Stress and Burnout among Radiation Oncologists in India

Abstract

Stress and burnout are known to be common among oncologists. There is lack of information on the prevalence amongst radiation oncologists in India. We carried out an online survey to determine levels of stress and burnout and the contributory factors On online survey was created and distributed through email and social media among radiation oncologists in India. Stress was assessed using the Cohen’s Perceived Stress (CPS) Scale (10 questions). The Copenhagen Burnout Inventory (CBI) was used to assess individual, work-related and client (patient)-related burnout. Additional questions assessed gender, age, years in/after training and public/private workplace. In addition, a descriptive answer was sought on the main reasons for stress and burnout for qualitative assessment. The survey was answered by 390 radiation oncologists in India from 22 states or union territories. The median age was 35 (range 23-67). Nearly half 192 (49.2%) were female. About a third 122 (31.3%) were trainees, and the majority 80.8% worked as hospital employees with a fixed pay. A high proportion (39.3%) were engaged in systemic treatment and a similar proportion were also engaged in palliative care services in addition to radiation oncology. Respondents worked a median of 50 hours a week (range 24-91 hours). The mean score from the CPS scale was 20.5, with 71.8% showing moderate stress levels (14-26) and 15.9% showing high stress levels (between 27-40). Based on the CBI, the mean scores for individual, work-related and client(patient)-related burnout levels were 51.3, 42.1 and 30.4, corresponding to high burnout levels (score > 50) in 49.5%, 34.6% and 15.6% respondents. Factors predisposing to burnout were assessed and are summarized in Table 1 (p value > 0.5 denoted as 'similar'). Qualitative assessment of the main contributors to stress identified workload and behavior of seniors and supervisors as the main factors. A fairly large proportion of radiation oncologists in India have high levels of stress, individual burnout and work-related burnout. However, client(patient)-related burnout levels are low. Several factors affect stress and burnout and some of the main factors can be addressed by improvements in workload and attitude.Tabled 1Abstract 2930; TableFactorStressIndividual burnoutWork-related burnoutPatient-related burnoutWomen (vs. men)HigherHigherSimilarLowerTrainee (vs. consultant)HigherHigherHigherSimilarVariable pay (vs. fixed pay)LowerLowerLowerSimilarSystemic treatment or palliative care service (vs. Radiation Oncology alone)SimilarSimilarSimilarSimilarIncreasing age (R2)Lower (6.7%)Lower (3.4%)Lower (3.8%)Similar (1%)Increasing working hours (R2)Higher (7.8%)Higher (6%)Higher (12.3%)Higher (1.5%) Open table in a new tab