Hlubocky Fay J, Rose Miko, Epstein Ronald M
From the Department of Medicine, Section of Hematology/Oncology, The University of Chicago, Chicago, IL; Department of Adult Psychiatry, Michigan State University, East Lansing, MI; University of Rochester School of Medicine and Dentistry, Rochester, NY.
Am Soc Clin Oncol Educ Book. 2017;37:771-781. doi: 10.1200/EDBK_173874.
Oncology clinician burnout has become a noteworthy issue in medical oncology directly affecting the quality of patient care, patient satisfaction, and overall organizational success. Due to the increasing demands on clinical time, productivity, and the evolving medical landscape, the oncology clinician is at significant risk for burnout. Long hours in direct care with seriously ill patients/families, limited control over daily responsibilities, and endless electronic documentation, place considerable professional and personal demands on the oncologist. As a result, the oncology clinician's wellness is adversely impacted. Physical/emotional exhaustion, cynicism, and feelings of ineffectiveness evolve as core signs of burnout. Unaddressed burnout may affect cancer clinician relationships with their patients, the quality of care delivered, and the overall physical and emotional health of the clinician. Oncology clinicians should be encouraged to build upon their strengths, thrive in the face of adversity and stress, and learn to positively adapt to the changing cancer care system. Fostering individual resilience is a key protective factor against the development of and managing burnout. Empowering clinicians at both the individual and organizational level with tailored resilience strategies is crucial to ensuring clinician wellness. Resilience interventions may include: burnout education, work-life balance, adjustment of one's relationship to work, mindful practice, and acceptance of the clinical work environment. Health care organizations must act to provide institutional solutions through the implementation of: team-based oncology care, communication skills training, and effective resiliency training programs in order to mitigate the effects of stress and prevent burnout in oncology.
肿瘤临床医生职业倦怠已成为肿瘤医学领域一个值得关注的问题,直接影响患者护理质量、患者满意度以及整个机构的成功。由于对临床时间、工作效率的要求不断提高,以及医学环境的不断演变,肿瘤临床医生面临着职业倦怠的重大风险。长时间直接护理重症患者/家属、对日常职责的控制有限以及没完没了的电子文档工作,给肿瘤学家带来了相当大的职业和个人压力。结果,肿瘤临床医生的健康受到了不利影响。身体/情绪疲惫、玩世不恭和无效感逐渐成为职业倦怠的核心症状。未得到解决的职业倦怠可能会影响癌症临床医生与患者的关系、所提供护理的质量以及临床医生的整体身心健康。应鼓励肿瘤临床医生发挥自身优势,在逆境和压力中茁壮成长,并学会积极适应不断变化的癌症护理系统。培养个人适应力是预防和应对职业倦怠的关键保护因素。在个人和组织层面为临床医生提供量身定制的适应力策略至关重要,这对于确保临床医生的健康至关重要。适应力干预措施可能包括:职业倦怠教育、工作与生活平衡、调整个人与工作的关系、正念练习以及接受临床工作环境。医疗保健机构必须采取行动,通过实施以下措施提供制度性解决方案:基于团队的肿瘤护理、沟通技能培训以及有效的适应力培训项目,以减轻压力影响并预防肿瘤临床医生的职业倦怠。