Supporting oncology health professionals: a review

Background

Caring for patients with cancer can be both personally rewarding and stressful. Confrontation with suffering, working with people facing complex life-threatening illness, demanding treatment regimens and frequent death of patients are challenging for many clinicians. Responding to the emotional needs of patients and families is often perceived as among the most stressful. These emotional sources of stress can be compounded by organisational factors and work demands. The resulting emotional impact can have an adverse effect on clinicians’ performance in and satisfaction with their professional roles, their own health and well-being and the quality of patient care.

Objective

The objective of this paper was to review the factors contributing to emotional stress and burnout in health professionals and identify evidence-based strategies to support health professionals in their role, with illustrations of current Australian initiatives on how to apply these in clinical practice.

Results

Research to date indicates the contribution of a combination of individual and contextual factors in the development of these emotional adjustment problems, reflecting an interaction of clinicians’ personal attributes and aspects of their work that influence risk to such stress and “burnout” among cancer clinicians. Evidence-based strategies to address these problems and promote resilience among clinicians include skills development through training and mentorship, particularly in communication skills and psychosocial care. Such training and mentorship can lead to improvements in clinicians’ stress management and confidence in their role, as well as to patient outcomes through improved response to patients’ concerns and suffering.

Conclusion

No single strategy is likely to be successful in alleviating stress related to work in oncology. Interventions must be multi-faceted, flexible and incorporate attention to the complex inter-relationships of clinicians, their personality and experiences, patients and health care systems. Mentorship and clinical supervision can provide personal support, maintenance of skills and promote reflective practices and translation of these skills into everyday practice. Service models that also reduce professional isolation and promote inter-disciplinary team function are discussed, with illustrations of current initiatives in Australia.