Mindfulness, Health, Well-being, and Patient Care of Oncologists

Abstract

MINDFULNESS, HEALTH, WELL-BEING, AND PATIENT CARE OF ONCOLOGISTS By Amanda C. Kracen, M.S. A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University. Virginia Commonwealth University, 2009. Major Director: Kathleen M. Ingram, J.D., Ph.D. Associate Professor of Psychology, Department of Psychology Demands on physicians in the workplace are growing, as are the occupational and psychosocial stressors they encounter. However, there is scant research regarding physicians, their patient care, and strategies that enhance their well-being. Mindfulness, the ability to be present in the moment, is increasingly being encouraged among healthcare workers for personal benefits and possible positive effects for patients. Thus, the present study examined (a) the health, wellbeing, and patient care practices of oncologists, (b) the relationship between oncologists’ mindfulness and health indicators (general health and sleep problems) with three outcomes (satisfaction with life [SWL], job satisfaction, and suboptimal patient care), and (c) whether mindfulness moderated the relationship between health and outcome variables. Survey data were collected from oncologists who were members of the American Society of Clinical Oncologists (N = 114, response rate of 29%). Participants were predominantly male (76%), Caucasian (78%), and married (84%), and featured a mean age of 52 years and an average work week of 58 hours. Half (51%) reported sleeping 6 or fewer hours per night and the mean sleep duration was 6.3 hours. Thirty-five percent reported not getting adequate sleep and 57% believed that lack of sleep interfered with daily functioning. They reported very good general health, high levels of trait mindfulness, and satisfaction with their lives and jobs. They reported engaging in occasional suboptimal patient care practices and attitudes. About 20% endorsed some degree of burnout, but only 12% were considering changing jobs in the next 5 years. Hierarchical multiple regressions indicated that general health predicted greater SWL, greater job satisfaction, and less suboptimal patient care, whereas mindfulness predicted greater SWL and less suboptimal patient care beyond the variance accounted for by general health. Sleep problems predicted less SWL, whereas mindfulness predicted less suboptimal patient care, beyond the variance accounted for by sleep problems. Finally, mindfulness moderated the relationship between oncologists’ sleep problems and suboptimal patient care; as sleep problems increased for oncologists with low mindfulness, they reported that their patient care actually improved. Possible explanations for findings are presented and implications for oncologists’ health, well-being and patient care are discussed.