Prevalence and Predictors of Burnout Among Hospice and Palliative Care Clinicians in the U.S. |
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| Institution: | 1. Duke Center for Learning Health Care, Duke Clinical Research Institute, Durham, North Carolina, USA;2. Duke Cancer Institute, Durham, North Carolina, USA;3. Four Seasons Compassion for Life, Flat Rock, North Carolina, USA;4. University of Alabama – Birmingham, Birmingham, Alabama, USA;5. Mayo Clinic, Rochester, Minnesota, USA;6. American Academy of Hospice and Palliative Medicine, Rosemont, Illinois, USA;7. University of Pittsburgh, Pittsburgh, Pennsylvania, USA;8. University of Kansas, Kansas City, Kansas, USA;1. Department of Integration of Chinese and Western Medicine, Key Lab of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institution, Beijing, China;2. Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA;1. Memorial Sloan Kettering Cancer Center, New York, New York, USA;2. Weill Cornell Medicine, New York, New York, USA;1. Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA;2. Department of GI Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA |
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| Abstract: | ContextMany clinical disciplines report high rates of burnout, which leads to low quality of care. Palliative care clinicians routinely manage patients with significant suffering, aiming to improve quality of life. As a major role of palliative care clinicians involves educating patients and caregivers regarding identifying priorities and balancing stress, we wondered how clinician self-management of burnout matches against the emotionally exhaustive nature of the work.ObjectivesWe sought to understand the prevalence and predictors of burnout using a discipline-wide survey.MethodsWe asked American Academy of Hospice and Palliative Medicine clinician members to complete an electronic survey querying demographic factors, job responsibilities, and the Maslach Burnout Inventory. We performed univariate and multivariable regression analyses to identify predictors of high rates of burnout.ResultsWe received 1357 responses (response rate 30%). Overall, we observed a burnout rate of 38.7%, with higher rates reported by nonphysician clinicians. Most burnout stemmed from emotional exhaustion, with depersonalization comprising a minor portion. Factors associated with higher odds of burnout include nonphysician clinical roles, working in smaller organizations, working longer hours, being younger than 50 years of age, and working weekends. We did not observe different rates between palliative care clinicians and hospice clinicians. Higher rated self-management activities to mitigate burnout include participating in interpersonal relationships and taking vacations.ConclusionBurnout is a major issue facing the palliative care clinician workforce. Strategies at the discipline-wide and individual levels are needed to sustain the delivery of responsive, available, high-quality palliative care for all patients with serious illness. |
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| Keywords: | Burnout workforce resilience |
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