Risk of burnout and protective factors in palliative care

Burnout refers to a loss of energy that usually happens when the person feels ‘burned’ or exhausted, either in physical and psychological terms. A burned out person evidences signs of distress in his/her daily behaviour, and it turns out to be almost impossible to perform normally due to fatigue. The contact with death, dying and human suffering is commonly described as a risk factor for burnout development. Complementarily, palliative care practice implies ethical decision making related to end-of-life dilemmas, which may be complex and demanding. Therefore, the provision of palliative care may lead health care providers to physical, psychological and emotional exhaustion and it is possible that burnout may occur. Despite this fact, studies about burnout in palliative care show low levels of burnout, especially when compared with the results obtained in other health care settings. These results converge to those found in a study about professional caregiver burnout carried out in Portuguese palliative care units. We realised that one of the protective factors referred to by Portuguese professionals was the attribution of a meaningful sense to death, dying and suffering. This sense and the definition of active strategies and rituals after death helped professionals to deal with the loss of the patient.