STRESS PERCEPTION, PROFESSIONAL PERFORMANCE AND BURNOUT: A MULTICENTRE STUDY^©

The medical profession is recognized widely as highly stressful, with its training period being identified as one of the most difficult times in the career. This highly stressful physical and emotional environment is compounded by a lack of healthy coping skills and a sub-optimal peer support system, activating specific copying mechanisms that influence behavior and performance. When perceived demands exceed one’s coping capabilities it leads to mental and physical exhaustion and subsequently burnout. Burnout is a syndrome characterized by losing enthusiasm for work (emotional exhaustion), distant attitude towards work (generalized cynicism), treating self and people as they were objects (de-personalization), and having a sense that work is no longer meaningful (low personal accomplishment). Studies have reported up to 60% providers have experienced symptoms of burnout during their professional career. Studies done on medical residents have shown they may have a higher risk of this stress coping dysfunction. Burnout has been associated with impaired performance, increased errors, sub-optimal patient care and poor mental and physical health. Studies evaluating behavioral programs to reduce burnout before it results in impairment are rare. Studies have found hypothalamic-pituitary-adrenal (HPA) axis dysregulation on patients with chronic stress and burnout. These studies suggest that cortisol and oxytocin have a fundamental role on regulating coping mechanism and maintaining behavioral homeostasis. Studies also suggest salivary cortisol and oxytocin as useful tools to assess effects of mind-body interventions on health outcomes in population under high levels of stress. Mind-body and behavioral interventions reported in the literature have mostly evaluated cognitive-behavioral training (CBT) and/or mental and physical relaxation and data on these programs are scarce. Innovative strategies are needed to assist health care providers in the management and prevention of stress and burnout, especially during transition times and early stages of their career. Love2Care Behavioral training program integrates the latest evidence based lifestyle intervention and health coaching strategies and Deutsch’s innovative unconditional self-love behavioral training approach and pioneering concept of love as nourishment to acknowledge and attend to the inner resistance that many in healthcare have to self-care behavior. By training health care providers how to overcome this resistance we are adding a vital dimension missing in mainstream stress management programs. Love2Care’s main goal is to ensure that what is learned becomes a permanent lifestyle change. The study is designed as a prospective, non-randomized pre–post intervention study. Qualitative and quantitative outcomes to be measured include different stress perception, burnout, lifestyle, patient care and self-compassion validated questionnaires, salivary cortisol and oxytocin test, anthropometrics measurements (weight and height) and body composition by bioelectrical impedance analysis. The results of this study should contribute to improving health care provider’s stress perception and management, optimizing professional performance and well-being, and improving patient care and satisfaction, ideally creating a ripple effect that transforms current healthcare/hospital culture.