Incivility Is Associated with Burnout and Reduced Compassion Satisfaction: A Mixed-Method Study to Identify Causes of Burnout among Oncology Clinical Research Coordinators
Abstract
:1. Introduction
2. Methods
2.1. Study Overview
2.2. Participants
2.3. Self-Report Measures
- Depression, Anxiety, and Stress Scale 21 (DASS-21) [30]: The DASS-21 contains 21 items, scored on a four-point scale ranging from did not apply to me at all to applied to me very much or most of the time. DASS includes subscales for depression, anxiety, and stress. (Cronbach’s alpha: depression: 0.91; anxiety: 0.77; stress: 0.86)
- Connor–Davidson Resilience Scale (CD-RISC-25) [31]: The CD-RISC is a 25 item-scale, scored on a 5-point scale (not true at all to true nearly all of the time). (Cronbach’s alpha: 0.90)
- PROMIS Sleep Disturbance Instrument [32]: A nine-item scale that assesses self-reported perceptions of sleep quality, sleep depth, and restoration associated with sleep. It includes perceived difficulties and concerns with getting to sleep or staying asleep, as well as perceptions of the adequacy of and satisfaction with sleep (Cronbach’s alpha: 0.64).
2.4. Qualitative
2.5. Statistical Analysis
3. Results
3.1. Burnout
3.2. Compassion Satisfaction
3.3. Qualitative Focus Group
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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n | % | |
---|---|---|
Gender identity | ||
Male | 7 | 15.6 |
Female | 38 | 84.4 |
Non-binary | 0 | 0 |
Other | 0 | 0 |
Race | ||
White | 15 | 33.3 |
African American/Black | 19 | 42.2 |
Asian | 6 | 13.3 |
Other | 4 | 8.9 |
Did not answer | 1 | 2.2 |
Disease team | ||
Breast | 4 | 8.9 |
GI | 2 | 4.4 |
Head and neck | 4 | 8.9 |
Leukemia/lymphoma | 3 | 6.7 |
Melanoma | 4 | 8.9 |
Multiple myeloma | 18 | 40.0 |
Phase 1 | 7 | 15.6 |
Radiation oncology | 1 | 2.2 |
Thoracic | 2 | 4.4 |
Measure | Range | Mean | Std Dev |
---|---|---|---|
ProQOL—Compassion satisfaction | 10–50 | 40.3 | 6.9 |
ProQOL—Burnout | 10–50 | 21.9 | 5.7 |
DASS—Depression | 0–21 | 2.0 | 3.4 |
DASS—Anxiety | 0–21 | 2.7 | 3.6 |
DASS—Stress | 0–21 | 4.7 | 4.1 |
Workplace Incivility—Physicians and hospital personnel | 12–42 | 23.56 | 7.49 |
Workplace Incivility—CRC teammates | 10–39 | 22.12 | 8.95 |
Workplace Incivility—Patients and Family | 10–40 | 20.74 | 7.83 |
Sleep Disturbance | 8–40 | 22.4 | 7.1 |
Connor–Davidson Resilience Scale | 0–100 | 76.6 | 16.5 |
DV: Burnout | Unstandardized | Stand. | 95% CI | |||||
---|---|---|---|---|---|---|---|---|
Model | Predictor Variable | B | SE B | Beta | t | p | Lower | Upper |
Reduced Personal | (Constant) | 24.06 | 4.04 | 5.96 | 0.000 | 15.88 | 32.25 | |
Resilience | −0.13 | 0.04 | −0.37 | −3.30 | 0.002 | −0.21 | −0.05 | |
Sleep | 0.25 | 0.09 | 0.32 | 2.68 | 0.011 | 0.06 | 0.44 | |
Stress | 0.45 | 0.17 | 0.33 | 2.66 | 0.012 | 0.11 | 0.79 | |
Reduced Interpersonal | (Constant) | 15.32 | 2.31 | 6.65 | 0.000 | 10.66 | 19.98 | |
Inc. from patients, fam | 0.31 | 0.11 | 0.43 | 2.97 | 0.005 | 0.10 | 0.53 | |
Combined | (Constant) | 18.43 | 4.42 | 4.17 | 0.000 | 9.47 | 27.40 | |
Resilience | −0.11 | 0.04 | −0.32 | −2.91 | 0.006 | −0.19 | −0.03 | |
Sleep | 0.29 | 0.09 | 0.36 | 3.18 | 0.003 | 0.10 | 0.47 | |
Stress | 0.36 | 0.16 | 0.26 | 2.20 | 0.034 | 0.03 | 0.68 | |
Inc. from patients, fam | 0.19 | 0.08 | 0.26 | 2.47 | 0.018 | 0.03 | 0.34 |
DV: Compassion Satisfaction | Unstandardized | Stand. | 95% CI | |||||
---|---|---|---|---|---|---|---|---|
Model | Predictor Variable | B | SE B | Beta | t | p | Lower | Upper |
Reduced Personal | (Constant) | 18.90 | 3.70 | 5.11 | 0.000 | 11.43 | 26.37 | |
Resilience | 0.28 | 0.05 | 0.69 | 5.99 | 0.000 | 0.19 | 0.38 | |
Reduced Interpersonal | (Constant) | 45.43 | 2.70 | 16.80 | 0.000 | 39.96 | 50.90 | |
Inc. from coordinators | 0.30 | 0.10 | 0.41 | 2.95 | 0.005 | 0.10 | 0.51 | |
Inc. from patients, fam | −0.56 | 0.12 | −0.65 | −4.72 | 0.000 | −0.80 | −0.32 | |
Reduced Combined | (Constant) | 27.38 | 4.47 | 6.13 | 0.000 | 18.35 | 36.42 | |
Resilience | 0.24 | 0.05 | 0.60 | 5.45 | 0.000 | 0.15 | 0.34 | |
Inc. from patients, fam | −0.28 | 0.09 | −0.32 | −2.92 | 0.006 | −0.47 | −0.09 |
Theme | Quote |
---|---|
Burnout is caused by feeling overwhelmed from too many work responsibilities | “I’m always playing catch up…now…cause like there’s three patients that needs three different set of labs…and…you know list goes on and on.” [John*] “You are doing you…you are answering emails, you are entering data, you are trying to do it all at once. And you find yourself not being able to go to lunch because you’re like, “you know why I can’t go to lunch because I have too much to do. I can’t take 30 min to go grab something to eat and come back.” [Rachel] |
Burnout can be exacerbated by a lack of understanding and engagement from physicians and leadership (Networks and Communications) | “Yeah. Sometimes we had the doctors who were like ego tripping and they are like, “Oh. You are coordinator. You are supposed to coordinate.” Then I am like, “You are the doctor. You are supposed to know your study. I’m here to supply support. Not know everything in and out and then tell you what to do.” I’m just…to remind you, “Hey. Do this. Do that. We might need to review this.” You know and then you want to challenge me like I am idiot. Like… First, I’m not going to just sit there and tolerate that type of abuse. But can you just like…we are…at the end of the day…we’re both human beings. The only thing separating you from me is that you have a medical degree and that’s it.” [Sara] |
Nevertheless, there is a supportive work culture among CRCs based in teamwork (Organizational Culture) | “The support is amazing from your fellow colleague cause for me I came from a non-research field and I was kind of like a little bit doubtful how I’d be able to like fit in to it even though I came from a data aspect of it but when I arrived here everybody rallied around almost like, “You don’t have to worry and you have any problem come to me”. And they didn’t just say it. They put it into action. You don’t go to someone like come visit. Everybody has time for everybody. So that’s really amazing. Really makes the work far easier.” [Charles] |
CRCs want more appreciation from leadership (Org Incentives and Rewards) | “I just wish the CTO would like appreciate the coordinators more. I feel like…if they showed us like…even if it’s,” Hey! We have lunch for all of us.” That would just be great…” [Sara] |
Intervention and programming would be especially useful for new staff who are adjusting to working in a cancer setting (Needs and Resources) | “Because…because this is cancer. You…you know…you go into a room and you have been doing this for so long and your patients are coming from [unintelligible] city and they are discussing Hospice. It’s…it’s…it’s breaking your heart and you also see new people who don’t have the coping mechanisms of somebody who has been doing this for three or four years and [unintelligible].” [Rachel] |
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Mascaro, J.S.; Palmer, P.K.; Ash, M.J.; Peacock, C.; Escoffery, C.; Grant, G.; Raison, C.L. Incivility Is Associated with Burnout and Reduced Compassion Satisfaction: A Mixed-Method Study to Identify Causes of Burnout among Oncology Clinical Research Coordinators. Int. J. Environ. Res. Public Health 2021, 18, 11855. https://doi.org/10.3390/ijerph182211855
Mascaro JS, Palmer PK, Ash MJ, Peacock C, Escoffery C, Grant G, Raison CL. Incivility Is Associated with Burnout and Reduced Compassion Satisfaction: A Mixed-Method Study to Identify Causes of Burnout among Oncology Clinical Research Coordinators. International Journal of Environmental Research and Public Health. 2021; 18(22):11855. https://doi.org/10.3390/ijerph182211855
Chicago/Turabian StyleMascaro, Jennifer S., Patricia K. Palmer, Marcia J. Ash, Caroline Peacock, Cam Escoffery, George Grant, and Charles L. Raison. 2021. "Incivility Is Associated with Burnout and Reduced Compassion Satisfaction: A Mixed-Method Study to Identify Causes of Burnout among Oncology Clinical Research Coordinators" International Journal of Environmental Research and Public Health 18, no. 22: 11855. https://doi.org/10.3390/ijerph182211855