Comparison and Literature Review of Occupational Stress in a Palliative Radiotherapy Clinic's Interprofessional Team, the Radiation Therapists, and the Nurses at an Academic Cancer Centre

Abstract

PurposeThe purpose of this study was to assess the predisposing factors for occupational stress within the Rapid Response Radiotherapy Program (RRRP), radiation therapists (RTs), and registered nurses (RNs) at the Odette Cancer Centre (OCC). Materials and MethodsAll RRRP team members (n = 15, including radiation oncologists, residents, and students), RTs (n = 130), and ambulatory care nurses (n = 80) at the OCC were asked to complete a demographics form on professional background and three validated surveys designed to evaluate stress. The Maslach Burnout Inventory (MBI) was used to assess burnout in the workplace through assessment of personal accomplishment, emotional exhaustion, and depersonalization; the General Health Questionnaire (GHQ-12) assessed psychological morbidity; and the Professional Quality of Life Scale (ProQOL) assessed compassion satisfaction, compassion fatigue, and burnout. Univariate general linear regression was used to determine significant demographic predictors for occupational stress, and one-way analysis of variance was used to compare stress among the three groups. ResultsThe overall response rate was 28%: 80% for RRRP, 20% for RTs, and 31% for RNs. Females were more likely to report greater personal accomplishment (P = .0393). Being younger (P = .0041), male (P = .0056), having less professional experience (P = .008), and being in the RRRP (P = .0019) was associated with greater depersonalization. Greater self-reported spirituality was predictive of higher compassion satisfaction (P = .0064); those reporting no or lower spirituality experienced higher levels of burnout (P = .0053). Higher GHQ-12 scores (greater stress) were reported by participants that spend more of their work time with palliative patients, and lower GHQ-12 scores (less stress) was reported in participants that participated in stress-relieving activities. A significant difference between groups was only seen in the MBI scale assessing depersonalization (P = .0077), with the RRRP experiencing greater depersonalization. For burnout subscales, 59.0% (RNs), 40.0% (RRRP), and 58.3% (RTs) reported low levels of personal accomplishment; 50% (RNs), 20% (RRRP), and 25% (RTs) reported high levels of emotional exhaustion; and 86.3% (RNs), 53.3% (RRRP), and 66.7% (RTs) reported low levels of depersonalization. ConclusionGreater psychological stress was seen in respondents that worked primarily with palliative patients. Individuals that identified themselves as being spiritual had higher professional satisfaction with work, whereas a detached response to professional practice was associated with being younger, male, having less work experience, and being a member of the RRRP team. Future initiatives should place emphasis on promoting stress-relieving activities, the necessity for stress management courses, and the overall importance of increasing awareness of the potential signs and causes of occupational stress.