The influence of trauma and patient characteristics on provider burnout in VA post-traumatic stress disorder specialty programmes

Hector A Garcia; Cindy A McGeary; Erin P Finley; Donald D McGeary; Norma S Ketchum; Alan L Peterson

doi:10.1111/papt.12057

The influence of trauma and patient characteristics on provider burnout in VA post-traumatic stress disorder specialty programmes

Psychol Psychother. 2016 Mar;89(1):66-81. doi: 10.1111/papt.12057. Epub 2015 Jan 21.

Authors

Hector A Garcia^{1

2}, Cindy A McGeary², Erin P Finley^{1

3}, Donald D McGeary², Norma S Ketchum⁴, Alan L Peterson²

Affiliations

¹ South Texas Veterans Health Care System, The University of Texas Health Science Center at San Antonio, Texas, USA.
² Department of Psychiatry, The University of Texas Health Science Center at San Antonio, Texas, USA.
³ Department of Medicine, The University of Texas Health Science Center at San Antonio, Texas, USA.
⁴ Department of Epidemiology and Biostatistics, The University of Texas Health Science Center at San Antonio, Texas, USA.

PMID: 25643839
DOI: 10.1111/papt.12057

Abstract

Objective: Prolonged exposure (PE) and cognitive processing therapy (CPT) - post-traumatic stress disorder (PTSD) treatments now available at the Veterans Health Administration (VHA) - expose the provider to graphic traumatic material. Little is known about the impact of traumatic material on VHA providers. The purpose of this study was to examine the relationship between trauma content, patient characteristics, and burnout among VHA PTSD Clinical Team (PCT) providers. It was hypothesized that trauma content and patient characteristics would significantly predict burnout in this population.

Design: This cross-sectional study consisted of 137 participants. The sample was mostly female (67%), Caucasian (non-Hispanic; 81%), and married (70%) with a mean age of 44.3 years (SD = 11.3).

Methods: Participants completed an electronic survey that assessed demographics, patient characteristics (i.e., anger, personality disorder, malingering), trauma content characteristics (e.g., killing of women and children) as well as burnout as measured by the Maslach Burnout Inventory-General Survey (MBI-GS; Maslach et al., 1996, Burnout inventory manual. Palo Alto: Consulting Psychologist Press).

Results: Over half of the study population reported being bothered by trauma content; however, trauma content did not predict burnout. Treating patients with personality disorders and suspected malingering predicted burnout in PCT providers. High numbers (77%) reported perceiving that emotional exhaustion impacted the quality of care they provided.

Conclusion: These findings suggest an important role of burnout assessment, prevention, and treatment strategies at the VHA.

Practitioner points: This paper addresses the impact of provider burnout on perceived quality of care. This paper also addresses potential predictors of burnout in PCT settings. This paper outlines potential remedies to provider burnout in the VHA.

Keywords: Veterans Health Administration; burnout; malingering; personality disorders; post-traumatic stress disorder.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Burnout, Professional / epidemiology
Burnout, Professional / etiology*
Cognitive Behavioral Therapy
Cross-Sectional Studies
Female
Humans
Implosive Therapy
Male
Psychiatric Status Rating Scales
Quality of Health Care
Risk Factors
Stress Disorders, Post-Traumatic / psychology
Stress Disorders, Post-Traumatic / therapy*
United States
United States Department of Veterans Affairs / statistics & numerical data