Impact Of Intervention On Burnout In Medical Officers And Paramedical Staff Of

Oncology Department.

ABSTRACT:Burnout is psychological condition characterized by emotional exhaustion,

overwhelming workloads, strained workplace relationships, and the Medical Profession is

uniquely challenging and comes with significant personal pressures, Factors such as prolonged

patient care, the emotional toll of supporting those with severe illnesses, and limited decision-

making authority compound their stress, leading to higher burnout scores. AIM This study

underscores the significant burnout levels among medical professionals, and impact of

interventions on burnout levels particularly within oncology. METHOD A survey method using

Burnout Questionnaire was conducted among all the Medical Officers (MO) and nursing staff of

three oncology hospital followed by 3 months individual and group intervention followed by

second survey using same questionnaire to assess the impact of intervention. RESULTS The data

reveals that paramedical staff exhibits a mean burnout score of 56.33 ± 7.76, compared to

doctors at 45.01 ± 4.53. In oncology, these figures are even more pronounced; nurses have the

highest burnout score at 71 ± 7.94, while medical officers also show elevated levels at 58.21 ±

6.95. The effectiveness of intervention strategies was also assessed, with notable results after

three months. 51% MO reported reduction in symptoms with burnout scores with mean of 40.1 ±

6.94 whereas 34% paramedical staff reported decrease in symptoms after intervention with mean

burnout score of 56.1 ± 16.94 CONCLUSION: Addressing burnout in high-stress medical fields

is essential interventions can significantly reduce burnout, additional support may be required for

nursing staff to reach comparable improvements.

Keywords : Burnout , Medical officers , Nurses, Intervention.

INTRODUCTION

Burnout is a psychological condition resulting from prolonged exposure to chronic stress at

work, marked by three key dimensions: overwhelming exhaustion, cynicism and detachment

from the job, and a diminished sense of effectiveness and accomplishment. It highlights the

importance of understanding burnout as a socially influenced experience, shaped by how

individuals perceive themselves and their interactions with others. First described by

psychologist Herbert Freudenberg in the 1970s, burnout occurs when work and personal life

pressures exceed one’s ability to cope, causing significant mental and physical distress. While

burnout can affect any profession, it is particularly common among healthcare workers,

especially oncologists. These professionals face emotional challenges, such as dealing with

death, delivering difficult news, making complex treatment decisions, and managing demanding

tasks, all of which contribute to a heightened risk of burnout.According to the World Medical

Association, physicians globally are experiencing significant frustration due to limited resources,

government or corporate control over healthcare, negative media coverage, and challenges to

their authority. Research shows that 20% to 70% of oncologists worldwide exhibit symptoms of

burnout.Burnout among doctors and paramedical professionals has serious consequences,

including increased medical errors, professional misconduct, and attrition from the field. The

incidence of burnout is high globally, with a prevalence of 50% among medical oncologists in

Europe, the U.S., and Australia.In healthcare, burnout not only harms the well-being of providers

but also threatens patient care by increasing errors, reducing satisfaction, and compromising

safety. Oncology, with its emotional demands, is particularly vulnerable to burnout compared to

other specialties.
Burnout among doctors also correlates with poor decision-making, hostile behavior toward

patients, diminished commitment to quality care, and strained professional relationships. Burnout

and compassion fatigue are closely linked and can form a spectrum, as shown in a study among

family physicians. This paper focuses on burnout among physicians, particularly junior doctors

and medical students, who face unique pressures that may differ from their senior counterparts.

While chronic stress can lead to burnout in some doctors, not everyone exposed to such stress

experiences burnout. The study will also explore strategies for preventing or addressing burnout

in the medical profession. Burnout among healthcare professionals is well-documented, with

research consistently showing high rates across various medical fields. Meta-analyses provide

strong evidence linking physician burnout to poor performance and sustainability within

healthcare organizations, first by causing physicians to disengage from their careers and leave,

and then by diminishing the quality of patient care. To address burnout in all specialties,

healthcare organizations should prioritize implementing evidence-based initiatives, particularly

in emergency medicine and among physicians in training or residency. Burnout causes a range of

symptoms, including anxiety, mood swings, insomnia, feelings of failure, sadness, and substance

abuse, and it negatively affects a doctor’s professionalism, self-care, and safety. Physicians face

significant work-related stress from patient care responsibilities, time pressures, decision-making

under uncertainty, and challenging cases. According to West et al. (2018), burnout in doctors is

linked to lower clinical care quality and increased risks of errors, depression, and substance

abuse. Specialties like oncology, critical care, and emergency medicine experience particularly

high levels of burnout. Medisauskaite and Kamau (2017) note that oncologists frequently suffer

from compassion fatigue, emotional exhaustion, and a sense of diminished accomplishment due

to the emotional demands of their work.Burnout in Paramedical Staff: Paramedical staff,

including nurses, technicians, and allied healthcare professionals, play a crucial role in the

functioning of healthcare systems. Due to their frontline nature of work, they are often

overburdened with tasks, patient interaction, and administrative duties. Studies like that of

Gomes et al. (2019) emphasize that paramedical staff working in high-stress environments, such

as oncology wards, experience burnout at higher rates compared to those working in general

wards. The emotional labor of supporting patients through difficult diagnoses and end-of-life

care adds to the cumulative stressA systematic review conducted by Rotenstein et al. (2018)

found that 45-60% of physicians report symptoms of burnout at some point in their careers.

Similarly, paramedical staff, including nurses and technicians, exhibit high burnout rates due to

constant physical, emotional, and cognitive demands,Patnaik et al. (2024), in their study found

that 37.4 % of NHS workers in 2022 said they feel emotionally tired on the job.Burnout in

Oncology vs. General Medical Practice: Research by Meier and Back (2020) indicates that

oncology professionals experience higher burnout rates due to the nature of their work. The

emotional burden of dealing with end-stage cancer patients, grief management, and the high

stakes of treatment outcomes create more intense stress compared to general medical officers.A

2021 study by von Hanno et al. Found that oncology nurses have significantly higher levels of

emotional exhaustion and depersonalization compared to their peers in other medical

departments.Some factors contributing in burnout are Workload & Emotional Toll – Long hours,

high patient loads, and emotional strain contribute significantly to burnout.Lack of Support–

Absence of counseling, peer support, and stress management resources worsens the

issue .Administrative Burdens – Excessive paperwork, bureaucratic pressures, and regulatory

demands add to stress .Lack of Control – Limited autonomy in scheduling and patient care leads
to frustration and helplessness. Apart from this work-life imbalance, emergencies and on-call

duties disrupt personal time and contribute to chronic stress.

Consequences Of Burnout: Burnout has significant repercussions not only for the individuals

affected but also for healthcare institutions and patients. Burnout leads to absenteeism, higher

turnover rates, lower job satisfaction, and diminished productivity, In patient care, burnout

correlates with reduced empathy, increased medical errors, and lower patient satisfaction. In

paramedical staff, high burnout rates result in decreased engagement, leading to a compromised

quality of care.

Interventions:Interventions can improve the mental health and emotional resilience of medical

officers, enabling them to better manage work-related stress.2 Improving Patient Outcomes:

Reducing burnout can enhance the quality of care, improve patient trust and communication, and

lead to better clinical outcomes.3 Promoting a Healthy Work Environment: System-level

interventions (e.g., manageable workloads, supportive leadership) can create a more sustainable

and satisfying work culture.4 Preventing Long-Term Impacts: Early interventions can mitigate

the progression of burnout, reducing the likelihood of more severe psychological conditions and

job abandonment.5 Fostering Professional Development: Addressing burnout ensures oncology

medical officers remain engaged, motivated, and able to contribute their expertise effectively

over the long term.Potential Interventions 1 Individual-Level Interventions: Mindfulness-based

stress reduction (MBSR), cognitive-behavioral therapy (CBT), and self-care strategies. 2

Training in emotional regulation and communication skills. 3 Encouraging regular physical

activity and work-life balance. 2 Organizational-Level Interventions: Adjusting workloads and

staffing ratios. Providing access to mental health resources and peer support groups. Establishing

a culture of appreciation and recognition. Ensuring regular debriefings to process emotional

challenges. 3 Policy-Level Interventions: Implementing work-hour regulations to prevent

overwork. Creating policies that support continuous professional development and mental health

care access.Burnout in oncology medical officers is a multifaceted issue that demands a

comprehensive approach to safeguard both their well-being and the quality of oncology care.

METHODS

This study underscores the significant burnout levels among medical professionals, and impact

of interventions on burnout levels particularly within oncology with three objectives 1 To find

out the levels of the burnout among medical officers and paramedical staff of multispecialty

hospitals 2 To find out the level of burnout in medical officers and paramedical staff working in

oncology department 3 To find out impact of intervention on the burnout levels medical officers

and paramedical staff working in oncology department.The present study was conducted with

non probability sampling on 588 participants were screened from different hospitals of

hisar(Haryana) where 158 medical officers aged between 25-40 years, and400 were nursing staff

aged 22-46 years of age working on rotational shifts in the multispecialtyhospital, the sample is

then filtered on the base of oncology department where the intervention was implemented with

sample of N1 -=42 ( medical officers) and N2 = 104 nursing staff,Survey method was used to

screen the burnout by using Burnout survey

Conduction: This study is conducted in three phases Phase 1 : we used focus groups and

questionnaires to gather data retrospectively and analyze the baseline level of burnout. Phase 2 :

After the analysis we started the prospective study: we hypothesized to reduce burnout in

medical officers and nurses of oncology department of the hospital through tailored

interventions. Phase 3 :3 months after the end of the intervention, a second survey was
performed among the participants using the same questionnaires on the participants from

oncology ipd only From march 2024 to may 2024 a preliminary survey on Burnout status was

conducted among Healthcare professionals (medical doctors and nurses)in all Department of

three multispecialty Hospital of hisarand then separated the data of oncology department of

these hospitals, the medical doctors and nurses who were totally clinically involved with cancer

patients. They had to complete the Burnout survey(supplementary sheet-4) (Adapted by Michelle

Post, MA, LMFT from Public Welfare, Vol. 39, No. 1, 1981, American Public Welfare

Association.: it is a 28-item self-completed questionnaire based on three subscales The

participant had reply to each question on the basis of a Likert scale measuring the frequency of

events over time (from 0: never to 5: always). These subscales are divided into “dangerous”,

“high”, “moderate” or “low”, according to cut off scores based on normative data

(Supplementary Table S1). Score is considered high if it is in the upper third of the normative

distribution, from range of 51 and above, and average if it is 50 or below 50, low if it is below

the score of 28, higher scores describe more critical situation.After the first burnout survey(table

Three types of interventions are provided to the participants who score moderate to high in

burnout from may 2024 to august 2024 twice weekly individual and group sessions were

provided, after each session the worksheets were given for more insight about the individual

issues, Worksheets were tailored according to theneed of participants mental conditions the three

types of interventions were1 Individual Counseling, 2 Group Workshops on 3 Emotional

Management, Self help worksheets etc. The participants who were called for intervention

facilitated with biweekly meetings in which they shared their all types of psychological and

emotional issues in detail the further group sessions were planned according to the need of the
participantsThe second survey was conducted in September 2024 to evaluate the impact of

interventions on the burnout levels, the 10 percent reduction in burnout levels is considered with

a p value≤ 0.05, the only consideration is burnout levels independent of sociodemographic

representation , age n gender of the participants the data is then analyzed on SPSS 23.

Results : Total 558 medical and nursing staff were screened for burnout levels, out of which

158(28.3%)were medical officers and rest 400(71.6%) were nursing staff, out of which 42

medical officers and 104 nursing staff were dedicated to cancer wards and exclusively posted in

indoor patient department on rotational shifts, the result of first survey shows alarming burnout

levels,64 ( 40.5%) medical officers and 214 ( 53.5%)nursing staff screened positive for burnout

levels with mean score of 45.01±14.53 in doctors and the mean score of 56.33±17.76 in

paramedical staff, the data analyses of medical officers and nursing staff of oncology department

shows that 24/42 ( 57.1%) MO,and 69/104 (66.3%)nursing staff is having moderate to severe

burnout levels, with mean score of score of burnout of medical officers of oncology department

is 58.21±6.95. The mean score of burnout of nursing staff of oncology department is 71.±11.94

All 24 Medical Officers and 69 Nursing Staff will be provided with individual as well as group

interventions for 3 months, all MO completed the interventions but 24 nursing participants were

not able to complete the intervention due to their different personnel or professional reasons the

individual intervention includes eclectic counseling approach with CBT the group sessions were

provided for relaxation therapies, like mindful meditation,JPMR,2-4-8 breathing exercise. The

second survey with same questionnaire was applied to the participants who undergone

interventions, all24 medical officers completed intervention of three months from june 2024 to

august 2024 but due to rotational shifts and other job schedule /responsibilities the nursing staff

was not regular in taking therapy and group sessions, after second survey mean score of burnout
for medical officers was 40.1 ± 6.94 and they reported 51% reduction in scores, but nursing staff

shows only 34 % reduction in the burnout scores with mean of 56.1 ± 16.94.the participants

confirmed that they didn’t undergo any other treatment apart from the interventions provided to

them.

Table 1 distribution of results before and after intervention

mean score mean score

dept
subjects no % no mean score before before
oncology
intervention intervention
doctors 158 28% 45.01±14.53 42(26%) 58.21±6.95 40.1 ± 6.94

nurses 400 72% 56.33±17.76 104(26%) 71.±11.94 56.1 ± 16.94

DISCUSSION:

Burnout is increasingly common among medical professionals: Healthcare workers face a high

risk of burnout due to the demands of their roles. Our research investigates burnout levels among

oncology healthcare professionals, examining whether a three-month program effectively

reduces and prevents burnout. This study thoroughly analyzes burnout rates among medical

professionals, specifically within the oncology department of multispecialty hospitals, and

assesses the success of focused interventions. The analysis reveals several key points: The study

utilized a multi-faceted intervention approach customized to individual needs, which included:

Individual counseling (using an eclectic approach with cognitive-behavioral therapy), group

sessions concentrating on emotional regulation and stress reduction techniques such as

mindfulness meditation, Jacobson Progressive Muscle Relaxation (JPMR), and breathing

exercises, along with self-help worksheets aimed at reinforcing learning and fostering self-

awareness. Despite thorough planning, not all participants were able to fully engage in the
interventions due to work-related limitations, particularly among nursing staff, which impacted

their overall results. Medical officers experienced a notable 51% decrease in burnout scores, with

their average scores dropping from 58.21 ± 6.95 to 40.1 ± 6.94. This positive outcome may be

attributed to better adherence to the interventions, increased access to resources, or adjunctive

medication assistance. Nursing staff, while still seeing a significant reduction (34%),

demonstrated less improvement, with burnout scores falling from 71 ± 11.94 to 56.1 ± 16.94.

Irregular attendance due to shift rotations and heavy workloads likely played a role in the lesser

effect. The results highlight the crucial need for consistent attendance and institutional backing

for burnout interventions. For nurses, adopting flexible scheduling or workplace-based programs

could enhance outcomes. For medical officers, merging counseling with medication seems to be

an effective approach. Hisar (Haryana) serves as a useful reference for future research and

clinical applications.

CONCLUSION: Burnout among health care providers is a common issue. Due to the nature of

their profession, doctors are particularly vulnerable to experiencing burnout. Besides leading to

worse health outcomes, physician burnout can contribute to decrease patient care, increased

medical errors, and challenges with staff retention. Preventing burnout may involve creating a

supportive work environment that promotes work-life balance, job security, and family-friendly

policies, as well as enhancing individual resilience and work engagement among doctors and

nurses. Future investigations could look into technology-assisted interventions or policy changes

to improve access to and compliance with these programs. This study demonstrates that targeted,

structured interventions can significantly mitigate burnout in healthcare professionals, especially

when tailored to the needs of specific groups. However, logistical and systemic barriers need to

be addressed to maximize the impact, particularly among nursing staff. Conflicts of Interest: The
author declares no conflict of interest Limitations: The present study is conducted in a small

sample that lacks the generalization of the result of the present study. The data is collected from

a homogeneous group, that is only from hisar( Haryana) Suggestions :Further, study can be

suggested in a heterogeneous population using a large sample from different regions of India.

And Other variables related to depression, anxiety and stress of doctors and paramedical

professional.
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RESULTS (SUPPLIMENTSHEET-1)

Distribution of all participants (demographic data) Medical officers and Paramedical staff

Subjects Male Female 20-30 30- 40-50 Urban Rural

years 40 years
years
MBBS 34 24 35 21 2 30 28
BAMS 40 32 28 40 4 32 40
SR 11 11 8 3
PG 12 2 12 7 5
MD 3 3 3
100 58 63 87 6 80 76
PARAMEDICAL Male Female 20-30 30-40 40-50 Urban Rural
years years years
BSC 40 140 90 90 60 120
GNM 52 126 100 72 6 42 137
ANM 42 28 14 42
92 308 218 176 6 102 279
 (Supplement Sheet-2)
Distribution Of Medical Officers and Paramedical Staff Of Oncology Department With
BurnoutScore after 1st Survey
MEDICAL OFFICERS
Subjects Male Female Score Score % Score Score Score Score % Score Score Score Score
28 – 38-50 % 50-70 71-90 % above %
38 90
MBBS 18 8 6 23.08% 2 7.69% 9 34.62% 6 23.08% 3 11.54%
BAMS 6 4 4 40.00% 2 20.00% 1 10.00% 1 10.00% 2 20.00%
SR 2 1 50.00% 0.00% 0.00% 1 50.00% 0.00%
PG 2 1 50.00% 0.00% 0.00% 1 50.00% 0.00%
MD 2 2 100.00% 0.00% 0.00% 0.00% 0.00%
TOTAL 30 12 14 4 10 9 5
PARAMEDICAL
Subjects Male Female Score Score % Score Score Score Score % Score Score Score Score
28 – 38-50 % 50-70 71-90 % above %
38 90
BSC 20 48 16 23.53% 4 5.88% 28 41.18% 14 20.59% 6 8.82%
GNM 8 22 9 30.00% 6 20.00% 6 20.00% 7 23.33% 2 6.67%
ANM 6 0.00% 0.00% 6 100.00% 0.00% 0.00%
28 76 25 10 40 21 8

(Supplement Sheet-3)Distribution Of Medical Officers And Paramedical Staff Of Oncology

Department With Burnout Score after 2nd Survey

MEDICAL OFFICERS
Subjects Male Female Scor Score % Scor Score % Scor Score Scor Score Score Score
e e e % e % above %
28 – 38- 50- 71- 90
38 50 70 90
MBBS 18 8 19.23 0.00
12 46.15% 9 34.62% 5 % 0.00% %
BAMS 6 4 0.00
6 60.00% 4 40.00% 0.00% 0.00% %
SR 2 0.00
1 50.00% 1 50.00% 0.00% 0.00% %
PG 2 0.00
1 50.00% 1 50.00% 0.00% 0.00% %
MD 2 100.00 0.00
2 % 0.00% 0.00% 0.00% %
TOTAL 30 12 0.00
22 61.23% 15 34.92% 5 3.85% 0.00% %
PARAMEDICAL
Subjects Male Female Scor Score % Scor Score % Scor Score Scor Score Score Score
e e e % e % above %
28 – 38- 50- 71- 90
 38 50 70 90
BSC 14 33 38.30 17.02 6.38
10 21.28% 8 17.02% 18 % 8 % 3 %
GNM 6 16 27.27 0.00
8 36.36% 6 27.27% 6 % 2 9.09% %
ANM 6 100.00 0.00
0.00% 6 % 0.00% 0.00% %
20 55 21.86 2.13
18 19.21% 20 48.10% 24 % 10 8.70% 3 %