N03 - The impact of Aggressiveness and Depression in Burn-out among operators in Oncology

Abstract

Background: Over the last thirty years, Burn-out Syndrome has been mainly matched to psychological discomfort among the staff in Oncology Departments, therefore it was considered almost the unique issue, which need to be diagnosed, treated and prevented. Conversely, there is a lack of studies aimed to evaluate from the clinical point of view the relation between psychological states and traits with the different Burn-out Scales. Patients and methods: Three questionnaires have been administered to all the staff (Medical Oncologists, Fellows of the Postgraduate School of Medical Oncology, Nurses and Healthcare Assistants) working at our institution from February to April 2016. We administered the Link Burn-out Questionnaire (LBQ) – depersonalization scale, which is made of two different scales: Relational deterioration and professional ineffectiveness. STAXI-2 evaluated the aggression manifestation (internal aggression plus external aggression plus self and external control). BDI measured depression. Results: 72 operators have been included in our analysis. M/F ratio was 18/54. Median age was 37 years (range 20-62). 32 Physicians (17 medical oncologists and 15 fellows), 28 nurses, 12 Healthcare Assistants. Regarding LBQ, 7% showed burn-out (3 subject according to Relational Deterioration scale and 2 according to Disillusion scale). Regarding BDI, 11% of the operators showed depression; furthermore, 57% had sleep problems, 15% low self-exteem issues and 33% excessive self-criticism. Depression was not related to operators' age, years of work, professional role and relational decline, while a statistically significant association between depression and professional ineffectiveness (p = 0.0007), disillusion (p = 0.001) and psychophysical exhaustion (p = 0.0007) was observed. According to STAXI 2, 15% of the personnel had a high expression of aggressiveness, 10% was over-controlled. Aggressiveness was related to depression (p = 0.001), disillusion (p = 0.01), relational decline (p = 0.04) and psychophysical exhaustion (p = 0.002). Conclusions: This study showed that aggressiveness and depression play an essential role and need to be taken into account together with burn-out when screening the psychological discomfort among operators in the Oncology field. These data warrant further investigations.