CoChat
Sign Up
Cited by 60Healthcare professionals’ stress and burnoutStress and Burnout ResearchOccupational Health and Burnout

Burnout and resilience among Canadian palliative care physicians

Open access
Wang, Cindy, Grassau, Pamela, Lawlor, Peter G., Webber, Colleen, Bush, Shirley H., Gagnon, Bruno, Kabir, Monisha, Spilg, Edward G.·2020·BMC Palliative Care
DOI 10.1186/s12904-020-00677-zPMC PMC7648393
Open this paper in CoChat — free accountOpen PDF

Abstract

Background: Physicians experience high rates of burnout, which may negatively impact patient care. Palliative care is an emotionally demanding specialty with high burnout rates reported in previous studies from other countries. We aimed to estimate the prevalence of burnout and degree of resilience among Canadian palliative care physicians and examine their associations with demographic and workplace factors in a national survey. Methods: Physician members of the Canadian Society of Palliative Care Physicians and Société Québécoise des Médecins de Soins Palliatifs were invited to participate in an electronic survey about their demographic and practice arrangements and complete the Maslach Burnout Inventory for Medical Professionals (MBI-HSS (MP)), and Connor-Davidson Resilience Scale (CD-RISC). The association of categorical demographic and practice variables was examined in relation to burnout status, as defined by MBI-HSS (MP) score. In addition to bivariable analyses, a multivariable logistic regression analysis, reporting odds ratios (OR), was conducted. Mean CD-RISC score differences were examined in multivariable linear regression analysis. Results: One hundred sixty five members (29%) completed the survey. On the MBI-HSS (MP), 36.4% of respondents reported high emotional exhaustion (EE), 15.1% reported high depersonalization (DP), and 7.9% reported low personal accomplishment (PA). Overall, 38.2% of respondents reported a high degree of burnout, based on having high EE or high DP. Median CD-RISC resilience score was 74, which falls in the 25th percentile of normative population. Age over 60 (OR = 0.05; CI, 0.01–0.38), compared to age ≤ 40, was independently associated with lower burnout. Mean CD-RISC resilience scores were lower in association with the presence of high burnout than when burnout was low (67.5 ± 11.8 vs 77.4 ± 11.2, respectively, p < 0.0001). Increased mean CD-RISC score differences (higher resilience) of 7.77 (95% CI, 1.97–13.57), 5.54 (CI, 0.81–10.28), and 8.26 (CI, 1.96–14.57) occurred in association with age > 60 as compared to ≤40, a predominantly palliative care focussed practice, and > 60 h worked per week as compared to ≤40 h worked, respectively. Conclusions: One in three Canadian palliative care physicians demonstrate a high degree of burnout. Burnout prevention may benefit from increasing resilience skills on an individual level while also implementing systematic workplace interventions across organizational levels.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1186/s12904-020-00677-z

Cites

11 of 11 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 49

  1. [1]Maslach C Jackson SE The measurement of experienced burnout J Organ Behav 1981 2 99 113 10.1002/job.4030020205 · DOI · Paper page
  2. [2]Maslach C, Jackson SE, Leiter MP. Maslach burnout inventory manual. 3rd ed. Palo Alto, CA: Consulting Psychologists Press; 1996.
  3. [4]Shirom A Melamed S Toker S Burnout, mental and physical health: a review of the evidence and a proposed explanatory model Int Rev Ind Organ Psychol 2005 20 269 309
  4. [6]Schaufeli W. Past performance and future perspectives of burnout research. South African J Indust Psychol. 2003;29. 10.4102/sajip.v29i4.127. · DOI · Paper page
  5. [7]Pompili M Innamorati M Narciso V Burnout, hopelessness and suicide risk in medical doctors Clin Ter 2010 161 511 514 21181078
  6. [8]Argentero P Dell'Olivo B Ferretti MS Staff burnout and patient satisfaction with the quality of dialysis care Am J Kidney Dis 2008 51 80 92 10.1053/j.ajkd.2007.09.011 18155536 · DOI
  7. [9]Vogel L CMA must address physician burnout, pharmacare, say doctors CMAJ 2017 189 E1171 e1172 10.1503/cmaj.1095493 28893892 PMC5595570 · DOI
  8. [11]Prins JT van der Heijden FM Hoekstra-Weebers JE Burnout, engagement and resident physicians' self-reported errors Psychol Health Med 2009 14 654 666 10.1080/13548500903311554 20183538 · DOI
  9. [12]Shanafelt TD Balch CM Bechamps G Burnout and medical errors among American surgeons Ann Surg 2010 251 995 1000 10.1097/SLA.0b013e3181bfdab3 19934755 · DOI · Paper page
  10. [13]West CP Huschka MM Novotny PJ Association of perceived medical errors with resident distress and empathy: a prospective longitudinal study JAMA 2006 296 1071 1078 10.1001/jama.296.9.1071 16954486 · DOI · Paper page
  11. [14]Williams ES Manwell LB Konrad TR The relationship of organizational culture, stress, satisfaction, and burnout with physician-reported error and suboptimal patient care: results from the MEMO study Health Care Manage Rev 2007 32 203 212 10.1097/01.Hmr.0000281626.28363.59 17666991 · DOI · Paper page
  12. [16]Tei S Becker C Kawada R Can we predict burnout severity from empathy-related brain activity? Transl Psychiatry 2014 4 e393 10.1038/tp.2014.34 24893064 PMC4080316 · DOI
  13. [18]Mercer SW Reynolds WJ Empathy and quality of care Br J Gen Pract 2002 52 Suppl S9 12 12389763 PMC1316134
  14. [19]Soler JK Yaman H Esteva M Burnout in European family doctors: the EGPRN study Fam Pract 2008 25 245 265 10.1093/fampra/cmn038 18622012 · DOI
  15. [20]Siu C Yuen SK Cheung A Burnout among public doctors in Hong Kong: cross-sectional survey Hong Kong Med J 2012 18 186 192 22665681
  16. [21]Zhang Y Feng X The relationship between job satisfaction, burnout, and turnover intention among physicians from urban state-owned medical institutions in Hubei, China: a cross-sectional study BMC Health Serv Res 2011 11 235 10.1186/1472-6963-11-235 21943042 PMC3197494 · DOI
  17. [22]Hoff T Whitcomb WF Nelson JR Thriving and surviving in a new medical career: the case of hospitalist physicians J Health Soc Behav 2002 43 72 91 11949198
  18. [24]Yoon JD Hunt NB Ravella KC Physician burnout and the calling to Care for the Dying: a National Survey Am J Hosp Palliat Med 2017 34 931 937 10.1177/1049909116661817 27465404 · DOI
  19. [25]Reddy SK, Yennu S, Tanco K, et al. Frequency of burnout among palliative care physicians participating in a continuing medical education course. J Pain Symptom Manage, DOI. 20202020/02/28. 10.1016/j.jpainsymman.2020.02.013. 32105789 · DOI
  20. [26]Kamal AH Bull JH Wolf SP RETRACTED: prevalence and predictors of burnout among hospice and palliative care clinicians in the U.S J Pain Symptom Manage 2016 51 690 696 10.1016/j.jpainsymman.2015.10.020 26620234 PMC4846384 · DOI
  21. [27]Kamal A Bull JH Wolf SP Letter to the editor regarding “prevalence and predictors of burnout among hospice and palliative care professionals” J Pain Symptom Manage 2020 59 e3 e5 10.1016/j.jpainsymman.2019.11.001 31734409 · DOI
  22. [28]Koh MY Chong PH Neo PS Burnout, psychological morbidity and use of coping mechanisms among palliative care practitioners: a multi-Centre cross-sectional study Palliat Med 2015 29 633 642 10.1177/0269216315575850 25829444 · DOI
  23. [29]Dunwoodie DA Auret K Psychological morbidity and burnout in palliative care doctors in Western Australia Intern Med J 2007 37 693 698 10.1111/j.1445-5994.2007.01384.x 17517081 · DOI
  24. [30]Dreano-Hartz S Rhondali W Ledoux M Burnout among physicians in palliative care: impact of clinical settings Palliat Support Care 2016 14 402 410 10.1017/s1478951515000991 26462566 · DOI
  25. [31]Connor KM Davidson JR Development of a new resilience scale: the Connor-Davidson resilience scale (CD-RISC) Depress Anxiety 2003 18 76 82 10.1002/da.10113 12964174 · DOI · Paper page
  26. [32]Dyrbye LN Power DV Massie FS Factors associated with resilience to and recovery from burnout: a prospective, multi-institutional study of US medical students Med Educ 2010 44 1016 1026 10.1111/j.1365-2923.2010.03754.x 20880371 · DOI
  27. [33]Back AL Steinhauser KE Kamal AH Building resilience for palliative care clinicians: an approach to burnout prevention based on individual skills and workplace factors J Pain Symptom Manage 2016 52 284 291 10.1016/j.jpainsymman.2016.02.002 26921494 · DOI
  28. [37]Kawamura Y Takayashiki A Ito M Stress factors associated with burnout among attending physicians: a cross-sectional study J Clin Med Res 2018 10 226 232 10.14740/jocmr3299w 29416582 PMC5798270 · DOI
  29. [38]Kamal AH Bull JH Wolf SP Prevalence and predictors of burnout among hospice and palliative care clinicians in the U.S J Pain Symptom Manage 2020 59 e6 e13 10.1016/j.jpainsymman.2015.10.020 31778784 · DOI
  30. [39]Morrison RS A national palliative care strategy for Canada J Palliat Med 2018 21 S-63 S-75 10.1089/jpm.2017.0431 29283876 PMC5733738 · DOI
  31. [41]Shanafelt TD Hasan O Dyrbye LN Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014 Mayo Clin Proc 2015 90 1600 1613 10.1016/j.mayocp.2015.08.023 26653297 · DOI · Paper page
  32. [46]Braun V Clarke V What can "thematic analysis" offer health and wellbeing researchers? Int J Qual Stud Health Well-being 2014 9 26152 10.3402/qhw.v9.26152 25326092 PMC4201665 · DOI · Paper page
  33. [48]O'Dowd E O'Connor P Lydon S Stress, coping, and psychological resilience among physicians BMC Health Serv Res 2018 18 730 10.1186/s12913-018-3541-8 30241524 PMC6151040 · DOI
  34. [49]Agarwal SD Pabo E Rozenblum R Professional dissonance and burnout in primary care: a qualitative study JAMA Intern Med 2020 180 395 401 10.1001/jamainternmed.2019.6326 31904796 PMC6990959 · DOI
  35. [50]Kavalieratos D Siconolfi DE Steinhauser KE "it is like heart failure. It is chronic … and it will kill you": a qualitative analysis of burnout among hospice and palliative care clinicians J Pain Symptom Manage 2017 53 901 910.e901 10.1016/j.jpainsymman.2016.12.337 28063867 PMC5410187 · DOI
  36. [51]Swetz KM Harrington SE Matsuyama RK Strategies for avoiding burnout in hospice and palliative medicine: peer advice for physicians on achieving longevity and fulfillment J Palliat Med 2009 12 773 777 10.1089/jpm.2009.0050 19622012 · DOI
  37. [52]Brady KJS Trockel MT Khan CT What do we mean by physician wellness? A systematic review of its definition and measurement Acad Psychiatry 2018 42 94 108 10.1007/s40596-017-0781-6 28913621 · DOI
  38. [54]Granek L Buchman S Improving physician well-being: lessons from palliative care CMAJ 2019 191 E380 e381 10.1503/cmaj.190110 30962195 PMC6453678 · DOI
  39. [55]Arya A Buchman S Gagnon B Pandemic palliative care: beyond ventilators and saving lives Can Med Assoc J 2020 192 E400 E404 10.1503/cmaj.200465 32234725 PMC7162443 · DOI
  40. [56]Lavin Venegas C, Nkangu MN, Duffy MC, et al. Interventions to improve resilience in physicians who have completed training: a systematic review. PLoS One. 2019;14:e0210512. 10.1371/journal.pone.0210512. PMC6336384 30653550 · DOI
  41. [57]West CP Dyrbye LN Sinsky C Resilience and burnout among physicians and the general US working population JAMA Netw Open 2020 3 e209385 10.1001/jamanetworkopen.2020.9385 32614425 PMC7333021 · DOI
  42. [59]Gazelle G Liebschutz JM Riess H Physician burnout: coaching a way out J Gen Intern Med 2015 30 508 513 10.1007/s11606-014-3144-y 25527340 PMC4371007 · DOI
  43. [60]Leiter MP Maslach C Six areas of worklife: a model of the organizational context of burnout J Health Hum Serv Adm 1999 21 472 489 10621016
  44. [61]West CP Dyrbye LN Shanafelt TD Physician burnout: contributors, consequences and solutions J Intern Med 2018 283 516 529 10.1111/joim.12752 29505159 · DOI · Paper page
  45. [62]LaDonna KA Taylor T Lingard L Why open-ended survey questions are unlikely to support rigorous qualitative insights Acad Med 2018 93 347 349 10.1097/acm.0000000000002088 29215376 · DOI
  46. [63]O'Cathain A Thomas KJ "any other comments?" open questions on questionnaires – a bane or a bonus to research? BMC Med Res Methodol 2004 4 25 10.1186/1471-2288-4-25 15533249 PMC533875 · DOI
  47. [64]Mills J Wand T Fraser JA Exploring the meaning and practice of self-care among palliative care nurses and doctors: a qualitative study BMC Palliat Care 2018 17 63 10.1186/s12904-018-0318-0 29669559 PMC5907186 · DOI
  48. [65]Koh MYH Hum AYM Khoo HS Burnout and resilience after a decade in palliative care: what survivors have to teach us. A qualitative study of palliative care clinicians with more than 10 years of experience J Pain Symptom Manage 2020 59 105 115 10.1016/j.jpainsymman.2019.08.008 31465787 · DOI
  49. [67]Rotenstein LS Torre M Ramos MA Prevalence of burnout among physicians: a systematic review Jama 2018 320 1131 1150 10.1001/jama.2018.12777 30326495 PMC6233645 · DOI · Paper page

Cited by

Sorted by citations

Authors
Wang, C., Grassau, P., Lawlor, P. G., Webber, C., Bush, S. H., Gagnon, B., Kabir, M., & Spilg, E. G.
Affiliations
  • University of Ottawa (CA)
  • Carleton University (CA)
  • Bruyère (CA)
  • Université Laval (CA)
Corresponding author
Spilg, Edward G.
ORCID
Venue
BMC Palliative Care
Publisher
Springer Science and Business Media LLC
Published
2020-11-06
Volume
19
Issue
1
Pages
169-169
ISSN
1472-684X (ISSN-L)
DOI
10.1186/s12904-020-00677-z
PMC
PMC7648393
OpenAlex
W3096112705
Cited by
60
References
11
Citations by year
2026: 3 · 2025: 14 · 2024: 12 · 2023: 16 · 2022: 10 · 2021: 5
FWCI
8.09
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Palliative Care (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • uO Research (University of Ottawa) (submittedVersion, public-domain)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
  • Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
  • Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Burnout
Keywords
physician burnout, resilience, palliative care physicians, emotional exhaustion, depersonalization, personal accomplishment, age, workplace factors, palliative care practice, Canadian physicians, Connor-Davidson Resilience Scale, physician well-being, burnout prevalence
MeSH terms
Adult, Burnout, Professional, Canada, Cross-Sectional Studies, Female, Humans, Job Satisfaction, Male, Middle Aged, Palliative Care, Physicians, Surveys and Questionnaires, Prevalence, Multivariate Analysis, Resilience, Psychological

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