Hlubocky Fay J, Back Anthony L, Shanafelt Tait D
From the Department of Medicine, Section of Hematology Oncology, The University of Chicago Medicine, Chicago, IL; Division of Oncology, University of Washington, Fred Hutchinson Cancer Research Center, Seattle, WA; Mayo Clinic, Rochester, MN.
Am Soc Clin Oncol Educ Book. 2016;35:271-9. doi: 10.1200/EDBK_156120.
Despite their benevolent care of others, today, more than ever, the cancer care professional who experiences overwhelming feelings of exhaustion, cynicism, and inefficacy is in grave jeopardy of developing burnout. Clinicians are repeatedly physically and emotionally exposed to exceedingly long hours in direct care with seriously ill patients/families, limited autonomy over daily responsibilities, endless electronic documentation, and a shifting medical landscape. The physical and emotional well-being of the cancer care clinician is critical to the impact on quality care, patient satisfaction, and overall success of their organizations. The prevention of burnout as well as targeting established burnout need to be proactively addressed at the individual level and organizational level. In fact, confronting burnout and promoting wellness are the shared responsibility of both oncology clinicians and their organizations. From an individual perspective, oncology clinicians must be empowered to play a crucial role in enhancing their own wellness by identification of burnout symptoms in both themselves and their colleagues, learning resilience strategies (e.g., mindful self-compassion), and cultivating positive relationships with fellow clinician colleagues. At the organizational level, leadership must recognize the importance of oncology clinician well-being; engage leaders and physicians in collaborative action planning, improve overall practice environment, and provide institutional wellness resources to physicians. These effective individual and organizational interventions are crucial for the prevention and improvement of overall clinician wellness and must be widely and systematically integrated into oncology care.
尽管癌症护理专业人员悉心照料他人，但如今，与以往任何时候相比，那些感到极度疲惫、愤世嫉俗和无能为力的癌症护理专业人员面临着职业倦怠的严重风险。临床医生在直接护理重症患者/家属时，身体和情感上反复承受超长的工作时间，日常工作自主权有限，电子文档工作没完没了，而且医疗环境不断变化。癌症护理临床医生的身心健康对于优质护理、患者满意度以及所在机构的整体成功至关重要。必须在个人层面和组织层面积极应对职业倦怠的预防以及已出现的职业倦怠问题。事实上，应对职业倦怠和促进健康是肿瘤临床医生及其所在机构的共同责任。从个人角度来看，肿瘤临床医生必须有能力通过识别自身和同事的职业倦怠症状、学习恢复力策略（如正念自我同情）以及与临床医生同事建立积极关系，在提升自身健康方面发挥关键作用。在组织层面，领导层必须认识到肿瘤临床医生身心健康的重要性；让领导和医生参与协作行动计划，改善整体执业环境，并为医生提供机构健康资源。这些有效的个人和组织干预措施对于预防和改善临床医生的整体健康状况至关重要，必须广泛且系统地融入肿瘤护理工作中。
