depletion. Higher CS scores were significantly associated with: “My institution values my contribution to the COVID-19 crisis”; workplace debriefs; pet therapy. Conclusions The pandemic has only increased the need for physicians to receive social/emotional support from their institution and to feel their workplace contributions are valued. Successful pre-pandemic workplace interventions may not adequately support physicians during the pandemic. Further study is needed to identify supports that best counter the pandemic’s unprecedented challenges. Impact The sentiment “My institution has valued my contribution to the Covid-19 crisis” was the only significant factor associated with lower BO scores and was also associated with higher CS scores in pediatric subspecialists. This study is the first comparison of pre- and early-pandemic CF, BO, and CS scores in a national cohort of pediatric subspecialists. When considering interventions to promote CS and mitigate CF and BO for pediatric subspecialists during and after the pandemic, institutional leadership must offer wellness programming focused on social/emotional supports and prioritize a culture that explicitly recognizes and values every physician’s contributions.

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“…Kase et al [( 76 ), p. 3] found that only 60% of pediatric physicians had participated in those programs and their reasons for not partaking in them included “inconvenience of scheduling” (45.3%), time constraints (27.2%), the preference of participants to “handle things on my own” (34.1%), and the sentiment that partaking in the activity would not be helpful (21.9%). Studies have found that “one-size-fits-all” wellness programs offered by an institution might not effectively address specific needs of their employees and professional affiliates ( 76 , 78 , 79 ). Parravicini concurred, stating, “What people find to be helpful for self-care is a highly individual matter.…”

Section: Discussionmentioning

confidence: 99%

Fostering Vicarious Resilience for Perinatal Palliative Care Professionals

et al. 2020

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Background: The demands on healthcare professionals caring for families grappling with a life-limiting condition in an unborn or newly born child can be overwhelming. Clinicians working in emergency/trauma, hospice, and pediatric settings are already at high risk for burnout and compassion fatigue, which can leave healthcare institutions increasingly vulnerable to poor retention, absenteeism, and waning quality of care. The provision of exemplary palliative care requires a cohesive interdisciplinary team of seasoned professionals resilient to daily challenges. In September 2019, the American College of Gynecology, in a committee opinion, published standard of care guidelines for perinatal palliative care. This has created an impetus for exceptional caregiving and a greater demand for both physician and interdisciplinary healthcare provider education, training, and ongoing support that promotes truly beneficent care for pregnant patients confronted with life-limiting fetal conditions. Methods: A scoping review of the research literature was conducted in order to distinguish the barriers and facilitators of professional resiliency in perinatal palliative care. PubMed, Medline, CINAHL, and EBSCO Psychology & Behavioral Sciences Collections were systematically reviewed. Because of the paucity of studies specific to perinatal palliative care, several interviews of nurses and physicians in that field were conducted and analyzed for content distinctly pertaining to personal practices or workplace factors that support or hinder professional resiliency. Results: The research indicated that medical professionals often cite a lack of knowledge, inexperience using effective communication skills related to perinatal palliative care and bereavement, challenges with interdisciplinary collaboration, misconceptions about the role and function of palliative care in the perinatal or neonatal settings, moral distress, and workload challenges as encumbrances to professional satisfaction. Strategic implementation of facility-wide bereavement care training, effective communication modalities, and evidenced-based practical applications are critical components for a thriving perinatal palliative care team. Authentic formal and informal debriefing, peer mentoring, adequate caseloads, robust provider self-care practices, exceptional relational efficacy, and cultural and spiritual humility can foster personal growth and even vicarious resilience for perinatal palliative care professionals. Conclusions: Support should be strategic and multifaceted. The onus to implement salient measures to cultivate resilience in the perinatal palliative caregiver should not be only upon the individuals themselves but also upon prevailing regulatory governing bodies and healthcare institutions.

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A pilot study exploring interventions for physician distress in pediatric subspecialists

Cited by 8 publications

References 31 publications

Burnout, professional fulfillment, and post‐traumatic stress among pediatric solid organ transplant teams

Burnout, professional fulfillment, and post‐traumatic stress among pediatric solid organ transplant teams

Compassion fatigue, burnout, and compassion satisfaction in pediatric subspecialists during the SARS-CoV-2 pandemic

Fostering Vicarious Resilience for Perinatal Palliative Care Professionals

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