High levels of burnout during the COVID-19 pandemic was commonly reported by pediatric hematology/oncology (PHO) providers and staff and was found to be associated with prepandemic burnout and location of practice, according to the results of the phase 3 CLEAR study published in JCO Oncology Practice.

“It is important to understand how within a subspecialty, individuals with different roles and responsibilities responded to the pandemic to best address potential needs,” the authors proposed. The aim of this study was to evaluate the effect of the COVID-19 pandemic on the wellbeing of PHO providers and staff working in the New York City and New Jersey epicenter.

In the study, electronic questionnaires comprising questions about burnout, stress, emotional wellbeing, and pandemic experiences were completed by 252 PHO providers and staff. The survey was sent during June 2020 to PHO providers and staff working at multiple institutions across New York City and New Jersey. The survey was completed primarily by female practitioners (88.8%) and included physicians or advanced practice providers (39.3%), direct care providers (31.3%), those in indirect care or administrative roles (16.3%), and those in psychosocial roles or counselors (13.3%).

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A high level of burnout was reported by 51.6% of PHO providers and staff. This level of burnout was significantly associated with prepandemic burnout (odds ratio [OR], 7.475; 95% CI, 2.959-18.886; P <.001), whereas low levels of burnout were associated with trust in leadership (OR, 0.534; 95% CI, 0.292-0.957; P <.05) and hospital location (OR, 0.492; 95% CI, 0.272-0.888; P <.05). Lack of trust in leadership and working in a New York hospital were associated with higher levels of burnout.

Stress was reported to be mild to moderate, with an average Perceived Stress Scale (PSS)-4 score of 6.88 on a scale of 0 to 16. Higher levels of stress were associated with prepandemic burnout, having an indirect patient care or administrative role, hospital location, and being deployed to other areas of the hospital.

Wellbeing symptomatology was reported as none to mild by 77.6% of PHO providers and staff, with 22.4% reporting moderate to severe symptoms. Prepandemic burnout, hospital location, and indirect patient care or administrative roles were associated with more symptoms.

“The discrepancy between reported burnout and the reported levels of stress and wellbeing may suggest that these measures are capturing different aspects of the respondents’ emotional experiences,” the authors stated. They also suggested that respondents may feel more comfortable reporting burnout than emotional wellbeing.

Although 87% of PHO providers and staff reported that mental health resources were being provided by their workplaces, only 8.4% reported having taken advantage of them.

The authors concluded that “…although PHO providers and staff in the NY/NJ area are experiencing a range in the impact on their burnout, stress, and wellbeing during the COVID-19 pandemic, they are not using current resources.” They added that “…we must continue efforts in [an] attempt to improve provider and staff distress, especially with the potential for a cumulative impact.”

Disclosure: One of the study authors declared an affiliation with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.


Moerdler S, Steinberg DM, Jin Z, et al. Well-being of pediatric hematology oncology providers and staff during the COVID-19 pandemic in the New York and New Jersey epicenter. JCO Oncol Pract. Published online February 17, 2021. doi:10.1200/OP.20.00882