December 7, 2021 – Efforts to combat burnout in healthcare professionals may be extended to patients with chronic conditions – who may show some of the same signs, as prolonged stress, hopelessness or a sense of loss of control.
Identifying these patients and acknowledging their increased risk of burnout could improve physician-patient relationships as well as increase the likelihood that patients will follow treatment guidelines and improve outcomes, according to Dr. Adrienne Martinez-Hollingsworth and colleagues.
Investigators have created a “Combustion Dyad Model”. This strategy considers both sides of the health-patient relationship, independently and together. It also moves combustion out of the workplace.
“The unique part of the model is that traditional burnout is only described as an employment-based illness; it must be related to your occupation,” says Martinez-Hollingsworth, professor and dean of the Samuel School of Nursing at Merritt University in Oakland, Oakland, California.
“But if you look at what patients with chronic diseases are going through, there are a lot of features that overlap, [including] the idea that there is some kind of long-term exhaustion, ”she says.
The study was published this month in a special issue of the magazine Journal of Continuing Education in Health Professions.
Other burnout experts welcome patient involvement.
Dr. Martinez-Hollingsworth and co-workers open an important new ground in the development of the Burnout Dyad Model concept, which reshapes the burnout conversation to recognize the comprehensiveness of patient burnout and how it can affect clinical attitudes, quality of care, and numerous outcomes. patient, ”says Michael J. Brenner, MD.
Screening could help
“It’s an interesting idea to consider examining patients with chronic conditions to see if they have a burning sensation in treating their disease,” says Mark Thomas Hughes, MD, an assistant professor of medicine at Johns Hopkins Medicine in Baltimore.
“If the antidote to burnout is more attention to resilience and well-being, and chronic illness directly affects one’s sense of well-being, then it makes sense that screening patients for burnout is a way to help them cope with chronic illness,” he says.
“There is no doubt that chronic conditions affect patients, healthcare professionals and carers,” says Brenner, an associate professor at the University of Michigan School of Medicine in Ann Arbor.
Understanding the frequency and extent of burnout in people with chronic conditions could help improve management and outcomes in this population, says Brenner, who published guidance online Nov. 22 on how leaders can prevent burnout and instill resilience among health professionals.
Combustion among health professionals is well studied and ubiquitous. For example, 42% of doctors reported to have been burned in “Death by 1000 Cuts”: Medscape National Physician Burnout & Suicide Report 2021
It is less well known how often it occurs and how difficult it is among patients.
To find out more, researchers asked a diverse group of 25 health professionals, patients and carers about burnout patients during the Medicine X Conference at Stanford University. Interestingly, the group included service providers who identified themselves as chronically ill.
Hughes supports this approach.
Ovo This is a thought-provoking study based on the experience of collaboration between service providers and patients… [that] adds an interesting dimension to our understanding of patient-centered chronic disease management. “
The strategy can also help patients get more involved.
“Seeing the patient as a team member in their own care opens up the burnout dimension in their role of caregiver for themselves,” says Hughes, whose latest publication on burnout is a Nov. 16 report on how The COVID-19 pandemic contributed burning health workers.
Diabetes is a prime example
The idea for the Burnout Dyad model came from Martinez-Hollingsworth who was trying to understand the disruption in communication between a patient and a service provider during diabetes treatment.
People with diabetes are at risk of burnout, especially when it comes to lifestyle or treatment guidelines.
“It’s an everyday thing that affects every decision you make during the day: how much training you get, how much you sleep, whether you eat and how much you eat, ”she says.
“Pretending to be less tedious than treating diabetes, which is also exhausting for service providers, seems to me like a very simplistic view.”
Social explanations of combustion
When assessing burnout, the use of social factors that determine patients ’health is also important, Martinez-Hollingsworth says. People from traditionally displaced communities may be at higher risk of burnout because they may lack the resources to help other patients afford medicines to manage their chronic health conditions.
“Let’s hope that shared understanding and an open communication space will improve trust, which is one of the biggest challenges,” she says.
Some health professionals have traditionally considered disrespect a moral flaw, Martinez-Hollingsworth says.
“But we don’t recognize all the many steps that have led to being in that position. It’s important to recognize some patients who are present with a history of lost trust … or inequalities that a person has carried throughout their life.”
“But all we see is that he’s late for every appointment,” Martinez-Hollingsworth says.
One potential solution is to hire more health professionals from the same communities.
“If you get a patient from this background that you have to manage, but you are also a provider from this background,” it can improve your understanding of patient disease management and burnout challenges.