Suffering among carers working in critical care can be reduced by an intensive communication strategy on end-of-life practices

• Published in: Intensive care medicine Vol. 38; no. 1; pp. 55 - 61
• Main Authors: Quenot, J. P., Rigaud, J. P., Prin, S., Barbar, S., Pavon, A., Hamet, M., Jacquiot, N., Blettery, B., Hervé, C., Charles, P. E., Moutel, G.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.01.2012; Springer; Springer Nature B.V; Springer Verlag
• Subjects: Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Anesthesiology; Biological and medical sciences; Burn out (Psychology); Burnout; Caregivers; Clinical death. Palliative care. Organ gift and preservation; Communication; Critical care; Critical Care Medicine; Depression, Mental; Emergency Medicine; Female; France; Hospitals, University; Humans; Intensive; Intensive care; Intensive care medicine; Intensive Care Units; Interdisciplinary Communication; Job stress; Male; Medical personnel; Medical sciences; Medical Staff, Hospital - psychology; Medicine; Medicine & Public Health; Meetings; Mental depression; Middle Aged; Nurses; Original; Pain Medicine; Palliative treatment; Pediatrics; Physicians; Pneumology/Respiratory System; Psychologists; Stress, Psychological - prevention & control; Surveys and Questionnaires; Terminal Care; Work environment; Working groups; Young Adult; France; Ethics; Critical care organisation; Communication; Ethnics; Intensive care; Resuscitation
• ISSN: 0342-4642; 1432-1238
• DOI: 10.1007/s00134-011-2413-z

Purpose Burnout syndrome (BOS) has frequently been reported in healthcare workers, and precipitating factors include communication problems in the workplace and stress related to end-of-life situations. We evaluated the effect of an intensive communication strategy on BOS among caregivers working in intensive care (ICU). Methods Longitudinal, monocentric, before-and-after, interventional study. BOS was evaluated using the Maslach Burnout Inventory (MBI) and depression using the Centre for Epidemiologic Studies Depression Scale (CES-D) in 2007 (period 1) and 2009 (period 2). Between periods, an intensive communication strategy on end-of-life practices was implemented, based on improved organisation, better communication, and regular staff meetings. Results Among 62 caregivers in the ICU, 53 (85%) responded to both questionnaires in period 1 and 49 (79%) in period 2. We observed a significant difference between periods in all three components of the MBI (emotional exhaustion, p  = 0.04; depersonalization p  = 0.04; personal accomplishment, p  = 0.01). MBI classified burnout as severe in 15 (28%) caregivers in period 1 versus 7 (14%) in period 2, p  < 0.01, corresponding to a 50% risk reduction. Symptoms of depression as evaluated by the CES-D were present in 9 (17%) caregivers in period 1 versus 3 (6%) in period 2, p  < 0.05, corresponding to a risk reduction of almost 60%. Conclusion The implementation of an active, intensive communication strategy regarding end-of-life care in the ICU was associated with a significant reduction in the rate of burnout syndrome and depression in a stable population of caregiving staff.