title: What do clinicians derive from partnering with their patients? A reliable and valid measure of "personal meaning in patient care".
abstract: OBJECTIVE
  Burnout is high among clinicians and may relate to loss of "meaning" in patient care. We sought to develop and validate a measure of "personal meaning" that practitioners derive from patient care.
  
  
  METHODS
  As part of a larger study of well-being among genetics professionals, we conducted three focus groups of clinical genetics professionals: physicians, nurses and genetic counselors (N=29). Participants were asked: "What gives you meaning in patient care?" Eight themes were identified, converted into Likert items, and included in a questionnaire. Next, we mailed the questionnaire to clinical geneticists, genetic counselors and genetic nurses (N=480) randomly selected from mailing lists of their professional associations. Results were subjected to exploratory factor analysis. The survey also included validated scales of burnout and professional satisfaction, and a 1-item measure of gratitude, to assess predictive validity.
  
  
  RESULTS
  214 eligible providers completed the survey out of an estimated 348 eligible (61% response rate). Factor analysis resulted in a unidimensional scale consisting of 6-items with an alpha of 0.82 and an eigen value of 3.2. Factor loadings ranged from 0.69-0.77. The mean total score was 18.1 (S.D. 3.7) out of a possible high score of 24. Higher meaning scores were associated with being female (p=0.044), a nurse (p<0.001), and in practice longer (p=0.006). Meaning scores were inversely correlated with burnout (p<0.001), and positively correlated with gratitude (p<0.001) and professional satisfaction (p<0.022).
  
  
  CONCLUSIONS
  The 6-item "personal meaning in patient care" scale demonstrates high reliability and predictive validity in a select group of health professionals. Future research should validate this scale in a broader population of clinicians.
  
  
  CONCLUSIONS
  The scale could be useful in identifying providers at risk of burnout, and in evaluating interventions designed to counteract burnout, enhance meaning and improve communication and partnership between providers and patients.
authors.affiliation: Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD 21205, USA. ggeller@jhmi.edu
authors.forename: Gail
authors.initials: G
authors.lastname: Geller
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Bernhardt
authors.forename: Joseph
authors.initials: J
authors.lastname: Carrese
authors.forename: Cynda H
authors.initials: CH
authors.lastname: Rushton
authors.forename: Ken
authors.initials: K
authors.lastname: Kolodner
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D015142:Baltimore; D002055:Burnout, Professional / Q000209:etiology / Q000517:prevention & control / Q000523:psychology; D003142:Communication; D003299:Cooperative Behavior; D005163:Factor Analysis, Statistical; D005260:Female; D017144:Focus Groups; D005817:Genetic Counseling; D005826:Genetics, Medical; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D010358:Patient Participation / Q000379:methods / Q000523:psychology; D011237:Predictive Value of Tests; D011369:Professional-Patient Relations; D011594:Psychometrics; D012737:Sex Factors; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires / Q000592:standards*; D013997:Time Factors