Burnout and psychiatric morbidity among physicians engaged in end-of-life care for cancer patients: a cross-sectional nationwide survey in Japan.

PURPOSE To determine the prevalence of burnout and psychiatric morbidity among physicians engaged in end-of-life care for cancer patients in Japan and to explore associated factors related to end-of-life care. METHODS Questionnaires were mailed to 1436 Japanese clinical oncologists and palliative care physicians with a request to complete the Maslach Burnout Inventory (MBI), the General Health Questionnaire (GHQ-12), and to report on individual factors, including confidence in patient care. High levels of burnout and psychiatric morbidity were identified using cut-off scores of the MBI and GHQ-12. RESULTS A total of 697 physicians returned the questionnaires (response rate, 49.6%). Twenty-two percent of the respondents had a high level of emotional exhaustion, 11% had a high level of depersonalization, 62% had a low level of personal accomplishment, and 20% had psychiatric morbidity. Clinical oncologists showed a significantly higher psychiatric morbidity than palliative care physicians. Confidence in having sufficient time to communicate with patients was significantly associated with all the burnout subscales. CONCLUSIONS A low level of personal accomplishment was relatively high among Japanese physicians compared with previous studies. Insufficient confidence in the psychological care of patients was associated with physician burnout rather than involvement in end-of-life care.