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The effects of stress on oncology staff
CMAJ 2000;163(7):807[Letters section in PDF]


The recent article by Eva Grunfeld and colleagues contributes further information on stress and its effects on oncology staff [Research].1 The amount of published evidence indicates that stress is a substantial problem.2,3 What Grunfeld and colleagues did not address is the source of stress and what might be done about the problem.

Models of work-related stress, work disengagement and burnout have been presented and reviewed by Vachon2 and Maslach and colleagues,4,5 among others. Gifted, intelligent and empathic workers are more likely to experience distress;3 personality types2 and personal values4 are also relevant. However, Maslach and colleagues strongly argue that the main determinants of worker impoverishment and burnout are corporate rather than individual and that due attention to such factors may promote work engagement and job satisfaction.4 Attention is now being paid to contexts of work, particularly the quality of any organization, including its values,4,5 culture, moral climate and institutional ethics.6 Hierarchical organizations with overemphasis on standardization and efficiencies, combined with increasing expectations of perfection (by patients, corporations and the college) may promote burnout and reduce the quality of professional practice.

The underlying theme in research in burnout and work engagement seems to be that group and management processes have to promote more open futures in which professionals are able to deploy their gifts in meaningful ways, and in which they are able to grow as human beings. To better understand the present problem and to apply appropriate corrective measures, it may be essential to measure moral climate,6 assess the culture of each workplace3,4 and evaluate spiritual concerns of staff. The latter might include clarification and strengthening of meaning and purpose conducive to both personal vitality and agility of the organization.

Glenn Jones
Stephen Sagar
Raimond Wong
McMaster University and Spiritual Evaluation
  and Research in Complementary Health (SEARCH)
McMaster University
Hamilton, Ont.


References

    1.   Grunfeld E, Whelan TJ, Zitzelsberger L, Willan AR, Montesanto B, Evans WK. Cancer care workers in Ontario: prevalence of burnout, job stress and job satisfaction. CMAJ 2000;163(2):166-9.
    2.   Vachon MLS. Stress in oncologists. Can J Oncol 1993;3:166-72.
    3.   Ramirez AJ, Graham J, Richards MA, Cull A, Gregory WM, Leaning MS, Snashall DC, Timothy AR. Burnout and psychiatric disorder among cancer clinicians. Br J Cancer 1995;71:1263-9. [MEDLINE]
    4.   Maslach C, Leiter M. The truth about burnout: how organizations cause personal stress and what to do about it. San Francisco (CA): Jossey-Bass; 1998.
    5.   Maslach C, Goldberg J. Prevention of burnout: new perspectives. Appl Prev Psychol 1998;7:63-74.
    6.   Cohen D. Creating ethical work climates: a socioeconomic perspective. J Socio-Econom 1995;24:317-44.

 

 

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