Granek Leeat, Ben-David Merav, Nakash Ora, Cohen Michal, Barbera Lisa, Ariad Samuel, Krzyzanowska Monika K
Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, PO Box 653, 84105, Beer-Sheva, Israel.
Radiation Oncology Department, Sheba Medical Center, Ramat-Gan, Israel & The Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Support Care Cancer. 2017 May;25(5):1607-1614. doi: 10.1007/s00520-016-3562-y. Epub 2017 Jan 13.
The aims of this study were to examine the relationship between negative attitudes towards expressing emotion following patient death and burnout in oncologists and to explore oncologists' preferences for institutional interventions to deal with patient death.
The participants included a convenience sample of 177 oncologists from Israel and Canada. Oncologists completed a questionnaire package that included a sociodemographic survey, a burnout measure, a survey assessing negative attitudes towards expressing emotion, and a survey assessing desired interventions to cope with patient death. To examine the association between burnout and negative attitudes while controlling for the effect of sociodemographic variables, a hierarchical linear regression was computed.
Higher burnout scores were related to higher negative attitudes towards perceived expressed emotion (partial r = .25, p < .01) of those who viewed this affect as a weakness and as a sign of unprofessionalism. Approximately half of the oncologists found each of the five categories of institutional interventions (pedagogical strategies, emotional support, group/peer support, taking time off, and research and training) helpful in coping with patient death.
Our findings suggest that high burnout scores are associated with negative attitudes towards expressing emotion and that there is a wide variation in oncologist preferences in coping with patient death. Institutions should promote interventions that are varied and that focus on the needs of oncologists in order to reduce burnout. Interventions that legitimize expression of emotion about patient death may be useful. Another way to reduce stigma would be to require oncologists to "opt out" rather than "opt in" to accessing a selection of social and/or individual interventions.
本研究旨在探讨肿瘤学家在患者死亡后对表达情感的消极态度与职业倦怠之间的关系,并探究肿瘤学家对处理患者死亡的机构干预措施的偏好。
参与者包括来自以色列和加拿大的177名肿瘤学家的便利样本。肿瘤学家完成了一套问卷,其中包括社会人口学调查、职业倦怠测量、评估对表达情感的消极态度的调查,以及评估应对患者死亡所需干预措施的调查。为了在控制社会人口学变量影响的同时检验职业倦怠与消极态度之间的关联,进行了分层线性回归分析。
较高的职业倦怠得分与那些将这种情感视为弱点和不专业标志的人对感知到的表达情感的较高消极态度相关(偏相关系数r = 0.25,p < 0.01)。大约一半的肿瘤学家认为五类机构干预措施(教学策略、情感支持、团体/同伴支持、休假以及研究与培训)中的每一类都有助于应对患者死亡。
我们的研究结果表明,高职业倦怠得分与对表达情感的消极态度相关,并且肿瘤学家在应对患者死亡方面的偏好存在很大差异。机构应推广多样化的、关注肿瘤学家需求的干预措施,以减少职业倦怠。使对患者死亡表达情感合法化的干预措施可能会有所帮助。另一种减少污名化的方法是要求肿瘤学家“选择退出”而不是“选择加入”某些社会和/或个人干预措施。