Study Suggests Some VA Polytrauma Team Members Caring for Veterans with Traumatic Brain Injury at Risk for Job Burnout

BACKGROUND:
Since 2000, more than 230,000 military service members have been diagnosed with traumatic brain injury (TBI). Traumatic brain injuries can range in severity from 'mild' to 'moderate' to 'severe,' and can result in permanent physical deficits, as well as cognitive problems and concomitant mental health conditions. For many persons, TBI-related impairments, deficits, and conditions create a need for lifelong medical care and/or caregiving. The VA Polytrauma System of Care is comprised of different component sites (i.e., Polytrauma Rehabilitation Centers, Polytrauma Support Clinic Teams) located throughout the U.S. that are responsible for diagnosing and treating the majority of service members experiencing TBI. This national, cross-sectional study sought to examine the extent of job burnout among VA polytrauma team members engaged in the diagnosis and treatment of traumatic brain injury — and to identify their coping strategies for dealing with job-related stress. Burnout is a psychological syndrome comprised of three dimensions: emotional exhaustion, a depersonalization of patient interactions, and a lessened sense of personal accomplishment at work. Investigators collected data via an online survey of 233 polytrauma care team members who were focused on coordination of care for TBI within the VA healthcare system. In addition to demographics and measures of burnout, investigators assessed coping strategies for work stress.

FINDINGS:

• VA polytrauma team members experienced moderate levels of emotional exhaustion, low levels of depersonalization, and high levels of personal accomplishment. However, 24% of participants in this study reported high levels of emotional exhaustion, which may be a precursor to job burnout.
• Polytrauma team members who reported caring for Veterans with TBI >50% of their time experienced higher levels of emotional exhaustion than those who spent <50% of their time caring for Veterans with TBI.
• Coping strategies included: connecting with others (e.g., relating to family, friends, and coworkers); promoting a healthy lifestyle (e.g., healthy diet, exercise); pursuing outside interests (e.g., hobbies); managing the work environment (e.g., staying organized); and maintaining positive thinking.
• No significant differences in participant characteristics for any of the subscales that were measured (emotional exhaustion, depersonalization, and personal accomplishment) were found for age category, race, years in practice, years at VA, primary role, or percent of time providing direct care.

LIMITATIONS:

• This study was descriptive in design and had a relatively small sample size.

AUTHOR/FUNDING INFORMATION:
This study was funded by VA/HSR&D's Quality Enhancement Research Initiative (QUERI; SDR 08-409). Dr. Hogan is part of eHealth-QUERI. Drs. Saban, Evans, Bauer, Pape, and Smith are part of HSR&D's Center for Management of Complex Chronic Care, Hines, IL.

Saban KL, Hogan TP, DeFrino D, Evans CT, Bauer E, Pape TL, Steiner M, Proescher E, Vlasses FR, and Smith BM. Burnout and Coping Strategies of Polytrauma Team Members Caring for Veterans with Traumatic Brain Injury. Brain Injury March 2013;27(3):301-309.