Skip to main content
Top
Published in: Medical Oncology 2/2013

01-06-2013 | Review Article

A medical oncologist’s perspective on communication skills and burnout syndrome with psycho-oncological approach (To die with each patient one more time: the fate of the oncologists)

Author: Ozgur Tanriverdi

Published in: Medical Oncology | Issue 2/2013

Login to get access

Abstract

The increasing incidence of cancer is at the same time one of the leading causes of death all over the world. Many clinical studies show that the psychological disorders are more frequent in cancer patients than the normal population. That is the reason why “psycho-oncology” is getting popular each day. On the other hand, clinical studies about psychological status of the oncologists who are in contact with cancer patients ceaselessly and who are mostly responsible to give the “bad news” to the cancer patients are very limited. In fact, if the clinical studies which show that the frequency of depression and burnout syndrome are increasing among physicians are taken into consideration, one can say that psycho-oncology must cover all the medical personnel who are dealing with cancer patients. It is determined that the rate of depression and burnout syndrome is high among oncologists when referred to the literature. Several solutions are proposed for the psychological conditions of the oncologists and other related personnel who empathize with the patients and deliver “bad news” and also try to adopt ideal “patient–physician” communication model. The knowledge on the psychological conditions of oncology professionals and their behaviour and the results of the clinical studies on this subject will be discussed and the personal opinion will also be presented in this paper.
Literature
1.
go back to reference Nq CG, Boks MP, Zainal NZ, de Wit NJ. The prevalence and pharmacotherapy of depression in cancer patients. J Affect Disord. 2011;131:1–7.CrossRef Nq CG, Boks MP, Zainal NZ, de Wit NJ. The prevalence and pharmacotherapy of depression in cancer patients. J Affect Disord. 2011;131:1–7.CrossRef
2.
go back to reference Buckman R, Tulsky JA, Rodin G. Empathic responses in clinical practice: intuition or tuition? CMAJ. 2011;183:569–71.PubMed Buckman R, Tulsky JA, Rodin G. Empathic responses in clinical practice: intuition or tuition? CMAJ. 2011;183:569–71.PubMed
3.
go back to reference Gattellari M, Butow PN, Tattersall MH. Sharing decisions in cancer care. Soc Sci Med. 2001;52:1865–78.PubMedCrossRef Gattellari M, Butow PN, Tattersall MH. Sharing decisions in cancer care. Soc Sci Med. 2001;52:1865–78.PubMedCrossRef
4.
go back to reference Cherny NI, Palliative Care Working Group of the European Society for Medical Oncology. Factors influencing the attitudes and behaviors of oncologists regarding the truthful disclosure of information to patients with advanced and incurable cancer. Psychooncology. 2011;20:1269–84. Cherny NI, Palliative Care Working Group of the European Society for Medical Oncology. Factors influencing the attitudes and behaviors of oncologists regarding the truthful disclosure of information to patients with advanced and incurable cancer. Psychooncology. 2011;20:1269–84.
5.
go back to reference Geffen JR. Integrative oncology for the whole person: a multidimensional approach to cancer care. Integr Cancer Ther. 2010;9:105–21.PubMedCrossRef Geffen JR. Integrative oncology for the whole person: a multidimensional approach to cancer care. Integr Cancer Ther. 2010;9:105–21.PubMedCrossRef
6.
go back to reference McHenry M, Parker PA, Baile WF, Lenzi R. Voice analysis during bad news discussion in oncology: reduced pitch, decreased speaking rate, and nonverbal communication of empathy. Support Care Cancer. 2011;20:1073–8.PubMedCrossRef McHenry M, Parker PA, Baile WF, Lenzi R. Voice analysis during bad news discussion in oncology: reduced pitch, decreased speaking rate, and nonverbal communication of empathy. Support Care Cancer. 2011;20:1073–8.PubMedCrossRef
7.
go back to reference Pollak KI, Arnold RM, Jeffreys AS, Alexander SC, Olsen MK, et al. Oncologist communication about emotion during visits with patients with advanced cancer. J Clin Oncol. 2007;25:5748–52.PubMedCrossRef Pollak KI, Arnold RM, Jeffreys AS, Alexander SC, Olsen MK, et al. Oncologist communication about emotion during visits with patients with advanced cancer. J Clin Oncol. 2007;25:5748–52.PubMedCrossRef
8.
go back to reference Pollak KI, Arnold RM, Alexander SC, Jeffreys AS, Olsen MK, et al. Do patient attributes predict oncologist empathic responses and patient perceptions of empathy? Support Care Cancer. 2010;18:1405–11.PubMedCrossRef Pollak KI, Arnold RM, Alexander SC, Jeffreys AS, Olsen MK, et al. Do patient attributes predict oncologist empathic responses and patient perceptions of empathy? Support Care Cancer. 2010;18:1405–11.PubMedCrossRef
9.
go back to reference Han JY, Shah DV, Kim E, Namkoong K, Lee SY, et al. Empathic exchanges in online cancer support groups: distinguishing message expression and reception effects. Health Commun. 2011;26:185–97.PubMedCrossRef Han JY, Shah DV, Kim E, Namkoong K, Lee SY, et al. Empathic exchanges in online cancer support groups: distinguishing message expression and reception effects. Health Commun. 2011;26:185–97.PubMedCrossRef
10.
go back to reference Kissane DW, Bylund CL, Banerjee SC, Bialer PA, Levin TT, et al. Communication skills training for oncology professionals. J Clin Oncol. 2012;30:1242–7.PubMedCrossRef Kissane DW, Bylund CL, Banerjee SC, Bialer PA, Levin TT, et al. Communication skills training for oncology professionals. J Clin Oncol. 2012;30:1242–7.PubMedCrossRef
11.
go back to reference Krasner MS, Epstein RM, Beckman H, Suchman AL, Chapman B, et al. Association of an educational program in mindful communication with burnout, empathy, and attitudes among primary care physicians. JAMA. 2009;302:1284–93.PubMedCrossRef Krasner MS, Epstein RM, Beckman H, Suchman AL, Chapman B, et al. Association of an educational program in mindful communication with burnout, empathy, and attitudes among primary care physicians. JAMA. 2009;302:1284–93.PubMedCrossRef
12.
go back to reference Seetharamu N, Iqbal U, Weiner JS. Determinants of trust in the patient-oncologist relationship. Palliat Support Care. 2007;5:405–9.PubMedCrossRef Seetharamu N, Iqbal U, Weiner JS. Determinants of trust in the patient-oncologist relationship. Palliat Support Care. 2007;5:405–9.PubMedCrossRef
13.
go back to reference Kennifer SL, Alexander SC, Pollak KI, Jeffreys AS, Olsen MK, et al. Negative emotions in cancer care: do oncologists’ repsonses depend on severity and type of emotion? Patient Educ Couns. 2009;76:51–6.PubMedCrossRef Kennifer SL, Alexander SC, Pollak KI, Jeffreys AS, Olsen MK, et al. Negative emotions in cancer care: do oncologists’ repsonses depend on severity and type of emotion? Patient Educ Couns. 2009;76:51–6.PubMedCrossRef
14.
go back to reference Saraiya B, Arnold R, Tulsky JA. Communication skills for discussing treatment options when chemotherapy has failed. Cancer J. 2010;16:521–3.PubMedCrossRef Saraiya B, Arnold R, Tulsky JA. Communication skills for discussing treatment options when chemotherapy has failed. Cancer J. 2010;16:521–3.PubMedCrossRef
15.
go back to reference Otani H, Morita T, Esaki T, Ariyami H, Tsukasa K, et al. Burden on oncologists when communicating the discontinuation of anticancer treatment. Jpn J Clin Oncol. 2011;41:999–1006.PubMedCrossRef Otani H, Morita T, Esaki T, Ariyami H, Tsukasa K, et al. Burden on oncologists when communicating the discontinuation of anticancer treatment. Jpn J Clin Oncol. 2011;41:999–1006.PubMedCrossRef
16.
go back to reference Voelter V, Mirimanoff RO, Stiefel F, Rousselle I, Leyvraz S. Breaking bad news. Rev Med Suisse. 2005;1:1350–3.PubMed Voelter V, Mirimanoff RO, Stiefel F, Rousselle I, Leyvraz S. Breaking bad news. Rev Med Suisse. 2005;1:1350–3.PubMed
17.
go back to reference Spiegel W, Zidek T, Maier M, Vutuc C, Isak K, et al. Breaking bad news to cancer patients: survey and analysis. Psychooncology. 2009;18:179–86.PubMedCrossRef Spiegel W, Zidek T, Maier M, Vutuc C, Isak K, et al. Breaking bad news to cancer patients: survey and analysis. Psychooncology. 2009;18:179–86.PubMedCrossRef
18.
go back to reference Barraclough J. Cancer and emotion: a practical guide to psycho-oncology. 3rd ed. Chichester, UK: Wiley; 1994. Barraclough J. Cancer and emotion: a practical guide to psycho-oncology. 3rd ed. Chichester, UK: Wiley; 1994.
19.
go back to reference Glajchen M. The emerging role and needs of family caregivers in cancer care. J Support Oncol. 2004;2:145–55.PubMed Glajchen M. The emerging role and needs of family caregivers in cancer care. J Support Oncol. 2004;2:145–55.PubMed
20.
go back to reference Sherman AC, Edwards D, Simonton S, Mehta P. Caregiver stress and burnout in an oncology unit. Palliat Support Care. 2006;4:65–80.PubMed Sherman AC, Edwards D, Simonton S, Mehta P. Caregiver stress and burnout in an oncology unit. Palliat Support Care. 2006;4:65–80.PubMed
21.
go back to reference Peppercorn JM, Smith TJ, Helft PR, DeBono DJ, Berry SR, et al. American society of clinical oncology statement: toward individualized care for patients with advanced cancer. J Clin Oncol. 2011;29:755–60.PubMedCrossRef Peppercorn JM, Smith TJ, Helft PR, DeBono DJ, Berry SR, et al. American society of clinical oncology statement: toward individualized care for patients with advanced cancer. J Clin Oncol. 2011;29:755–60.PubMedCrossRef
22.
go back to reference Hack TF, Degner LF, Parker PA, SCRN Communication Team. The communication goals and needs of cancer patients: a review. Psychooncology. 2005;14:831–45.PubMedCrossRef Hack TF, Degner LF, Parker PA, SCRN Communication Team. The communication goals and needs of cancer patients: a review. Psychooncology. 2005;14:831–45.PubMedCrossRef
23.
go back to reference Butow P, Cockburn J, Girgis A, Bowman D, Schofield P, et al. Increasing oncologists’ skills in eliciting and responding to emotional cues: evaluation of a communication skills training program. Psychooncology. 2008;17:209–18.PubMedCrossRef Butow P, Cockburn J, Girgis A, Bowman D, Schofield P, et al. Increasing oncologists’ skills in eliciting and responding to emotional cues: evaluation of a communication skills training program. Psychooncology. 2008;17:209–18.PubMedCrossRef
24.
go back to reference Eggly S, Penner LA, Greene M, Harper FW, Ruckdeschel JC, et al. Information seeking during “bad news” oncology interactions: question asking by patients and their companions. Soc Sci Med. 2006;63:2974–85.PubMedCrossRef Eggly S, Penner LA, Greene M, Harper FW, Ruckdeschel JC, et al. Information seeking during “bad news” oncology interactions: question asking by patients and their companions. Soc Sci Med. 2006;63:2974–85.PubMedCrossRef
25.
go back to reference Falagas ME, Zarkadoulia EA, Ioannidou EN, Peppas G, Christodoulou C, et al. The effect of psychosocial factors on breast cancer outcome: a systematic review. Breast CancerRes. 2007;9:R44.CrossRef Falagas ME, Zarkadoulia EA, Ioannidou EN, Peppas G, Christodoulou C, et al. The effect of psychosocial factors on breast cancer outcome: a systematic review. Breast CancerRes. 2007;9:R44.CrossRef
26.
go back to reference Cegala DJ, Lenzmeier Broz S. Physician communication skills training: a review of theoretical backgrounds, objectives and skills. Med Educ. 2002;36:1004–16.PubMedCrossRef Cegala DJ, Lenzmeier Broz S. Physician communication skills training: a review of theoretical backgrounds, objectives and skills. Med Educ. 2002;36:1004–16.PubMedCrossRef
27.
go back to reference Donovan HS, Ward S. A representational approach to patient education. J Nurs Scholarsh. 2001;33:211–6.PubMedCrossRef Donovan HS, Ward S. A representational approach to patient education. J Nurs Scholarsh. 2001;33:211–6.PubMedCrossRef
28.
go back to reference Wolpin BM, Chabner BA, Lynch TJ Jr, Penson RT. Learning to cope: how far is too close? Oncologist. 2005;10:449–56.PubMedCrossRef Wolpin BM, Chabner BA, Lynch TJ Jr, Penson RT. Learning to cope: how far is too close? Oncologist. 2005;10:449–56.PubMedCrossRef
29.
go back to reference Kash KM, Holland JC, Breitbart W, Berenson S, Dougherty J, et al. Stress and burnout in oncology. Oncology (Huntington). 2000;14:1621–37. Kash KM, Holland JC, Breitbart W, Berenson S, Dougherty J, et al. Stress and burnout in oncology. Oncology (Huntington). 2000;14:1621–37.
30.
go back to reference Costa AJ, Schrop SL, McCord G, Ritter C. Depression in family medicine faculty. Fam Med. 2005;37:271–5.PubMed Costa AJ, Schrop SL, McCord G, Ritter C. Depression in family medicine faculty. Fam Med. 2005;37:271–5.PubMed
31.
go back to reference Katz ED, Sharp L, Ferguson E. Depression among emergency medicine residents over an academic year. Acad Emerg Med. 2006;13:284–7.PubMedCrossRef Katz ED, Sharp L, Ferguson E. Depression among emergency medicine residents over an academic year. Acad Emerg Med. 2006;13:284–7.PubMedCrossRef
32.
go back to reference Grunfeld E, Whelan TJ, Zitzelsberger L, Willan AR, Montesanto B, et al. Cancer care workers in Ontario: prevalence of burnout, job stress and job satisfaction. CMAJ. 2000;163:166–9.PubMed Grunfeld E, Whelan TJ, Zitzelsberger L, Willan AR, Montesanto B, et al. Cancer care workers in Ontario: prevalence of burnout, job stress and job satisfaction. CMAJ. 2000;163:166–9.PubMed
33.
go back to reference Lee SJ, Back AL, Block SD, Stewart SK. Enhancing physician-patient communication. Hematol Am Soc Hematol Educ Program. 2002;2002:464–83.CrossRef Lee SJ, Back AL, Block SD, Stewart SK. Enhancing physician-patient communication. Hematol Am Soc Hematol Educ Program. 2002;2002:464–83.CrossRef
34.
go back to reference Holland JM, Neimeyer RA. Reducing the risk of burnout in end-of-life care settings: the role of daily spiritual experiences and training. Palliat Support Care. 2005;3:173–81.PubMedCrossRef Holland JM, Neimeyer RA. Reducing the risk of burnout in end-of-life care settings: the role of daily spiritual experiences and training. Palliat Support Care. 2005;3:173–81.PubMedCrossRef
35.
go back to reference Selph RB, Shiang J, Engelberg R, Curtis JR, White DB. Empathy and life support decisions in intensive care units. J Gen Intern Med. 2008;23:1311–7.PubMedCrossRef Selph RB, Shiang J, Engelberg R, Curtis JR, White DB. Empathy and life support decisions in intensive care units. J Gen Intern Med. 2008;23:1311–7.PubMedCrossRef
36.
go back to reference Shanafelt TD. Enhancing meaning in work: a prescription for preventing physician burnout and promoting patient-centered care. JAMA. 2009;302:1338–40.PubMedCrossRef Shanafelt TD. Enhancing meaning in work: a prescription for preventing physician burnout and promoting patient-centered care. JAMA. 2009;302:1338–40.PubMedCrossRef
37.
go back to reference Shanafelt T, Dyrbye L. Oncologist burnout: causes, consequences, and responses. J Clin Oncol. 2012;30:1235–41.PubMedCrossRef Shanafelt T, Dyrbye L. Oncologist burnout: causes, consequences, and responses. J Clin Oncol. 2012;30:1235–41.PubMedCrossRef
38.
go back to reference Allegra CJ, Hall R, Yothers G. Prevalence of burnout in the U.S. oncology community: results of a 2003 survey. J Oncol Prac. 2005;2005(1):140–7.CrossRef Allegra CJ, Hall R, Yothers G. Prevalence of burnout in the U.S. oncology community: results of a 2003 survey. J Oncol Prac. 2005;2005(1):140–7.CrossRef
39.
go back to reference Alacacioglu A, Yavuzsen T, Dirioz M, Oztop I, Yilmaz U. Burnout in nurses and physicians working at an oncology department. Psychooncology. 2009;18:543–8.PubMedCrossRef Alacacioglu A, Yavuzsen T, Dirioz M, Oztop I, Yilmaz U. Burnout in nurses and physicians working at an oncology department. Psychooncology. 2009;18:543–8.PubMedCrossRef
40.
go back to reference Arigoni F, Bovier PA, Mermillod B, Waltz P, Sappino AP. Prevalence of burnout among Swiss cancer clinicians, paediatricians and general practitioners: who are most at risk? Support Care Cancer. 2009;17:75–81.PubMedCrossRef Arigoni F, Bovier PA, Mermillod B, Waltz P, Sappino AP. Prevalence of burnout among Swiss cancer clinicians, paediatricians and general practitioners: who are most at risk? Support Care Cancer. 2009;17:75–81.PubMedCrossRef
41.
go back to reference Camps C, Escobar Y, Esteban E, Almenarez JA, Moreno Jimenez B, et al. Professional burnout among Spanish medical oncologists. Clin Transl Oncol. 2009;11:86–90.PubMedCrossRef Camps C, Escobar Y, Esteban E, Almenarez JA, Moreno Jimenez B, et al. Professional burnout among Spanish medical oncologists. Clin Transl Oncol. 2009;11:86–90.PubMedCrossRef
42.
go back to reference Jones JW, Barge BN, Steffy BD, Fay LM, Kunz LK, et al. Stress and medical malpractice: organizational risk assessment and intervention. J Appl Psychol. 1988;73:727–35.PubMedCrossRef Jones JW, Barge BN, Steffy BD, Fay LM, Kunz LK, et al. Stress and medical malpractice: organizational risk assessment and intervention. J Appl Psychol. 1988;73:727–35.PubMedCrossRef
43.
go back to reference Ramirez AJ, Graham J, Richards MA, Cull A, Gregory WM, et al. Burnout and psychiatric disorder among cancer clinicians. Br J Cancer. 1995;71:1263–9.PubMedCrossRef Ramirez AJ, Graham J, Richards MA, Cull A, Gregory WM, et al. Burnout and psychiatric disorder among cancer clinicians. Br J Cancer. 1995;71:1263–9.PubMedCrossRef
44.
go back to reference Inam SNB, Saqib A, Alam E. Prevalence of anxiety and depression among medical students of private University. J Pak Med Ass. 2003;53:44–7. Inam SNB, Saqib A, Alam E. Prevalence of anxiety and depression among medical students of private University. J Pak Med Ass. 2003;53:44–7.
45.
go back to reference Abdulghani HM, AlKanhal AA, Mahmoud ES, Ponnamperuma GG, Alfaris AA. Stress and its effect on medical students: a cross-sectional study at a College of Medicine at Saudi Arabia. J Health Popul Nutr. 2011;29:516–22.PubMedCrossRef Abdulghani HM, AlKanhal AA, Mahmoud ES, Ponnamperuma GG, Alfaris AA. Stress and its effect on medical students: a cross-sectional study at a College of Medicine at Saudi Arabia. J Health Popul Nutr. 2011;29:516–22.PubMedCrossRef
46.
go back to reference Whippen DA, Canellos GP. Burnout syndrome in the practice of oncology: results of a random survey of 1,000 oncologists. J Clin Oncol. 1991;9:1916–20.PubMed Whippen DA, Canellos GP. Burnout syndrome in the practice of oncology: results of a random survey of 1,000 oncologists. J Clin Oncol. 1991;9:1916–20.PubMed
47.
go back to reference Schernhammer ES, Colditz AG. Suicide rates among physicians: a quantitative and gender assessment (meta-analysis). Am J Psychiatry. 2004;161:2295–302.PubMedCrossRef Schernhammer ES, Colditz AG. Suicide rates among physicians: a quantitative and gender assessment (meta-analysis). Am J Psychiatry. 2004;161:2295–302.PubMedCrossRef
48.
go back to reference Mirza I, Jenkins R. Risk factors, prevalence, and treatment of anxiety and depressive disorders in Pakistan: systematic review. BMJ. 2004;328:794–7.PubMedCrossRef Mirza I, Jenkins R. Risk factors, prevalence, and treatment of anxiety and depressive disorders in Pakistan: systematic review. BMJ. 2004;328:794–7.PubMedCrossRef
Metadata
Title
A medical oncologist’s perspective on communication skills and burnout syndrome with psycho-oncological approach (To die with each patient one more time: the fate of the oncologists)
Author
Ozgur Tanriverdi
Publication date
01-06-2013
Publisher
Springer US
Published in
Medical Oncology / Issue 2/2013
Print ISSN: 1357-0560
Electronic ISSN: 1559-131X
DOI
https://doi.org/10.1007/s12032-013-0530-y

Other articles of this Issue 2/2013

Medical Oncology 2/2013 Go to the issue