Mitigating Burnout in an Oncological Unit: A Scoping Review

Alabi, Rasheed Omobolaji; Hietanen, Päivi; Elmusrati, Mohammed; Youssef, Omar; Almangush, Alhadi; Mäkitie, Antti

doi:10.3389/fpubh.2021.677915

Cited by 26 publications

(19 citation statements)

References 78 publications

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“…Although this finding does not directly support an association between tumor board hours and burnout, it is consistent with data reporting that increased work hours, clerical burden, and stressful professional events have been associated with burnout in oncologists . Similarly, burnout has been associated with oncologists’ decreasing sense of autonomy as administrative activities begin to outweigh direct patient care . Furthermore, several respondents in this study commented about the association of tumor boards with their wellness and wellness activities.…”

Section: Discussionsupporting

confidence: 78%

“…And while individual-focused interventions, such as resiliency training or self-care programs, have been shown to help with burnout, institution-based strategies that call for wider organizational change have demonstrated a significant reduction in burnout . The combination of individual and institutional interventions is more effective, with longer-lasting results than person-directed interventions . Further investigation of burnout, depersonalization, and derealization would allow for a deeper understanding of the association between TBB and burnout and is warranted.…”

Section: Discussionmentioning

confidence: 99%

“…18 Similarly, burnout has been associated with oncologists' decreasing sense of autonomy as administrative activities begin to outweigh direct patient care. [18][19][20] Furthermore, several respondents in this study commented about the association of tumor boards with their wellness and wellness activities. And while individual-focused interventions, such as resiliency training or self-care programs, have been shown to help with burnout, institution-based strategies that call for wider organizational change have demonstrated a significant reduction in burnout.…”

Section: Discussionmentioning

confidence: 99%

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Association of Parental Status and Gender With Burden of Multidisciplinary Tumor Boards Among Oncology Physicians

Chau,

LaGuardia,

Kim

et al. 2023

JAMA Netw Open

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ImportanceTumor boards are integral to the care of patients with cancer. However, data investigating the burden of tumor boards on physicians are limited.ObjectiveTo investigate what physician-related and tumor board–related factors are associated with higher tumor board burden among oncology physicians.Design, Setting, and ParticipantsTumor board burden was assessed by a cross-sectional convenience survey posted on social media and by email to Cedars-Sinai Medical Center cancer physicians between March 3 and April 3, 2022. Tumor board start times were independently collected by email from 22 top cancer centers.Main Outcomes and MeasuresTumor board burden was measured on a 4-point scale (1, not at all burdensome; 2, slightly burdensome; 3, moderately burdensome; and 4, very burdensome). Univariable and multivariable probabilistic index (PI) models were performed.ResultsSurveys were completed by 111 physicians (median age, 42 years [IQR, 36-50 years]; 58 women [52.3%]; 60 non-Hispanic White [54.1%]). On multivariable analysis, factors associated with higher probability of tumor board burden included radiology or pathology specialty (PI, 0.68; 95% CI, 0.54-0.79; P = .02), attending 3 or more hours per week of tumor boards (PI, 0.68; 95% CI, 0.58-0.76; P &lt; .001), and having 2 or more children (PI, 0.65; 95% CI, 0.52-0.77; P = .03). Early or late tumor boards (before 8 am or at 5 pm or after) were considered very burdensome by 33 respondents (29.7%). Parents frequently reported a negative burden on childcare (43 of 77 [55.8%]) and family dynamics (49 of 77 [63.6%]). On multivariable analysis, a higher level of burden from early or late tumor boards was independently associated with identifying as a woman (PI, 0.69; 95% CI, 0.57-0.78; P = .003) and having children (PI, 0.75; 95% CI, 0.62-0.84; P &lt; .001). Independent assessment of 358 tumor boards from 22 institutions revealed the most common start time was before 8 am (88 [24.6%]).Conclusions and RelevanceThis survey study of tumor board burden suggests that identifying as a woman or parent was independently associated with a higher level of burden from early or late tumor boards. The burden of early or late tumor boards on childcare and family dynamics was commonly reported by parents. Having 2 or more children, attending 3 or more hours per week of tumor boards, and radiology or pathology specialty were associated with a significantly higher tumor board burden overall. Future strategies should aim to decrease the disparate burden on parents and women.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Association of Parental Status and Gender With Burden of Multidisciplinary Tumor Boards Among Oncology Physicians

Chau,

LaGuardia,

Kim

et al. 2023

JAMA Netw Open

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“…In recent years, medicine has made numerous attempts to involve machine learning (ML) algorithms to improve patient outcomes and facilitate the work of clinicians. In addition to improving patients’ quality of life, machine learning can be used to reduce doctors’ professional burnout [ 1 ]. Primary uses of machine learning are related to image processing [ 2 ], but artificial intelligence (AI) in general also allows scientists to keep up with the multitude of data generated for patients: MRI scans, CT scans, radiotherapy results, histology slides, sequencing results, and others.…”

Section: Introductionmentioning

confidence: 99%

Platelet-Based Liquid Biopsies through the Lens of Machine Learning

Cygert

Pastuszak

Górski

et al. 2023

Cancers

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Liquid biopsies offer minimally invasive diagnosis and monitoring of cancer disease. This biosource is often analyzed using sequencing, which generates highly complex data that can be used using machine learning tools. Nevertheless, validating the clinical applications of such methods is challenging. It requires: (a) using data from many patients; (b) verifying potential bias concerning sample collection; and (c) adding interpretability to the model. In this work, we have used RNA sequencing data of tumor-educated platelets (TEPs) and performed a binary classification (cancer vs. no-cancer). First, we compiled a large-scale dataset with more than a thousand donors. Further, we used different convolutional neural networks (CNNs) and boosting methods to evaluate the classifier performance. We have obtained an impressive result of 0.96 area under the curve. We then identified different clusters of splice variants using expert knowledge from the Kyoto Encyclopedia of Genes and Genomes (KEGG). Employing boosting algorithms, we identified the features with the highest predictive power. Finally, we tested the robustness of the models using test data from novel hospitals. Notably, we did not observe any decrease in model performance. Our work proves the great potential of using TEP data for cancer patient classification and opens the avenue for profound cancer diagnostics.

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“…BO, as described by Maslach et al, 1 includes emotional exhaustion (EE), depersonalization (DP), and reduced feelings of personal accomplishment (PA). Contributing to the risk for BO in the HCT unit are workplace factors such as limited staffing and long work hours, 2 and practice-related factors that include breaking bad news, witnessing patients suffering, repeated exposure to death, and dealing with treatment-related complications. 3-6 BO can lead to depression, irritability, anxiety, impaired immune responses, and somatic symptoms, which in turn cause increased absenteeism, increased treatment errors, decreased productivity, and high staff turnover.…”

Section: Introductionmentioning

confidence: 99%

Decreasing Burnout and Improving Work Environment: The Impact of Firgun on a Pediatric Hematopoietic Cell Transplant Team

Stein

Madni

Moody

et al. 2023

JCO Oncology Practice

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PURPOSE: Oncology teams are challenged by BO, which may be alleviated by meaningful recognition. In this study, firgun—altruistic acknowledgment—was implemented on a pediatric hematopoietic cell transplant unit to evaluate its impact on staff and work environment. METHODS: In this longitudinal, mixed-methods pilot study, interdisciplinary inpatient hematopoietic cell transplant providers received web-based firgun education. Electronic administration of validated surveys occurred at baseline and 8 weeks, including Perceived Stress Scale, Professional Quality of Life Scale, Maslach Burnout Inventory, Workplace Civility Index, Areas of Work Life Survey, and WHO-5. Weekly e-mails reminded participants to practice and log firgun. Wilcoxon signed test for paired data compared pre/post results. Interviews conducted at project completion were coded using MaxQDA software. RESULTS: Forty-two participants enrolled; 25 completed pre/post surveys; eight were interviewed. At study end, participants reported feeling less nervous and stressed ( P = .008), and less difficulty coping ( P = .01; Perceived Stress Scale), while noting increased acknowledgment of others' work ( P = .04) and seeking constructive feedback ( P = .04; Workplace Civility Index). Marked BO was not evident overall on the Maslach Burnout Inventory; however, emotional exhaustion subscale mean (SD) scores improved from pre (19.4 [8.6]) to post (16 [6.3; P = .02]) and individual items illustrated decreased fatigue ( P = .008), frustration ( P = .04), and feeling “at the end of my rope” ( P = .001). Postintervention participants noted increased receipt of recognition ( P = .02; Areas of Work Life Survey), decreased feeling “bogged down” ( P = .02), decreased affective stress ( P = .04), and negative pre-occupations ( P = .04; Professional Quality of Life Scale). Qualitative analysis revealed themes of improved confidence at work and enhanced feelings of trust and teamwork. CONCLUSION: Firgun is a tool that can potentially reduce BO and stress in interdisciplinary providers, facilitate teamwork, and promote positive work environments in clinical oncology and beyond.

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Mitigating Burnout in an Oncological Unit: A Scoping Review

Cited by 26 publications

References 78 publications

Association of Parental Status and Gender With Burden of Multidisciplinary Tumor Boards Among Oncology Physicians

Association of Parental Status and Gender With Burden of Multidisciplinary Tumor Boards Among Oncology Physicians

Platelet-Based Liquid Biopsies through the Lens of Machine Learning

Decreasing Burnout and Improving Work Environment: The Impact of Firgun on a Pediatric Hematopoietic Cell Transplant Team

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