Burnout, staff support, and coping in Pediatric Oncology.

GOALS OF WORK: The goals of the study were the following: (1) to study the rate of burnout of the staff in Pediatric Oncology and compare it with that of a group of staff in other pediatric specialties, (2) to find out if job satisfaction, role clarity, staff support, and ways of coping are related to the burnout of these two groups, and (3) as a secondary aim, to identify other parameters, i.e., profession, experience, having children, etc., which might affect burnout, staff support, and ways of coping. MATERIALS AND METHODS: The study group (n = 58) consisted of the staff of two Pediatric Oncology units and a Bone Marrow Transplantation unit, and the control group (n = 55) consisted of the staff of two Pediatric departments and one Pediatric Orthopedics department. The Maslach Burnout Inventory, the Staff Support Questionnaire, the Shortened Ways of Coping Questionnaire-Revised, and the Social Readjustment Scale were used. MAIN RESULTS: No differences were found in burnout between Pediatric Oncology staff and that of other specialties, the existing staff support, and the ways of coping. Decreased role clarity and wishful thinking, as a way of coping, were positively correlated to emotional exhaustion, whereas a negative correlation of the lack of role clarity existed with personal accomplishment. Not having children and less experience increased burnout in both groups studied. CONCLUSIONS: The hospital management and the heads of departments should be knowledgeable of ways to prevent burnout in their staff. Strategies targeting role clarity and wishful thinking are useful toward this goal.

Rectal-skin temperature difference in septicaemic newborn infants.

Serial skin (sole) and rectal temperatures were simultaneously taken from 55 healthy and 26 septicaemic newborn infants to find out prospectively whether septicaemic newborn infants have any thermoregulatory reaction to the septicaemia, and whether regular temperature measurements could help in the early diagnosis of septicaemia. The septicaemic infants were divided into three groups: the first comprised eight feverish infants, the second 11 with normal temperatures who were in relatively good clinical condition, and the third seven with normal temperatures who were in poor clinical condition. All 55 healthy babies had rectal temperatures of less than 37.8 degrees C and a mean rectal-sole temperature difference of 2.5 degrees C. The first group of septicaemic infants had rectal temperatures over 37.8 degrees C and a high mean temperature difference of 6.9 degrees C, whereas the second group had rectal temperatures less than 37.8 degrees C and a mean temperature difference of 4.7 degrees C. Infants of the third group had a low rectal temperature and a low mean temperature difference (1.1 degrees C). We conclude that septicaemic newborn infants show an adequate thermoregulatory reaction, which is reflected by a widening of the rectal-sole temperature difference of more than 3.5 degrees C, except for those who are critically ill, who lose this ability. In view of these results infants with normal temperatures but with a rectal-sole temperature difference of more than 3.5 degrees C should be suspected of septicaemia and investigated thoroughly.