Burnout, stress, and resilience in pediatric onco-hematology rehabilitation: results from the multicenter Rehabilitation Burnout Study (REBURN)

BACKGROUND: Rehabilitation professionals in pediatric onco-hematology face intense emotional and relational demands that heighten vulnerability to burnout. Despite their key role in children's recovery, this group remains underrepresented in psycho-oncology research. OBJECTIVE: To assess burnout, compassion satisfaction, compassion fatigue, perceived stress, and resilience among rehabilitation professionals in Italian pediatric onco-hematology centers and to explore the organizational meanings underpinning their experiences. METHODS: A mixed-methods multicenter study was conducted across eleven centers in the AIEOP network. Thirty professionals completed validated scales (ProQOL-5, Maslach Burnout Inventory, Perceived Stress Scale, Resilience Scale for Adults). Semi-structured interviews were analyzed using Automated Co-occurrence Analysis for Semantic Mapping (ACASM). RESULTS: Participants reported high compassion satisfaction and moderate burnout, with 66.7% scoring high on depersonalization. Compassion fatigue correlated positively with emotional exhaustion (ρ = 0.45, p = 0.013) and perceived stress (ρ = 0.36, p = 0.048). Resilience did not correlate significantly with distress measures. ACASM identified two semantic dimensions-Relationship-Intervention and Users-Institution-indicating that emotional strain stems largely from institutional and relational dynamics rather than patient contact. CONCLUSIONS: Rehabilitation professionals experience a complex balance of meaning and fatigue. Organizational support, structured supervision, and participatory dialogue with management are crucial to sustain well-being and preserve care quality.