Novel Intervention Helps Prevent COVID Burnout in Young Oncologists

Liam Davenport

June 10, 2021

The rising tide of burnout among oncologists during the COVID-19 pandemic might be held back by a novel wellbeing intervention focused on flexibility and hopefulness, suggest the results of a pilot study in UK junior doctors.

Dr Alfred Chung Pui So, Guy's and St Thomas' NHS Foundation Trust, London, and colleagues developed a weekly, 30-minute intervention that focused on clinical debriefing, reflective practice, and mindfulness.

Initial results in 10 junior oncologists showed that all the patients were highly satisfied with the intervention, and they saw their wellbeing scores maintained over a 6-month period, despite practising through the worst of the COVID-19 pandemic.

"Our novel intervention was able to prevent burnout," said Dr So, who added that "maintaining mental wellbeing can be achieved" through the promotion of "psychological flexibility and collective reflection with peers".

The research was presented at the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting on June 4.

'Growing Concerns'

Dr So explained that burnout is a "well-recognised syndrome of emotional exhaustion, depersonalisation, and reduced personal accomplishment, and there are "growing concerns" over the risks of burnout among oncology doctors.

Previous research has shown that oncology professionals have faced distress and reduced wellbeing, as well as feelings of burnout, in response to the COVID-19 pandemic, which worsened as the pandemic went on.

As reported by Medscape Medical News, a survey of more than 1500 individuals in the first round and 900-plus in the second round showed that, between April/May and July/August 2020, the risk of distress on the Employee Well-Being Index increased significantly from 25% to 33% (p<0.0001).

Over the same period, the number of participants reporting feelings of burnout increased from 38% to 49% (p<0.001). These feelings were significantly associated with increased working hours and out-of-hours work, and concerns over one's training or career (p<0.05).

Lower distress was significantly associated with higher self-reported resilience, being older than age 40, being male, having pleasant working conditions, and feeling valued by their organisation (p<0.05).

Worse wellbeing was associated with increased working hours, concerns over one's training or career, self-isolating due to COVID-19 symptoms, reduced clinical trial activity, and dietary changes (p<0.05 for all).

Novel Intervention

In response to these findings, Dr So and colleagues developed a novel wellbeing intervention for junior doctors, designed by the educational lead consultant and clinical psychologists at Guy's and St Thomas's Hospital.

The aim of the intervention was to promote psychological flexibility, hopefulness, and a meaningful connection to work via collective reflection with peers and support to engage with wellbeing services in their department.

It consisted of a 5-minute breathing/relaxation exercise, following by a combination of clinical debriefing, reflective practice, and mindfulness led by a clinical psychologist, which each session lasting 30 minutes and given once a week.

Between August 2020 and February 2021, 10 junior doctors took part in the pilot study, with 3–6 doctors attending each session. The median number of sessions each doctor attended was nine.

Mean scores on the 14-point Warwick-Edinburgh Well Being Scale (WEMWBS) were 52.3 at baseline, suggesting that the majority had average wellbeing, and increased by an average of 2.2 points to 54.5 following treatment (p=0.34).

There was also a statistically significant increase in optimism for the future subscale of the WEMWBS, at an average of 0.4 points (p=0.037).

The researchers also found that 100% of the participants were satisfied or very satisfied with the intervention, and 100% found the sessions helpful or very helpful.

In particular, they appreciated reflecting in a safe and structured environment, the breathing exercises, and learning mindfulness strategies.

Acknowledging the small sample size, the researchers aim to collect more data to support the intervention, as the development of evidence-based interventions to prevent burnout in the medical profession "is warranted", said Dr So.

No funding declared.

No relevant financial relationships declared.

American Society of Clinical Oncology Annual Meeting: Abstract 11015. Presented June 4.

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