Soutenir les professionnels de la santé en oncologie : une recension

Abstract

Background: Caring for patients with cancer can be both personally rewarding and stressful. Confrontation with suffering, working with people facing complex lifethreatening illness, demanding treatment regimens and frequent death of patients are challenging for many clinicians. Responding to the emotional needs of patients and families is often perceived as among the most stressful. These emotional sources of stress can be compounded by organisational factors and work demands. The resulting emotional impact can have an adverse effect on clinicians' performance in and satisfaction with their professional roles, their own health and well-being and the quality of patient care. Objective: The objective of this paper was to review the factors contributing to emotional stress and burnout in health professionals and identify evidence-based strategies to support health professionals in their role, with illustrations of current Australian initiatives on how to apply these in clinical practice. Results: Research to date indicates the contribution of a combination of individual and contextual factors in the development of these emotional adjustment problems, reflecting an interaction of clinicians' personal attributes and aspects of their work that influence risk to such stress and "burnout" among cancer clinicians. Evidence-based strategies to address these problems and promote resilience among clinicians include skills development through training and mentorship, particularly in communication skills and psychosocial care. Such training and mentorship can lead to improvements in clinicians' stress management and confidence in their role, as well as to patient outcomes through improved response to patients' concerns and suffering. Conclusion: No single strategy is likely to be successful in alleviating stress related to work in oncology. Interventions must be multi-faceted, flexible and incorporate attention to the complex inter-relationships of clinicians, their personality and experiences, patients and health care systems. Mentorship and clinical supervision can provide personal support, maintenance of skills and promote reflective practices and translation of these skills into everyday practice. Service models that also reduce professional isolation and promote inter-disciplinary team function are discussed, with illustrations of current initiatives in Australia. To cite this journal: Psycho-Oncol. 5 (2011).Keywords Health professionals · Stress · Burnout · Inter-disciplinary team Résumé Contexte : Prendre soin d'une personne atteinte de cancer peut à la fois être une expérience personnelle gratifiante et souffrante. La confrontation avec la souffrance, l'accompagnement de personnes affrontant une maladie sévère, l'administration de traitements exigeants et l'exposition aux deuils multiples constituent des défis de taille pour plusieurs cliniciens. Répondre aux besoins émotionnels de la personne atteinte et de ses proches est souvent perçu parmi les expériences les plus stressantes. Ces facteurs émotionnels peuvent se vo...

Burnout and the provision of psychosocial care amongst Australian cancer nurses

“…Until recently supervision was not widely used outside of psychology and psychiatry (Turner et al, 2011); however, the present findings contribute to emerging research suggesting links between supervision and burnout. One study found that health professionals, including nurses, who received supervision for a period of six months reported higher levels of personal accomplishment (Hyrkas et al, 2006).…”

An Interview Study of Work- and Home-based Stressors in Radiation Therapists and Radiation Oncology Nurses: Implications for Provision of Psychotherapy Services to Cancer-care Health Professionals

“…Due to the small numbers of participants in this study, it was difficult to conclusively measure the effectiveness of these coping strategies. However, ignoring the emotional responses to the suffering of patients and not acknowledging this potentially preventable source of an ongoing stressor within the workforce are more likely to contribute to burnout [22].…”

“…Finally, in terms of potential counselling strategies for cancer care workers, it is salutary to reflect on the comment made by Turner and colleagues [22] that, despite cancer care workers having better access to healthcare, many are less likely to actively seek and receive appropriate care, perhaps because of the stigma associated with acknowledging emotional problems. Improving awareness of the availability and success of counselling interventions for stress management in the workplace may therefore represent the first task of counsellors who offer their services to cancer care staff.…”

“…Archives of Psychiatry and Psychotherapy, 2015; 2: [21][22][23][24][25][26][27][28][29][30] been some bias in terms of who volunteered, although this limitation is countered by the consistency in reports across participants.…”

“…Alternatively, workplace stress can be caused by industrial/organisational issues, and the possible counselling interventions which might be relevant to those stressors experienced by cancercare staff will be different to those occasioned by patient death -and illness-related issues. In addition to patient care and organisational issues, Archives of Psychiatry and Psychotherapy, 2015; 2: [21][22][23][24][25][26][27][28][29][30] cancer care staff may also experience non-workplace stressors that could affect their ability to function. The provision of adequate counselling services to these individuals assumes that counsellors have an understanding of the particular aspects of patient care, organisation issues and non-workplace issues which act as major stressors for these carers, how they have attempted to cope with those stressors, and how successful those attempts have been.…”