Staff well-being in UK children's hospices: a national survey.

OBJECTIVES: Poor psychological well-being among healthcare workers can have numerous negative impacts, but evidence about levels of burnout in children's hospice care staff is limited. This study aimed to determine the prevalence of burnout and to explore the association between staff characteristics and support mechanisms with burnout among children's hospice care staff in the UK. METHODS: Two national online surveys collecting data on hospice care staff psychological well-being and hospice organisational characteristics. All children's hospices in the UK were invited.Thirty-one hospices (out of 52) responded to the hospice survey and 583 staff responded to the staff survey. Data collection took place between May and December 2020 and measures included the Copenhagen Burnout Inventory, Work Engagement and the Health and Safety Executive Management Standards Indicator Tool. RESULTS: Burnout prevalence was 11% and mean burnout score was 32.5 (SD: 13.1). Burnout levels were independent of working arrangements (eg, working from home or at the hospice) during the COVID-19 pandemic. Hospices performed well in most management standards, but poorly on the 'Control' domain. The average Work Engagement score for staff was 7.5 (SD: 1.5). CONCLUSIONS: Burnout levels for staff in children's hospices in the UK were lower than in other healthcare settings, with this comparing to 17.3% among palliative care staff generally. Overall, hospices performed well in management standards and there was no indication of urgent action needed. Work Engagement in our sample was higher compared with other National Health Service workers during the COVID-19 pandemic.

Measuring Burnout in Pediatric Oncology Staff: Should We Be Using the Maslach Burnout Inventory?

Burnout in health service staff is a cause for concern since it has negative consequences for the individual affected, the wider organization, and patients. The Maslach Burnout Inventory-Human Services Survey (MBI-HSS) has been widely used to assess the prevalence of burnout within oncology services. The MBI-HSS is a self-report measure comprising three subscales-Emotional Exhaustion (EE), Depersonalization (DP), and Personal Accomplishment (PA). This article reports on the first study to investigate the psychometric properties of the MBI-HSS when administered to pediatric oncology staff. Two hundred and three pediatric oncology staff recruited through seven UK Principal Treatment Centers (PTCs) and a children's cancer charity completed the MBI-HSS. The factor structure of the instrument was tested using confirmatory and exploratory factor analysis, with Rasch analysis applied to assess whether the measure meets the requirements of an interval-level scale. Cronbach alpha was used to assess internal reliability. Factor analysis did not support the traditional three-factor structure of the MBI-HSS but instead suggested seven factors. Rasch analysis and alpha coefficients indicated that while the EE and the PA subscales fulfilled the requirements of an interval-level measure for group-level diagnosis, DP did not. Further investigation revealed a "floor effect" on many DP items. Whereas the EE and PA subscales of the MBI-HSS can be used in research with pediatric oncology staff working in PTCs, there are considerable problems with the DP subscale, and researchers should be cautious in interpreting data from this subscale.

Burnout, psychiatric morbidity, and work-related sources of stress in paediatric oncology staff: a review of the literature.

OBJECTIVE: A growing body of research suggests that staff working in adult oncology services are at risk of burnout and psychiatric morbidity, but whether or not these findings can be generalised to staff working in paediatric oncology is questionable. This paper reports the findings of a comprehensive review of the literature on burnout, psychiatric morbidity, and sources of work-related stress in paediatric oncology staff. METHODS: Electronic searches of MEDLINE and PSYCHINFO. This was followed by a screening process, during which papers where checked against inclusion and exclusion criteria, and the quality of study reporting was assessed. Information about the study design and methods was then extracted from each paper so that the methodological quality could be critiqued. RESULTS: Ten studies meeting the review inclusion criteria were identified. No studies were identified which compared paediatric and adult oncology staff. Research on paediatric oncology staff has failed to use the well-established standardised measures of burnout and psychiatric morbidity employed in studies of adult oncology staff. There is some qualitative evidence to suggest paediatric oncology nurses experience a unique, additional set of stressors not encountered by colleagues in adult oncology services. CONCLUSION: The evidence on stress and burnout in paediatric oncology staff is extremely limited. In order to devise appropriate and effective interventions to support staff, we need to have a much better understanding of the level of burnout and psychiatric morbidity experienced by all members of the paediatric oncology multi-disciplinary team, as well as the factors that contribute to these experiences.