The DOI matches its Crossref record; 96 of the 96 references it cites were found in a registry or an index.
Self-care of Physicians Caring for Patients at the End of Life: “Being Connected . . . A Key to My Survival”
Abstract
Physicians providing end-of-life care are subject to a variety of stresses that may lead to burnout and compassion fatigue at both individual and team levels. Through the story of an oncologist, we discuss the prodromal symptoms and signs leading to burnout and compassion fatigue and present the evidence for prevention. We define and discuss factors that contribute to burnout and compassion fatigue and consider factors that may mitigate burnout. We explore the practice of empathy and discuss an approach for physicians to maximize wellness through self-awareness in the setting of caring for patients with end-stage illness. Finally, we discuss some practical applications of self-care in the workplace.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“This is not surprising, since learning to rest in the experience of suffering and developing healing connections are key aspects of palliative care [71, 72].”
Citations
Cites
Mindfulness-based interventions in context: Past, present, and future
Kabat-Zinn, J. (2003) · Clinical Psychology: Science and Practice · doi:10.1093/clipsy.bpg016 · Cited by 8,615 · cited 3×
“Mindfulness meditation is now widely used by both clinicians and patients for its psychological benefits in a variety of health care settings, such as the Stress Reduction and Relaxation Program of the University of Massachusetts Medical Center.(90) The psychological benefits include reducing anxiety; enhancing a sens…”
BackgroundMindfulness-based interventions in context: Past, present, and future.
Kabat-Zinn, J. (2003) · Clinical Psychology: Science and Practice · doi:10.1093/clipsy/bpg016 · Cited by 8,612
Mindfulness-based stress reduction and health benefits
Grossman, P., Niemann, L., Schmidt, S., & Walach, H. (2004) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(03)00573-7 · Cited by 3,958
Stressful life events, personality, and health: An inquiry into hardiness.
Kobasa, S. C. (1979) · Journal of Personality and Social Psychology · doi:10.1037//0022-3514.37.1.1 · Cited by 3,816
Alterations in brain and immune function produced by mindfulness meditation
Davidson, R. J., Kabat-Zinn, J., Schumacher, J., Rosenkranz, M., Muller, D., Santorelli, S. F., Urbanowski, F., Harrington, A., Bonus, K., & Sheridan, J. F. (2003) · Psychosomatic Medicine · doi:10.1097/01.psy.0000077505.67574.e3 · Cited by 2,925
Early predictors of job burnout and engagement.
Maslach, C., & Leiter, M. P. (2008) · Journal of Applied Psychology · doi:10.1037/0021-9010.93.3.498 · Cited by 2,397 · cited 4×
“Exhaustion prompts efforts to cope by distancing oneself emotionally and cognitively from work.(12) Depersonalizationrefers tonegative, callous,or excessivelydetached responses to various aspects of the job and is another distancing mechanism.”
BackgroundInfluentialMaslach, C., & Jackson, S. E. (1979) · PsycTESTS Dataset · doi:10.1037/t55656-000 · Cited by 2,360
Charon, R. (2001) · JAMA · doi:10.1001/jama.286.15.1897 · Cited by 2,351
Hardiness and health: A prospective study.
Kobasa, S. C., Maddi, S. R., & Kahn, S. (1982) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.42.1.168 · Cited by 1,892
Meditation experience is associated with increased cortical thickness
Lazar, S. W., Kerr, C. E., Wasserman, R. H., Gray, J. R., Greve, D. N., Treadway, M. T., McGarvey, M., Quinn, B. T., Dusek, J. A., Benson, H., et al. (2005) · NeuroReport · doi:10.1097/01.wnr.0000186598.66243.19 · Cited by 1,698
Flagged first, then by citations
Cited by
Sorted by citations
Items 301–400 of 440
Art Therapy in Medical Settings
David, I. R. (2015) · doi:10.1002/9781118306543.ch42 · Cited by 3
Olafson, K., Pirzada, S., Mosienko, L., Papineau, K., Pankratz, L., Gill, G. K., Hiebert, T., Kredentser, M. S., Reynolds, K., Bolton, J. M., et al. (2025) · Journal of Critical Care · doi:10.1016/j.jcrc.2025.155360 · Cited by 2
Donnelly, S. M., Walker, S. T., McMillan, J. R., & Hay-Smith, J. E. (2026) · BMJ Supportive & Palliative Care · doi:10.1136/spcare-2025-006023 · Cited by 2
Lovell, B. (2015) · Medical Education · doi:10.1111/medu.12660 · Cited by 2
What Makes Oncologists Feel Compassion Fatigue? Qualitative Findings From Korea
Yi, J., Kim, M. A., & Choi, K. (2021) · SAGE Open · doi:10.1177/21582440211006712 · Cited by 2
Incorporating reflective writing & art therapy in my palliative care practice
Stilos, K. K., & Burgoyne, K. (2021) · Canadian Oncology Nursing Journal · doi:10.5737/23688076312205212 · Cited by 2
Schmitz, A. C., Witeck, C. D. R., de Oliveira, J. M. D., Clemons, M. J., Paiva, C. E., Porporatti, A. L., Canto, G. D. L., & Grosseman, S. (2022) · Brazilian Journal of Oncology · doi:10.5935/2526-8732.20220320 · Cited by 3
Krikorian, A., Siegert, A., Soto, M. M. R., Palacio, C., Vargas, J. J., Cubides, S. L. P., & Mesa, C. (2023) · Psicooncología · doi:10.5209/psic.88671 · Cited by 2
Sense of failure in end of life care: Perspectives from physicians and nurses
Stokar, Y. N. (2024) · Social Science & Medicine · doi:10.1016/j.socscimed.2024.116805 · Cited by 4
Turgeon-Brown, L. E. (2025) · OBM Integrative and Complementary Medicine · doi:10.21926/obm.icm.2502017 · Cited by 2
Mapping workplace compassion research across the social sciences: A bibliometric review
Kunst, H., Byington, E. K., Johnson, A. M., & Nguyen, H. (2025) · Australian Journal of Management · doi:10.1177/03128962251358615 · Cited by 4
Rebuttal: do we overdramatize family physician burnout?: YES.
Kay, M. P. (2012) · PubMed Central · Cited by 2
Halpern, J. (2012) · The Journal of Clinical Ethics · doi:10.1086/jce201223105 · Cited by 2
Encountering Grief in Patient Care
Gilewski, T. A. (2012) · American Society of Clinical Oncology Educational Book · doi:10.14694/edbook_am.2012.32.302 · Cited by 2
Mindfulness, Compassion, and the Foundations of Global Health Ethics
Addiss, D. G. (2017) · Mindfulness in behavioral health · doi:10.1007/978-3-319-64924-5_12 · Cited by 2
Professional Caregivers: Stress and Coping in the Face of Loss and Trauma
Machando, D., Maasdorp, V., Wogrin, C., Javangwe, G., & Muchena, K. C. (2019) · Indo-Pacific Journal of Phenomenology · doi:10.1080/20797222.2019.1692989 · Cited by 2
Haller, S., & Kern, M. (2021) · Zeitschrift für Palliativmedizin · doi:10.1055/a-1322-9301 · Cited by 2
Psychological Ownership in Athletic Training
Young, J. P., Games, K. E., Rivera, M. J., & Eberman, L. E. (2021) · Journal of Athletic Training · doi:10.4085/1062-6050-0638.20 · Cited by 2
Liben, S., & Papadatou, D. (2011) · Elsevier eBooks · doi:10.1016/b978-1-4377-0262-0.00018-9 · Cited by 2
What palliative care physicians wish neurologists knew
Hauser, J. M. (2022) · Handbook of clinical neurology · doi:10.1016/b978-0-323-85029-2.00013-0 · Cited by 2
Teamarbeit und Selbstreflexion
Hirsmüller, S., Kern, M., Schallenburger, M., & Schröer, M. (2019) · Elsevier eBooks · doi:10.1016/b978-3-437-15315-0.00010-3 · Cited by 2
Cinco cuestiones esenciales para acompañar en el sufrimiento
Pereira, C. C., Arranz, S. D., Milán, B. M., Viejo, J. M. P., de Albornoz, P. A. C., & Llana, H. G. (2020) · Psicooncología · doi:10.5209/psic.71360 · Cited by 2
Hlubocky, F. J., Dokucu, M. E., & Back, A. L. (2021) · Springer eBooks · doi:10.1007/978-3-030-84785-2_7 · Cited by 3
Volunteer Mentor Experiences of Mentoring Forced Migrants in the United Kingdom
Tynewydd, I., Semlyen, J. K., North, S., & Rushworth, I. (2021) · Refuge Canada s Journal on Refuge · doi:10.25071/1920-7336.40708 · Cited by 1
Sousa, D. S., da Silva, A. N., & Neto, D. D. (2024) · Interdisciplinaria Revista de Psicología y Ciencias Afines · doi:10.16888/interd.2024.41.1.20 · Cited by 1
Hess, D. (2024) · Springer eBooks · doi:10.1007/978-3-031-50864-6_20 · Cited by 1
García, T. S., Kareaga, A. A., López-González, L., Herrero‐Fernández, D., & Páez, D. (2025) · Universitas Psychologica · doi:10.11144/javeriana.upsy22.eapm · Cited by 3
Compassion fatigue, quality of care and clinical governance
Rocha, C., Leitão, L., Gonçalves, A., Rodrigues, C., Bento, A. F., Severino, S., & Sousa, L. (2025) · SAP Nursing Depths Series · doi:10.56294/nds2025406 · Cited by 1
Making Music in a Hospice: A Personal Reflection
Walker, J. (2026) · Journal of Palliative Medicine · doi:10.1177/10966218261457195 · Cited by 1
Feel the Fear, But Do It Anyway
Levy, A., Roth, M. E., Morrone, K. A., & Moody, K. M. (2010) · Journal of Palliative Medicine · doi:10.1089/jpm.2010.0251 · Cited by 1
Yes, I can. Learning to cope with death.
Wang, Y. M. (2013) · PubMed · Cited by 1
Emotions related to labor—the significance of focusing on the emotions of medical doctors
Yamagami, M. (2012) · An Official Journal of the Japan Primary Care Association · doi:10.14442/generalist.35.306 · Cited by 1
Ethics and Teaching Mindfulness to Physicians and Health Care Professionals
Krasner, M. S., & Lück, P. (2017) · Mindfulness in behavioral health · doi:10.1007/978-3-319-64924-5_5 · Cited by 1
Empathy: From Attribute to Relationship
Jeffrey, D. I. (2019) · Springer eBooks · doi:10.1007/978-3-030-11211-0_3 · Cited by 1
Experiencing Empathy in the Patient-Doctor Relationship
Jeffrey, D. I. (2020) · Springer eBooks · doi:10.1007/978-3-030-64804-6_5 · Cited by 1
Burstein, D. S., Chretien, K. C., Puchalski, C. M., Teufel, K., Aivaz, M., Kaboff, A., & Tuck, M. (2022) · Teaching and Learning in Medicine · doi:10.1080/10401334.2021.2018696 · Cited by 1
Richards, J., & Shrayer, G. (2023) · International Journal of Social Welfare · doi:10.1111/ijsw.12626 · Cited by 2
Estudio piloto: viabilidad de la formación en línea en bioneuroemoción para docentes
Rivera‐Medina, C. L., Corbera, D., Inda, A., Ohaco, E. H., Sastre, E. C., & Pallarès, S. (2024) · Educación y Educadores · doi:10.5294/edu.2023.26.3.5 · Cited by 1
Cultivating Vicarious Resilience Through Attachment Bonds in Healthcare Supervision
Piccolino, S. T. (2024) · Clinical Social Work Journal · doi:10.1007/s10615-024-00975-6 · Cited by 1
Empowerment in der Palliative Care
Haller, S. (2025) · Zeitschrift für Palliativmedizin · doi:10.1055/a-2496-1138 · Cited by 1
A Thematic Analysis of Intensive Care Unit Diaries Content
Kredentser, M. S., Reynolds, K., Marten, N., Blouw, M., Sareen, J., & Olafson, K. (2025) · Nursing in Critical Care · doi:10.1111/nicc.70107 · Cited by 1
Holistic Supportive Care in Oral Cancer: Principles and Practice
Vallath, N., & Salins, N. S. (2017) · Springer eBooks · doi:10.1007/978-3-319-43857-3_5 · Cited by 2
Huggard, P., & Huggard, J. (2019) · Springer eBooks · doi:10.1007/978-3-319-77740-5_44 · Cited by 1
Grief and Bereavement in Perinatal and Pediatric Palliative Care
Limbo, R. K., Kobler, K., & Davies, B. I. (2019) · Oxford University Press eBooks · doi:10.1093/med/9780190862374.003.0063 · Cited by 1
Education in Perinatal Palliative Care for Nurses, Physicians, and Other Health Professionals
Limbo, R. K., & Denney‐Koelsch, E. M. (2020) · Springer eBooks · doi:10.1007/978-3-030-34751-2_17 · Cited by 1
Pacheco, N. (2020) · The Journal of nursing care · doi:10.37421/2167-1168.2020.9.505 · Cited by 1
La vulnerabilidad humana como un valor ético en el cuidado en final de vida
Radosta, D. I., & Ham, M. D. S. (2021) · Apuntes de bioética · doi:10.35383/apuntes.v4i1.595 · Cited by 1
In the (Radical) Pursuit of Self-Care: Feminist Participatory Action Research with Victim Advocates
Homer, R. L. (2014) · Digital Commons - University of South Florida (University of South Florida) · Cited by 1
Interdisciplinary Team Care of Seriously Ill Hospitalized Patients
Gross, D. M., & Hawgood, J. (2015) · doi:10.1002/9781118772607.ch18 · Cited by 1
Anstey, S. (2012) · ORCA Online Research @Cardiff (Cardiff University) · Cited by 1
Take Care of Yourself: We Need You
Guest, R. S., & Bajorin, D. F. (2014) · Journal of Clinical Oncology · doi:10.1200/jco.2013.54.5319 · Cited by 1
Breiddal, S. M. F. (2013) · UVic’s Research and Learning Repository (University of Victoria) · Cited by 1
Dyble, G. L.-A. (2012) · Lincoln Repository (University of Lincoln) · doi:10.24385/lincoln.24327673 · Cited by 1
Michelson, K. N., & Siegel, L. B. (2014) · Springer eBooks · doi:10.1007/978-1-4471-6362-6_15
Tanganelli, M. R., & Scollo, M. A. (2012) · Springer eBooks · doi:10.1007/978-88-470-2059-7_2
Bisogni di cura di sé nei contesti sanitari: come individuarli, come leggerli, come accompagnarli
Zannini, L. (2014) · Encyclopaideia · doi:10.6092/issn.1825-8670/4551
Self‐Care and Resilience for Hospital Clinicians
Piper, S. M., Miller, B., & Rabow, M. W. (2015) · Wiley eBooks · doi:10.1002/9781118772607.ch19
Stenmarker, M. (2010) · Gothenburg University Publications Electronic Archive (Gothenburg University)
Physician's experiences with death and dying: A phenomenological study
Corker, D. J. (2010) · OpenSIUC (Southern Illinois University Carbondale)
Gallagher, R. E. (2013) · PubMed Central
La sécurité du patient comme futur enjeu de la médecine générale
Brami, J., & Amalberti, R. (2010) · Springer eBooks · doi:10.1007/978-2-8178-0002-8_6
Golub, R. M. (2010) · JAMA · doi:10.1001/jama.2010.1296
Shimma, E., Nogueira-Martins, M. C. F., & Nogueira-Martins, L. A. (2010)
Scott, I. (2015) · UVic’s Research and Learning Repository (University of Victoria)
Réfutation: Dramatisons-nous à l’excès l’épuisement professionnel chez les médecins de famille?: OUI
Kay, M. P. (2012) · PubMed Central
A Balanced Approach to Physician Responsibilities: Oncologists' Duties toward Themselves
Abernethy, A. P. (2012) · American Society of Clinical Oncology Educational Book · doi:10.14694/edbook_am.2012.32.82
A Professional Perspective on End-of-Life Care
Centeno, C. (2014) · Palgrave Macmillan US eBooks · doi:10.1057/9781137376480_12
Bruhn, J. G. (2016) · SpringerBriefs in well-being and quality of life research · doi:10.1007/978-3-319-29803-0_9
Complementary and Alternative Medicine
Guerrera, M. P. (2012) · Elsevier eBooks · doi:10.1016/b978-1-4377-1160-8.10011-9
Spivak, E. J. M. (2015) · Journal of Gerontology & Geriatric Research · doi:10.4172/2167-7182.1000210
Font, M. S. (2017) · Tesis Doctorals en Xarxa (Consorci de Serveis Universitaris de Catalunya) · doi:10.6035/14016.2017.165315
Hutchinson, T. A. (2017) · Springer eBooks · doi:10.1007/978-3-319-59005-9_16
Wellness, Burnout, and Compassion Fatigue
Hutchinson, T. A. (2017) · Springer eBooks · doi:10.1007/978-3-319-59005-9_12
The Organization of Healthcare
Hutchinson, T. A. (2017) · Springer eBooks · doi:10.1007/978-3-319-59005-9_17
Kariuki, J. N., Kimani, C. G., & Adeli, S. (2017) · Journal of Psychology & Psychotherapy · doi:10.4172/2161-0487.1000329
Clifton, D. A., & Ross, M. (2019) · Springer eBooks · doi:10.1007/978-3-319-77740-5_86
Sterbebegleitung: eigene Werte als wichtigste Ressource
George, W. M. (2018) · Pflegezeitschrift · doi:10.1007/s41906-018-0648-9
Berufsbiografische Entwicklungen bei der Betreuung Sterbender
George, W. M. (2018) · intensiv · doi:10.1055/a-0594-1639
The Role of the Physician in Palliative and End-of-Life Care
Marshall, D. (2011) · Elsevier eBooks · doi:10.1016/b978-1-4377-1619-1.00046-9
Mackey, R. M., & Reddy, S. (2018) · Oxford University Press eBooks · doi:10.1093/med/9780190633066.003.0038
Lewis, B. E. (2018) · Journal of Medical Humanities · doi:10.1007/s10912-018-9536-y
Barriers to Empathy: The Medical School Culture
Jeffrey, D. I. (2019) · Springer eBooks · doi:10.1007/978-3-030-11211-0_6
Jeffrey, D. I. (2019) · Springer eBooks · doi:10.1007/978-3-030-11211-0_4
Sick Surgeon: Problem and the panacea!
Ghimire, B. (2018) · Journal of Society of Surgeons of Nepal · doi:10.3126/jssn.v21i2.24353
Paice, J. A. (2011) · Elsevier eBooks · doi:10.1016/b978-1-4377-1619-1.00038-x
Burns, J. P., & Rushton, C. H. (2011) · Elsevier eBooks · doi:10.1016/b978-0-323-07307-3.10012-6
Personal reflections on volunteering in a children’s hospice
Chatburn, E. (2016) · Clinical Psychology Forum · doi:10.53841/bpscpf.2016.1.281.4
Bobbo, N., & Lazzaro, S. (2018) · Studies on adult learning and education/Studies on Adult Learning and Education · doi:10.36253/978-88-6453-672-9.37
Spruijt, O. (2020) · Lancaster EPrints (Lancaster University) · doi:10.17635/lancaster/thesis/1092
The Importance of Self-Care for Physicians and Providers
Sonenklar, M., & Malhotra, S. (2020) · Advances and controversies in hematopoietic transplantation and cell therapy · doi:10.1007/978-3-319-59014-1_16
Alabduljabbar, F. (2020) · Acta Scientific Medical Sciences · doi:10.31080/asms.2020.04.0781
Réfutation : Dramatisons-nous à l'excès l'épuisement professionnel chez les médecins de famille?
Kay, M. P. (2012) · Canadian Family Physician
Honoring Our Fallen Colleagues and Ourselves: Taking Time to Grieve
Bourgault, A. M. (2020) · Critical Care Nurse · doi:10.4037/ccn2020936
Intégrer l’écriture réflexive et l’art-thérapie à sa pratique de soins palliatifs
Stilos, K. K., & Burgoyne, K. (2021) · Canadian Oncology Nursing Journal · doi:10.5737/23688076312213220
Empathy-Based Ethics (EBE): A New Approach to Clinical Ethics
Jeffrey, D. I. (2020) · Springer eBooks · doi:10.1007/978-3-030-64804-6_7
The Mindful Pause: Cultivating Emotional Balance through Mindfulness (CEBtM)
Weininger, R. B. (2017) · Journal of Yoga and Physiotherapy · doi:10.19080/jyp.2017.03.555616
Self-citation(2017) · De Boeck Supérieur eBooks · doi:10.3917/dbu.isnar.2017.01.0195
How to Deliver Bad News: A Family Postmortem
Raman, J. (2022) · Difficult decisions in surgery: an evidence-based approach · doi:10.1007/978-3-030-84625-1_9
Self-Care and Team Care in Emotional Labor–Intensive Positions
(2020) · Springer Publishing Company eBooks · doi:10.1891/9780826158062.0007
Metadata
- Authors
- Kearney, M. K., Weininger, R. B., Vachon, M. L. S., Harrison, R. L., & Mount, B. M.
- Affiliations
- Santa Barbara Cottage Hospital (US)
- ORCID
- Vachon, Mary L. S.
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2009-03-18
- Volume
- 301
- Issue
- 11
- Pages
- 1155
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W2080857943
- Cited by
- 440
- References
- 96
- Citations by year
- 2026: 11 · 2025: 18 · 2024: 29 · 2023: 13 · 2022: 25 · 2021: 33 · 2020: 26 · 2019: 26 · 2018: 28 · 2017: 36 · 2016: 29 · 2015: 30 · 2014: 22 · 2013: 28 · 2012: 31
- FWCI
- 52.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
- Keywords
- physician self-care, burnout, compassion fatigue, end-of-life care, oncologists, empathy, physician well-being, self-awareness, burnout prevention, occupational stress
- MeSH terms
- Attitude of Health Personnel, Awareness, Burnout, Professional, Empathy, Humans, Job Satisfaction, Medical Oncology, Patient Care Team, Physicians, Self Care, Terminal Care, Workplace
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review