Well-being among Italian medical oncologists: An exploratory study

Background: Recently, attention has been focused on physicians' stress and quality-of-life improvement. Due to their relationship with patients, oncologists in particular are overloaded physically, emotionally and psychologically. Previous studies showed that training of communication skills improves the satisfaction and well-being of physicians and patients. Aims: Our research investigates the relationship between work stress and engagement and personal well-being in physicians working in Italian hospitals. Materials and Methods: 176 physicians were included. Doctors filled out self-report questionnaires to evaluate work stress and coping strategies, personal well-being, work engagement and two purpose-built scales to measure the degree of perceived organizational support and the level of specific training of social and relational skills. Descriptive statistics were used to analyze data, as well as correlation analysis (Pearson's r), hierarchical regression analysis (enter step) and analysis of variance (one-way ANOVA). Result: Positive and significant correlations were found between variables. Moreover, physicians who obtained higher levels of specific training on social and relational skills reported lower levels of stress. Oncologists experienced greater stress than other physicians in terms of maladaptive coping and lack of additional training. Conclusions: The study suggests that physicians' well-being is mediated by professional aspects, such as social skills in relationships with patients.M

Protection from work stress and burnout in Italian oncologists

Oncology is a field of medicine with an high psychological investment and therefore at high risk for burnout (Gandey, 2006). Is possible to identify the causes of burnout in the complex combination of environmental stressors, including factors that are closely related to oncology and elements of the personality of the subjects (Guarino, 2006). This work aims to explore burnout risk, job satisfaction, quality of life and coping styles in a sample of physicians that works in some Italian oncological units. We used the Health Professions Stress and Coping Scale, the Utrecht Work Engagement Scale, the General Health Questionnaire and a scale that explore the socio-relational perceived skills. The main hypothesis is that personal well-being of the oncologists interviewed (as protective factor of burn-out), can be modulated by variables connected with the role, adaptive coping strategies, degree of work engagement and perceived degree of organizational support

THE ROLE OF PSYCHOLOGICAL ASPECTS IN ONCOGENETIC COUNSELLING

Background: As result of the recent developments in DNA testing and the knowledge that cancer can be hereditary, it is now possible to offer genetic counselling to people within identified “cancer families”, and to inform them about their assumed increased risk for developing cancer. The aim of this study was to test the role of psychological aspect in oncogenetic counselling. The primary purpose of the research was to evaluate the difference between Anxiety Trait and Anxiety State in subjects going to oncogenetic counselling. The secondary aim was to explore the relationships between alexithymia, personality trait, coping style, psychological distress, in subjects attending genetic counselling for hereditary cancer. Methods: The questionnaires administered were: semi-structured interview, STAI, COPE, BFA, TAS 20, MHQ. In the first study, the group consisted of 65 subjects (56 females and 9 males; M = 42.3 years), while in the second study, they were 30 subjects (M = 40.4 years) completing the entire test battery of the oncogenetic counselling. Results: The results showed a weak but significant differences between Trait Anxiety and State Anxiety (t = 2.23; p < 0.05). It seems that for some subjects the particular conditions or oncogenetic counseling could cause more levels of anxiety. We think that the level of anxiety could diminish as result of a prolonged psychological support intervention, as suggested by the results of this research. With regard to the TAS 20, the results showed that 48.2% of subjects suffering from oncologic pathology obtained score ranging from 50 (borderline level) to greater than 60 (cut-off for Alexithymia). Conclusions: Our results indicate that the tendency to repress one’s emotions is associated to some general schemes of reaction to stress which, when used in a dysfunctional manner (such as the attempt to ignore how threatening an event), are maladaptive in the end

WELL-BEING, SOURCES OF STRESS AND COPING STRATEGIES IN A SAMPLE OF ONCOLOGISTS

Background: Several studies have highlighted that some professional categories, called: ‘helping professions’, appear, more than other professions, to be subjected to sources of stress and the connected risks of burn-out. In particular personnel working in oncology face potentially stressful situations and having to deal daily with the needs and concerns of the patients and their families. It is therefore necessary to understand the variables that can limit the impact of stress. This research seeks to explore the degree of personal well-being of the oncologists interviewed, taking into consideration some possible predictors, such as the age and specific trainings (i.e. in diagnosis communication, stress management, and so on). We connected this kind of predictors with the sources of stress typical to the medical profession, the coping strategies, the degree of work engagement and the perceived degree of organizational support. Methods: The research included 138 subjects (doctors that work in a range of oncological units in Italy). The subjects completed a self-report questionnaire with the aim of evaluating the perception of stress and coping strategies (Using the Health professions stress and coping scale), the degree of personal well-being (using the General Health Questionnaire) and the degree of work engagement (using the Utrecht Work Engagement Scale); a purpose-built scale to measure the degree of perceived organizational support was also administered. Results: According to our expectations, age is not related to the stress and his possible sources, whereas the training shows high correlation levels with the total amount of stress (r = 0.35), some of the possible daily stressors (i.e. facing to death, r = 0.33). Conclusions: The results are comparable with other international research, but we would obviously need to have an extended sample to better understand the possible psychological protection factors of the helping professions

The relation between socio-relational self-efficacy and work engagement in an Italian sample of social workers

This study examined how much in social workers the confidence about perceived socio-relational competencies is related to work engagement. We used a questionnaire delevoped to assess the socio- relational self-efficacy (according to the Bandura’s theory), and the UWES (Schaufeli & Bakker, 2003), a measure of work engagement, defined as a positive, fulfilling work-related state of mind. Subjects were interviewed in therapeutic commu- nities (for drug addicts, for abused women etc.) or family communities. It was found that some aspects of relational competence (like to feel able to understand others’ feelings) are strongly related to work engagement

Well-being of physicians who work in oncology unit and in BMT unit: analysis of protective factors from work stress

Background. Recently a great deal of attention has been given on doctors' work related stress and possibility of improving their quality of life. Several studies report that oncologists are overloaded psychologically. Contact with serious diseases, excessive working pressure, structural weaknesses, are some of the factors that predispose oncologists to stress. In 2008, at the ASPHO annual meeting, pediatric hematologists/oncologists noted burnout (considered as a result of protracted stress at work) was a significant challenge in their lives. To date, no studies have extensively ruled out on protective factors from work stress among pediatric oncologists. Aims. Our research investigates the relationship between Work Stress, Work Engagement and Personal Well-being in a sample of doctors working in Italian hospitals. Specifically, the study investigates whether Organizational Support, Self-efficacy Perceived, adaptive Coping styles and specific training on social and relational skills mediate between Work Stress, Personal Well-being and Work Engagement. In addition, it investigates the differences between oncologists, pediatricians and other kind of physician. Materials and Methods. The research included 176 physicians (M=89; F=83; MS=4) working in Italian healthcare units of oncology and onco-haematology; 15 of them work in pediatric unit. Doctors filled self-report questionnaires to evaluate Work Stress and Coping Strategies (Health Professions Stress and Coping Scale), Personal Well-being (General Health Questionnaire), Work Engagement (Utrecht Work Engagement Scale) and two purpose-built scales to measure the degree of perceived Organizational Support and the level of specific training on social and relational skills. Result.. It was found negative and significant correlations between the scores of the scales that measure the use of adaptive coping strategies and stress levels. Moreover, physicians who obtained higher levels of specific training on social and relational skills reported lower levels of stress. Finally, it was highlighted significant differences between pediatricians and other physicians, especially on the use of adaptive coping strategies. Conclusions. Our results seem to confirm that well-being of physicians is mediated by typical aspects of the profession, such as social skills in relationship with patients

Tailored Psychoeducational Home Interventions for Children with a Chronic Illness: Families’ Experiences

The quality of life for a child with a chronic illness depends on various factors, including the illness’s severity, medical treatments, psychosocial and educational support, resource availability, and community involvement. These biopsychosocial factors become significant when the child receives care at home. This article presents and evaluates a highly personalized support project offered to 40 Sicilian families, consisting of educational, social, and psychological services delivered at the families homes and in their communities. Guided by the Psychosocial Assessment Tool (PAT) and the Functional Psychology framework, the project employed a family-focused approach to healthcare and was based on a continuous dialogue between all stakeholders. The project was evaluated through a qualitative interview with eight families in the Palermo area, which was analyzed using consensual qualitative research. Results revealed families’ appreciation of the project and the importance of a professional who listened to their needs, provided a connection with the medical team, and tailored activities inside and outside the home. The ability of professionals to listen and adapt activities to different contexts and needs was crucial for the project’s success. We conclude that creating tailored family-level interventions with an educator acting as a liaison with the medical team is a widely acceptable strategy that should be further developed and investigated

Prosafe: a european endeavor to improve quality of critical care medicine in seven countries

BACKGROUND: long-lasting shared research databases are an important source of epidemiological information and can promote comparison between different healthcare services. Here we present ProsaFe, an advanced international research network in intensive care medicine, with the focus on assessing and improving the quality of care. the project involved 343 icUs in seven countries. all patients admitted to the icU were eligible for data collection. MetHoDs: the ProsaFe network collected data using the same electronic case report form translated into the corresponding languages. a complex, multidimensional validation system was implemented to ensure maximum data quality. individual and aggregate reports by country, region, and icU type were prepared annually. a web-based data-sharing system allowed participants to autonomously perform different analyses on both own data and the entire database. RESULTS: The final analysis was restricted to 262 general ICUs and 432,223 adult patients, mostly admitted to Italian units, where a research network had been active since 1991. organization of critical care medicine in the seven countries was relatively similar, in terms of staffing, case mix and procedures, suggesting a common understanding of the role of critical care medicine. conversely, icU equipment differed, and patient outcomes showed wide variations among countries. coNclUsioNs: ProsaFe is a permanent, stable, open access, multilingual database for clinical benchmarking, icU self-evaluation and research within and across countries, which offers a unique opportunity to improve the quality of critical care. its entry into routine clinical practice on a voluntary basis is testimony to the success and viability of the endeavor