Burnout and Resilience After a Decade in Palliative Care: What Survivors Have to Teach Us. A Qualitative Study of Palliative Care Clinicians With More Than 10 Years of Experience

Koh, Mervyn; Hum, Allyn; Khoo, Hoon‐Eng; Ho, Andy Hau Yan; Chong, Poh Heng; Ong, Wah Ying; Ong, Joseph; Neo, Patricia Soek Hui; Yong, Woon Chai

doi:10.1016/j.jpainsymman.2019.08.008

Cited by 36 publications

(28 citation statements)

References 38 publications

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“…Further identified were personal and professional comments about present-day stress, fatigue, and burnout, in addition to past experiences of burnout and how some participants were building resilience into their lives. Many of these issues have been identified in other studies [ 50 , 64 , 65 ], and further research using mixed-methods approaches is needed to better understand what contributes and mitigates experiences of burnout and resilience and importantly, what system-wide changes and potential interventions are required, to best support physicians across specialities [ 56 , 61 , 66 ]. Most importantly, it is critical that research in this area is integrated into policy and practice, to ensure that palliative care physicians are supported to provide compassionate, competent, comprehensive care.…”

Section: Discussionmentioning

confidence: 99%

Burnout and resilience among Canadian palliative care physicians

et al. 2020

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Background Physicians experience high rates of burnout, which may negatively impact patient care. Palliative care is an emotionally demanding specialty with high burnout rates reported in previous studies from other countries. We aimed to estimate the prevalence of burnout and degree of resilience among Canadian palliative care physicians and examine their associations with demographic and workplace factors in a national survey. Methods Physician members of the Canadian Society of Palliative Care Physicians and Société Québécoise des Médecins de Soins Palliatifs were invited to participate in an electronic survey about their demographic and practice arrangements and complete the Maslach Burnout Inventory for Medical Professionals (MBI-HSS (MP)), and Connor-Davidson Resilience Scale (CD-RISC). The association of categorical demographic and practice variables was examined in relation to burnout status, as defined by MBI-HSS (MP) score. In addition to bivariable analyses, a multivariable logistic regression analysis, reporting odds ratios (OR), was conducted. Mean CD-RISC score differences were examined in multivariable linear regression analysis. Results One hundred sixty five members (29%) completed the survey. On the MBI-HSS (MP), 36.4% of respondents reported high emotional exhaustion (EE), 15.1% reported high depersonalization (DP), and 7.9% reported low personal accomplishment (PA). Overall, 38.2% of respondents reported a high degree of burnout, based on having high EE or high DP. Median CD-RISC resilience score was 74, which falls in the 25th percentile of normative population. Age over 60 (OR = 0.05; CI, 0.01–0.38), compared to age ≤ 40, was independently associated with lower burnout. Mean CD-RISC resilience scores were lower in association with the presence of high burnout than when burnout was low (67.5 ± 11.8 vs 77.4 ± 11.2, respectively, p < 0.0001). Increased mean CD-RISC score differences (higher resilience) of 7.77 (95% CI, 1.97–13.57), 5.54 (CI, 0.81–10.28), and 8.26 (CI, 1.96–14.57) occurred in association with age > 60 as compared to ≤40, a predominantly palliative care focussed practice, and > 60 h worked per week as compared to ≤40 h worked, respectively. Conclusions One in three Canadian palliative care physicians demonstrate a high degree of burnout. Burnout prevention may benefit from increasing resilience skills on an individual level while also implementing systematic workplace interventions across organizational levels.

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Section: Discussionmentioning

confidence: 99%

Burnout and resilience among Canadian palliative care physicians

et al. 2020

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“…PC services also have higher rates of mortality and that increases the risk of burnout in health care professionals, which is even worse in nurses due to their typical deeper relationship with patients and their families in comparison with other healthcare professionals in PC. As a result of all these challenges, there is a risk of burnout among these nurses in PC [ 13 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Burnout Determinants among Nurses Working in Palliative Care during the Coronavirus Disease 2019 Pandemic

Gonçalves

Castro

Rêgo

et al. 2021

IJERPH

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Nurses working in palliative care are at risk of burnout. The Copenhagen Burnout Inventory was used to determine burnout levels of nurses working in the Portuguese national network of palliative care. We evaluated the contribution of personal, work, and COVID-19 variables in three burnout subclasses: personal, work, and patient-related. A cross-sectional, exploratory, and quantitative design was employed and participants were sampled using convenience and snowball technique. An online survey was conducted and 153 nurses participated in our study. Socio-demographic characterization was conducted, levels of burnout and determinants were explored through multiple linear regression models for its three dimensions. High levels of personal, working, and patient burnout were present in 71 (46%), 68 (44%), and 33 nurses (22%), respectively. Most of them agreed that COVID-19 had an impact on their activities. Significant personal and work related burnout factors found were specialization in palliative care, self-perceived health status, unit type, weekly hours of work, and allocation to COVID-19 units. Gender was found to be a significant factor in patient-related burnout. There is a high level of burnout among nurses working in the Portuguese national network of palliative care. Measures for identification and mitigation of burnout are necessary to protect health care professionals.

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“…McClosky and Taggart 2010), support of colleagues, family and friends (Cope et al 2016;Kutluturkan et al, 2016;Slater et al, 2018;Sullivan et al, 2019) and sound organisational support (Jackson et al 2018;Zander et al 2013). In addition, participants in both this study, and other work, have reported the development of social and emotional competence (Edo Gual et al, 2015;Gillman et al, 2015) over a long period of time of working within the sector (Bursch et al, 2018;Koh et al, 2019). Opportunities for debriefing were also commonly welcomed (Harrington et al, 2019;McConnell et al, 2016;Pattison et al, 2019) including an embracing of reflection (Jestico and Finlay, 2017;Mirlashari et al, 2017) and effective communication within the care team (Gillman et al, 2015;Kutlurkan et al, 2016;Zysk, 2018).…”

Section: Discussionmentioning

confidence: 76%

Factors influencing nurse retention within children’s palliative care

Whiting

O'Grady

Whiting

et al. 2020

J Child Health Care

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Retention of staff presents major challenges within children’s palliative care; this has substantial implications for children, families and the nursing workforce. To address this, a programme was undertaken that provided pathways of professional development for senior nurses working in this field. This study reports the views of nurses completing this programme, the overall project manager (PM) and the day-to-day programme lead (PL) as well as factors that influence nurse retention within children’s palliative care nursing. The study drew on an Appreciative Inquiry approach that comprised of interviews with the PM and PL as well as focus groups and questionnaires with senior nurses from the children’s palliative care sector, who participated in the training programme. Thematic analysis of data from interviews and focus groups revealed factors influencing nurse retention: speciality, positivity and making a difference, support, provision of adequate resources, tailored education/professional development and resilience. These themes were supported by the questionnaire findings. The programme was perceived as having a positive influence on nurse retention within the children’s palliative care workforce. In addition, it was felt to be very beneficial in terms of shared learning and development. Participants highlighted the need for similar opportunities in the future.

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Burnout and Resilience After a Decade in Palliative Care: What Survivors Have to Teach Us. A Qualitative Study of Palliative Care Clinicians With More Than 10 Years of Experience

Cited by 36 publications

References 38 publications

Burnout and resilience among Canadian palliative care physicians

Burnout and resilience among Canadian palliative care physicians

Burnout Determinants among Nurses Working in Palliative Care during the Coronavirus Disease 2019 Pandemic

Factors influencing nurse retention within children’s palliative care

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