This article, published in HealthMED in January 2011, investigates the burnout status and coping methods among health care personnel (HCP) working in oncology clinics. The study highlights that working in oncology is inherently stressful, leading HCP to experience a range of psychological and physical problems, dissatisfaction, unproductivity, and alienation from their jobs, ultimately resulting in burnout. Factors contributing to burnout in this field include the severity of patient conditions, increased patient expectations, inability to provide satisfactory care, feeling helpless against patient deaths, issues with patient relatives, heavy workload, poor working conditions, low income, and insufficient approval from patients and supervisors. The authors emphasize the importance of recognizing and defining burnout risk factors to effectively manage and control its adverse individual and organizational outcomes, especially given the limited number of studies on this topic in Turkey.
Methodology The study utilized a survey model, involving a total of 444 HCP (137 physicians, 290 nurses, 11 social workers, and 6 psychologists) from radiation and medical oncology clinics across six training and investigation hospitals in Turkey. Data were collected between January 2008 and May 2010 through face-to-face interviews. The data collection tools included:
- An Interview Form designed to gather information on socio-demographic characteristics (hospital, profession, sex, age, marital status, education, work duration, workload) and health problems related to burnout.
- The Maslach Burnout Inventory (MBI), a widely used 22-item scale, was employed to measure burnout levels across three subscales: Emotional Exhaustion (EE), Depersonalization (D), and Lack of Personal Accomplishment (LPA). Scores for EE and D were categorized as no burnout (1.3 or lower), moderate (1.4-2.7), or severe (2.8 or over), while LPA was evaluated conversely.
- The Ways of Coping Inventory, adapted from Folkman and Lazarus, was used to assess HCP’s coping methods. This 30-item scale evaluates five coping factors: self-confident, optimistic, submissive, helpless, and seeking social support, with scores ranging from 0-3, where scores closer to 3 indicate efficient use of that coping mechanism. Data analysis was performed using SPSS 12.0, employing t-tests, Kruskal Wallis Variance Analysis (ANOVA) F, and Pearson Moment Correlation (r) to test hypotheses and analyze mean differences.
Key Findings The study’s results painted a comprehensive picture of burnout among oncology HCP:
- Moderate Burnout Levels: Overall, HCP experienced a moderate level of burnout. The mean scores were 1.76 for Emotional Exhaustion (EE), 1.05 for Depersonalization (D), and 2.25 for Lack of Personal Accomplishment (LPA) (on a 0-4 scale).
- Coping Mechanisms: HCP predominantly utilized the “search for social support” approach (mean: 2.04) as their primary coping method, while the “submissive approach” was the least used (mean: 0.97). This suggests that HCP generally face problems directly and seek healthy ways to cope.
- Demographic and Work-Related Risk Factors:
- Emotional Exhaustion (EE): Nurses, HCP who perceived their income as inadequate, and those with excessive workloads were identified as high-risk groups. Women also showed higher EE compared to men, potentially due to responsibilities outside of work.
- Depersonalization (D): Males, physicians, HCP with higher education levels, and those who considered their income inadequate ran a higher risk. Men HCP showed a more negative picture in the D subgroup than women.
- Lack of Personal Accomplishment (LPA): Physicians, HCP with higher education levels, and those feeling under excessive workload had a greater risk. Women physicians specifically experienced higher burnout in terms of LPA.
- Age: A strong negative correlation was found between age and burnout subscales (EE, D, LPA), meaning that as age increased, burnout levels tended to decrease.
- Workload: High workload was a significant variable for all three burnout dimensions (EE, D, and LPA).
- Income: HCP who were dissatisfied with their wage levels were at higher risk for EE and D.
- Profession: Nurses scored highest in EE, while physicians scored highest in D and LPA. Psychologists showed the lowest LPA.
- Health Problems Associated with Burnout: The most frequently reported health problem was headache (21.80%), followed by sleep disorders (19.29%) and gastric/ulcer complaints (16.68%). Other reported issues included excessive nervousness, constipation, allergic reactions, hypertension, and various physical and psychological symptoms specific to different professions (e.g., hair loss, anxiety, musculoskeletal pains for physicians; depression, infections, hearing loss for nurses; high cholesterol for psychologists).
Conclusion and Recommendations The study concludes that burnout is unavoidable in oncology clinics, but its prevention and treatment are feasible through collective efforts from individuals and institutions. The administrators are urged to swiftly implement projects and regulations to protect personnel from burnout. Practical recommendations include:
- Reducing long working hours.
- Addressing the issue of low wages.
- Increasing opportunities for recreational and social activities.
- Eliminating personnel shortages.
- Clarifying job descriptions.
- Arranging regular team meetings and providing continuous training.
- Increasing opportunities for promotion.
- Implementing fair rotation of hard tasks and regular turns.
- Respecting break times. These measures are expected to not only decrease burnout but also boost workplace motivation. The study also suggests future research directions, such as conducting qualitative studies with smaller samples to uncover less-reported problems and investigating the impact of personal lifestyle, social support, and personnel characteristics on burnout, as well as burnout’s effects on the quality of healthcare.
Reference: Balbay, Ö. A., Işıkhan, V., Balbay, E. G., Annakkaya, A. N., & Arbak, P. M. (2011). Burnout Status of Health Care Personnel Working in Oncology and their Coping Methods. HealthMED, 5(4), 730–740
