Medical Imaging and Radiotherapy Journal (MIRTJ) 37 (2) 5
Original article
THE EFFECTS OF FAMILY AND WORKPLACE ON THE BURNOUT 
LEVELS OF RADIOGRAPHERS WORKING IN ONCOLOGY 
PATIENT CARE
Dávid SIPOS 1,2,3, Csaba VANDULEK 2, Attila András PANDUR 1, Péter KOVÁCS 2,3, 
Szabolcs CSEH 1, András KEDVES 1,2,3, József TOLLÁR 2,3, Árpád KOVÁCS 1,2,4, 
Imre REPA 1,3, Melinda PETŐNÉ CSIMA 1,5
1 Doctoral School of Health Sciences, University of Pécs, Pécs, Hungary
2 Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
3 Dr. József Baka Diagnostic, Radiation Oncology, Research and Teaching Center, “Moritz Kaposi” Teaching Hospital, Kaposvár, 
Hungary
4 Department of Oncoradiology, Faculty of Medicine, University of Debrecen, Hungary
5 Faculty of Pedagogy, Szent István University Kaposvár Campus, Kaposvár, Hungary
Corresponding author: Sipos Dávid; e-mail: cpt.david.sipos@gmail.com
Received: 12.11.2020
Accepted: 29.12.2020
https://doi.org/10.47724/MIRTJ.2020.i02.a001
Medical Imaging and Radiotherapy Journal (MIRTJ) 37 (2)
ABSTRACT
Purpose: The aim of the study was to explore the burnout rate 
of radiographers working in oncology patient care.
Materials and methods: Cross-sectional and targeted non-
random sampling research was conducted from June 2018 
to September 2018. We used the Maslach Burnout Inventory 
supplemented with our own questionnaire for online data 
collection. In addition to demographic aspects, we collected 
data on job characteristics to examine the predictors of 
burnout. Statistical analysis was performed using descriptive 
statistics. A two-sampled t-test, analysis of variance, the Mann-
Whitney test and the Kruskal-Wallis test were used at a 95% 
confi dence level (p=0.05).
Results: We analyzed data of 72 radiographers working 
in oncology patient care (n=72) and 332 radiographers 
working in other areas of patient care (n=332). The value of 
emotional exhaustion (p=0.001) was signifi cantly higher in 
radiographers working in oncology patient care. Respondents 
who were single, provided monthly on-call duty and held 
university degrees showed signs of depersonalization 
(p=0.001). Having a second job, working over 40 hours per 
week and participating in on-call duty services had a negative 
eff ect on emotional exhaustion (p=0.001). The value of 
personal accomplishment (p=0.001) was signifi cantly better 
in respondents with more than one child in their household. 
The subjective assessesment of poor fi nancial status had a 
negative eff ect on all three dimensions of burnout (p=0.001).
Conclusion: The mean values of emotional exhaustion in 
radiographers working in oncology patient care increased 
signifi cantly. The observed higher value of personal 
accomplishment demonstrates the positive feedback given 
by patients to radiographers.
Keywords: radiographer, burnout, oncology, Maslach Burnout 
Inventory
6 Medical Imaging and Radiotherapy Journal (MIRTJ) 37 (2)
Sipos D. et al./ The effects of family and workplace on the burnout levels of radiographers working in oncology patient care
INTRODUCTION
Healthcare professionals are at an increased risk of burnout 
due to the nature of their work. In their roles, they consistently 
provide help and care to patients, which requires both 
emotional stamina and empathy. In order to perform their 
tasks smoothly, it is essential that they are able to make 
quick and defi nite decisions, whilst being professional in any 
situation. The nature of healthcare work presupposes eff ective 
collaboration amongst the healthcare staff , an appropriate 
level of communication and an empathetic approach towards 
patients (1).
Burnout
Burnout is defi ned in the following three dimensions: 
depersonalization, emotional exhaustion, and an identifi ed 
sense of  decreased personal accomplishment. Previous 
research in the service sector was based on the internationally 
validated Maslach Burnout Inventory (MBI), a questionnaire 
designed to measure the three above mentioned scales (2).
Depersonalization refers to an individual frequently feeling as 
if they are outside observers of their own lives. Individuals with 
a depersonalization disorder perceive their self-identity, body, 
and life in a distorted form that fi lls them with discomfort 
(3). Emotional exhaustion is the feeling when an employee 
is no longer able to provide more on a psychological level. 
An individual feels that they have reached the physical 
and emotional limit of their abilities. A sense of decreased 
personal effi  ciency results in individuals’ negative evaluation 
of their performance. They might also view themselves as 
underperforming in comparison with their peers (3).
The emotional burden associated with the care of cancer 
patients and those with terminal conditions has been 
previously recognized among those working in oncology 
patient care. Based on the results of Dougherty et al., 
healthcare professionals working in acute and oncology 
patient care demonstrate higher workplace stress and lower 
job satisfaction rates than those working in other areas of 
healthcare. This suggests that workplace stress is infl uenced 
by the organization and culture of the work environment, 
and the nature of work. The results of the survey confi rmed 
that high stress levels in acute oncology conditions are 
associated with a high workload and low control over the 
work environment (4,5,6,7).
Work-related stress can cause problems in patient care, either 
because the quality of the provided care deteriorates or 
because the overburdened healthcare workers’ absences from 
work have a detrimental eff ect on the rest of the healthcare 
professionals as they experience an increased workload (8).
The incidence of cancer patients places an increased burden 
on patient care units (9). Due to complex oncology treatments 
and close monitoring of patients' health status, healthcare 
professionals working in oncology patient care are at a 
particular risk of work-related stress and burnout (10,11).
Recent reviews of burnout suggest that the theoretical 
foundations of research in the fi eld of oncology need to be 
strengthened, and that future work should focus more on 
organizational factors for burnout prevention (12). Burnout can 
have serious consequences such as substandard performance 
of health care, eff ects on the work environment including 
reduced working hours, taking work breaks more frequently, 
or a reduced affi  nity toward employee morale (2,3).
In our research published in 2019, we examined the burnout 
level of staff  working in the radiology department in terms of 
education, years of service in healthcare and age groups (13). 
The purpose of our current study was to assess the extent of 
burnout among radiographers working in oncology care units 
and to highlight the possible causes of phenomenon that may 
be related to family and work characteristics in contrast to 
radiographers working in other fi elds of patient care.
MATERIALS AND METHODS
Approval for this study was obtained from the Society of 
Hungarian Radiographers, Budapest, Hungary. Regarding 
our quantitative, cross-sectional research, we initiated a 
targeted non-random sampling procedure by sending our 
questionnaire electronically to nearly 3,000 radiographers 
registered with the Society of Hungarian Radiographers.
In addition to the internationally validated Maslach Burnout 
Inventory (MBI), we designed a questionnaire related to socio-
demographic and workplace characteristics. With regard to 
the interpretation of the results of the MBI questionnaire, 
scores for statements about personal accomplishment 
were low, while high scores for statements about emotional 
exhaustion and depersonalization suggest diff erent degrees 
of burnout (14,15). 
Statistical analysis
We used descriptive statistics, a two-sample t-test, analysis 
of variance (ANOVA), Kruskal-Wallis, and Mann-Whitney 
test at a 95% confi dence level (p=0.05). Data processing 
was implemented with the Statistical Package for the Social 
Sciences (SPSS) version 24.0 software.
RESULTS
The questionnaire was completed by a total of 404 
respondents (n=404). Based on the aim of our study, our 
sample was divided into a cohort of radiographers working 
in oncology patient care (n=72) and radiographers working 
in other areas of patient care (n=332).
Based on the evaluation of the results of the MBI, it can 
be observed that the average scores in the dimensions of 
depersonalization and emotional exhaustion are well above 
the MBI normal values, which can be negatively interpreted 
for both groups in our sample. The value of the personal 
accomplishment dimension also exceeds the normal values 
of MBI however, which means that radiographers working 
in oncology patient care and other areas of patient care feel 
more successful and positive in their eff orts. There was a 
signifi cantly increased value of emotional exhaustion among 
radiographers working in oncology patient care compared 
to their peers who were measured in the same dimension 
(p=0.001) (Table 1).
Medical Imaging and Radiotherapy Journal (MIRTJ) 37 (2) 7
Sipos D. et al./ The effects of family and workplace on the burnout levels of radiographers working in oncology patient care
Relationship between family composition 
and burnout
The majority (93.1%) of the radiographers working in the 
fi eld of oncology were female (n=67). Among them, the 
depersonalization subscale value was lower than that of the 
male radiographers; nevertheless, the female radiographers 
were more aff ected in the dimension of emotional exhaustion. 
The male radiographers' personal achievement subscale 
value proved to be signifi cantly lower compared to the mean 
value of the female radiographers (p=0.01). The marital status 
of the sample reveals that 40.3% (n=29) live with a spouse/
partner; however, the average value of the depersonalization 
dimension of those respondents who are single (n=16; 22.2%) 
was signifi cantly lower than in other categories of marital 
status (p=0.01). Marital status had no signifi cant eff ect on 
either emotional exhaustion nor personal accomplishment. 
The results show that 61.1% (n=44) of the respondents 
have no children. Respondents with one or more children 
in their family had signifi cantly lower mean emotional 
exhaustion (p=0.05) and also a signifi cantly higher personal 
accomplishment value (p=0.01).
The results show that female respondents were also 
overrepresented by 84.3% (n=280) among the radiographers 
working in other fi elds of patient care. There was no signifi cant 
gender diff erence in respect to the three dimensions of 
burnout. The mean values also showed similar distribution 
in every dimension. Regarding the family composition, a 
signifi cantly lower sense of personal accomplishment was 
observed in those who lived with other family members/
individuals (n=29; 8.7%) compared to those with a diff erent 
type of family composition (p=0.01). Regarding the number 
of children in the family, signifi cantly higher burnout was 
observed in the dimensions of depersonalization (p=0.01) and 
emotional exhaustion (p=0.05) for respondents who did not 
have children in their family; values of personal achievement 
(p=0.05) were also signifi cantly lower.
Subjective fi nancial situation assessment 
and the relationship between education 
and burnout
The results for the radiographers working in oncology patient 
care show that 63.9% (n=43) of the sample consider that 
they live well from their salary and are able to make regular 
savings from their income. Those respondents (8.3%, n=6) 
whose salary was not suffi  cient to make a living, (based on 
their own subjective judgment), had a signifi cantly higher 
mean of depersonalization and emotional exhaustion. 
Furthermore, their mean value measured on the personal 
accomplishment subscale was signifi cantly lower compared 
to other respondents (p=0.001; p=0.001; p=0.05). 
Radiographers with a Bachelor’s degree predominated in 
the sample at 69.4% (n=50). Those respondents who hold 
a Master’s degree (n=14; 19.4%) had a signifi cantly higher 
mean value of depersonalization compared to respondents 
with tertiary vocational education (n=8; 11.1%) (p = 0.001). 
Respondents with a completed high school education had a 
signifi cantly lower level of emotional exhaustion compared to 
those with a completed higher education (p=0.01). 
Based on their subjective judgment, respondents who did not 
have enough monthly income to make a living and did not 
work in oncology patient care, had a signifi cantly increased 
emotional exhaustion value (p=0.01) and had a signifi cantly 
lower value of personal accomplisment (p=0.01).
In terms of educational level, more than half of the 
respondents in the sample had a university degree (n=188; 
56.6%). This group showed a signifi cantly elevated value in 
the depersonalization subscale compared to respondents 
with completed tertiary vocational education (n=109; 32.8%) 
and secondary education (n=35; 10.5%) (p=0.05) (Table 2).
The eff ects of workplace characteristics on 
burnout
The results show that 13.9% of the respondents (n=10) had a 
second job.  The average emotional exhaustion value of this 
group was signifi cantly higher than the average value of those 
without a second job (p=0.001). Respondents who worked 
more than 40 hours per week (n=64; 88.9%) were signifi cantly 
more prevalent in the dimensions of depersonalization and 
emotional exhaustion (p=0.001; p=0.001). The majority of the 
respondents in the sample (n=65; 90.3%) did not participate 
in on-call shifts; nevertheless, those radiographers (n=7; 
9.7%) who provided on-call shifts (1-3 times per month) 
had depersonalization and emotional mean values which 
signifi cantly deviated in the negative direction (p=0.001; 
p=0.001). We also measured a signifi cant diff erence between 
the above two groups in the average value of the dimension 
of personal achievement, with the result showing that the on-
call staff  have a positive experience in relation to the way they 
judge the success of their eff orts at work. 
The assessment examined how the radiographers view their 
relationship with their colleagues. Based on the results of the 
study, the majority (n=52; 72.2%) of the sample experienced 
a good relationship with their colleagues. The mean value 
Table 1: Relationship between mean MBI values of radiographers working in oncology patient care and other fi elds of patient care compared 
to normal MBI values (normal values represent the mean values of physicians and nurses)
Depersonalization  
(Mean ± SD) 
Emotional exhaustion  
(Mean ± SD) 
Personal accomplishment  
(Mean ± SD)
Radiographers working in 
oncology patient care 72 13.62 ± (7.74) 40.28 ± (11.94)*** 43.00 ± (7.02)
Radiographers working in 
other fi elds of patient care 332 12.64 ± (6.35) 32.98 ± (12.85)*** 40.60 ± (8.98)
MBI values USA 11.067 8.7 ± (5.9) 22.0 ± (10.8) 34.6 ± (7.1)
*** p<0.001
8 Medical Imaging and Radiotherapy Journal (MIRTJ) 37 (2)
Sipos D. et al./ The effects of family and workplace on the burnout levels of radiographers working in oncology patient care
Table 2: Respondents' values measured by the MBI burnout questionnaire on the subscales of depersonalization, emotional exhaustion, and 
personal accomplishment in relation to gender, family status, number of children in the family, fi nancial situation and level of education.
Radiographers working in 
oncology patient care
Radiographers working in other fi elds 
of patient care
Value n (%)
Depersonali-
zation  
Emotional 
exhaustion  
Personal 
accomplish-
ment  n (%)
Depersonali-
zation
Emotional 
exhaustion  
Personal 
accomplish-
ment  
Gender
Men 5 (6.9)
16.60 
(SD=6.98)
36.80 
(SD=16,34)
34.60 
(SD=12.03)**
52 
(15.7)
15.63 
(SD=4.67)
32.08 
(SD=9.72)
38.29 
(SD=9.46)
Women 67 (93.1)
13.40 
(SD=7.80)
40.54 
(SD=11.67)
43.63 
(SD=6.20)
280 
(84.3)
12.08 
(SD=6.46)
33.14 
(SD=13.35)
41.04 
(SD=8.83)
Family status
Living with spouse/ 
partner
29 
(40.3)
13.66 
(SD=7.70)
41.66 
(SD=11.21)
44.45 
(SD=5.83)
127 
(38.3)
11.96 
(SD=4.76)
31.73 
(SD=12.97)
40.79 
(SD=8.59)
Living with spouse/
partner and with 
children
18 
(25.0)
15.97 
(SD=7.43)
38.17 
(SD=11.70)
40.28 
(SD=10.19)
82 
(24.7)
12,05 
(SD=6.64)
34.70 
(SD=11.32)
42.16 
(SD=7.83)**
Single 16 (22.2)
9.88 
(SD=7.58)**
40.81 
(SD=13.41)
43.31 
(SD=4.34)
94 
(28.3)
13.89 
(SD=7.36)*
32.95 
(SD=13.95)
40.45 
(SD=9.22)
Living with other 
person/ family 
member
9 
(12.5)
15.56 
(SD=7.43)
39.11 
(SD=13.42)
43.22 
(SD=6.11)
29 
(8.7)
13.17 
(SD=7.0)
33.66 
(SD=12.75)
35.90 
(SD=11.41)**
Number of children
One 16 (22.2)
13.44 
(SD=8.31)
42.31 
(SD=12.13)
39.81 
(SD=10.39)
82 
(24.7)
11.91 
(SD=6.70)
31.13 
(SD=12,84)
42-65 
(SD=8.5)*
More than one 12 (16.7)
11.92 
(SD=7.15)
33.08 
(SD=11.22)*
47.50
(SD=4.70)**
107 
(32.2)
11.22 
(SD=6.32)
32.53 
(SD=13.20)
40.69 
(SD=10.09
None 44 (61.1)
14.16 
(SD=7.80)
41.50 
(SD=11.59)
42.93 
(SD=5.35)
143 
(43.1)
14.10 
(SD=5.87)**
34.36 
(SD=12.53)*
39.36 
(SD=8.26)*
Current fi nancial state
Living well 4 (5.6) 12.50 (SD=5.10)
39.25 
(SD=15.50)
43.50 
(SD=7.00)
13 
(3.9)
15.54 
(SD=717)
29.15 
(SD=16.24)
43.62 
(SD=13.25)
Living good, is able 
to save
46 
(63.9)
11.70 
(SD=7.65)
38.11 
(SD=11.23)
44.20 
(SD=6.30)
182 
(54.8)
11.99 
(SD=5.65)
31.36 
(SD=12.08)
40.26 
(SD=9.15)
Just enough to 
make a living
16 
(22.2)
14.94 
(SD=7.57)
38.13 
(SD=10.21)
41.31 
(SD=9.31)
109 
(32.8)
13.40 
(SD=7.39)
34.31 
(SD=13.77)
41.36 
(SD=8.81)
Not enough for 
living 6 (8.3)
19.14 
(SD=4.45)***
49.10 
(SD=5.11)***
38.00 
(SD=4.15)*
28 
(8.4)
12.64 
(SD=5.67)
42.12 
(SD=11.16)**
37.72 
(SD=6.25)**
Level of education
Secondary 
-education
8 
(11.1)
11.50 
(SD=8.38)
29.63** 
(SD=12.48)
45.88 
(SD=7.31)
35 
(10.5)
12.63 
(SD=6.96)
32.17 
(SD=13.04)
42.69 
(SD=7.04)
Higher vocational 
education
14 
(19.4)
8.86 
(SD=4.78)**
36.86 
(SD=13.49)
46.79 
(SD=6.47)
109 
(32.8)
10.94 
(SD=6.06)
31.52 
(SD=12.93)
41.34 
(SD=9.11)
University degree 
(BSc., Msc.)
50 
(69.4)
15.30 
(SD=7.79)***
42.91 
(SD=10.35)
41.48 
(SD=6.69)
188 
(56.6)
15.54 
(SD=5.79)*
30.19 
(SD=11.1)
42.66 
(SD=8.67)
*p ≤ 0.05     **p ≤ 0.01     ***p ≤ 0.001
of the emotional exhaustion subscale of those respondents 
who state that they have poor collegial relationship (n=16; 
22.2%) showed a signifi cantly increased value compared to 
those who assumed as to having good collegial relationship 
(p=0.010). The values of those who felt that they had excellent 
collegial relationship (n=4; 5.6%) were signifi cantly higher 
(p=0.010; p=0.001) on the depersonalization and emotional 
exhaustion subscales. 
Those radiographers who work in various other non-
oncology patient care and have a secondary job (n=81; 24.4) 
showed signifi cantly higher depersonalization and emotional 
exhaustion values (p=0.001; p=0.001). Respondents who 
worked more than 40 hours per week (n=225; 67.7%) also 
showed a signifi cant increase of depersonalization and 
emotional exhaustion (p=0.001; p=0.001). Monthly on-
call duty had no signifi cant eff ect on the dimensions of 
burnout. Based on the answers to the questions related 
to the subjectively judged employee relationship, 63.9% 
of the respondents (n=212) assumed that they had a good 
relationship with their colleagues. Depersonalization and 
Medical Imaging and Radiotherapy Journal (MIRTJ) 37 (2) 9
Sipos D. et al./ The effects of family and workplace on the burnout levels of radiographers working in oncology patient care
emotional exhaustion were signifi cantly higher in those 
radiographers with poor collegial relationships (n=52; 15.7%) 
and were signifi cantly lower in the dimensions of personal 
accomplishment (p=0.001; p=0.001; p= 0.001) (Table 3).
DISCUSSION
The majority of research in Hungary focusing on the quality 
of life and burnout of healthcare professionals is related to 
healthcare professionals working with severely ill patients. 
According to our knowledge, there has not yet been a survey 
on burnout conducted among radiographers working in 
oncology patient care units. 
The incidence of prostate and lung cancer has increased 
dramatically since the middle of the millennium. The 
constantly evolving technology allows for a maximum 
eff ectiveness of oncology treatments relative to the potential 
of the workplace and the patient’s health status (16,17). In 
addition to the oncologists working in the oncology patient 
care unit, radiographers play a key role in the implementation 
of these treatments. Those working in oncology patient 
care treat patients with specifi c characteristics compared to 
other patient care units. During the course of the disease, 
oncology patients often experience psychological problems, 
vulnerability, anxiety, fear, and depression, which may be 
related to an increased stress factor that may be aimed towards 
treatment providers. In their analysis, Kubota et al. mention 
that in addition to these factors, nurses working in oncology 
care also have to deal with ethically complex clinical decision-
making situations such as the complexity of tumor treatments, 
grief, communicating bad news and death. These situations 
do not necessarily occur in other services for chronic patients, 
such as primary care and emergency care, where the contact 
time with patients is shorter, or services where patients spend 
most of the time under the eff ect of sedatives, such as in the 
operating room. For these reasons, it can be predicted that 
the burnout of oncology patient care professionals may show 
elevated values (18,19,20).
In their study, Révay et al. mention that health care workers 
dealing with severely ill patients are exposed to greater 
physical and mental strain than those working in other areas 
of health care. Their survey that analyzed burnout and coping 
strategies of hospice workers found that hospice workers 
were overworked as nearly 50% of the respondents in the 
sample worked 12 hours a day, had self-esteem disorders, 
and more than 70% of respondents remembered having 
diffi  culty sleeping at work. It should be emphasized that, in 
addition to physical and mental strain, satisfaction arising 
from compassion is also present in the examined job, which 
means that employees are also satisfi ed with their profession, 
but the negative impact of diffi  culties in the workplace should 
not be overlooked (21).
Table 3: Relation of workplace characteristics with the mean values of the dimensions of the Maslach Burnout Inventory
Radiographers working in 
oncology patient care
Radiographers working in other fi elds 
of patient care
Value n (%)
Depersonali-
zation 
Emotional 
exhaustion  
Personal 
accomplish-
ment n (%)
Depersonali-
zation
Emotional 
exhaustion  
Personal 
accomplish-
ment  
Second job
Yes 10 (13.9)
13.40 
(SD=7.23)
53.60*** 
(SD=3.09)
41.60 
(SD=4.64)
81 
(24.4)
15.10 
(SD=7.39)***
39.90 
(SD=12.92)***
39.15 
(SD=9.13)
No 62 (86.1)
13.66 
(SD=7.88)
38.13 
(SD=11.44)
43.23 
(SD=7.33)
251 
(75.6)
11.84 
(SD=5.76)
30.74 
(SD=12.03)
41.07 
(SD=8.89)
Number of hours worked per week
Less than 
40 hours
8 
(11.1)
12.92 
(SD=7.57)
39.13 
(SD=12.12)
41.25 
(SD=9.54)
107 
(32.2)
11,22 
(SD=5.31)
27.16 
(SD=10.84)
39.80 
(SD=9.07)
More than 
40 hours
64 
(88.9)
19.25 
(SD=7.18)** 
49.50 
(SD=3.92)**
43.22 
(SD=6.70)
225 
(67.7)
15.25 
(SD=6.79)***
39.06 
(SD=12.59)***
39.06 
(SD=8.90)
On-call duties
none 65 (90.3)
12,28 
(SD=6.89)
39.05 
(SD=11.92)
42.74 
(SD=7.34)
134 
(40.4)
12.30 
(SD=6.10)
33.29 
(SD=13.23)
41.12 
(SD=8.39)
more than one 7 (9.7)
26.14 
(SD=3.06)***
51.71 
(SD=2.13)***
45.43 
(SD=3.53)**
198 
(59.6)
12.94 
(SD=6.32)
33.32 
(SD=12.04)
40.35 
(SD=8.89)
Collegial relationship
Excellent 4 (5.6)
15.13 
(SD=5.90
51.12 
(SD=6.18)***
46.50 
(SD=4.45)
68 
(20.5)
10.31 
(SD=5.64)
25.31 
(SD=7.96)
43.00 
(SD=7.71)
Good 52 (72.2)
12.67 
(SD=7.91)
38.08 
(SD=11.68)
43.54 
(SD=6,16)
212 
(63.9)
12.13 
(SD=5.75)
32.65 
(SD=12.55)
41.54 
(SD=8.53)
Bad 16 (22.2)
19.10 
(SD=7.14)**)
44.25 
(SD=11.58)**
40.38 
(SD=9.61)
52 
(15.7)
21.99 
(SD=5.64)***
50.36 
(SD=7.52)***
33.8 
(SD=5.90)***
*p ≤ 0.05     **p ≤ 0.01     ***p ≤ 0.001
10 Medical Imaging and Radiotherapy Journal (MIRTJ) 37 (2)
Sipos D. et al./ The effects of family and workplace on the burnout levels of radiographers working in oncology patient care
The results do not suggest a signifi cant diff erence in 
the dimensions of depersonalization and personal 
accomplishment between radiology professionals working 
in oncology patient care and other areas of patient care. 
However, there was a signifi cant diff erence in the dimension 
of emotional exhaustion among radiographers working in 
oncology patient care (p=0.001). This result may be attributed 
to the increased mental burden associated with the care of 
terminally ill patients, which is characteristic of oncology 
patient care (4,5). 
Sale et al. examined the burnout rate of those working in 
oncology care units in Canada. The study analyzed the fi ndings 
of physicians, nurses, physicists, and radiotherapists. With 
physicians and radiotherapists, the rate of depersonalization 
and emotional exhaustion increased in parallel with the time 
they spent at work (22). In our previously published results, 
we examined the eff ect of age and time spent working in 
healthcare in relation to burnout. We found that radiographers 
aged between 31–35, as well as those radiographers who 
have worked in the healthcare system for 16–20 years, were 
the ones most at risk considering all three dimensions of 
burnout (22).
Daugherty et al. examined the burnout level of sonographers 
whose emotional exhaustion was aff ected by the number 
of examinations performed weekly. A correlation was found 
between the type of job and emotional exhaustion, showing 
that the value of those working in the public sector increased 
compared to those working in private health care. In addition 
to workplace factors, male radiographers showed an increased 
value in the dimension of depersonalization (23).
In light of our own results, male radiographers working in 
oncology patient care showed increased depersonalization 
values and decreased emotional exhaustion values compared 
to female respondents. Regarding the dimension of personal 
accomplishment, the mean value of men was signifi cantly 
lower than that of women (p=0.01). The depersonalization 
value of radiographers working in other areas of patient care 
also showed an increased value. No signifi cance was detected 
in the dimensions of emotional exhaustion and personal 
accomplishment.
A study published by Jaspers et al. found that emotional 
exhaustion of the non-doctoral workforce in radiotherapy and 
radiology units is greater than that of physicians, oncologists, 
and radiologists. The survey also analyzes that those working 
in the public health sector are more emotionally exhausted 
than those working in the private sector. The results show that 
the high workload, the presence of patients and organizational 
stressors increase emotional exhaustion. Finally, the study 
found that less work experience and an increased workload 
signifi cantly aff ected emotional exhaustion and feelings of 
depersonalization (24). 
When examining our results, we observed a signifi cant increase 
of emotional exhaustion compared to radiographers working 
in other areas of patient care. The increased values may be due 
to the emotional burden characterictic of everyday oncology 
patient care, a secondary job, participation in monthly on-call 
duties, the quality of relationships with colleagues, and the 
perception of a negative fi nancial status.
In his publication, Hegedűs mentions that one of the negative 
conditions for healthcare workers dealing with critical patients 
is the lack of the chance to regenerate physically and mentally; 
therefore he emphasized the importance of implementing 
methods of burnout prevention. In their survey published at 
the turn of the millennium, medical training contained only 
a limited (0.7%) number of courses dealing with the issues of 
death, dying, and mourning. From a mental hygiene point of 
view, it is of paramount importance that a medical student is 
able to interpret and process the fate of terminally ill patients 
with the help of evidence-based literature. According to the 
author, a time interval of a quarter of an hour a day may be 
suffi  cient to settle ones physical and mental condition, which 
may greatly contribute to the improvement of the quality of 
the mental load of care for patients (25,26).
The fi rst step in treating the burnout syndrome could be to 
change the working conditions of the aff ected staff , with an 
aim to reduce work overload, yet this is not always possible 
due to the lack of healthcare staff . However,  problems arising 
at work and in private lives should be resolved and focused 
group discussions, regular rest periods incorprated in the work 
schedule,  and vacation may be some of the useful methods. 
Scheiderman et al. discuss the importance of stress-reducing 
activities and intermittent relaxation in their research to 
reduce burnout, with some of the most eff ective activities 
being group lectures and group discussions in a workplace 
environment (27,28,29).
According to Szényei et al., primary, secondary and tertiary 
prevention can play a key role in alleviating and avoiding 
burnout. These methods include relaxation techniques, 
cognitive-behavioral therapies, and stress management, the 
positive eff ects of which are unquestionable. It is important 
to emphasize that strategies to reduce burnout need to be 
interpreted in a rather complex way, and may therefore vary 
from individual to individual (30).
Kovács et al. studied the emotional exhaustion of those 
healthcare professionals who work with severely ill patients. 
They realized that a signifi cant relationship of trust is 
generated with patients in their daily work and that this 
relationship grows with personal communication, which can 
be a positive signifi cant factor regarding burnout. Based on 
their results, emotional dissonance appears as a signifi cant 
stress factor among those working in oncology patient care, 
which may be contributed to the healthcare workers' need 
to regularly show understanding and express compassion 
towards patients during their work (31).
Czeglédi and Tandari-Kovács examined the burnout of nurses 
and concluded that the reason for the shortage of nurses 
in Hungary is career abandonment and migration. The low 
degree of social esteem and the increase in both physical 
and emotional strain also play a role in this phenomenon. 
Professional psychological help could help professionals, 
as well as continuous professional development and 
participation in research activities (32).
Our results show that the burnout syndrome of healthcare 
professionals working in oncology patient care requires 
serious attention, mainly due to increased values of 
depersonalization and emotional exhaustion subscales. 
It should also be emphasized that various workplace and 
personal factors such as pay, childlessness, education, having 
a second job and working more than 40 hours per week, 
may increase the risk of burnout. To confi rm our results, 
further research is necessary to assess the radiographers 
working in oncology patient care. Our results suggest that 
Medical Imaging and Radiotherapy Journal (MIRTJ) 37 (2) 11
Sipos D. et al./ The effects of family and workplace on the burnout levels of radiographers working in oncology patient care
increased attention should be paid to the burnout syndrome 
among professions related to oncology. Our fi ndings of the 
risk factors may also help establish burnout preventions for 
healthcare professionals working in high-risk oncology care. 
Limitations of the study include the impossibility of making 
a substantive statement about causal relationships due to 
the retrospective nature of our survey. Also, to the best of 
our knowledge, a study focusing on burnout has not been 
conducted among radiographers working in oncology patient 
care in Hungary. Based on these facts and in light of our 
results, we propose that decision-makers and management 
support the development of psychological interventions that 
contribute to the prevention of burnout of those working in 
oncology patient care.
CONCLUSION
In our study of radiographers working in oncology patient care, 
we examined the signifi cant increase of burnout subscales. 
Sociodemographic and occupational variables, workplace 
overcrowding, and workplace-related factors were observed 
as having a signifi cant infl uence on the development of the 
burnout syndrome. 
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