Compassion fatigue among oncologists: the role of grief, sense of failure, and exposure to suffering and death

Abstract

Purpose: Oncologists cope with unique work characteristics that increase their risk of developing compassion fatigue-that is, burnout and secondary traumatic stress-and can result in reduced capacity and interest in being empathetic to the suffering of others (Stamm B. The concise ProQOL manual, 2010). At the same time, oncologists can experience compassion satisfaction-that is, the positive aspects of caring. This study explored the associations of compassion fatigue and compassion satisfaction with oncologists' grief and sense of failure beyond their reported exposure to suffering and death.

Methods: Seventy-four oncologists completed self-administered questionnaires examining compassion fatigue, compassion satisfaction, grief, exposure to suffering and death, and sense of failure.

Results: The oncologists reported that they face the loss of approximately 50% of their patients, and that their patients suffer from profound emotional and physical pain. High levels of compassion fatigue and grief, and moderate levels of sense of failure, were reported. Findings showed a lack of association between exposure to suffering and death and compassion fatigue and satisfaction. However, grief and sense of failure were found to predict both aspects of compassion fatigue: secondary traumatic stress (p < 0.001, p < 0.003, respectively) and burnout (p < 0.002, p < 0.025, respectively).

Conclusions: These results highlight the importance of the oncologists' subjective experiences of grief and sense of failure, beyond their reports of exposure to suffering and death, in terms of their levels of compassion fatigue. Implications of these findings include the need to develop interventions for oncologists that will allow them to acknowledge, process, and overcome negative experiences of failure and grief.

Keywords: Burnout; Compassion fatigue; Grief; Oncology; Sense of failure.

Conflict of interest statement

Dr. Braun, Mrs. Laor-Maayany, and Mrs. Engler-Gross report grants from the Israel Cancer Association, during the conduct of the study; Prof. Goldzweig, Prof. Hasson-Ohayon, and Dr. Bar-Sela have nothing to disclose.

Figures

Fig. 1

Exposure to suffering and death. The participants estimated that on average 41.74% (SD = 23.62) of their patients died from the disease (a), 32.58% (SD = 21.06) of their patients suffer from medium to severe levels of physical pain (b), and that 54.45% (SD = 24.18) of the patients suffer from emotional pain during a significant amount of the time (c)