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Medicine and particularly palliative care are considered to be stressful professions, with risks of psychological morbidity and burnout. There is little published work quantitatively documenting their prevalence among medical... more
Medicine and particularly palliative care are considered to be stressful professions, with risks of psychological morbidity and burnout. There is little published work quantitatively documenting their prevalence among medical practitioners practising in palliative care. Three questionnaires, including the General Health Questionnaire (GHQ-12) and the Maslach Burnout Inventory, were sent to palliative care practitioners in Western Australia. Forty-one of 43 (95%) practitioners completed the questionnaires. The mean score on the GHQ-12 was 1.9 (range 0-8), with 11 (27%) scoring 4 or more. On the Maslach Burnout Inventory, mean scores on the emotional exhaustion (EE, mean 17.5, range 1-47) and depersonalization subscales (DP, 4.5, 0-24) fell within the low range, with scores for personal accomplishment (39, 32-46) falling within the average range. Ten respondents (24%) scored high on either the EE subscale or the DP subscale, meeting criteria for burnout. GHQ-12 scores were associated with hours of work per week in palliative care (P = 0.004). The EE (P = 0.024) and DP (P = 0.006) components of burnout were associated with years of work in palliative care. Specialist practitioners were more likely to score in the high category for GHQ-12 (odds ratio = 4.8, P = 0.036) and EE (odds ratio = 8.33, P = 0.031). GHQ (P = 0.038) and DP (P = 0.006) scores were higher in those working in tertiary institutions, with tertiary practitioners more likely to be in the high EE category (odds ratio = 7.5, P = 0.034). Levels of psychiatric morbidity and burnout in palliative medicine are not higher than in other specialties.
Research Interests:
Research Interests:
Governments and the medical profession are concerned that there continues to be less than optimal health outcomes despite escalating expenditure on health services from the effect of the ageing population with chronic illnesses. In this... more
Governments and the medical profession are concerned that there continues to be less than optimal health outcomes despite escalating expenditure on health services from the effect of the ageing population with chronic illnesses. In this context, doctors will need to have knowledge and skills in effective chronic condition management (CCM) and chronic condition self-management (CCSM). A national workshop of representatives of eight medical schools from the CCSM special interest group (SIG) of the Australian and New Zealand Association on Medical Education met in September 2004, to consider curriculum content in CCM and CCSM. The workshop recommended that the Committee of Deans of Australian Medical Schools and the Commonwealth Department of Health and Ageing consider the identification and possible development of a specific curriculum for CCM and CCSM within the curricula of Australian Medical Schools. Consideration needs to be given to the changing nature of medical practice and that as part of this; doctors of the future will need skills in team participation, continuity of care, self-management support and patient-centered collaborative care planning. Doctors will also need skills to assist patients to better adhere to medical management, lifestyle behaviour change and risk factor reduction, if optimal health outcomes are to be achieved and costs are to be contained.
Research Interests: Medical Education, Australia, Self Care, Chronic illness, Chronic, and 17 moreMedical Students, Humans, Needs Assessment, Program Development, Health Services, Chronic Disease, Undergraduate medical education, New Zealand, Continuity of Care, Risk factors, Clinical Sciences, Public health systems and services research, Risk Factors, Clinical Competence, Competency Based Education, Special Interest Group, and Health Outcome
Anaesthesiologists will be asked to provide pain management for cancer patients in the absence of more specialised services, when interventional techniques are indicated and in the postoperative period. In all these settings, the... more
Anaesthesiologists will be asked to provide pain management for cancer patients in the absence of more specialised services, when interventional techniques are indicated and in the postoperative period. In all these settings, the complexity of cancer pain and its psychosocial connotations need to be considered to provide appropriate and holistic care. Principles of systemic pain management, effective in most patients, continue to follow established guidelines; identification of neuropathic pain and its appropriate treatment is important here. Interventional pain relief is required in a minority of cancer patients, but it should be considered when appropriate and then done with best available expertise. Neurolytic procedures have lost importance here over the years. Postoperative pain management should be multimodal with consideration of regional techniques when applicable. In managing postoperative pain in cancer patients, opioid tolerance needs to be addressed to avoid withdrawal and poor analgesia. Preventive techniques aiming to reduce chronic postoperative pain should be considered.