JOB STRESS AND SATISFACTION AMONG PALLIATIVE PHYSICIANS

A national questionnaire-based survey has found that palliative physic ians report lower levels of burnout and similar levels of psychiatric morbidity than those reported by consultants in other specialties. To try to explain these findings, this study compared the sources of job stress and satisfaction reported by consultant palliative physicians w ith those reported by consultants working in four other specialties: s urgery, gastroenterology, radiology and oncology. Stressful and satisf ying aspects of work were assessed using questionnaires designed speci fically for the study. The response rate for the palliative physicians was 126/154 (82%) and for the consultants in the other specialties 88 2/1133 (78%). Palliative physicians reported that feeling overloaded a nd its effect on home life made the greatest contribution to their job stress, and having good relationships with patients, relatives and st aff made the greatest contribution to their job satisfaction. However, compared with the other specialist groups, palliative physicians repo rted less stress from overload (p < 0.001) and more satisfaction from having good relationships (p < 0.001). They also reported less stress and more satisfaction with the way they are managed and resourced (bot h p < 0.001). Hospital-based palliative physicians reported more stres s and less satisfaction from their management and resources than their colleagues working in hospices (both p = 0.05). Thirty-five percent o f palliative physicians felt insufficiently trained in communication s kills and 81% felt insufficiently trained in management skills. Burnou t was more prevalent among consultants who felt insufficiently trained in communication and management skills than among those who felt suff iciently trained. It is important therefore that effective training in communication and management skills are provided and that, at the ver y least, existing levels of resourcing and management practices within palliative medicine are maintained in order that physicians working i n the specialty are able to provide care to dying patients without pre judicing their own mental health.