Burnout, Moral Distress, Work–Life Balance, and Career Satisfaction among Hematopoietic Cell Transplantation Professionals

Abstract

A projected shortage of hematopoietic cell transplantation (HCT) health professionals was identified as a major issue during the National Marrow Donor Program/Be The Match System Capacity Initiative. Work-related distress and work-life balance were noted to be potential barriers to recruitment/retention. This study examined these barriers and their association with career satisfaction across HCT disciplines. A cross-sectional, 90-item, web-based survey was administered to advanced practice providers, nurses, physicians, pharmacists, and social workers in 2015. Participants were recruited from membership lists of 6 professional groups. Burnout (measured with the Maslach Burnout Inventory subscales of emotional exhaustion and depersonalization) and moral distress (measured by Moral Distress Scale-Revised) were examined to identify work-related distress. Additional questions addressed demographics, work-life balance, and career satisfaction. Of 5759 HCT providers who received an individualized invitation to participate, 914 (16%) responded; 627 additional participants responded to an open link survey. Significant differences in demographic and practice characteristics existed across disciplines (P < .05). The prevalence of burnout differed across disciplines (P < .05) with an overall prevalence of 40%. Over one-half of pharmacists had burnout, whereas social workers had the lowest prevalence at less than one-third. Moral distress scores ranged from 0 to 336 and varied by discipline (P < .05); pharmacists had the highest mean score (62.9 ± 34.8) and social workers the lowest (42.7 ± 24.4). In multivariate and univariate analyses, variables contributing to burnout varied by discipline; however, moral distress was a significant contributing factor for all providers. Those with burnout were more likely to report inadequate work-life balance and a low level of career satisfaction; however, overall there was a high level of career satisfaction across disciplines. Burnout, moral distress, and inadequate work-life balance existed at a variable rate in all HCT disciplines, yet career satisfaction was high. These results suggest specific areas to address in the work environment for HCT health professionals, especially the need for relief of moral distress and a greater degree of personal time. As the creation of healthy work environments is increasingly emphasized to improve quality care and decrease costs, these findings should be used by HCT leadership to develop interventions that mitigate work-related distress and in turn foster recruitment and retention of HCT providers.

Feeling the burn? A systematic review of burnout in pharmacists

“…The overall estimates of the prevalence of burnout based on individual MBI subscales ranged from 8% to 53% (Figure ). This is a broader range of prevalence than reported by individual studies, which cited overall burnout ranging from 52% to 61% using a composite of one or more MBI subscales (Table ) …”

“…The 15 included articles were all cross‐sectional studies by design, involving a total of 6342 US‐based pharmacists and were published between 1982 and 2018 . There were two sets of articles that were published using the same sample and were analyzed as one data set each .…”

“…Two articles defined burnout only using the EE subscale; Holden and colleagues reported using an abbreviated 4‐item subscale and Chui reported using the full 9‐item subscale . Of the 13 articles that reported using the MBI to measure burnout, only 5 (45%) reported the scoring cutoff that would define a respondent as burned out . Barnett and colleagues provided scoring cutoffs for each subscale, but only reported average subscale scores and did not specify numbers or percentages of respondents who met their definition of burnout .…”

What is known about paediatric nurse burnout: a scoping review

“…Personal Accomplishment subscale results were high, perhaps indicating a factor of pediatric nursing that increases resilience despite moderate burnout in other domains. In studies that compared nurses who work in pediatric units to other in-patient units, burnout results were mixed [26,32,35,36,38,74,78,94]. The majority of the included studies identified correlational relationships using cross-sectional study designs, which limited causal inferences.…”

“…Burnout was found to be high in certain high-acuity pediatric units including emergency, medical/surgical, surgery, pediatric intensive care unit (PICU), and neonatal intensive care unit (NICU) [26,32,35,36,76,88]. Davis et al [38] found that adult oncology nurses had higher personal accomplishment than pediatric oncology nurses while Neumann et al [74] found nurses who care for both pediatric and adult patients had lower emotional exhaustion than those who cared for adult patents only. Conversely, Sun et al [94] found that nurses who worked in adult obstetrics and gynecology units had more burnout than nurses who worked in pediatric units; however, Ohue et al [78] reported the inverse.…”