Grief in the practice of oncology: Prevalence and impact.

Abstract

253 Background: Oncology providers regularly face death and serious illness while shepherding patients through the cancer journey. International research shows that oncologists frequently experience grief and that grief is linked to compassion fatigue. Providing care for patients with terminal cancer has been linked to burnout, but the relationship between grief and burnout has not been explored. We sought to describe the prevalence of grief in oncology providers in the US and its link to burnout. Methods: We surveyed 255 Duke oncology providers, including in the Duke Cancer Network. Our survey included demographics, two questions about burnout, and an adaptation of the Traumatic Grief Inventory. Results: We received 128 responses, with 50% response rate. Our sample included 26% attendings, 12% fellows, and 62% advanced practice providers, with 78% of providers from the academic setting and 22% from the community. Of 123 participants who completed the grief inventory, 92 (94%) endorsed feelings of grief in the past year. Approximately half of participants endorsed burnout, and they attributed an average of 30.6% of their burnout to grief. Oncologists with personal grief, in academic settings, and <10 years in practice had higher grief scores trending toward statistical significance. Using logistic regression, we found that burden of grief predicted burnout in providers. For each increase in one point on the grief scale there was a 15% increase in odds of experiencing burnout (95% CI 7% - 22%). Conclusions: The prevalence of grief among US oncologists has not been studied. We found that the experience of professional grief is widespread among oncology providers, with 94% answering at least “sometimes” to any item on an adapted grief inventory. Moreover, we found grief to be an important predictor of burnout, suggesting a key opportunity for intervention in support of oncology providers. [Table: see text]