Professional Grief, Burnout and Coping among Neuro-Oncologists: A Cross-Sectional Online Study (PROGRESS)

Physicians treating patients with malignant central nervous system tumors frequently experience patient deaths, yet the impact of professional grief on burnout has not been examined in neuro-oncology. This study investigated whether acute grief responses following patient deaths (Short-term Bereavement Reactions, SBR) and long-term changes resulting from cumulative loss exposure (Accumulated Global Changes, AGC) are associated with emotional exhaustion (EE) among neuro-oncologists in Germany, and whether resilience moderates these relationships.

This cross-sectional study included n = 131 physicians working in neuro-oncology in Germany. Validated instruments assessed professional grief, burnout, resilience, self-compassion, psychological distress, and neuroticism. Hierarchical regression tested associations and moderation hypotheses. Cluster analysis identified stress-vulnerability-capacity profiles.

The sample comprised physicians across five neuro-oncological specialties (mean age 45.5, 48.1% female). SBR were significantly associated with higher EE after controlling for self-compassion, neuroticism, and psychological distress (B = 0.46, 95% CI: 0.27, 0.64, P < 0.001), whereas AGC was not (B = 0.04, P = 0.602). Resilience did not moderate these associations. Self-compassion was independently associated with lower EE (B = -0.33, P = 0.012). Cluster analyses identified three distinct stress-vulnerability profiles: Low-Risk (51.1%), Moderate (35.1%), and High-Risk (13.7%). EE differed substantially across profiles (η² = 0.34), with 72.2% of the High-Risk group exceeding clinical EE thresholds. 40.5% of participants desired supervision that was unavailable.

SBR, but not AGC, were associated with EE among neuro-oncologists. The High-Risk profile may represent a clinically relevant target for screening. Self-compassion and access to supervision warrant further investigation as potential intervention targets.