{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T02:10:19Z","timestamp":1783649419492,"version":"3.55.0"},"reference-count":53,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2021,11,12]],"date-time":"2021-11-12T00:00:00Z","timestamp":1636675200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>While oncology clinical research coordinators (CRCs) experience a combination of factors that are thought to put them at increased risk for burnout, very little research has been conducted to understand the risk factors associated with burnout among CRCs. We used a mixed-method approach, including self-report questionnaires to assess burnout and compassion satisfaction, as well as individual and interpersonal variables hypothesized to impact CRC well-being. We also conducted a focus group to gain a more nuanced understanding of coordinators\u2019 experiences around burnout, teamwork, resilience, and incivility. Coordinators reported relatively moderate levels of burnout and compassion satisfaction. Resilience, sleep dysfunction, stress, and incivility experienced from patients\/family were significant predictors of burnout. Resilience and incivility from patients\/family were significant predictors of compassion satisfaction. Themes that emerged from the focus group included that burnout is triggered by feeling overwhelmed from the workload, which is buffered by what was described as a supportive work culture based in teamwork. This study identified variables at the individual and interpersonal level that are associated with burnout and compassion satisfaction among oncology CRCs. Addressing these variables is of critical importance given that oncology CRCs and team-based coordinator care are vital to the success of clinical trials.<\/jats:p>","DOI":"10.3390\/ijerph182211855","type":"journal-article","created":{"date-parts":[[2021,11,12]],"date-time":"2021-11-12T08:10:22Z","timestamp":1636704622000},"page":"11855","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Incivility Is Associated with Burnout and Reduced Compassion Satisfaction: A Mixed-Method Study to Identify Causes of Burnout among Oncology Clinical Research Coordinators"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6199-8455","authenticated-orcid":false,"given":"Jennifer S.","family":"Mascaro","sequence":"first","affiliation":[{"name":"Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, GA 30322, USA"},{"name":"Woodruff Health Sciences Center, Department of Spiritual Health, Emory University, Atlanta, GA 30322, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia K.","family":"Palmer","sequence":"additional","affiliation":[{"name":"Woodruff Health Sciences Center, Department of Spiritual Health, Emory University, Atlanta, GA 30322, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8946-1828","authenticated-orcid":false,"given":"Marcia J.","family":"Ash","sequence":"additional","affiliation":[{"name":"Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Peacock","sequence":"additional","affiliation":[{"name":"Woodruff Health Sciences Center, Department of Spiritual Health, Emory University, Atlanta, GA 30322, USA"},{"name":"Winship Cancer Institute, Emory University, Atlanta, GA 30322, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cam","family":"Escoffery","sequence":"additional","affiliation":[{"name":"Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Grant","sequence":"additional","affiliation":[{"name":"Woodruff Health Sciences Center, Department of Spiritual Health, Emory University, Atlanta, GA 30322, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles L.","family":"Raison","sequence":"additional","affiliation":[{"name":"Woodruff Health Sciences Center, Department of Spiritual Health, Emory University, Atlanta, GA 30322, USA"},{"name":"School of Human Ecology, University of Wisconsin-Madison, Madison, WI 53706, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,12]]},"reference":[{"key":"ref_1","first-page":"117","article-title":"Satisfaction and Perception of Researchers towards the Enrollment of Clinical Research Coordinators on Research Conduct and Promptness: A Cross-Sectional Study","volume":"2","year":"2017","journal-title":"Int. J. Clin. Res. Trials"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e77","DOI":"10.1200\/OP.20.00501","article-title":"Clinical trial metrics: The complexity of conducting clinical trials in North American Cancer Centers","volume":"17","author":"Lee","year":"2021","journal-title":"JCO Oncol. Pract."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1188\/05.ONF.1123-1130","article-title":"Burnout in Clinical Research Coordinators in the United States","volume":"32","author":"Gwede","year":"2005","journal-title":"Oncol. Nurs. Forum"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1111\/jnu.12229","article-title":"Understanding Compassion Fatigue in Healthcare Providers: A Review of Current Literature","volume":"48","author":"Sorenson","year":"2016","journal-title":"J. Nurs. Sch."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1097\/JTN.0000000000000055","article-title":"Burnout, compassion fatigue, compassion satisfaction, and secondary traumatic stress in trauma nurses","volume":"21","author":"Hinderer","year":"2014","journal-title":"J. Trauma Nurs."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1097\/00001888-200604000-00009","article-title":"Systematic Review of Depression, Anxiety, and Other Indicators of Psychological Distress Among U.S. and Canadian Medical Students","volume":"81","author":"Dyrbye","year":"2006","journal-title":"Acad. Med."},{"key":"ref_7","first-page":"363","article-title":"Physician and nurse well-being: Seven things hospital boards should know","volume":"63","author":"Shanafelt","year":"2018","journal-title":"J. Healthc. Manag."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.31478\/201707b","article-title":"Burnout among health care professionals: A call to explore and address this underrecognized threat to safe, high-quality care","volume":"7","author":"Dyrbye","year":"2017","journal-title":"NAM Perspect."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Shanafelt, T.D., Hasan, O., Dyrbye, L.N., Sinsky, C., Satele, D., Sloan, J., and West, C.P. (2015). Changes in Burnout and Satisfaction with Work-Life Balance in Physicians and the General US Working Population between 2011 and 2014, Elsevier. Mayo Clinic Proceedings.","DOI":"10.1016\/j.mayocp.2015.08.023"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2009","DOI":"10.1001\/jama.2011.652","article-title":"Physician burnout: A potential threat to successful health care reform","volume":"305","author":"Dyrbye","year":"2011","journal-title":"JAMA"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1826","DOI":"10.1001\/jamainternmed.2017.4340","article-title":"The business case for investing in physician well-being","volume":"177","author":"Shanafelt","year":"2017","journal-title":"JAMA Intern. Med."},{"key":"ref_12","unstructured":"The Blue Ridge Academic Health Group (2018, January 10). The Hidden Epidemic: The Moral Imperative for Academic Health Centers to Address Health Professional\u2019s Well-Being 2017\u20132018. Available online: http:\/\/whsc.emory.edu\/blueridge\/publications\/archive\/blue-ridge-winter2017-2018.pdf."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/j.outlook.2011.10.002","article-title":"Altruism in clinical research: Coordinators\u2019 orientation to their professional roles","volume":"60","author":"Fisher","year":"2012","journal-title":"Nurs. Outlook"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1111\/j.1468-0432.2009.00464.x","article-title":"Re-inscribing gender in new modes of medical expertise: The investigator\u2013coordinator relationship in the clinical trials industry","volume":"17","author":"Fisher","year":"2010","journal-title":"Gend. Work Organ."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.1200\/JOP.2016.013060","article-title":"Resolving rivalries and realigning goals: Challenges of clinical and research multiteam systems","volume":"12","author":"Gerber","year":"2016","journal-title":"J. Oncol. Pract."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"100424","DOI":"10.1016\/j.conctc.2019.100424","article-title":"Knowledge and use of recruitment support tools among study coordinators at an academic medical center: The Novel Approaches to Recruitment Planning Study","volume":"15","author":"Scott","year":"2019","journal-title":"Contemp. Clin. Trials Commun."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1002\/pon.3743","article-title":"Oncology staff: Burnout, job satisfaction and coping with stress","volume":"24","author":"Guveli","year":"2015","journal-title":"Psycho-Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1200\/JOP.2016.014746","article-title":"Mixed-methods study of the impact of chronic patient death on oncologists\u2019 personal and professional lives","volume":"13","author":"Granek","year":"2017","journal-title":"J. Oncol. Pract."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.1200\/JCO.2011.39.7380","article-title":"Oncologist burnout: Causes, consequences, and responses","volume":"30","author":"Shanafelt","year":"2012","journal-title":"J. Clin. Oncol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1134","DOI":"10.1037\/0021-9010.91.5.1134","article-title":"Sources of social support and burnout: A meta-analytic test of the conservation of resources model","volume":"91","author":"Halbesleben","year":"2006","journal-title":"J. Appl. Psychol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1037\/0021-9010.93.5.1082","article-title":"Do peers make the place? Conceptual synthesis and meta-analysis of coworker effects on perceptions, attitudes, OCBs, and performance","volume":"93","author":"Chiaburu","year":"2008","journal-title":"J. Appl. Psychol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1006\/jvbe.1998.1661","article-title":"The role of social support in the process of work stress: A meta-analysis","volume":"54","author":"Viswesvaran","year":"1999","journal-title":"J. Vocat. Behav."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1300\/J077v23n04_01","article-title":"Secondary traumatic stress and oncology social work: Protecting compassion from fatigue and compromising the worker\u2019s worldview","volume":"23","author":"Simon","year":"2006","journal-title":"J. Psychosoc. Oncol."},{"key":"ref_24","first-page":"2007","article-title":"The ProQOL manual","volume":"16","author":"Stamm","year":"2005","journal-title":"Retrieved July"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e11086","DOI":"10.1097\/MD.0000000000011086","article-title":"Determinants of compassion satisfaction, compassion fatigue and burn out in nursing: A correlative meta-analysis","volume":"97","author":"Zhang","year":"2018","journal-title":"Medicine"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1111\/joim.12752","article-title":"Physician burnout: Contributors, consequences and solutions","volume":"283","author":"West","year":"2018","journal-title":"J. Intern. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/0005-7967(94)00075-U","article-title":"The Structure of Negative Emotional States-Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories","volume":"33","author":"Lovibond","year":"1995","journal-title":"Behav. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1002\/da.10113","article-title":"Development of a new resilience scale: The Connor-Davidson resilience scale (CD-RISC)","volume":"18","author":"Connor","year":"2003","journal-title":"Depress. Anxiety"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1080\/15402002.2012.636266","article-title":"Development of short forms from the PROMIS\u2122 sleep disturbance and sleep-related impairment item banks","volume":"10","author":"Yu","year":"2012","journal-title":"Behav. Sleep Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1891\/1061-3749.18.3.176","article-title":"The nursing incivility scale: Development and validation of an occupation-specific measure","volume":"18","author":"Guidroz","year":"2010","journal-title":"J. Nurs. Meas."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1186\/1748-5908-4-50","article-title":"Fostering implementation of health services research findings into practice: A consolidated framework for advancing implementation science","volume":"4","author":"Damschroder","year":"2009","journal-title":"Implement. Sci."},{"key":"ref_32","unstructured":"Bazeley, P. (2013). Qualitative Data Analysis: Practical Strategies, Sage."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1146\/annurev.psych.58.110405.085530","article-title":"Missing data analysis: Making it work in the real world","volume":"60","author":"Graham","year":"2009","journal-title":"Annu. Rev. Psychol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1007\/s10897-014-9716-5","article-title":"Who is at risk for compassion fatigue? An investigation of genetic counselor demographics, anxiety, compassion satisfaction, and burnout","volume":"24","author":"Lee","year":"2015","journal-title":"J. Genet. Couns."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1037\/a0031341","article-title":"Predictors of burnout among correctional mental health professionals","volume":"10","author":"Gallavan","year":"2013","journal-title":"Psychol. Serv."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1348\/014466503321903544","article-title":"The Depression Anxiety Stress Scales (DASS): Normative data and latent structure in a large non-clinical sample","volume":"42","author":"Crawford","year":"2003","journal-title":"Br. J. Clin. Psychol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"113216","DOI":"10.1016\/j.psychres.2020.113216","article-title":"Psychological resilience during the COVID-19 lockdown","volume":"291","author":"Killgore","year":"2020","journal-title":"Psychiatry Res."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1002\/jclp.22229","article-title":"Burnout and depression: Two entities or one?","volume":"72","author":"Schonfeld","year":"2016","journal-title":"J. Clin. Psychol."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Wurm, W., Vogel, K., Holl, A., Ebner, C., Bayer, D., M\u00f6rkl, S., Szilagyi, I.-S., Hotter, E., Kapfhammer, H.-P., and Hofmann, P. (2016). Depression-burnout overlap in physicians. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0149913"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"113212","DOI":"10.1016\/j.psychres.2020.113212","article-title":"Distinguishing burnout from depression: An exploratory qualitative study","volume":"291","author":"Tavella","year":"2020","journal-title":"Psychiatry Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e2023256","DOI":"10.1001\/jamanetworkopen.2020.23256","article-title":"Association of Sleep Disorders With Physician Burnout","volume":"3","author":"Weaver","year":"2020","journal-title":"JAMA Netw. Open"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"803","DOI":"10.5664\/jcsm.8408","article-title":"Sleep, fatigue and burnout among physicians: An American Academy of Sleep Medicine position statement","volume":"16","author":"Kancherla","year":"2020","journal-title":"J. Clin. Sleep Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1111\/j.1752-8062.2012.00423.x","article-title":"The critical need for academic health centers to assess the training, support, and career development requirements of clinical research coordinators: Recommendations from the Clinical and Translational Science Award Research Coordinator Taskforce","volume":"5","author":"Speicher","year":"2012","journal-title":"Clin. Transl. Sci."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1111\/j.1748-720X.2002.tb00410.x","article-title":"The invisible hand in clinical research: The study coordinator\u2019s critical role in human subjects protection","volume":"30","author":"Davis","year":"2002","journal-title":"J. Law Med. Ethics"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1097\/00006199-200503000-00002","article-title":"The impact of hospital nursing characteristics on 30-day mortality","volume":"54","author":"Estabrooks","year":"2005","journal-title":"Nurs. Res."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1767","DOI":"10.1016\/S0277-9536(01)00146-0","article-title":"Nurse\u2013physician communication and quality of drug use in Swedish nursing homes","volume":"54","author":"Schmid","year":"2002","journal-title":"Soc. Sci. Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1111\/j.1552-6909.2009.01007.x","article-title":"Factors affecting delivery of evidence-based procedural pain care in hospitalized neonates","volume":"38","author":"Latimer","year":"2009","journal-title":"J. Obstet. Gynecol. Neonatal Nurs."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1111\/jnu.12553","article-title":"Examining the influence of workplace incivility on nurses\u2019 patient safety competence","volume":"52","author":"Alquwez","year":"2020","journal-title":"J. Nurs. Scholarsh."},{"key":"ref_49","first-page":"742","article-title":"Respondent fatigue","volume":"2","year":"2008","journal-title":"Encycl. Surv. Res. Methods"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1097\/NNR.0000000000000482","article-title":"Recruiting nurses via social media for survey studies","volume":"70","author":"Bethel","year":"2021","journal-title":"Nurs. Res."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"47","DOI":"10.17062\/cjil.v2i1.28","article-title":"Influence of Teamwork Behaviors on Workplace Incivility as It Applies to Nurses","volume":"2","author":"Logan","year":"2016","journal-title":"Creighton J. Interdiscip. Leadersh."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"e3785","DOI":"10.7717\/peerj.3785","article-title":"Factors influencing healthcare provider respondent fatigue answering a globally administered in-app survey","volume":"5","year":"2017","journal-title":"PeerJ"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"100451","DOI":"10.1016\/j.hjdsi.2020.100451","article-title":"The impact of survey nonresponse on estimates of healthcare employee burnout","volume":"8","author":"Simonetti","year":"2020","journal-title":"Healthcare"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/22\/11855\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:29:00Z","timestamp":1760167740000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/22\/11855"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,12]]},"references-count":53,"journal-issue":{"issue":"22","published-online":{"date-parts":[[2021,11]]}},"alternative-id":["ijerph182211855"],"URL":"https:\/\/doi.org\/10.3390\/ijerph182211855","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,12]]}}}