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

BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.