2025 Proffered Presentations
S116: EXPLORING PROFESSIONAL QUALITY OF LIFE, SELF-COMPASSION AND WELLNESS IN SKULL BASE SURGEONS
Janissardhar Skulsampaopol, MD1; Sylvia Shitsama, MD2; Michael D Cusimano, MD, MHPE, FRCSC, DABNS, PhD, FACS, FAANS1; 1St Michael's Hospital, University of Toronto; 2Jomo Kenyatta University of Agriculture and Technology
Introduction: Skull base surgery (SBS) is a highly rewarding but at times stressful subspecialty given the complexity of patients and current work environments that can contribute to stress, anxiety and reduced professional quality of life for surgeons. Measures of Professional quality of life include compassion satisfaction, compassion fatigue and burnout. Despite the importance of these issues, there are currently no studies that focus primarily on the elements of professional quality of life and other components of wellness among skull base surgeons (SBS).
Objectives: To assess the levels of compassion satisfaction, self-compassion, self-esteem, compassion fatigue and burnout among (SBS) and compare these with non-skull base surgeons (non-SBS).
Method: An international electronic survey, developed using a physician wellness framework, was distributed to neurosurgeons. Only those who responded to the question regarding their subspecialty were included in the analysis.
Results: Out of a total of 250 responses, 47 were skull base surgeons (SBS) and 203 were non-skull base surgeons (non-SBS). More SBS were male (OR 2.60, 95%CI 1.02-7.89, p=0.03) and practiced in academic centers (OR 5.22, 95%CI 2.25-13.51, p<0.001) compared to non-SBS. There was no significant difference between SBS and non-SBS in terms of age, relationship status, work experience and region of practice. Both SBS and non-SBS had high compassion satisfaction (66% vs 72.3%, p=0.39), normal self-esteem (95.7% vs 94.1%, p=0.65), and similar rates of burnout (34% vs 32.7%, p=0.86). There was no significant difference in levels of self-compassion between the two groups. However, SBS HAD higher levels of compassion fatigue compared to non-SBS (p=0.004).
SBS are more likely to experience high levels of anxiety, stress, and depression due to reaction/responses from the physician colleagues they work with compared to non-SBS (34.8% vs. 21.4%, OR 1.96, 95%CI 0.91-4.11, p=0.055). Other sources of high levels of anxiety, stress, and depression reported by skull base surgeons (SBS) is from the reactions/responses from the patients they try to help (31.1%), people outside of work (20%), and non-medical colleagues, such as nurses and administrators (17.8%).
Conclusion: Although SBS have high levels of compassion satisfaction, self-compassion and self-esteem which are protective factors against burnout, SBS experience higher levels of compassion fatigue compared to their non-SBS counterparts. Surgical/medical colleagues were found to be the most critical source of stress, anxiety, depression among SBS. To improve the wellness of SBS, it is vital to address both individual and organizational factors. Organized skull base surgery societies can take a leading role in advocating for and implementing comprehensive wellness strategies worldwide.