Impact of burn-out syndrome in oncology staff and its improvement through specific interventions.

Abstract

249 Background: Burn-Out Syndrome (BOS) is defined by: emotional and physical exhaustion; cynicism and depersonalization; and no personal nor professional fulfillment. With increasing incidence, it impacts negatively in the patient attention quality and the quality of institutional processes. Few experiences reported about its incidence and impact in Medical Oncology. Lack of resources for its diagnosis and management. Our objective was to determine the incidence of the BOS in our workers, analyze its causes and try to reduce in 20% the percentage of workers suffering or at risk of suffering BOS. Developed as a Quality Training Program (ASCO - ECO Foundation) project. Methods: 23 nurses/nurse-assistants Medical Oncology Department at University General Hospital of Valencia fulfilled anonymized questionnaire with personal details, GHQ-12 evaluation and Maslach index questions, at baseline and after intervention. Causes of BOS analyzed and process map and Ishikawa fish-bone scheme designed. Interventions carried in consequence. Results: 23 subjects, 87% women, 47 year-old median age. 14 nurses, 8 working in the clinic. 90% with more than 5 years of experience in Oncology. At baseline, 75% GHQ-12 good health. Maslech index: 70%, 45% and 55% in risk (medium+high) of BOS related to exhaustion, depersonalization or fulfillment, respectively. In exhaustion, 35% medium risk, 35% high risk of BOS. After priority-matrix development, ergonomy tips and self-improvement tools were identified as the adequate interventions to improve exhaustion risk. After ergonomy tips intervention, 90% GHQ-12 good health, 15% exhaustion medium risk, 50% exhaustion high risk, 65% at risk of BOS related to exhaustion. An improvement of 5% lowering the risk of suffering Burn-Out Syndrome among our workers was achieved Conclusions: BOS risk is complex due to answer subjectivity. We have healthier workers (GHQ-12), but although levels of exhaustion have decreased mildly, those who were already exhausted are worse than before (Maslach Index). Possible causes: renovation work on Clinic, labor instability, local holidays during project. Additional self-improvement tools sessions are now being held.