Burnout in end-of-life care: work-related experiences in intensive and palliative care units and relation to burnout

Introduction: Professionals working in end-of-life care are at risk of developing burnout. Literature shows that work-related experiences are determinant factors to develop this syndrome. Objectives: To identify which work-related experiences are significant and positively associated with burnout among physicians and nurses working in palliative and intensive care units in Portugal. Methods: Multicenter quantitative, comparative study. The Maslach Burnout Inventory was used for data collection together with a questionnaire including a set of work-related experiences. 355 professionals from intensive and palliative care units were included in this study. Univariate and multivariate logistic regression analyses were performed; OR sidelong with 95% of CI were calculated. Results: Out of the 355 professionals included in this study, 27% were in burnout. Univariate regression analyses showed that burnout was significantly associated with the following work-related experiences: night shifts, conflicts, forgoing treatment decisions (both withholding and withdrawing treatments) and implementing terminal sedation. When controlling for professionals’ characteristics (socio-demographic and education) and setting (intensive vs. palliative care units), the only variable that remained significantly associated to higher burnout levels was ‘conflicts’. Conclusions: Work-related experiences increase the risk of developing burnout among professionals providing end-of-life care. Experiencing conflicts with others was the most significant variable associated to higher burnout levels. These findings suggest the need to further implement conflict-management strategies in these settings, helping professionals to cope with high-demanding situations associated to providing end-of-life care.