Burnout and job satisfaction among hematologists: A cross-sectional study.

1. Introduction

Burnout and job satisfaction have emerged as critical occupational health concerns among healthcare professionals, particularly those working in high-intensity and emotionally demanding specialties such as hematology. Hematologists are responsible for the diagnosis, treatment and long-term management of a wide spectrum of hematological disorders, encompassing both malignant conditions – such as leukemia, lymphoma and multiple myeloma – and nonmalignant diseases including aplastic anemia and thrombophilia. Their clinical responsibilities often involve caring for patients with complex medical needs, overseeing intensive treatment protocols and providing support in the context of poor prognoses and end-of-life care. These challenges, coupled with the frequent need to manage critically ill patients, deliver distressing news, respond to emergencies and maintain long and demanding work hours, expose hematologists to significant emotional and psychological stressors.

Studies have reported high rates of burnout among healthcare professionals working in the field of hematology. In a study conducted in the United States, 36.5% of hematologists reported experiencing burnout, with 12.2% showing severe burnout symptoms. Notably, higher burnout levels were observed among physicians subjected to productivity-based compensation models (e.g., Relative Value Units) and among female clinicians. [ 1 ] In Italy, a similar study reported that 32.2% of healthcare workers in hematology and oncology experienced high levels of emotional exhaustion. A study conducted in Germany examined the stress and relaxation factors in the work of hematologists and oncologists in relation to emotional exhaustion, a core dimension of burnout syndrome and found that work-related conflicts in private life (work-home conflict) are associated with increased levels of emotional exhaustion. [ 2 ] A cross-sectional survey conducted among hematologists treating malignancies in Italy revealed that 55% of participants reported experiencing burnout within the past 6 months, with administrative workload identified as a significant contributor to burnout risk. [ 3 ]

Job dissatisfaction and physical fatigue were identified as significant contributors to burnout. [ 4 ] In the United Kingdom, one-third of hematology nurses were found to have high levels of emotional exhaustion, although 64% expressed personal satisfaction with their roles. This paradox was primarily attributed to a lack of work-life balance and insufficient organizational support. [ 5 ] Furthermore, comparative studies among nurses have revealed a negative correlation between burnout levels and job satisfaction. Particularly, a strong negative correlation was identified between levels of depersonalization and job satisfaction. [ 6 ]

While burnout has been extensively studied among certain medical specialties, such as oncology, emergency medicine and intensive care, research specifically focusing on hematologists remains limited. However, in countries like Turkey, hematologists frequently assume broader responsibilities, treating both benign and malignant hematological conditions and often following patients through complex disease trajectories involving relapse, remission and advanced procedures such as hematopoietic stem cell transplantation. These unique clinical demands may lead to a distinct burnout profile, yet empirical data focusing exclusively on hematologists remain scarce. In the existing literature on burnout, hematologists have frequently been evaluated alongside oncologists. [ 1 , 2 , 4 , 6 ]

In response to these challenges, a range of institutional and individual interventions have been proposed. Institutional strategies include transitioning from productivity-driven payment systems to more balanced compensation models, redistributing workloads, reducing administrative burdens and promoting leadership and mentorship programs. On an individual-level, mindfulness-based stress reduction, cognitive-behavioral therapy techniques and enhanced coping and self-care skills have demonstrated efficacy in reducing burnout and improving well-being. Both organizational and individual-level interventions are considered vital in mitigating the long-term effects of burnout and improving job satisfaction among hematology professionals. [ 7 – 9 ]

The present study aimed to investigate the prevalence of burnout and job satisfaction among hematologists and to explore the relationship between these variables and sociodemographic characteristics in Turkey. Given the limited research available on this subject within the hematology field, this study is expected to contribute valuable insights that may inform strategies aimed at enhancing psychological resilience and coping mechanisms among hematology professionals.

2. Methods

2.1. Participants

This study was conducted at the Department of Psychiatry, TOBB University of Economics and Technology University and received ethical approval from the local ethics committee (Ethics Committee No: BAEK-29). The study included 139 hematologists who met the inclusion criteria and provided informed consent. Inclusion criteria included being a hematologist practicing in Turkey and a willingness to participate. Exclusion criteria included reluctance to participate, incomplete participation, or expectation of financial benefit. Data was recorded anonymously.

2.2. Procedure

This study employed a cross-sectional design. The participants were assessed with a sociodemographic data form, job satisfaction survey scale (JSS) and Maslach burnout inventory (MBI). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

2.3. Instruments

Participants were assessed using the following instruments:

2.3.1. Sociodemographic data form

Data were collected on various sociodemographic characteristics, including gender, age, marital status, institution of employment, hospital level, duration of work in the field of hematology, subspecialty (pediatric vs adult hematology), presence of psychological distress and current psychiatric treatment, voluntary choice of specialty and prior training in coping skills.

2.3.2. Job Satisfaction survey scale (JSS )

Job satisfaction was assessed using the scale originally developed by Spector [ 10 ] and subsequently adapted into Turkish by Yelboğa. [ 11 ] The scale consists of 9 subdimensions including pay, promotion, supervision, fringe benefits, contingent rewards, operating procedures, coworkers, nature of work and communication and a total of 36 items. Each subscale is assessed with 4 items and a total score is computed from all items. A summated rating scale format is used, with 6 choices per item ranging from “strongly disagree” to “strongly agree.” For the 4-item subscale, scores of 4 to 12 indicate dissatisfaction, 13 to 16 indicate ambivalent and 17 to 24 indicate satisfaction. For the 36-item subscale, scores of 36 to 108 indicate dissatisfaction, 109 to 144 indicate ambivalent and 145 to 216 indicate satisfaction. In the Turkish adaptation of the scale, Cronbach alpha coefficients for the subscales ranged from 0.61 to 0.91 and 0.91 for the total scale, indicating acceptable to excellent internal consistency. [ 11 ]

2.3.3. Maslach burnout inventory

The inventory is a 22-item instrument that is considered the “gold standard” for assessing burnout [ 12 ] and its validity and reliability were tested in Türkiye by Ergin in 1992. [ 13 ] The inventory is a 5-point Likert type scale and consists of 22 items under 3 subscales: emotional exhaustion, depersonalization and personal accomplishment. In the Emotional Exhaustion subscale, scores ranging from 0 to 13 indicate low levels of burnout, scores between 14 and 26 reflect moderate levels and scores of 27 or above suggest high levels of emotional exhaustion. In the Depersonalization subscale, scores between 0 and 6 indicate low burnout, scores from 7 to 13 represent moderate burnout and scores of 14 or higher denote high depersonalization. For the Personal Accomplishment subscale, scores between 0 and 31 are indicative of high burnout, scores between 32 and 38 suggest a moderate level, while scores of 39 or above reflect low burnout. In the original Turkish validation study, Cronbach alpha coefficients were reported as 0.83 for emotional exhaustion, 0.65 for depersonalization and 0.72 for personal accomplishment, indicating acceptable internal consistency. [ 13 ]

2.4. Statistical analysis

Statistical analyses were conducted using IBM SPSS Statistics for Windows, Version 22.0 (IBM Corp., Armonk). Mean ± standard deviation and median (minimum-maximum) were used as descriptives for quantitative variables and the number of people (percentage) were used for qualitative variables. Normality of distribution of the numerical variables was examined by the Kolmogorov Smirnov test and the homogeneity of the variances was examined by the Levene test. The relationship between burnout severity, job satisfaction and the clinical variables of the participants was examined. Spearman correlation analysis was used to examine relationships between numerical variables. The Mann–Whitney U test was used for 2-group comparisons and the Kruskal-Wallis test was used for comparisons of more than 2 independent groups. Participants were categorized into 3 groups based on their levels of job satisfaction (dissatisfied, ambivalent, and satisfied) and separately into groups according to their levels of burnout – emotional exhaustion, depersonalization, and personal accomplishment – classified as high, moderate, or low. Categorical variables were compared using the Chi-square test. The significance level was set at P <.05.

3. Results

3.1. Sociodemographic and clinical characteristics

One hundred and thirty-nine hematologists who met the inclusion criteria participated in this study. Sociodemographic and clinical characteristics of the study population are presented in Table 1 . The sample consisted of 85 women (61.2%) and 54 men (38.8%). Mean age of the sample was 40.95 ± 6.86 years. It was observed that 74.8% of the participants’ specialty was adult hematology and 90.6% of them had chosen the department with the desire to work in this field. Mean score of the clinical scales are presented in Table 1 . Among the participants, 21.6% exhibited high levels of emotional exhaustion, while 66.2% demonstrated moderate levels and 12.2% reported low levels. Job satisfaction levels among participants were distributed as follows: 38.8% reported dissatisfaction, 50.4% were ambivalent and 10.8% expressed satisfaction (Fig. 1 ).

3.2. Relationships between burnout severity, job satisfaction and sociodemographic and clinical factors

The relationships between burnout severity, job satisfaction and the participants’ sociodemographic and clinical characteristics were examined (Table 2 ). The MBI-Personal Accomplishment score demonstrated a positive correlation with both age ( R = 0.265, P = .002) and duration of employment in hematology ( R = 0.272, P = .001). However, no significant correlations were found between MBI-Emotional Exhaustion or MBI-Depersonalization scores and either age or duration of employment in hematology. Additionally, neither the total nor the subscale scores of the Job Satisfaction Survey were correlated with age or duration of employment in hematology.

There was a statistically significant difference in terms of the JSS-Pay scores (8.6 ± 3.1/7.4 ± 3, P = .042) and the JSS-Nature of Work scores (17.2 ± 3.8/18.9 ± 2.9, P = .013) between adult and pediatric hematologists. Furthermore, in individuals experiencing mental distress, MBI-Emotional Exhaustion (19.9 ± 5.9/17 ± 6.9, P = .015) and MBI-Depersonalization (5.6 ± 3/4.3 ± 3.1, P = .006) scores were significantly higher than in others, while JSS-Nature of Work (17.1 ± 3.7/18.4 ± 3.5, P = .034) and JSS-Communication (13.6 ± 3.5/15.4 ± 4.1, P = .021) scores were lower. The MBI-Emotional Exhaustion score (21.9 ± 5.7/18.3 ± 6.5, P = .022) was significantly higher in those currently receiving psychiatric treatment, while the JSS-Nature of Work score (15.7 ± 4.1/17.9 ± 3.5, P = .038) was lower. In individuals who had chosen the department willingly, the JSS-Nature of Work score (17.9 ± 3.5/15 ± 4.4, P = .028) was significantly higher, while the MBI-Emotional Exhaustion score (18.3 ± 6.2/23.9 ± 7.7, P = .013) was lower. The JSS-Supervision score was found to be significantly higher in those who received training to improve coping skills (14.6 ± 5.1/14 ± 5.7, P = .003).

3.3. The correlation of clinical scale scores

The MBI-Emotional Exhaustion and MBI-Depersonalization scores were positively correlated with overall burnout severity. In contrast, the MBI-Personal Accomplishment score showed a negative correlation, as it is reverse-coded. As expected, significant correlations were found among the subscales of the MBI. The total score of the JSS demonstrated positive correlations with all of its subscales. However, no significant correlations were observed between the JSS-Nature of Work subscale and JSS-Pay, JSS-Fringe Benefits or JSS-Operating Procedures.

The total JSS score was negatively correlated with the MBI-Emotional Exhaustion score ( r = −0.404, P <.000); however, no significant relationships were found between the total JSS score and the MBI-Depersonalization or MBI-Personal Accomplishment subscales. The MBI-Emotional Exhaustion score had a negative correlation with the subscales of JSS (JSS-Pay, JSS-Promotion, JSS-Fringe Benefits, JSS-Contingent Rewards, JSS-Operating Procedures, JSS-Co-Workers, JSS-Nature of Work, JSS-Communication) except the JSS-Supervision subscale. The MBI-Depersonalization score showed no significant correlation with any of the JSS subscales, except for a negative correlation with the JSS-Nature of Work subscale ( r = −0.277, P = .001). The MBI-Personal Accomplishment score had a positive correlation with JSS-Contingent Rewards ( R = 0.17, P = .045), JSS-Nature of Work ( R = 0.635, P <.000), JSS-Communication ( R = 0.228, P = .007) and a negative correlation with JSS-Supervision ( r = −0.185, P = .029) (Table 3 ).

3.4. Comparison of clinical variables based on job satisfaction levels

Participants were categorized into 3 groups based on their level of job satisfaction: dissatisfaction, ambivalent and satisfaction. These groups were compared across several clinical variables, including gender, age, duration of practice in hematology, specialty, type of institution, presence of mental distress, current psychiatric treatment, voluntary choice of specialty and MBI subscale scores. A statistically significant difference was found in terms of age ( P = .002) and duration of working in hematology ( P = .015), with the highest mean values observed in the satisfaction group. Additionally, a significant difference was observed in MBI-Emotional Exhaustion scores ( P = .002), where the dissatisfaction group had the highest mean score and the satisfaction group had the lowest (Table 4 ).

3.5. Comparison of job satisfaction in groups separated by burnout level

Participants were categorized into groups based on their level of burnout (emotional exhaustion, depersonalization, personal accomplishment): high, moderate, low. These groups were compared across JSS total scores. A statistically significant difference in job satisfaction levels was observed across groups categorized by MBI-Emotional Exhaustion levels ( P = .000, Kruskal-Wallis test). Participants with low emotional exhaustion reported the highest job satisfaction (132.13 ± 24.96), followed by those with moderate emotional exhaustion (113.82 ± 18.99), while those with high emotional exhaustion had the lowest job satisfaction scores (93.41 ± 18.93). In contrast, no statistically significant differences in JSS total scores were found between moderate and low burnout groups classified by MBI-Depersonalization levels (N = 1 in high group) ( P = .231, Mann–Whitney U test). Due to an insufficient number of participants in the high and moderate MBI-Personal Accomplishment categories (with only one participant in the moderate group and none in the high group), statistical comparison was not feasible for this subscale.

4. Discussion

This study investigated the level of burnout and job satisfaction among hematologists practicing in Turkey (Fig. 1 ) and explored their associations with various sociodemographic and clinical variables. The findings underscore a significant burden of emotional exhaustion and depersonalization among hematology professionals, with notable links to job satisfaction, mental distress and working conditions. These results contribute to the limited but growing body of literature addressing physician well-being in hematology, a field marked by emotionally and cognitively demanding responsibilities.

Consistent with previous research, our findings demonstrate that burnout is a significant concern among hematologists, particularly in the domain of emotional exhaustion. Notably, previous studies have shown that 36.5% of hematologists experience burnout, with 12.2% exhibiting severe symptoms. [ 1 ] In our study, 21.6% of participants reported high levels of emotional exhaustion, 66.2% moderate and 12.2% low levels. These findings underscore the intense psychological burden faced by hematologists, which may result from sustained patient interactions, emotionally demanding clinical encounters and the responsibility of managing life-threatening conditions. [ 1 – 3 ]

A key finding of this study is the inverse relationship between emotional exhaustion and job satisfaction. Emotional exhaustion was significantly negatively correlated with multiple subdimensions of the JSS, including pay, promotion, fringe benefits, communication and the nature of work. These results echo prior studies that have demonstrated that dissatisfaction with compensation, administrative burden and lack of institutional support are key predictors of burnout among medical professionals. [ 4 , 5 ] Of particular importance is the strong positive correlation between job satisfaction and personal accomplishment, as well as the negative association between job satisfaction and emotional exhaustion, which reflects the complex interplay between professional fulfillment and psychological distress.

A positive correlation was found between age and duration of professional experience in hematology with the personal accomplishment subscale of the MBI. This suggests that with greater clinical experience, hematologists may develop more effective coping mechanisms, increased resilience, or a stronger sense of professional efficacy. Similar trends have been observed in other studies, indicating that seniority can be a protective factor against the emotional toll of clinical work. [ 14 ] A study examining physicians in Turkey demonstrated that younger doctors reported significantly higher emotional exhaustion and depersonalization scores and lower personal accomplishment and job satisfaction compared to older doctors, which is similar to findings in our study. [ 15 ] Contrary to studies in the literature, [ 16 ] no significant difference was found between genders in our study.

Higher emotional exhaustion and depersonalization scores were observed in participants reporting psychological distress or currently receiving psychiatric treatment. This finding underscores the close connection between occupational burnout and broader mental health concerns. The significant emotional demands placed on hematologists – who frequently manage critically ill patients andmake critical decisions – may contribute to a higher vulnerability to mental health difficulties, consistent with prior literature linking burnout to depressive and anxiety symptoms. [ 6 , 8 ] Importantly, participants who voluntarily chose hematology as a specialty reported significantly higher job satisfaction and lower emotional exhaustion. This highlights the protective role of intrinsic motivation and personal interest in career choice, which may buffer against the adverse effects of workplace stress. Supporting autonomy and career alignment in medical training could thus be a long-term strategy to enhance psychological well-being among physicians.

The study also revealed that total job satisfaction scores were inversely correlated with emotional exhaustion, but not with depersonalization or personal accomplishment. This finding suggests that emotional exhaustion may be the most closely related dimension of burnout in the context of workplace satisfaction. Among the subscales of the JSS, the “nature of work,” “contingent rewards,” and “communication” dimensions demonstrated significant positive correlations with personal accomplishment. These associations indicate that greater recognition, meaningfulness of tasks and positive interpersonal interactions are related to higher levels of perceived personal accomplishment. The absence of significant correlations between certain job satisfaction subscales (e.g., pay, fringe benefits) and burnout components suggests that not all facets of job satisfaction are equally associated with burnout experiences.

Participants reporting current psychiatric treatment or subjective mental distress had higher scores on the MBI-emotional exhaustion and depersonalization subscales. These findings reinforce the bidirectional relationship between mental health and burnout, where preexisting psychological vulnerabilities may exacerbate burnout, while chronic occupational stress may precipitate or worsen psychiatric symptoms. [ 17 ] The significant association between coping skills training and higher supervision satisfaction highlights the importance of equipping physicians with tools for stress management and emotional resilience. [ 18 ]

From a policy perspective, the findings support the need for institutional interventions aimed at reducing burnout and enhancing job satisfaction. Strategies such as reducing administrative burden, promoting flexible scheduling, fostering supportive leadership and implementing mental health resources should be prioritized. Furthermore, individual-level interventions including mindfulness-based stress reduction, cognitive-behavioral techniques and resilience training have demonstrated efficacy and should be incorporated into professional development programs. [ 7 – 9 ]

This study has limitations, including its cross-sectional design, reliance on self-reported measures and the lack of assessment of mental distress using an objective instrument. Moreover, the sample was limited to hematologists in Turkey, which may limit the generalizability of the findings to other cultural or institutional contexts. Longitudinal studies are needed to explore how burnout evolves over time in hematology practice and to evaluate the effectiveness of targeted interventions.

5. Conclusion

This study examined the associations between burnout and job satisfaction among hematologists in Turkey. The results showed that emotional exhaustion was the most prominent dimension of burnout and was negatively associated with overall job satisfaction and several of its subdomains. The observed relationships between certain job satisfaction aspects – such as nature of work, communication and contingent rewards – and personal accomplishment may reflect interconnected workplace dynamics rather than direct effects. Increased emotional exhaustion and depersonalization among participants with psychological distress, as well as lower emotional exhaustion among those who voluntarily chose the specialty or received training in coping skills, highlight the potential role of both individual and institutional factors in occupational well-being.

From a clinical perspective, enhancing support systems, increasing access to mental health services and providing training in stress management may help improve the well-being of hematologists. For future research, longitudinal and multivariate studies are recommended to explore causal relationships and identify potential predictors of burnout and job satisfaction in this professional group.

Acknowledgments

We would like to thank to Ahmet Gürcan.

Author contributions

Conceptualization: Gamze Gürcan, Başak Bostankolu Değirmenci.

Data curation: Gamze Gürcan, Başak Bostankolu Değirmenci.

Formal analysis: Gamze Gürcan, Başak Bostankolu Değirmenci.

Investigation: Gamze Gürcan, Başak Bostankolu Değirmenci.

Methodology: Gamze Gürcan, Başak Bostankolu Değirmenci.

Supervision: Gamze Gürcan, Başak Bostankolu Değirmenci.

Validation: Gamze Gürcan, Başak Bostankolu Değirmenci.

Writing – original draft: Gamze Gürcan, Başak Bostankolu Değirmenci.

Writing – review & editing: Gamze Gürcan, Başak Bostankolu Değirmenci.

Abbreviations: JSS job satisfaction survey MBI Maslach burnout inventory

Ethical approval from the local ethics committee (TOBB University of Economics and Technology Scientific Research Ethics Committee, No: BAEK-29) was received. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the Helsinki declaration and its later amendments or comparable ethical standards.

The authors have no funding and conflicts of interest to disclose.

The datasets generated during and/or analyzed during the current study are not publicly available, but are available from the corresponding author on reasonable request.

How to cite this article: Gürcan G, Bostankolu Değirmenci B. Burnout and job satisfaction among hematologists: A cross-sectional study. Medicine 2025;104:46(e45929).

References

[1] Lee AI, Masselink LE, De Castro LM, et al. Burnout in US hematologists and oncologists: impact of compensation models and advanced practice provider support. Blood Adv. 2023;7:3058–68.

[2] Nitzsche A, Neumann M, Groß SE, et al. Recovery opportunities, work-home conflict and emotional exhaustion among hematologists and oncologists in private practice. Psychol Health Med. 2017;22:462–73.

[3] Petruzzelli D, Vignetti M, Trasarti S, et al. Exploring the administrative burden faced by hematologists: a comprehensive study in Italy. Global Reg Health Technol Assess. 2024;11:161–8.

[4] Bressi C, Manenti S, Porcellana M, et al. Haemato-oncology and burnout: an Italian survey. Br J Cancer. 2008;98:1046–52.

[5] Gribben L, Semple CJ. Prevalence and predictors of burnout and work-life balance within the haematology cancer nursing workforce. Eur J Oncol Nurs. 2021;52:101973.

[6] Yildirim D, Kocatepe V. A comparison of burnout and job satisfaction among cancer nurses in oncology, hematology and palliative care clinics. Psychiatr Danub. 2020;32:471–7.

[7] Razai MS, Kooner P, Majeed A. Strategies and interventions to improve healthcare professionals’ well-being and reduce burnout. J Prim Care Community Health. 2023;14:21501319231178641.

[8] Duarte J, Pinto-Gouveia J. Effectiveness of a mindfulness-based intervention on oncology nurses’ burnout and compassion fatigue symptoms: a non-randomized study. Int J Nurs Stud. 2016;64:98–107.

[9] Perolla A, Çalliku E. Burnout in hematologists: a comprehensive literature review. Int J Health Sci Res. 2023;13:74–82.

[10] Spector PE. Measurement of human service staff satisfaction: development of the Job Satisfaction Survey. Am J Community Psychol. 1985;13:693–713.

[11] Yelboğa A. Validity and reliability of the Turkish version of the Job Satisfaction Survey (JSS). World Appl Sci J. 2009;6:1066–72.

[12] Maslach C, Jackson SE, Leiter MP. The maslach burnout inventory manual. In: Zalaquett CP, Wood RJ, eds. Evaluating Stress: A Book of Resources. The Scarecrow Press; 1997:191–218.

[13] Ergin C. Doktor ve hemşirelerde tükenmişlik ve Maslach Tükenmişlik Ölçeği’nin uyarlanmasi. In: Bayraktar R, Dağ İ, eds. VII. Ulusal Psikoloji Kongresi Bilimsel Çalişmalari. Türk Psikologlar Derneği Yayinlari; 1992:143–154.

[14] Murali K, Makker V, Lynch J, Banerjee S. From burnout to resilience: an update for oncologists. Am Soc Clin Oncol Educ Book. 2018;38:862–72.

[15] Ozyurt A, Hayran O, Sur H. Predictors of burnout and job satisfaction among Turkish physicians. QJM. 2006;99:161–9.

[16] Hoff T, Lee DR. Burnout and physician gender: what do we know? Med Care. 2021;59:711–20.

[17] Imo UO. Burnout and psychiatric morbidity among doctors in the UK: a systematic literature review of prevalence and associated factors. BJPsych Bull. 2017;41:197–204.

[18] Romani M, Ashkar K. Burnout among physicians. Libyan J Med. 2014;9:23556.