title: Suffering among carers working in critical care can be reduced by an intensive communication strategy on end-of-life practices.
abstract: OBJECTIVE
  Burnout syndrome (BOS) has frequently been reported in healthcare workers, and precipitating factors include communication problems in the workplace and stress related to end-of-life situations. We evaluated the effect of an intensive communication strategy on BOS among caregivers working in intensive care (ICU).
  
  
  METHODS
  Longitudinal, monocentric, before-and-after, interventional study. BOS was evaluated using the Maslach Burnout Inventory (MBI) and depression using the Centre for Epidemiologic Studies Depression Scale (CES-D) in 2007 (period 1) and 2009 (period 2). Between periods, an intensive communication strategy on end-of-life practices was implemented, based on improved organisation, better communication, and regular staff meetings.
  
  
  RESULTS
  Among 62 caregivers in the ICU, 53 (85%) responded to both questionnaires in period 1 and 49 (79%) in period 2. We observed a significant difference between periods in all three components of the MBI (emotional exhaustion, p = 0.04; depersonalization p = 0.04; personal accomplishment, p = 0.01). MBI classified burnout as severe in 15 (28%) caregivers in period 1 versus 7 (14%) in period 2, p < 0.01, corresponding to a 50% risk reduction. Symptoms of depression as evaluated by the CES-D were present in 9 (17%) caregivers in period 1 versus 3 (6%) in period 2, p < 0.05, corresponding to a risk reduction of almost 60%.
  
  
  CONCLUSIONS
  The implementation of an active, intensive communication strategy regarding end-of-life care in the ICU was associated with a significant reduction in the rate of burnout syndrome and depression in a stable population of caregiving staff.
authors: Service de Réanimation Médicale, CHU Dijon, Dijon, France. jean-pierre.quenot@chu-dijon.fr
authors: J P
authors: JP
authors: Quenot
authors: J P
authors: JP
authors: Rigaud
authors: S
authors: S
authors: Prin
authors: S
authors: S
authors: Barbar
authors: A
authors: A
authors: Pavon
authors: M
authors: M
authors: Hamet
authors: N
authors: N
authors: Jacquiot
authors: B
authors: B
authors: Blettery
authors: C
authors: C
authors: Hervé
authors: P E
authors: PE
authors: Charles
authors: G
authors: G
authors: Moutel
mesh_terms: D000328:Adult; D005260:Female; D005602:France; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units; D033183:Interdisciplinary Communication; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology*; D008875:Middle Aged; D013315:Stress, Psychological / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D013727:Terminal Care; D055815:Young Adult