Alexithymia, empathy and burn-out amongst medical physicists: the PRO BONO survey

Purpose or Objective Burn-out syndrome (BOS) is frequently observed amongst oncology professional staff. It may impact work performance as well as physical and mental well-being. Personality influences the likelihood to experience BOS. Alexithymia is a psychological construct involving disfunctional emotion processing and awareness. Empathy is the capacity to intercept and understand another’s ‘state of mind’ or emotion. The PROject on Burn-Out in RadiatioN Oncology (PRO BONO study) was developed to explore BOS amongst oncology professionals and to investigate the correlation between alexithymia and empathy, and the probability to develop BOS. Material and Methods An anonymous online survey was distributed to European Society for Radiotherapy and Oncology (ESTRO) members. Each participant was requested to complete 3 validated questionnaires to evaluate alexithymia, empathy and BOS: the Toronto Alexithymia Scale (TAS-20), the Interpersonal Reactivity Index (IRI) and the Professional Quality of Life Scale (ProQoL), respectively. The present analysis focuses on the population of medical physicists (MPs). Compassion satisfaction (CS), a measure of satisfaction at work, secondary traumatic stress (STS) and BOS (the 3 ProQoL subscales) were evaluated and correlation with alexithymia and empathy (empathic concern, perspective taking and personal distress) was investigated with generalized linear modelling. Covariates found to be significant on univariate linear regression analysis were included in the multivariate linear regression model. R2 and adjusted R2 were used to assess model fit. Results A total of 308 MPs, 49.7% female and 50.3% male, completed all requested questionnaires. Mean age was 39.9 years (SD:9.6). Point prevalence of alexithymic trait in this cohort was 13.6%, while borderline alexithymia was observed in 20.8%. With respect to professional quality of life, high levels of STS and BOS were observed with 23.1% and 30.2% of respondents, respectively. Interestingly, only 13.6% of MPs scored high in the CS domain of ProQoL. A higher level of alexithymia (β:0.255;SE:0.025;p<0.001), a lower score in the domain ‘perspective taking’ within IRI (β:-0.901;SE:0.370;p=0.015) and not ‘feeling valued by supervisors’ (β:-3.724;SE:0.582; p<0.001) were found to correlate with higher scores in BOS. A lower level of alexithymia (β:-0.127;SE:0.028;p<0.001), higher scores in the domains ‘empathic concern’ (β:1.414;SE:0.470;p=0.003) and ‘perspective taking’ (β:1.414;SE:0.470;p=0.003) within IRI (β:1.025;SE:0.459;p=0.026) and ‘feeling valued by supervisors’ (β:2.844;SE:0.656; p<0.001) were found to be correlated to higher levels in CS. Conclusion The PRO BONO study provided an overview of BOS, alexithymia and empathy among MPs involved in the field of radiation oncology. Alexithymic personality trait increased the likelihood to develop BOS, with less professional satisfaction. This finding can be potentially used to implement screening programs to address this issue with preventive measures.