Wellness and Distress in Health Care Professionals Dealing With End of Life and Bioethical Issues (WeDistressHELL)

Burnout, fatigue, distress and negative issues are well known in health care providers with different percentages.

This issue is internationally considered relevant; physicians have 36% more probability of developing burnout with respect to the American high school graduated population and, in general, medical students, residents/fellows, and early career physicians are more likely to suffer from burnout compared to the general population. Moreover, between 2011 and 2014, the trend of job satisfaction and burnout was getting worse in these worker categories. This condition has to be seriously taken in consideration; indeed, chronic distress and burnout in health care providers affect both the quality of patient care and satisfaction, as well as the employee professional quality of life and psychological and physical wellbeing.

Risk factors are various and the most relevant include work features, interpersonal relationships and personal factors. However, only recently literature has focused on positive and protective factors which modulate too the relationship between the health care professional and her/his job. To date, little is known about the experience of burnout, fatigue and distress related with end of life and bioethical issues in everyday working life.

What emerges from qualitative studies is that a relevant source of distress is linked to the physicians and nurses' necessity to take bioethical decisions against their personal values, and another source of distress arises from balancing family, institutional and moral constraints.

According to quantitative researches, the exposure to death and dying results in distress, fatigue and impoverishment of professional quality of life. Moreover, a review reports that critical care nurses experience their most stressful job situation when they have to manage with the unnecessary prolongation of life of their patients on the bases of family's desire. Indeed, a risk factor to burnout seems to be the ethical decision-making regarding end of life and foregoing life-sustaining therapy. Another qualitative and quantitative review shows that health care practitioners' end-of-life decision making may contribute to the distress and burnout experience.