title: Building Resilience for Palliative Care Clinicians: An Approach to Burnout Prevention Based on Individual Skills and Workplace Factors.
abstract: For palliative care (PC) clinicians, the work of caring for patients with serious illness can put their own well-being at risk. What they often do not learn in training, because of the relative paucity of evidence-based programs, are practical ways to mitigate this risk. Because a new study indicates that burnout in PC clinicians is increasing, we sought to design an acceptable, scalable, and testable intervention tailored to the needs of PC clinicians. In this article, we describe our paradigm for approaching clinician resilience, our conceptual model, and curriculum for a workplace resilience intervention for hospital-based PC teams. Our paradigm for approaching resilience is based on upstream, early intervention. Our conceptual model posits that clinician well-being is influenced by personal resources and work demands. Our curriculum for increasing clinician resilience is based on training in eight resilience skills that are useful for common challenges faced by clinicians. To address workplace issues, our intervention also includes material for the team leader and a clinician perception survey of work demands and workplace engagement factors. The intervention will focus on individual skill building and will be evaluated with measures of resilience, coping, and affect. For PC clinicians, resilience skills are likely as important as communication skills and symptom management as foundations of expertise. Future work to strengthen clinician resilience will likely need to address system issues more directly.
authors.affiliation: Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington, USA. Electronic address: tonyback@uw.edu.
authors.forename: Anthony L
authors.initials: AL
authors.lastname: Back
authors.affiliation: Center for Health Services Research in Primary Care Durham VA Medical Center, the Department of Medicine, Division of General Internal Medicine, Duke University, Durham, North Carolina, USA.
authors.forename: Karen E
authors.initials: KE
authors.lastname: Steinhauser
authors.affiliation: Duke University, Durham, North Carolina, USA.
authors.forename: Arif H
authors.initials: AH
authors.lastname: Kamal
authors.affiliation: Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Vicki A
authors.initials: VA
authors.lastname: Jackson
mesh_terms: D000223:Adaptation, Psychological; D000339:Affect; D002055:Burnout, Professional / Q000517:prevention & control*; D002983:Clinical Competence; D003479:Curriculum; D004502:Education, Medical, Continuing; D006801:Humans; D008960:Models, Psychological; D010166:Palliative Care / Q000458:organization & administration / Q000523:psychology*; D010465:Perception; D010820:Physicians / Q000523:psychology*; D011795:Surveys and Questionnaires; D000074824:Work Engagement
keywords: Resilience; burnout; palliative care; well-being; work engagement