Associations of Job Demands and Patient Safety Event Involvement on
Burnout among a Multidisciplinary Group of Pediatric Hematology/Oncology
Clinicians
Abstract
BACKGROUND: Workplace burnout can result in negative consequences for
clinicians and patients. We assessed burnout prevalence and sources
among pediatric hematology/oncology inpatient nurses, ambulatory nurses,
physicians (MDs), and advanced practice providers (APPs) by evaluating
effects of job demands and involvement in patient safety events (PSEs).
METHODS: A cross-sectional survey (Maslach Burnout Inventory) measured
emotional exhaustion, depersonalization, and reduced personal
accomplishment. The NASA Task Load Index measured mental demand,
physical demand, temporal demand, effort, and frustration. Relative
weights analyses estimated the unique contributions of tasks and PSEs on
burnout. Post-hoc analyses evaluated open-response comments for burnout
factors. RESULTS: Burnout prevalence was 33%, 20%, 34% and 33% in
inpatient nurses, ambulatory nurses, and MD, and APPs respectively
(N=481, response rate 69%). Reduced personal accomplishment was
significantly higher in inpatient nurses than MDs & APPs. Job
frustration was the most significant predictor of burnout across all
four cohorts. Other significant predictors of burnout included temporal
demand (nursing groups & MDs) effort (inpatient nurses & MDs) and PSE
involvement (ambulatory nurses). Open-response comments identified time
constraints, lack of administrator support, insufficient institutional
support for self-care, and inadequate staffing and/or turnover as
sources of frustration. CONCLUSIONS: All four clinician groups reported
substantial levels of burnout, and job demands predicted burnout. The
body of knowledge on job stress and workplace burnout supports targeting
organizational-level sources, versus individual-level factors, as the
most effective prevention and reduction strategy. This study elaborates
on this evidence by identifying structural drivers of burnout within a
multidisciplinary context of pediatric hematology/oncology clinicians.