title: Stress, satisfaction and burnout amongst Australian and New Zealand radiation oncologists.
abstract: BACKGROUND
  The aim of this study was to determine the self-reported prevalence of stress, job satisfaction and burnout among radiation oncologists in Australia and New Zealand. A secondary aim was to determine the association between stress and satisfaction parameters with burnout.
  
  
  METHODS
  An anonymous online survey was distributed to all radiation oncologists listed on Royal Australian and New Zealand College of Radiologists membership database. There were 37 Likert scale questions on stress, 17 Likert scale questions on job satisfaction and burnout assessed by the Maslach Burnout Inventory - Human Services Survey (MBI-HSS). A principal component analysis was done for stress and satisfaction to identify specific areas. Independent samples t-tests and analysis of variances were done.
  
  
  RESULTS
  There were 220 responses out of 348 eligible respondents (63.2% response rate).For stress, a principal component analysis identified five areas: delivery demands, demands on time, continuing professional development (CPD), value and security, and interpersonal/teaching demands. Specialist radiation oncologists were more stressed by value and security than generalists (P < 0.01). Lung cancer specialists had higher levels of stress associated with delivery demands, demands on time and CPD compared with others (P = 0.01). Those over 60 years were less stressed by delivery demands (P = 0.02), demands on time (P = 0.01) and CPD (P = 0.01) than their younger colleagues. Four satisfaction factors were identified in the principal component analysis: resources/remuneration, status/security, delivery of services and professional activities. [Correction added on 15 August 2014, after first online publication: stress/security was replaced with status/security.] Males and Australian radiation oncologists were more satisfied with professional activities (P = 0.02). Brachytherapy specialists were more satisfied with status/security (P = 0.01) while those interested in urology were more satisfied with resources/renumeration (P = 0.01) and professional activities (P = 0.01). The burnout results revealed at least 48.5% of respondents scoring highly in at least one of the three measures of burnout (emotional exhaustion, depersonalisation and personal accomplishment) while 37.5% scoring highly in the emotional exhaustion and depersonalisation subscales. Public sector radiation oncologists had higher levels of emotional exhaustion and lower levels of personal accomplishment than their private sector counterparts, while those interested in lung cancer had higher levels of emotional exhaustion. Multiple regression analysis revealed that the stress subscale demands on time had a significant effect on emotional exhaustion. Higher CPD stress and interpersonal/teaching demands increased the feeling of depersonalisation, while satisfaction with delivery of services was associated with lower levels of depersonalisation and higher levels of personal accomplishment.
  
  
  CONCLUSIONS
  This first study of stress, satisfaction and burnout among radiation oncologists in Australia and New Zealand had a reasonable response rate and identified specific areas of stress and satisfaction. Nearly half of the respondents scored highly in one burnout subscale. Some of the stress and satisfaction subscales correlated with certain aspects of burnout. Further research will be undertaken to refine the stress and satisfaction parameters and address burnout interventions.
authors.affiliation: Department of Radiation Oncology, Adelaide Radiotherapy Centre, Adelaide, South Australia, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Leung
authors.forename: Pilar
authors.initials: P
authors.lastname: Rioseco
authors.forename: Philip
authors.initials: P
authors.lastname: Munro
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D002055:Burnout, Professional / Q000453:epidemiology*; D003625:Data Collection; D006801:Humans; D015994:Incidence; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D018787:Radiation Oncology / Q000706:statistics & numerical data*; D016526:Workload / Q000706:statistics & numerical data*
keywords: Australia; burnout; satisfaction; stress