Grief Among Oncology Providers: Prevalence and Association with Burnout

International research shows that oncology providers frequently experience grief and that grief is linked to burnout. Evidence on the prevalence of grief and its link to burnout is limited, especially in the United States (US). We investigated the prevalence of grief and its association with burnout at our institution. We surveyed 238 oncology providers in the Duke Cancer Institute and Duke Cancer Network. Our survey included demographic information, questions about burnout, and an adaptation of the Traumatic Grief Inventory Self Report (TGI-SR). We received 128 responses, including 27% attending physicians, 12% fellows, and 62% advanced practice providers. Seventy-eight percent of providers were from the academic setting. Of 123 participants who completed the TGI-SR, 115 (93%) reported at least one grief symptom. Approximately half of the participants endorsed burnout. An average of 31% of their burnout was attributed to grief. Grief scores were higher among women, those endorsing burnout, and those endorsing more frequently feeling emotionally exhausted by work. Using linear regression, we found that higher grief scores were associated with an increased risk of burnout. For each one-point increase in the grief score, the odds of endorsing burnout increased by 15% (95% CI 7-22.6%). Professional grief is nearly universal among oncology providers, with 93% answering at least "sometimes" to one of the grief symptom questions on the TGI-SR. Moreover, grief was an important predictor of burnout, marking the first time this association has been demonstrated in the US.