1
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Apathy NC, Holmgren AJ, Cross DA. Physician EHR Time and Visit Volume Following Adoption of Team-Based Documentation Support. JAMA Intern Med 2024; 184:1212-1221. [PMID: 39186284 PMCID: PMC11348094 DOI: 10.1001/jamainternmed.2024.4123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 06/25/2024] [Indexed: 08/27/2024]
Abstract
Importance Physicians spend the plurality of active electronic health record (EHR) time on documentation. Excessive documentation limits time spent with patients and is associated with burnout. Organizations need effective strategies to reduce physician documentation burden; however, evidence on team-based documentation (eg, medical scribes) has been limited to small, single-institution studies lacking rigorous estimates of how documentation support changes EHR time and visit volume. Objectives To analyze how EHR documentation time and visit volume change following the adoption of team-based documentation approaches. Design, Setting, and Participants This national longitudinal cohort study analyzed physician-week EHR metadata from September 2020 through April 2021. A 2-way fixed-effects difference-in-differences regression approach was used to analyze changes in the main outcomes after team-based documentation support adoption. Event study regression models were used to examine variation in changes over time and stratified models to analyze the moderating role of support intensity. The sample included US ambulatory physicians using the EHR. Data were analyzed between October 2022 and September 2023. Exposure Team-based documentation support, defined as new onset and consistent use of coauthored documentation with another clinical team member. Main Outcomes and Measures The main outcomes included weekly visit volume, EHR documentation time, total EHR time, and EHR time outside clinic hours. Results Of 18 265 physicians, 1024 physicians adopted team-based documentation support, with 17 241 comparison physicians who did not adopt such support. The sample included 57.2% primary care physicians, 31.6% medical specialists, and 11.2% surgical specialists; 40.0% practiced in academic settings and 18.4% in outpatient safety-net settings. For adopter physicians, visit volume increased by 6.0% (2.5 visits/wk [95% CI, 1.9-3.0]; P < .001), and documentation time decreased by 9.1% (23.3 min/wk [95% CI, -30.3 to -16.2]; P < .001). Following a 20-week postadoption learning period, visits per week increased by 10.8% and documentation time decreased by 16.2%. Only high-intensity adopters (>40% of note text authored by others) realized reductions in documentation time, both for the full postadoption period (-53.9 min/wk [95% CI, -65.3 to -42.4]; 21.0% decrease; P < .001) and following the learning period (-72.2 min/wk; 28.1% decrease). Low adopters saw no meaningful change in EHR time but realized a similar increase in visit volume. Conclusions and Relevance In this national longitudinal cohort study, physicians who adopted team-based documentation experienced increased visit volume and reduced documentation and EHR time, especially after a learning period.
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Affiliation(s)
- Nate C. Apathy
- Department of Health Policy and Management, University of Maryland School of Public Health, College Park
| | - A. Jay Holmgren
- Division of Clinical Informatics and Digital Transformation, University of California, San Francisco
| | - Dori A. Cross
- Division of Health Policy & Management, University of Minnesota School of Public Health, Minneapolis
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2
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Cantor J, Whaley CM, Ward J, Jena AB. COVID-19 School Closures Were Associated With A Decline In Employment For Female Nurses With Young Children. Health Aff (Millwood) 2024; 43:1329-1337. [PMID: 39226495 DOI: 10.1377/hlthaff.2023.01250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2024]
Abstract
COVID-19-related school closures may have had unintended consequences affecting the ability of health professionals with school-age children to work-particularly female professionals, who often have disproportionate child care responsibilities. We combined labor-force participation data from the Current Population Survey with measures of school closures based on cell phone mobility data to examine the association between local school closures and labor supply among female nurses during the COVID-19 pandemic. During the six months after large-scale closure of schools at the end of the 2019-20 school year (March-August 2020), among counties with above-median school closure rates, the employment rate of female nurses with young children declined by 12.5 percentage points versus the rate during the prior four months (November 2019-February 2020); the change in the employment rate in below-median counties was not statistically significant. No statistically significant changes were observed among female nurses who had only older children or among male nurses. During public health emergencies, policies should consider how disruptions to schooling may affect the labor supply of health care professionals. Strategies might include direct provision of child care by health care facilities, subsidies and other aid to child care centers, or subsidies to health care workers for affordable child care.
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Affiliation(s)
| | | | | | - Anupam B Jena
- Anupam B. Jena , Harvard University, Boston, Massachusetts
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3
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Carlasare LE, Wang H, West CP, Trockel M, Dyrbye LN, Tutty M, Sinsky C, Shanafelt TD. Associations Between Organizational Support, Burnout, and Professional Fulfillment Among US Physicians During the First Year of the COVID-19 Pandemic. J Healthc Manag 2024; 69:368-386. [PMID: 39240266 DOI: 10.1097/jhm-d-23-00124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2024]
Abstract
GOAL This research aimed to evaluate variations in perceived organizational support among physicians during the first year of the COVID-19 pandemic and the associations between perceived organizational support, physician burnout, and professional fulfillment. METHODS Between November 20, 2020, and March 23, 2021, 1,162 of 3,671 physicians (31.7%) responded to the study survey by mail, and 6,348 of 90,000 (7.1%) responded to an online version. Burnout was assessed using the Maslach Burnout Inventory, and perceived organizational support was assessed by questions developed and previously tested by the Stanford Medicine WellMD Center. Professional fulfillment was measured using the Stanford Professional Fulfillment Index. PRINCIPAL FINDINGS Responses to organizational support questions were received from 5,933 physicians. The mean organizational support score (OSS) for male physicians was higher than the mean OSS for female physicians (5.99 vs. 5.41, respectively, on a 0-10 scale, higher score favorable; p < .001). On multivariable analysis controlling for demographic and professional factors, female physicians (odds ratio [OR] 0.66; 95% CI: 0.55-0.78) and physicians with children under 18 years of age (OR 0.72; 95% CI: 0.56-0.91) had lower odds of an OSS in the top quartile (i.e., a high OSS score). Specialty was also associated with perceived OSS in mean-variance analysis, with some specialties (e.g., pathology and dermatology) more likely to perceive significant organizational support relative to the reference specialty (i.e., internal medicine subspecialty) and others (e.g., anesthesiology and emergency medicine) less likely to perceive support. Physicians who worked more hours per week (OR for each additional hour/week 0.99; 95% CI: 0.99-1.00) were less likely to have an OSS in the top quartile. On multivariable analysis, adjusting for personal and professional factors, each one-point increase in OSS was associated with 21% lower odds of burnout (OR 0.79; 95% CI: 0.77-0.81) and 32% higher odds of professional fulfillment (OR 1.32; 95% CI: 1.28-1.36). PRACTICAL APPLICATIONS Perceived organizational support of physicians during the COVID-19 pandemic was associated with a lower risk of burnout and a higher likelihood of professional fulfillment. Women physicians, physicians with children under 18 years of age, physicians in certain specialties, and physicians working more hours reported lower perceived organizational support. These gaps must be addressed in conjunction with broad efforts to improve organizational support.
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Affiliation(s)
| | - Hanhan Wang
- Stanford University School of Medicine, Palo Alto, California
| | - Colin P West
- Mayo Clinic, Department of General Internal Medicine, Rochester, Minnesota
| | - Mickey Trockel
- Stanford University School of Medicine, Palo Alto, California
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4
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de Wit K, Tran A, Clayton N, Seeburruth D, Lim RK, Archambault PM, Chan TM, Rang LCF, Gray S, Ritchie K, Gérin-Lajoie C, Mercuri M. A Longitudinal Survey on Canadian Emergency Physician Burnout. Ann Emerg Med 2024; 83:576-584. [PMID: 38323951 DOI: 10.1016/j.annemergmed.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 12/11/2023] [Accepted: 01/04/2024] [Indexed: 02/08/2024]
Abstract
STUDY OBJECTIVE Since Canada eased pandemic restrictions, emergency departments have experienced record levels of patient attendance, wait times, bed blocking, and crowding. The aim of this study was to report Canadian emergency physician burnout rates compared with the same physicians in 2020 and to describe how emergency medicine work has affected emergency physician well-being. METHODS This longitudinal study on Canadian emergency physician wellness enrolled participants in April 2020. In September 2022, participants were invited to a follow-up survey consisting of the Maslach Burnout Inventory and an optional free-text explanation of their experience. The primary outcomes were emotional exhaustion and depersonalization levels, which were compared with the Maslach Burnout Inventory survey conducted at the end of 2020. A thematic analysis identified common stressors, challenges, emotions, and responses among participants. RESULTS The response rate to the 2022 survey was 381 (62%) of 615 between September 28 and October 28, 2022, representing all provinces or territories in Canada (except Yukon). The median participant age was 42 years. In total, 49% were men, and 93% were staff physicians with a median of 12 years of work experience. 59% of respondents reported high emotional exhaustion, and 64% reported high depersonalization. Burnout levels in 2022 were significantly higher compared with 2020. Prevalent themes included a broken health care system, a lack of societal support, and systemic workplace challenges leading to physician distress and loss of physicians from the emergency workforce. CONCLUSION We found very high burnout levels in emergency physician respondents that have increased since 2020.
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Affiliation(s)
- Kerstin de Wit
- Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada; Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
| | - Anna Tran
- School of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Natasha Clayton
- Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada; Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, Ontario, Canada; Emergency Department, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Darshana Seeburruth
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Rodrick K Lim
- Department of Pediatrics and Medicine, Western University, London, Ontario, Canada
| | - Patrick M Archambault
- Department of Family and Emergency Medicine, Université Laval, Québec City, Québec, Canada; Centre Intégré en Santé et Services Sociaux de Chaudière-Appalaches, Lévis, Québec, Canada
| | - Teresa M Chan
- Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, Ontario, Canada; Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada; McMaster Education Research, Innovation, and Theory (MERIT) program, McMaster University, Hamilton, Ontario, Canada; Dean of the School of Medicine, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Louise C F Rang
- Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada
| | - Sara Gray
- Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Kerri Ritchie
- People Health and Wellness and the Ottawa Hospital Research Institute, the Ottawa Hospital, Ottawa, Ontario, Canada
| | | | - Mathew Mercuri
- Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Institute for the Future of Knowledge, University of Johannesburg, Auckland Park, South Africa
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5
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Richards S, Wang T, Abel ED, Linzer M, Romberger D. Sustainable. Am J Med 2024; 137:552-558. [PMID: 38492767 DOI: 10.1016/j.amjmed.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 03/01/2024] [Indexed: 03/18/2024]
Affiliation(s)
- Sarah Richards
- Department of Medicine, University of Nebraska Medical Center, Omaha
| | | | | | - Mark Linzer
- Department of Medicine, Hennepin Healthcare and University of Minnesota, Minneapolis.
| | - Debra Romberger
- Department of Medicine, University of Nebraska Medical Center, Omaha
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6
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Corrente M, Park J, Akuamoah-Boateng H, Atanackovic J, Bourgeault IL. Work & life stress experienced by professional workers during the pandemic: a gender-based analysis. BMC Public Health 2024; 24:1441. [PMID: 38811928 PMCID: PMC11137937 DOI: 10.1186/s12889-024-18677-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 04/22/2024] [Indexed: 05/31/2024] Open
Abstract
The COVID-19 pandemic impacted work and home life exacerbating pre-existing stressors and introducing new ones. These impacts were notably gendered. In this paper, we explore the different work and home life related stressors of professional workers specifically as a result of the COVID-19 pandemic through the gender-based analysis of two pan Canadian surveys: The Canadian Community Health Survey (2019, 2020, 2021) and the Healthy Professional Worker Survey (2021). Analyses revealed high rates of work stress among professional workers compared to other workers and this was particularly notable for women. Work overload emerged as the most frequently selected source of work stress, followed by digital stress, poor work relations, and uncertainty. Similar trends were noted in life stress among professional workers, particularly women. Time pressure consistently stood out as the primary source of non-work stress, caring for children and physical and mental health conditions. These findings can help to develop more targeted and appropriate workplace mental health promotion initiatives that are applicable to professional workers taking gender more fully into consideration.
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Affiliation(s)
- Melissa Corrente
- School of Sociological and Anthropological Studies, University of Ottawa, 120 University Private, 75 Laurier Ave E, Ottawa, ON, K1N6N5, Canada
| | - Jungwee Park
- Health Analysis Division, Statistics Canada, 150 Tunney's Pasture Driveway, Ottawa, ON, Canada
| | - Henrietta Akuamoah-Boateng
- School of Sociological and Anthropological Studies, University of Ottawa, 120 University Private, 75 Laurier Ave E, Ottawa, ON, K1N6N5, Canada
| | - Jelena Atanackovic
- School of Sociological and Anthropological Studies, University of Ottawa, 120 University Private, 75 Laurier Ave E, Ottawa, ON, K1N6N5, Canada
| | - Ivy Lynn Bourgeault
- School of Sociological and Anthropological Studies, University of Ottawa, 120 University Private, 75 Laurier Ave E, Ottawa, ON, K1N6N5, Canada.
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7
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Lippert JF, Lewis T, Bruce D, Trifunović N, Singh M, Prachand N. Work-related factors of mental health among Chicago residents two years into the COVID-19 pandemic. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2024; 21:365-377. [PMID: 38560920 DOI: 10.1080/15459624.2024.2323108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
The COVID-19 pandemic led to widespread consequences for economic, social, and general wellbeing with rates of anxiety and depression increasing across the population and disproportionately for some workers. This study explored which factors were the most salient contributors to mental health through a cross-sectional 68-item questionnaire that addressed topics related to the pandemic. Data were collected through an address-based sampling frame over the two months from April 2022 to June 2022. A total of 2,049 completed surveys were collected throughout Chicago's 77 Community Areas. Descriptive statistics including frequency and percentages were generated to describe workplace characteristics, work-related stress, and sample demographics and their relationship to psychological distress. Independent participant and workplace factors associated with the outcomes were identified using multivariable logistic regression. The weighted prevalence of persons experiencing some form of psychological distress from mild to serious was 32%. After adjusting for potential confounding factors, certain marginalized communities experienced psychological distress more than others including females, adults over the age of 25 years of age, and people with higher income levels. Those who had been laid off, lost pay, or had reduced hours had increased odds of psychological distress (aOR = 1.71, CI95% 1.14-2.56; p = 0.009) as did people that reported that their work-related stress was somewhat or much worse as compared to before the COVID-19 pandemic (aOR = 2.22, CI95% 1.02-4.82; p = 0.04, aOR = 11.0, CI95% 4.65-26.1; p < 0.001, respectively). These results warrant further investigation and consideration in developing workplace and mental health interventions.
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Affiliation(s)
- Julia F Lippert
- Department of Health Sciences, DePaul University, Chicago, Illinois
| | - Taylor Lewis
- RTI International, Washington, District of Columbia
| | - Douglas Bruce
- Department of Health Sciences, DePaul University, Chicago, Illinois
| | - Nena Trifunović
- Department of Health Sciences, DePaul University, Chicago, Illinois
| | - Meha Singh
- Office of Epidemiology, Chicago Department of Public Health, Chicago, Illinois
| | - Nik Prachand
- Office of Epidemiology, Chicago Department of Public Health, Chicago, Illinois
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8
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MacCallum-Bridges CL, Admon LK, Daw JR. Childcare disruptions and maternal health during the COVID-19 pandemic. HEALTH AFFAIRS SCHOLAR 2024; 2:qxae061. [PMID: 38774574 PMCID: PMC11108245 DOI: 10.1093/haschl/qxae061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 04/29/2024] [Accepted: 05/03/2024] [Indexed: 05/24/2024]
Abstract
During the COVID-19 pandemic, nearly all US states enacted stay-at-home orders, upending usual childcare arrangements and providing a unique opportunity to study the association between childcare disruptions and maternal health. Using data from the 2021-2022 National Survey of Children's Health, we estimated the association between childcare disruptions due to the COVID-19 pandemic and self-reported mental and physical health among female parents of young children (ages 0-5 years). Further, we assessed racial, ethnic, and socioeconomic disparities in (1) the prevalence of childcare disruptions due to the COVID-19 pandemic and (2) the association between childcare disruptions and mental or physical health. Female parents who experienced childcare disruptions due to the COVID-19 pandemic were less likely to report excellent or very good mental (-7.4 percentage points) or physical (-2.5 percentage points) health. Further, childcare disruptions were more common among parents with greater socioeconomic privilege (ie, higher education, higher income), but may have been more detrimental to health among parents with less socioeconomic privilege (eg, lower education, lower income, and single parents). As state and federal policymakers take action to address the maternal health crisis in the United States, our findings suggest that measures to improve childcare stability may also promote maternal health and health equity.
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Affiliation(s)
| | - Lindsay K Admon
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI 48109, United States
| | - Jamie R Daw
- Department of Health Policy and Management, Columbia University Mailman School of Public Health, New York, NY 10032, United States
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9
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Williams-Brown MY, Summey RM, Newtson A, Burke W, Turner T, Sabu P, Davidson BA, Glaser G. System-level recommendations for improved wellness for gynecologic oncologists: A Society of Gynecologic Oncology Review. Gynecol Oncol 2024; 183:85-92. [PMID: 38554478 DOI: 10.1016/j.ygyno.2024.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 03/15/2024] [Accepted: 03/19/2024] [Indexed: 04/01/2024]
Abstract
Burnout and its negative sequelae are a persistent problem in gynecologic oncology, threatening the health of our physician workforce. Individual-level interventions such as stress management training, physical activity, and sleep hygiene only partially address this widespread, systemic crisis rooted in the extended work hours and stressful situations associated with gynecologic oncology practice. There is an urgent need for systematic, institution-level changes to allow gynecologic oncologists to continue the crucial work of caring for people with gynecologic cancer. We present recommendations for institution-level changes which are grounded in the framework presented by the National Plan for Health Workforce Well-Being by the National Academy of Medicine. These are aimed at facilitating gynecologic oncologists' well-being and reduction of burnout. Recommendations include efforts to create a more positive and inclusive work environment, decrease administrative barriers, promote mental health, optimize electronic medical record use, and support a diverse workforce. Implementation and regular evaluation of these interventions, with specific attention to at-risk groups, is an important next step.
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Affiliation(s)
- M Y Williams-Brown
- Department of Women's Health, Dell Medical School at The University of Texas at Austin, Austin, TX, United States of America.
| | - R M Summey
- Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - A Newtson
- Department of Obstetrics and Gynecology, University of Nebraska Medical Center, Omaha, NE, United States of America
| | - W Burke
- Department of Obstetrics, Gynecology and Reproductive Medicine, Stony Brook University Cancer Center, Stony Brook, NY, United States of America
| | - T Turner
- St. Luke's Cancer Institute, Boise, ID, United States of America
| | - P Sabu
- Division of Gynecologic Oncology, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - B A Davidson
- Division of Gynecologic Oncology, Duke University, Durham, NC, United States of America
| | - G Glaser
- Division of Gynecologic Oncology, Mayo Clinic College of Medicine, Rochester, MN, United States of America
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10
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O'Connor TM, Guaman MC, Randell KA, Keenan HT, Snowden J, Mack JW, Camp EA, Perez O, Chang ML, Myers AL, Nigrovic LE, O'Toole J, Reed JL, Reese J, Rosenberg AR, Slater AC, Wootton SH, Ziniel SI, Yost HJ, Murray KO, Shekerdemian L, Chumpitazi CE. Impact of the COVID-19 pandemic on pediatric faculty: a report from nine academic institutions. Pediatr Res 2024; 95:775-784. [PMID: 37454186 DOI: 10.1038/s41390-023-02726-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 06/05/2023] [Accepted: 06/14/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND The COVID-19 pandemic affected home and work routines, which may exacerbate existing academic professional disparities. Objectives were to describe the impact of the pandemic on pediatric faculty's work productivity, identify groups at risk for widening inequities, and explore mitigation strategies. METHODS A cross-sectional study of faculty members was conducted at nine U.S. pediatric departments. Responses were analyzed by demographics, academic rank, and change in home caregiving responsibility. RESULTS Of 5791 pediatric faculty members eligible, 1504 (26%) completed the survey. The majority were female (64%), over 40 years old (60%), and assistant professors (47%). Only 7% faculty identified as underrepresented in medicine. Overall 41% reported an increase in caregiving during the pandemic. When comparing clinical, administrative, research, and teaching activities, faculty reported worse 1-year outlook for research activities. Faculty with increased caregiving responsibilities were more likely to report concerns over delayed promotion and less likely to have a favorable outlook regarding clinical and research efforts. Participants identified preferred strategies to mitigate challenges. CONCLUSIONS The COVID-19 pandemic negatively impacted pediatric faculty productivity with the greatest effects on those with increased caregiving responsibilities. COVID-19 was particularly disruptive to research outlook. Mitigation strategies are needed to minimize the long-term impacts on academic pediatric careers. IMPACT The COVID-19 pandemic most negatively impacted work productivity of academic pediatric faculty with caregiving responsibilities. COVID-19 was particularly disruptive to short-term (1-year) research outlook among pediatric faculty. Faculty identified mitigation strategies to minimize the long-term impacts of the pandemic on academic pediatric career pathways.
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Affiliation(s)
- Teresia M O'Connor
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
- Division of Academic General Pediatrics, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
| | - Milenka Cuevas Guaman
- Division of Neonatology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Kimberly A Randell
- Division of Emergency Medicine, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA
- University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
- University of Kansas School of Medicine, Kansas City, KS, USA
| | - Heather T Keenan
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Jessica Snowden
- Section of Infectious Disease, Department of Pediatrics, University of Arkansas Medical School, Little Rock, AR, USA
| | - Jennifer W Mack
- Division of Hematology and Oncology, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Elizabeth A Camp
- Division of Emergency Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Oriana Perez
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Michael L Chang
- Division of Infectious Diseases, Department of Pediatrics, UT Health Houston McGovern Medical School and Children's Memorial Hermann Hospital, Houston, TX, USA
| | - Angela L Myers
- University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
- University of Kansas School of Medicine, Kansas City, KS, USA
- Division of Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Lise E Nigrovic
- Division of Emergency Medicine, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jennifer O'Toole
- Department of Pediatrics and Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Cincinnati Children's Hospital Medical Center, Division of Hospital Medicine, Cincinnati, OH, USA
- UC Health, Department of Internal Medicine, Cincinnati, OH, USA
| | - Jennifer L Reed
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Cincinnati Children's Hospital Medical Center, Division of Emergency Medicine, Cincinnati, OH, USA
| | - Jennifer Reese
- Division of Hospital Medicine, Department of Pediatrics, University of Colorado, Aurora, CO, USA
| | - Abby R Rosenberg
- Division of Hematology and Oncology, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
- Department of Psychosocial Oncology & Palliative Care, Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Anne C Slater
- Division of Emergency Medicine, Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Susan H Wootton
- Division of Infectious Diseases, Department of Pediatrics, UT Health Houston McGovern Medical School and Children's Memorial Hermann Hospital, Houston, TX, USA
| | - Sonja I Ziniel
- Division of Hospital Medicine, Department of Pediatrics, University of Colorado, Aurora, CO, USA
| | - H Joseph Yost
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Kristy O Murray
- Division of Tropical Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Lara Shekerdemian
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Corrie E Chumpitazi
- Division of Emergency Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
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11
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Akinleye D, Wu M, Efferen LS, McCauley S, Allen A, Bennett H, Snitkoff LS, Cleary LM, Bliss K, Martiniano R, Wang S, McNutt LA, Osinaga A. Newly Acquired Burnout During the Coronavirus Disease 2019 (COVID-19) Pandemic: A Retrospective Cohort Study on the Experiences of New York State Primary Care Clinicians. J Community Health 2024; 49:34-45. [PMID: 37382837 DOI: 10.1007/s10900-023-01247-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2023] [Indexed: 06/30/2023]
Abstract
The well-being of primary care clinicians represents an area of increasing interest amid concerns that the COVID-19 pandemic may have exacerbated already high prevalence rates of clinician burnout. This retrospective cohort study was designed to identify demographic, clinical, and work-specific factors that may have contributed to newly acquired burnout after the onset of the COVID-19 pandemic. An anonymous web-based questionnaire distributed in August 2020 to New York State (NYS) primary care clinicians, via email outreach and newsletters, produced 1,499 NYS primary care clinician survey respondents. Burnout assessment was measured pre-pandemic and early in the pandemic using a validated single-item question with a 5-point scale ranging from (1) enjoy work to (5) completely burned out. Demographic and work factors were assessed via the self-reporting questionnaire. Thirty percent of 1,499 survey respondents reported newly acquired burnout during the early pandemic period. This was more often reported by clinicians who were women, were younger than 56 years old, had adult dependents, practiced in New York City, had dual roles (patient care and administration), and were employees. Lack of control in the workplace prior to the pandemic was predictive of burnout early in the pandemic, while work control changes experienced following the pandemic were associated with newly acquired burnout. Low response rate and potential recall bias represent limitations. These findings demonstrate that reporting of burnout increased among primary care clinicians during the pandemic, partially due to varied and numerous work environment and systemic factors.
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Affiliation(s)
- Dean Akinleye
- Bureau of Clinical Research and Evaluation, Office of Quality and Patient Safety, New York State Department of Health, Empire State Plaza, Corning Tower, Room 1955, Albany, NY, 12237, USA.
| | - Meng Wu
- Bureau of Clinical Research and Evaluation, Office of Quality and Patient Safety, New York State Department of Health, Empire State Plaza, Corning Tower, Room 1955, Albany, NY, 12237, USA
| | - Linda S Efferen
- Office of Quality and Patient Safety, New York State Department of Health, ESP Corning Tower, Room 2019, Albany, NY, 12237, USA
| | - Susan McCauley
- Office of Quality and Patient Safety, New York State Department of Health, ESP Corning Tower, Room 2019, Albany, NY, 12237, USA
| | - Amanda Allen
- Communications, New York Chapter of the American College of Physicians, PO Box 38237, Albany, NY, 12203, USA
| | - Heather Bennett
- Diversity Equity and Inclusion Task Force, New York Chapter of the American College of Physicians, PO Box 38237, Albany, NY, 12203, USA
| | - Louis S Snitkoff
- Albany Medical College, New York Chapter of the American College of Physicians, PO Box 38237, Albany, NY, 12203, USA
| | - Lynn M Cleary
- Upstate Medical University, 750 East Adams Street, Syracuse, NY, 13210, USA
| | - Kate Bliss
- Office of Health Insurance Programs, New York State Department of Health, ESP Corning Tower, Room, Albany, NY, 12237, USA
| | - Robert Martiniano
- Center for Health Workforce Studies, University at Albany School of Public Health, 1 University Plaza, Pl #220, Rensselaer, NY, 12144, USA
| | - Shen Wang
- Center for Health Workforce Studies, University at Albany School of Public Health, 1 University Plaza, Pl #220, Rensselaer, NY, 12144, USA
| | - Louise-Ann McNutt
- Institute for Health and the Environment, University at Albany, State University of New York, 5 University Place, Room A217, Rensselaer, NY, 12144, USA
| | - Alda Osinaga
- Office of Quality and Patient Safety, New York State Department of Health, ESP Corning Tower, Room 2019, Albany, NY, 12237, USA
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Zhong J, Bradford V, Fernandez AM, Infosino A, Soneru CN, Staffa SJ, Raman VT, Cravero J, Zurakowski D, Meier PM. Continued challenges in pediatric anesthesia during COVID-19 in 2022: An international survey from the pediatric anesthesia COVID-19 collaborative. Paediatr Anaesth 2023; 33:1020-1028. [PMID: 37732382 DOI: 10.1111/pan.14762] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 08/27/2023] [Accepted: 09/04/2023] [Indexed: 09/22/2023]
Abstract
INTRODUCTION This international survey explored the ongoing impact of COVID-19 on pediatric anesthesiology. It assessed COVID-19's impact on the practice of pediatric anesthesiology, staffing, job satisfaction, and retention at the beginning of 2022 and addressed what should be done to ameliorate COVID-19's impact and what initiatives hospitals had implemented. METHODS This survey focused on five major domains: equipment/medication, vaccination/testing, staffing, burnout, and economic repercussions. Pilot testing for questionnaire clarity was conducted by members of the Pediatric Anesthesia COVID-19 Collaborative. The survey was administered by e-mail to a representative of the 72 collaborative centers. Respondents were instructed to answer based on their institution's practice from February through April of 2022. Descriptive statistics with 95% confidence intervals are reported. RESULTS Seventy of seventy-two institutions participated in this survey (97% response rate). Fifty-nine (84%) were from the United States, and 11 (16%) included other countries. The majority experienced equipment (68%) and medication (60%) shortages. Many institutions reported staffing shortages in nursing (37%), perioperative staff (27%), and attending anesthesiologists (11%). Sixty-two institutions (89%) indicated burnout was a frequent topic of conversation among pediatric anesthesiologists. Forty-three institutions (61%) reported anesthesiologists leaving current practice and 37 (53%) early retirement. Twenty-eight institutions (40%) canceled elective cases. The major suggestions for improving job retention included improving financial compensation (76%), decreasing clinical time (67%), and increasing flexibility in scheduled clinical time (66%). Only a minority of institutions had implemented the following initiatives: improving financial compensation (19%), increased access to mental health/counseling services (30%), and assistance with child or elder care (7%). At the time of the survey, 34% of institutions had not made any changes. CONCLUSION Our study found that COVID-19 has continued to impact pediatric anesthesiology. There are major discrepancies between what anesthesiologists believe are important for job satisfaction and faculty retention compared to implemented initiatives. Data from this survey provide insight for institutions and departments for addressing these challenges.
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Affiliation(s)
- John Zhong
- Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Victoria Bradford
- Department of Anesthesiology, University of Kentucky, Lexington, Kentucky, USA
| | - Allison M Fernandez
- Department of Anesthesia, Pain and Perioperative Medicine, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA
| | - Andrew Infosino
- Department of Anesthesia and Perioperative Care, University of California, San Francisco, California, USA
| | - Codruta N Soneru
- Department of Anesthesiology and Critical Care Medicine, University of New Mexico, Albuquerque, New Mexico, USA
| | - Steven J Staffa
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Vidya T Raman
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Joseph Cravero
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - David Zurakowski
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Petra M Meier
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Becker A, Sullivan EE, Leykum LK, Brown R, Linzer M, Poplau S, Sinsky C. Burnout Among Hospitalists During the Early COVID-19 Pandemic: a National Mixed Methods Survey Study. J Gen Intern Med 2023; 38:3581-3588. [PMID: 37507550 PMCID: PMC10713906 DOI: 10.1007/s11606-023-08309-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 06/28/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND : Hospitalist physician stress was exacerbated by the pandemic, yet there have been no large scale studies of contributing factors. OBJECTIVE Assess remediable components of burnout in hospitalists. PARTICIPANTS, STUDY DESIGN AND MEASURES In this Coping with COVID study, we focused on assessment of stress factors among 1022 hospital-based clinicians surveyed between April to December 2020. We assessed variables previously associated with burnout (anxiety/depression due to COVID-19, work overload, fear of exposure or transmission, mission/purpose, childcare stress and feeling valued) on 4 point Likert scales, with results dichotomized with the top two categories meaning "present"; burnout was assessed with the Mini Z single item measure (top 3 choices = burnout). Quantitative analyses utilized multilevel logistic regression; qualitative analysis used inductive and deductive methods. These data informed a conceptual model. KEY RESULTS Of 58,408 HCWs (median response rate 32%), 1022 were hospital-based clinicians (906 (89%) physicians; 449 (44%) female; 469 (46%) White); 46% of these hospital-based clinicians reported burnout. Work overload was associated with almost 5 times the odds of burnout (OR 4.9, 95% CIs 3.67, 6.85, p < 0.001), and those with anxiety or depression had 4 times the odds of burnout (OR 4.2, CIs 3.21, 7.12, p < 0.001), while those feeling valued had half the burnout odds (OR 0.43, CIs 0.31, 0.61, p < 0.001). Regression models estimated 42% of burnout variance was explained by these variables. In open-ended comments, leadership support was helpful, with "great leadership" represented by transparency, regular updates, and opportunities to ask questions. CONCLUSIONS In this national study of hospital medicine, 2 variables were significantly related to burnout (workload and mental health) while two variables (feeling valued and leadership) were likely mitigators. These variables merit further investigation as means of reducing burnout in hospital medicine.
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Affiliation(s)
| | - Erin E Sullivan
- Sawyer Business School, Suffolk University, Boston, MA, USA
- Harvard Medical School Center for Primary Care, Boston, MA, USA
| | - Luci K Leykum
- The University of Texas at Austin, Dell Medical School, Austin, TX, USA
- South Texas Veterans Health Care System, San Antonio, TX, USA
| | - Roger Brown
- University of Wisconsin School of Nursing, Madison, WI, USA
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Ligibel JA, Goularte N, Berliner JI, Bird SB, Brazeau CMLR, Rowe SG, Stewart MT, Trockel MT. Well-Being Parameters and Intention to Leave Current Institution Among Academic Physicians. JAMA Netw Open 2023; 6:e2347894. [PMID: 38100103 PMCID: PMC10724765 DOI: 10.1001/jamanetworkopen.2023.47894] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 11/01/2023] [Indexed: 12/18/2023] Open
Abstract
Importance Physician turnover interrupts care delivery and creates health care system financial burden. Objective To describe the prevalence of burnout, professional fulfillment, and intention to leave (ITL) among physicians at academic-affiliated health care systems and identify institutional and individual factors associated with ITL. Design, Setting, and Participants This cross-sectional study administered a survey to 37 511 attending-level medical specialists at 15 academic medical institutions participating in the Healthcare Professional Well-Being Academic Consortium. Data were collected from October 2019 to July 2021. Statistical analysis was performed from May 2022 to March 2023. Exposures Hypothesized institutional and individual determinants of occupational well-being. Main Outcomes and Measures The main outcome was ITL, defined as having at least a moderate intention (a score of 2 on a 0-4 scale) to leave one's institution within the next 2 years. Additional outcomes included burnout and professional fulfillment, defined using published Professional Fulfillment Index cut points. Results Of 18 719 academic physician survey respondents (8381 [44.8%] male; 2388 [12.8%] Asian, 10 599 [56.6%] White, 1039 [5.6%] other race, 4693 [25.1%] unknown race; 294 [1.6%] Hispanic or Latina/Latino/Latinx), 6903 of 18 217 (37.9%) met criteria for burnout and 7301 of 18 571 (39.3%) for professional fulfillment; 5177 of 15 890 (32.6%) reported moderate or greater ITL. Burnout, professional fulfillment, and ITL varied across specialties. After adjusting for demographics, each 1-point increase (range 0-10) in burnout was directly associated with ITL (odds ratio [OR], 1.52 [95% CI, 1.49-1.55])c, and each 1-point increase in professional fulfillment was inversely associated with ITL (OR, 0.64 [95% CI, 0.63-0.65]). After adjusting for demographics, burnout, and professional fulfillment, each 1-point increase (range 0-10) in supportive leadership behaviors (OR, 0.83 [95% CI, 0.82-0.84]), peer support (OR, 0.93 [95% CI, 0.91-0.95]), personal-organizational values alignment (OR, 0.81 [95% CI, 0.80-0.82]), perceived gratitude (OR, 0.95 [95% CI, 0.92-0.97]), COVID-19 organizational support (OR, 0.88 [95% CI, 0.85-0.91]), and electronic health record helpfulness (OR, 0.95 [95% CI, 0.93-0.97]) were inversely associated with ITL, whereas each 1-point increase (range 0-10) in depression (OR, 1.08 [95% CI, 1.05-1.10]) and negative impact of work on personal relationships (OR, 1.09 [1.07-1.11]) were directly associated with ITL. Conclusions and Relevance In this cross-sectional study of academic physicians, 32.6% indicated moderate or higher ITL within 2 years. Burnout, lack of professional fulfillment, and other well-being factors were associated with ITL, suggesting the need for a comprehensive approach to reduce physician turnover.
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Affiliation(s)
- Jennifer A. Ligibel
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Nicolette Goularte
- WellMD & WellPhD, Stanford University School of Medicine, Stanford, California
| | - Jennifer I. Berliner
- Division of Cardiology and The Heart and Vascular Institute, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Steven B. Bird
- Department of Emergency Medicine, UMass Chan Medical School, Worcester, Massachusetts
| | | | - Susannah G. Rowe
- Department of Ophthalmology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
- Office of Equity, Vitality and Inclusion, Boston Medical Center, Boston University Medical Group, Boston, Massachusetts
| | - Miriam T. Stewart
- Division of General Pediatrics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia
| | - Mickey T. Trockel
- WellMD & WellPhD, Stanford University School of Medicine, Stanford, California
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Zhao JL, Shen L, Shields J, Wang YX, Wu YJ, Yu Z, Li YX. Nurses' Work-Family Strategies during COVID-19 Lockdown and Their Association with Individual Health and Family Relations. Healthcare (Basel) 2023; 11:2960. [PMID: 37998452 PMCID: PMC10671543 DOI: 10.3390/healthcare11222960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 10/31/2023] [Accepted: 11/07/2023] [Indexed: 11/25/2023] Open
Abstract
The COVID-19 lockdown forced people to stay at home and address their family duties more equally. However, since nurses themselves were involved in the closed-loop management in hospitals and unable to return home, there was also an increased likelihood of non-traditional work-family strategies emerging. To ascertain the extant and implications of this phenomenon, this cross-sectional study explores work-family management strategies among nurses during the COVID-19 lockdown and their association with nurses' individual health, family relationships, and job performance. Survey data were collected from 287 nurses who were involved in the closed-loop management in Shanghai hospitals from March to June 2022. Latent Class Analysis of seven categorical variables of nurses' work-family status (e.g., the division of childcare labor) produced a best-fit solution of five strategies (BLRT (p) < 0.001, LMR (p) = 0.79, AIC = 5611.34, BIC = 6302.39, SSA-BIC = 5703.65, Entropy = 0.938): (1) fully outsourcing to grandparents, (2) partially outsourcing to grandparents, with the husband filling in the gap, (3) the husband does it all, (4) egalitarian remote workers, and (5) a neo-traditional strategy. Nurses who applied the egalitarian strategy had less psychological distress and relationship tension and better performance than those who applied the neo-traditional strategy and performed most of the childcare. The "husband does it all" strategy and the outsourcing strategies seem to have double-edged effects, with better job performance and family relations but also more distress and fewer sleeping hours among nurses. Overall, with a view to future risk mitigation, policymakers and practitioners should be aware of the diversity of the work-family strategies among nurse families during the lockdown period, and their association with individual and family outcomes, and provide tailored support.
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Affiliation(s)
- Jia-Lin Zhao
- Department of Sociology, College of Philosophy, Law and Political Science, Shanghai Normal University, Shanghai 200234, China; (J.-L.Z.); (Y.-X.W.); (Y.-J.W.); (Y.-X.L.)
| | - Li Shen
- Department of Sociology, School of Public Affairs, Nanjing University of Science and Technology, Nanjing 210014, China
| | - John Shields
- Discipline of Work and Organisational Studies, The University of Sydney Business School, The University of Sydney, Sydney, NSW 2006, Australia;
| | - Ya-Xuan Wang
- Department of Sociology, College of Philosophy, Law and Political Science, Shanghai Normal University, Shanghai 200234, China; (J.-L.Z.); (Y.-X.W.); (Y.-J.W.); (Y.-X.L.)
| | - Yu-Jia Wu
- Department of Sociology, College of Philosophy, Law and Political Science, Shanghai Normal University, Shanghai 200234, China; (J.-L.Z.); (Y.-X.W.); (Y.-J.W.); (Y.-X.L.)
| | - Zhan Yu
- Department of Social Work, School of Social Development, East China Normal University, Shanghai 200062, China;
- Shanghai Social Science Innovation Research Base of “Research on Transitional Sociology with Chinese Characteristics”, Shanghai 200062, China
| | - Yi-Xin Li
- Department of Sociology, College of Philosophy, Law and Political Science, Shanghai Normal University, Shanghai 200234, China; (J.-L.Z.); (Y.-X.W.); (Y.-J.W.); (Y.-X.L.)
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Pajek J, Mancini K, Murray M. COVID-19 and children's behavioral health: An overview. Curr Probl Pediatr Adolesc Health Care 2023; 53:101491. [PMID: 38040607 DOI: 10.1016/j.cppeds.2023.101491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
The paper reviews the impact of the COVID-19 pandemic on children's and adolescents' well-being. A trauma-informed framework is employed to discuss the emerging evidence of notable changes in youth's psychological, developmental, academic, and social well-being since the start of the COVID-19 pandemic. Children and adolescents have been uniquely affected based on their age at the start of the pandemic. Despite multiple resiliency factors, COVID-19 and its ramifications have had an adverse effect on youth in general and have exacerbated preexisting racial and socioeconomic disparities. This review concludes with recommendations for child health clinicians.
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Affiliation(s)
- Julie Pajek
- MetroHealth Medical Center, Case Western Reserve University School of Medicine, 2500 MetroHealth Drive, Cleveland, OH 44109, USA.
| | - Kathryn Mancini
- MetroHealth Medical Center, Case Western Reserve University School of Medicine, 2500 MetroHealth Drive, Cleveland, OH 44109, USA
| | - Marsheena Murray
- MetroHealth Medical Center, Case Western Reserve University School of Medicine, 2500 MetroHealth Drive, Cleveland, OH 44109, USA
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17
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Si X, Xue H, Song X, Liu X, Zhang F. The relationship between ethical leadership and nurse well-being: The mediating role of workplace mindfulness. J Adv Nurs 2023; 79:4008-4021. [PMID: 37226654 DOI: 10.1111/jan.15719] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 04/21/2023] [Accepted: 05/11/2023] [Indexed: 05/26/2023]
Abstract
AIM The purpose of this study was to explore the relationship between nurses' well-being and their ethical leadership, and the mediating role of workplace mindfulness in this relationship. DESIGN This was a quantitative cross-sectional study. METHODS This cross-sectional study was conducted in three tertiary hospitals in central China from May 2022 to July 2022, and the Nurses' Workplace Mindfulness, Ethical Leadership and Well-Being Scale were distributed and collected via the Internet. A total of 1579 nurses volunteered to participate in this study. SPSS 26.0 statistical software was used to analyse the data by Z-test and Spearman's rank correlation; the internal mechanism of workplace mindfulness and ethical leadership on nurses' well-being was completed by AMOS 23.0 statistical software. RESULTS The scores of nurses' well-being, workplace mindfulness and ethical leadership were 93.00 (81.00, 108.00), 96.00 (80.00, 112.00) and 73.00 (67.00, 81.00) respectively. The professional title, age and department atmosphere affect their well-being. Spearman's analysis showed that nurses' well-being was positively correlated with ethical leadership (r = .507, p < .01) and workplace mindfulness (r = .600, p < .01); workplace mindfulness partially mediated the relationship between ethical leadership and nurses' well-being accounting for 38.5% of the total effect ratio [p < .001, 95% CI = (0.215, 0.316)]. CONCLUSION Nurses' well-being was at a medium level, and had a higher score in ethical leadership and workplace mindfulness, and workplace mindfulness played a partial mediating role between ethical leadership and nurses' well-being. IMPACT This suggests that nursing managers need to pay attention to clinical nurses' well-being experience, actively focus on the relationship among ethical leadership, workplace mindfulness and well-being and integrate core values such as positivity and morality into nurses' daily routines, so as to improve the work enthusiasm and well-being experience of clinical nurses, enhancing the nursing quality and stabilizing the nursing team.
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Affiliation(s)
- Xiaona Si
- People's Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, Henan, China
| | - Huiyuan Xue
- People's Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, Henan, China
| | - Xiaoren Song
- People's Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, Henan, China
| | - Xiaoli Liu
- People's Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, Henan, China
| | - Fen Zhang
- People's Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, Henan, China
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Gettel CJ, Courtney DM, Bennett CL, Keim SM, Camargo CA, Venkatesh AK. Attrition From the US Emergency Medicine Workforce During Early Stages of the COVID-19 Pandemic. Ann Emerg Med 2023; 82:234-236. [PMID: 37140492 PMCID: PMC10153599 DOI: 10.1016/j.annemergmed.2023.03.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/01/2023] [Accepted: 03/01/2023] [Indexed: 05/05/2023]
Affiliation(s)
- Cameron J Gettel
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven, CT.
| | - D Mark Courtney
- Department of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, TX
| | - Christopher L Bennett
- Department of Emergency Medicine, Stanford University School of Medicine, Stanford, CA
| | - Samuel M Keim
- Department of Emergency Medicine, University of Arizona College of Medicine, Tucson, AZ
| | - Carlos A Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Arjun K Venkatesh
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven, CT
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19
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Ruza I. Exploring the Road of Women to Medical Leadership: A European Perspective. J Med Internet Res 2023; 25:e49247. [PMID: 37405827 DOI: 10.2196/49247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 05/25/2023] [Indexed: 07/06/2023] Open
Abstract
This paper addresses and discusses several issues and perspectives for women in medical leadership from the European perspective.
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Affiliation(s)
- Ieva Ruza
- Riga East Clinical University Hospital, Riga, Latvia
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20
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Tsang M, Banerjee R, Quiroga D, Idossa D, Schoenbeck KL. Where the Sidewalk Ends: Parenting as a trainee during COVID-19. Cancer Invest 2023:1-14. [PMID: 37243573 DOI: 10.1080/07357907.2023.2219747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/20/2023] [Accepted: 05/25/2023] [Indexed: 05/29/2023]
Abstract
Physicians who are also parents have faced significant difficulties during the COVID-19 pandemic. However, most studies of the physician-parent workforce have focused on the experiences of attending physicians. In this commentary, we highlight the ways that trainee parents have uniquely experienced three major stressors during the pandemic: (1) childcare challenges, (2) scheduling difficulties, and (3) career uncertainties. We discuss potential solutions to mitigate these challenges for the future hematology/oncology workforce. As the pandemic continues, we hope that these steps can improve the ability of trainee parents to care both for their patients and their families.
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Affiliation(s)
- Mazie Tsang
- Division of Hematology and Oncology, Department of Medicine, Mayo Clinic, Phoenix, AZ
| | - Rahul Banerjee
- Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, WA
| | - Dionisia Quiroga
- Division of Hematology/Oncology, Department of Medicine, Ohio State University
| | - Dame Idossa
- Division of Hematology, Oncology, and Transplantation Department of Medicine, University of Minnesota, Minneapolis, MN
| | - Kelly L Schoenbeck
- Division of Hematology/Oncology, Department of Medicine, San Francisco Veteran Affairs Medical Center, San Francisco, CA
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, San Francisco, CA
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Dodelzon K, Grimm LJ, Plimpton SR, Markovic D, Milch HS. Ongoing Impact of COVID-19 on Breast Radiologists' Wellness. JOURNAL OF BREAST IMAGING 2023; 5:287-296. [PMID: 38416885 DOI: 10.1093/jbi/wbac100] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Indexed: 03/01/2024]
Abstract
OBJECTIVE Assess the ongoing impact of COVID-19 on mental well-being of breast radiologists nationwide two years after the start of the pandemic and compared to early in the pandemic. METHODS A 27-question survey was distributed from December 2021 to January 2022 to physician members of the Society of Breast Imaging. Psychological distress and anxiety scores were calculated, and factors associated with them were identified with a multivariate logistic model. RESULTS A total of 550 surveys were completed (23% response rate); the mean respondent age was 50 +/- 10 years. Fifty percent (265/526) of respondents reported two or more psychological distress symptoms, down from 58% in 2020 (P = 0.002), whereas 70% (362/526) of respondents reported increased anxiety, down from 82% in 2020 (P < 0.001). As in 2020, reporting financial strain and childcare adversely affecting job ability were associated with worse psychological distress scores (OR 3.6, 95% CI: 1.6-8.3, P = 0.02 and OR 6.0, 95% CI: 2.5-14.4, P = 0.002, respectively). Less time spent consulting, educating, and discussing results with patients was associated with higher psychological distress (OR 5.3, 95% CI: 2.1-13.2, P = 0.036) and anxiety (OR 6.4, 95% CI: 2.3-17.5, P < 0.001). Diminished research collaboration was associated with higher anxiety (OR 1.8, 95% CI: 1.1-2.9, P = 0.019). CONCLUSION The COVID-19 pandemic continues to cause mental health symptoms in breast radiologists, especially for those with pandemic-specific childcare needs and financial distress. Pandemic-related decreased opportunities to connect with patients and colleagues negatively impacts radiologists' mental health.
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Affiliation(s)
- Katerina Dodelzon
- Weill Cornell Medicine at New York-Presbyterian, Department of Radiology, New York, NY, USA
| | - Lars J Grimm
- Duke University Medical Center, Department of Radiology, Durham, NC, USA
| | - S Reed Plimpton
- David Geffen School of Medicine at UCLA, Department of Radiology, Los Angeles, CA, USA
| | - Daniela Markovic
- David Geffen School of Medicine at UCLA, Department of Radiology, Los Angeles, CA, USA
| | - Hannah S Milch
- David Geffen School of Medicine at UCLA, Department of Radiology, Los Angeles, CA, USA
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22
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Briggs LG, Riew GJ, Kim NH, Aharon S, Klickstein JA, Cao AQ, Lites C, Sedlacek V, Seward MW, Soled DR, Palamara K. Racial and Gender Differences in Medical Student Burnout: A 2021 National Survey. Mayo Clin Proc 2023; 98:723-735. [PMID: 37137644 DOI: 10.1016/j.mayocp.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 11/01/2022] [Accepted: 11/03/2022] [Indexed: 05/05/2023]
Abstract
OBJECTIVE To measure racial and gender differences in medical student burnout and identify possible contributing factors. PATIENTS AND METHODS Electronic surveys were distributed to medical students at 9 US medical schools from December 27, 2020, through January 17, 2021. Questions covered demographic characteristics, stressors contributing to burnout, and the 2-item Maslach Burnout Inventory. RESULTS Of 5500 invited students, 1178 (21%) responded (mean age, 25.3 years; 61% identified as female). Fifty-seven percent of respondents identified as White, 26% as Asian, and 5% as Black. Overall, 75.6% of students met the criteria for burnout. Women reported more burnout (78% vs 72%; P=.049). There were no differences in burnout prevalence by race. Students commonly reported that lack of sleep (42%), decreased engagement in hobbies or self-care (41%), stress about grades (37%), feeling socially disconnected (36%), and lack of exercise (35%) contributed to burnout. Compared with students of other races, Black students reported that their feelings of burnout were affected significantly more by lack of sleep and poor diet, and Asian students more by stress about grades, residency, and publishing pressure (all P<.05). Female students were more affected than male students by stress about grades, poor diet, and feelings of social disconnectedness and inadequacy (all P<.05). CONCLUSION Burnout (75.6%) was higher than historical norms, and female students reported higher burnout than male students. There was no difference in burnout prevalence by race. There were racial and gender differences in self-identified contributors of burnout. Additional research is needed to confirm whether stressors were contributors to or consequences of burnout, as well as how to address them.
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Affiliation(s)
- Logan G Briggs
- Department of Urologic Surgery, Mayo Clinic, Phoenix, AZ.
| | | | | | - Shani Aharon
- Department of General Surgery, Virginia Mason Franciscan Health, Seattle, WA
| | | | | | | | | | | | - Derek R Soled
- Department of Medicine and Pediatrics, Brigham and Women's Hospital, Boston Children's Hospital, and Boston Medical Center, Boston, MA
| | - Kerri Palamara
- Harvard Medical School, Boston, MA; Department of Medicine, Massachusetts General Hospital, Boston, MA
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23
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Qin Z, He Z, Yang Q, Meng Z, Lei Q, Wen J, Shi X, Liu J, Wang Z. Prevalence and correlators of burnout among health professionals during different stages of the COVID-19 pandemic in China. Front Psychiatry 2023; 14:1156313. [PMID: 37181868 PMCID: PMC10169669 DOI: 10.3389/fpsyt.2023.1156313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/24/2023] [Indexed: 05/16/2023] Open
Abstract
Background Persistently increased workload and stress occurred in health professionals (HPs) during the past 3 years as the COVID-19 pandemic continued. The current study seeks to explore the prevalence of and correlators of HPs' burnout during different stages of the pandemic. Methods Three repeated online studies were conducted in different stages of the COVID-19 pandemic: wave 1: after the first peak of the pandemic, wave 2: the early period of the zero-COVID policy, and wave 3: the second peak of the pandemic in China. Two dimensions of burnout, emotional exhaustion (EE) and declined personal accomplishment (DPA), were assessed using Human Services Survey for Medical Personnel (MBI-HSMP), a 9-item Patient Health Questionnaire (PHQ-9), and a 7-item Generalized Anxiety Disorder (GAD-7) to assess mental health conditions. An unconditional logistic regression model was employed to discern the correlators. Results There was an overall prevalence of depression (34.9%), anxiety (22.5%), EE (44.6%), and DPA (36.5%) in the participants; the highest prevalence of EE and DPA was discovered in the first wave (47.4% and 36.5%, respectively), then the second wave (44.9% and 34.0%), and the third wave had the lowest prevalence of 42.3% and 32.2%. Depressive symptoms and anxiety were persistently correlated with a higher prevalence risk of both EE and DPA. Workplace violence led to a higher prevalence risk of EE (wave 1: OR = 1.37, 95% CI: 1.16-1.63), and women (wave 1: OR = 1.19, 95% CI: 1.00-1.42; wave 3: OR =1.20, 95% CI:1.01-1.44) and those living in a central area (wave 2: OR = 1.66, 95% CI: 1.20-2.31) or west area (wave 2: OR = 1.54, 95% CI: 1.26-1.87) also had a higher prevalence risk of EE. In contrast, those over 50 years of age (wave 1: OR = 0.61, 95% CI: 0.39-0.96; wave 3: OR = 0.60, 95% CI: 0.38-0.95) and who provided care to patients with COVID-19 (wave 2: OR = 0.73, 95% CI: 0.57-0.92) had a lower risk of EE. Working in the psychiatry section (wave 1: OR = 1.38, 95% CI: 1.01-1.89) and being minorities (wave 2: OR = 1.28, 95% CI: 1.04-1.58) had a higher risk of DPA, while those over 50 years of age had a lower risk of DPA (wave 3: OR = 0.56, 95% CI: 0.36-0.88). Conclusion This three-wave cross-sectional study revealed that the prevalence of burnout among health professionals was at a high level persistently during the different stages of the pandemic. The results suggest that functional impairment prevention resources and programs may be inadequate and, as such, continuous monitoring of these variables could provide evidence for developing optimal strategies for saving human resources in the coming post-pandemic era.
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Affiliation(s)
- Zhengshan Qin
- Department of Preventive Medicine, School of Public Health at Zunyi Medical University, Zunyi, China
| | - Zhehao He
- Department of Epidemiology and Health Statistics, School of Public Health at Guangdong Medical University, Dongguan, China
| | - Qinglin Yang
- Department of Preventive Medicine, School of Public Health at Zunyi Medical University, Zunyi, China
| | - Zeyu Meng
- Department of Preventive Medicine, School of Public Health at Zunyi Medical University, Zunyi, China
| | - Qiuhui Lei
- Department of Epidemiology and Health Statistics, School of Public Health at Guangdong Medical University, Dongguan, China
| | - Jing Wen
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
| | - Xiuquan Shi
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, China
| | - Jun Liu
- Department of Preventive Medicine, School of Public Health at Zunyi Medical University, Zunyi, China
| | - Zhizhong Wang
- Department of Epidemiology and Health Statistics, School of Public Health at Guangdong Medical University, Dongguan, China
- The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, China
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24
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Colucci L, Smith JA, Browne DT. Parenting and pandemic pressures: Examining nuances in parent, child, and family well-being concerns during COVID-19 in a Canadian sample. FRONTIERS IN EPIDEMIOLOGY 2023; 3:1073811. [PMID: 38455943 PMCID: PMC10910915 DOI: 10.3389/fepid.2023.1073811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 03/20/2023] [Indexed: 03/09/2024]
Abstract
Introduction The COVID-19 pandemic has caused vast disruptions in family life for Canadian parents since early 2020. While numerous environmental stressors have been identified, including job loss and the demands of balancing work-life conflicts and at-home schooling, relatively less is known about the areas of family life parents are most concerned about and how these worries relate to well-being across the family system. Methods Canadian parents (n = 29,831, 90.29% mothers, 57.40% Ontario residents) of children aged 0-14 were surveyed about their concerns related to child, parent, and family well-being in June 2020. Structural equation modelling was used to model the relationship between concerns about children, parenting, and the whole family, in association with several sociodemographic variables including child disability status, parent sex and education, job loss during COVID-19, and caregiver employment. Results Parenting, child, and family concerns were positively correlated. Higher child and family concerns were reported by parents who had not attended university, those who had experienced employment loss or reduced hours, and families with all adults working outside the home. Parents of children with a disability reported higher concerns across all three domains: child, parenting, and family psychosocial well-being. Discussion These results showcase distinct associations between social determinants of health and the types of worries caregivers exhibited across multiple areas of family life during the first wave of the COVID-19 pandemic in Canada. Findings are interpreted in relation to clinical intervention and public policy targets for families.
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Affiliation(s)
- Laura Colucci
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
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25
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Ge MW, Hu FH, Jia YJ, Tang W, Zhang WQ, Zhao DY, Shen WQ, Chen HL. COVID-19 pandemic increases the occurrence of nursing burnout syndrome: an interrupted time-series analysis of preliminary data from 38 countries. Nurse Educ Pract 2023; 69:103643. [PMID: 37060733 PMCID: PMC10088401 DOI: 10.1016/j.nepr.2023.103643] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/19/2023] [Accepted: 03/30/2023] [Indexed: 04/17/2023]
Abstract
AIM To evaluate the trends in nursing burnout rates before and during the coronavirus 2019 restrictions. METHOD Meta-analysis was used to extract the data on global nursing burnout from 1 Jan. 2010-15 Dec. 2022. An interrupted time-series analysis using segmented ordinary least squares (OLS) regression models was used to explore if the nursing burnout were affected by the epidemic. Newey-West standard error was used to adjust for autocorrelation and heteroskedasticity. RESULTS Before the epidemic (April 2020), the nursing burnout rate rose with 0.0007497 (95% CI: 0.0000316, 0.0014677, t = 2.07, P = 0.041) per month. The trend of nursing burnout rate has increased by 0.0231042 (95 CI%:0.0086818, 0.0375266, t = 3.18, P = 0.002). The increasing trend of nursing burnout rate after the COVID-19 restrictions is 0.0007497 + 0.0231042 = 0.0238539 per month. CONCLUSION The study indicated that the Covid-19 restrictions had an impact on nursing burnout, increasing the occurrence of nursing burnout syndrome.
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Affiliation(s)
- Meng-Wei Ge
- School of Medicine, Nantong University, Nantong, Jiangsu, PR China
| | - Fei-Hong Hu
- School of Medicine, Nantong University, Nantong, Jiangsu, PR China
| | - Yi-Jie Jia
- School of Medicine, Nantong University, Nantong, Jiangsu, PR China
| | - Wen Tang
- School of Medicine, Nantong University, Nantong, Jiangsu, PR China
| | - Wan-Qing Zhang
- School of Medicine, Nantong University, Nantong, Jiangsu, PR China
| | - Dan-Yan Zhao
- School of Medicine, Nantong University, Nantong, Jiangsu, PR China
| | - Wang-Qin Shen
- School of Medicine, Nantong University, Nantong, Jiangsu, PR China
| | - Hong-Lin Chen
- School of Public Health, Nantong University, Nantong, Jiangsu, PR China.
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26
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Raffa BJ, Schilling S, Henry MK, Ritter V, Bennett CE, Huang JS, Laub N. Ingestion of Illicit Substances by Young Children Before and During the COVID-19 Pandemic. JAMA Netw Open 2023; 6:e239549. [PMID: 37083660 PMCID: PMC10122182 DOI: 10.1001/jamanetworkopen.2023.9549] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
Importance Information about the trend in illicit substance ingestions among young children during the pandemic is limited. Objectives To assess immediate and sustained changes in overall illicit substance ingestion rates among children younger than 6 years before and during the COVID-19 pandemic and to examine changes by substance type (amphetamines, benzodiazepines, cannabis, cocaine, ethanol, and opioids) while controlling for differing statewide medicinal and recreational cannabis legalization policies. Design, Setting, and Participants Retrospective cross-sectional study using an interrupted time series at 46 tertiary care children's hospitals within the Pediatric Health Information System (PHIS). Participants were children younger than 6 years who presented to a PHIS hospital for an illicit substance(s) ingestion between January 1, 2017, and December 31, 2021. Data were analyzed in February 2023. Exposure Absence or presence of the COVID-19 pandemic. Main Outcome(s) and Measure(s) The primary outcome was the monthly rate of encounters for illicit substance ingestions among children younger than 6 years defined by International Statistical Classification of Diseases, Tenth Revision, Clinical Modification diagnosis code(s) for poisoning by amphetamines, benzodiazepines, cannabis, cocaine, ethanol, and opioids. The secondary outcomes were the monthly rate of encounters for individual substances. Results Among 7659 children presenting with ingestions, the mean (SD) age was 2.2 (1.3) years and 5825 (76.0%) were Medicaid insured/self-pay. There was a 25.6% (95% CI, 13.2%-39.4%) immediate increase in overall ingestions at the onset of the pandemic compared with the prepandemic period, which was attributed to cannabis, opioid, and ethanol ingestions. There was a 1.8% (95% CI, 1.1%-2.4%) sustained monthly relative increase compared with prepandemic trends in overall ingestions which was due to opioids. There was no association between medicinal or recreational cannabis legalization and the rate of cannabis ingestion encounters. Conclusions and Relevance In this study of illicit substance ingestions in young children before and during the COVID-19 pandemic, there was an immediate and sustained increase in illicit substance ingestions during the pandemic. Additional studies are needed to contextualize these findings in the setting of pandemic-related stress and to identify interventions to prevent ingestions in face of such stress, such as improved parental mental health and substance treatment services, accessible childcare, and increased substance storage education.
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Affiliation(s)
- Brittany J Raffa
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill
- The Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill
| | - Samantha Schilling
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill
| | - M Katherine Henry
- Safe Place: Center for Child Protection and Health, Division of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
- Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Victor Ritter
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill
| | - Colleen E Bennett
- Safe Place: Center for Child Protection and Health, Division of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Jeannie S Huang
- Department of Pediatrics, University of California San Diego
| | - Natalie Laub
- Division of Child Abuse Pediatrics, Department of Pediatrics, University of California at San Diego
- Department of Pediatrics, University of California San Diego
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27
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Fattori A, Comotti A, Mazzaracca S, Consonni D, Bordini L, Colombo E, Brambilla P, Bonzini M. Long-Term Trajectory and Risk Factors of Healthcare Workers' Mental Health during COVID-19 Pandemic: A 24 Month Longitudinal Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4586. [PMID: 36901597 PMCID: PMC10002366 DOI: 10.3390/ijerph20054586] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/28/2023] [Accepted: 03/02/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Research has shown the substantial impact of the COVID-19 pandemic on healthcare workers' (HCWs) mental health, however, it mostly relies on data collected during the early stages of COVID-19. The aim of this study is to assess the long-term trajectory of HCWs' mental health and the associated risk factors. METHODS a longitudinal cohort study was carried out in an Italian hospital. At Time 1 (July 2020-July 2021), 990 HCWs took part in the study and completed the General Health Questionnaire (GHQ-12), the Impact of Event Scale (IES-R), and the General Anxiety Disorder (GAD-7)questionnaire. McNemar's test measured changes in symptoms' trajectories, and random effects models evaluated risk factors associated with scores above the cut-off. RESULTS 310 HCWs participated to the follow-up evaluation (Time 2; July 2021-July 2022). At Time 2, scores above cut-offs were significantly lower (p < 0.001) than at Time 1 for all scales (23% vs. 48% for GHQ-12; 11% vs. 25% for IES-R; 15% vs. 23% for GAD-7). Risk factors for psychological impairment were being a nurse (IES-R: OR 4.72, 95% CI 1.71-13.0; GAD-7: OR 2.82, 95% CI 1.44-7.17), a health assistant (IES-R: OR 6.76, 95% CI 1.30-35.1), or having had an infected family member (GHQ-12: OR 1.95, 95% CI 1.01-3.83). Compared to Time 1, gender and experience in COVID-19 units lost significance with psychological symptoms. CONCLUSIONS data over more than 24 months from the pandemic onset showed improvement of HCWs' mental health; our findings suggested the need to tailor and prioritize preventive actions towards healthcare workforce.
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Affiliation(s)
- Alice Fattori
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Anna Comotti
- Occupational Medicine Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Sara Mazzaracca
- Occupational Medicine Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Dario Consonni
- Occupational Medicine Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Lorenzo Bordini
- Occupational Medicine Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Elisa Colombo
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Department of Pathophysiology and Trasplantation, University of Milan, 20122 Milan, Italy
| | - Matteo Bonzini
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
- Occupational Medicine Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
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28
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Hellwig K. Psychiatric Issues Encountered in Home Healthcare in the age of COVID-19. Home Healthc Now 2023; 41:78-83. [PMID: 36867480 DOI: 10.1097/nhh.0000000000001145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
The COVID-19 pandemic has caused physical and mental harm to home healthcare clinicians as well as the patients we serve. As home healthcare professionals, we became acutely aware of our patients' suffering while simultaneously dealing with our own personal and professional challenges. It is critical that those who provide healthcare learn how to manage the deleterious effects of this frightening virus. This article focuses on the effects of the COVID-19 pandemic on patients and healthcare providers and suggests ways of developing resilience. Home healthcare providers must be able to manage their own psychological needs before they can assess and intervene with the multiple mental health consequences of anxiety and depression in their patients that can result from COVID-19.
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Affiliation(s)
- Karen Hellwig
- Karen Hellwig, MN, RN-BC, PHN , is a Psychiatric Case Manager, Physicians Choice Home Health, Torrance, California
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Akdağ B, Ege D, Göksülük D, İpekten F, Erdoğan A, Önder A. The parental COVID-19 anxiety and emotional exhaustion in healthcare workers: exploring the roles of resilience, prosocialness, and optimism. CURRENT PSYCHOLOGY 2023; 42:1-10. [PMID: 36852082 PMCID: PMC9947882 DOI: 10.1007/s12144-023-04414-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2023] [Indexed: 02/25/2023]
Abstract
Healthcare workers (HCWs) also became the main protagonist of the tragic pandemic story. They have had a markedly higher risk of becoming infected with COVID-19. Outside work, healthcare workers with children have experienced mental health challenges, including the worry that they may carry COVID-19 home and infect their children. Based on these, the current study aimed to examine the effect of parental COVID-19 anxiety on emotional exhaustion and identify the roles of resilience, prosocialness, and optimism in this relationship. The findings demonstrated that prosocialness moderated the relationship between personal COVID-19 anxiety and emotional exhaustion by alleviating the depleting effects of personal COVID-19 anxiety. At the same time, prosocialness reinforced the negative effect of resilience on emotional exhaustion. On the other side, optimism moderated the relationship between parental COVID-19 anxiety and resilience by alleviating the adverse effect of parental COVID-19 anxiety. Moreover, it buffered the exacerbating effect of parental anxiety on personal anxiety. In conclusion, promoting personal resources (i.e., resilience, prosocialness, and optimism) seems an excellent way to mitigate the adverse consequences of the pandemic on mental health. Furthermore, the increment in parental mental health problems during COVID-19 pandemic may have long-term effects on children. Considering this perspective, we need to develop a proactive approach for parents' now and children's futures.
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Affiliation(s)
- Berhan Akdağ
- Department of Child and Adolescent Psychiatry, Silifke State Hospital, Mersin, Turkey
| | - Duygu Ege
- Department of Emergency Medicine, Silifke State Hospital, Mersin, Turkey
| | - Dinçer Göksülük
- Department of Biostatistics, Erciyes University, Kayseri, Turkey
| | - Funda İpekten
- Department of Biostatistics, Erciyes University, Kayseri, Turkey
| | - Ali Erdoğan
- Department of Psychiatry, Akdeniz University School of Medicine, Antalya, Turkey
| | - Arif Önder
- Department of Child and Adolescent Psychiatry, Akdeniz University School of Medicine, Antalya, Turkey
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Arora V, Overholser B, Spector ND. What happens when leaders burnout? Nine ways to counter leadership burnout. J Hosp Med 2023; 18:97-99. [PMID: 36314291 DOI: 10.1002/jhm.12992] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/04/2022] [Accepted: 10/06/2022] [Indexed: 11/07/2022]
Affiliation(s)
- Vineet Arora
- Department of Medicine, University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA
| | - Barbara Overholser
- Department of Pediatrics, Executive Leadership in Academic Medicine, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Nancy D Spector
- Department of Pediatrics, Executive Leadership in Academic Medicine, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
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Arenliu Qosaj F, Weine SM, Sejdiu P, Hasani F, Statovci S, Behluli V, Arenliu A. Prevalence of Perceived Stress, Anxiety, and Depression in HCW in Kosovo during the COVID-19 Pandemic: A Cross-Sectional Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16667. [PMID: 36554548 PMCID: PMC9779736 DOI: 10.3390/ijerph192416667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/04/2022] [Accepted: 12/09/2022] [Indexed: 06/17/2023]
Abstract
A pandemic may have a negative impact on healthcare workers' (HCW) mental health. In this cross-sectional study, we assess the self-reported prevalence of stress, anxiety, and depression and identify their predictive factors among HCW in Kosovo. The online questionnaire collected data on socio-demographics (sex, age, occupation, education, workplace) and the presence and severity of depression, anxiety, and stress through the 21-item Depression, Anxiety, and Stress Scale (DASS-21) questionnaire. Descriptive statistics, t-test, and linear logistic regression were used to analyze the data. Of the 545 respondents, the majority were male (53.0%), under 60 years of age (94.7%), and married (81.7%). Most of them were physicians (78.2%), while the remaining were nurses, midwives, and other health professionals (22%). Prevalence rates for moderate to extremely high stress, anxiety, and depressive symptoms were 21.9%, 13.0%, and 13.9%, respectively. The nurses reported significantly higher mean scores for depression and anxiety than the physicians (p < 0.05). Being married, having poor health, not exercising, and reporting "burnout" from work significantly predicted higher levels of depressive, anxiety, and stress symptoms among health workers (p < 0.05). Most HCWs (71.6%) reported a mild, moderate, or severe mental health burden, and certain factors predicted higher levels of such burden.
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Affiliation(s)
| | | | - Pleurat Sejdiu
- Kosovo Medical Chamber, 10000 Prishtina, Kosovo
- Orthopedic Clinic, Kosovo Hospital University Clinical Services, 10000 Prishtina, Kosovo
| | - Fekrije Hasani
- Alma Mater Europaea, Campus College Rezonanca, 10000 Prishtina, Kosovo
- Kosovo Nursing Chamber, 10000 Prishtina, Kosovo
- Ministry of Health, Government of the Republic of Kosovo, 10000 Prishtina, Kosovo
| | - Shukrije Statovci
- Psychiatry Clinic, Kosovo Hospital University Clinical Services, 10000 Prishtina, Kosovo
| | - Vigan Behluli
- Kosovo Association of Psychologists, 10000 Prishtina, Kosovo
| | - Aliriza Arenliu
- Department of Psychology, Prishtina University, 10000 Prishtina, Kosovo
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Catanzano T, Verma N, Sarkany D, Mohammed TL, Slanetz PJ. The Midcareer Syndrome: Reflection and Repositioning for Better Career Engagement. Acad Radiol 2022; 29:1619-1622. [PMID: 36192268 DOI: 10.1016/j.acra.2022.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/09/2022] [Accepted: 09/14/2022] [Indexed: 11/01/2022]
Affiliation(s)
- Tara Catanzano
- Department of Radiology, University of Massachusetts Chan Medical School-Baystate, Springfield, Massachusetts.
| | - Nupur Verma
- Department of Radiology, University of Florida, Gainesville, Florida
| | - David Sarkany
- Department of Radiology, Zucker School of Medicine at Hofstra/Northwell, Staten Island, New York
| | | | - Priscilla J Slanetz
- Department of Radiology, Boston University Medical Center, Boston, Massachusetts
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Bye E, Leval R, Sayles H, Doyle M, Mathes M, Cudzilo-Kelsey L. Parental postpartum depression among medical residents. Arch Womens Ment Health 2022; 25:1129-1135. [PMID: 36434278 PMCID: PMC9702781 DOI: 10.1007/s00737-022-01271-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 10/12/2022] [Indexed: 11/27/2022]
Abstract
The study aimed to quantify and compare rate of parental postpartum depression (PPD) among medical residents to that of the general population and identify potential areas of further support for resident parents. Our team, University of Nebraska Medical Center (UNMC) OB/GYN and Creighton Psychiatry departments, developed and disseminated 22 item anonymous survey distributed via email link to targeted specialties as well as the "Physician Mom's Group" on Facebook. The survey included both quantitative and qualitative measures on medical resident and resident partner mental health, demographics, specialty, year in residency, support from residency program, parental leave, and an open comment section. Seventy-two resident parents, 64% of whom were female, completed the survey. 42% of female respondents reported feeling they suffered from PPD symptoms, representing more than four times the rate of PPD within the general population (11%). Only 12% of these women reported having sought treatment or were diagnosed with PPD. Male residents did not report an increased rate of depressive symptoms; however, 19% of respondents believed their partner's symptoms were consistent with PPD. Responses from the survey and open-ended questions emphasized need for emotional support, transparency in programmatic leave policy, breastfeeding accommodations, and additional parental leave time. This is the first study of its kind to examine PPD among both male and female medical resident parents. Limitations of the study included small sample size, which impacted statistical significance. The data and commentary are nonetheless useful in highlighting risk of PPD amongst medical residents and indicate further study is warranted.
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Affiliation(s)
- Emma Bye
- Olson Center for Women's Health, Department of Obstetrics and Gynecology, College of Medicine, University of Nebraska Medical Center, NE, 68198-3255, Omaha, USA.
| | - Rebecca Leval
- Department of Psychiatry, Creighton University, Omaha, NE 68178 USA
| | - Harlan Sayles
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198 USA
| | - Marley Doyle
- Olson Center for Women’s Health, Department of Obstetrics and Gynecology, College of Medicine, University of Nebraska Medical Center, NE 68198-3255 Omaha, USA ,Department of Psychiatry, Creighton University, Omaha, NE 68178 USA
| | - Melissa Mathes
- Olson Center for Women’s Health, Department of Obstetrics and Gynecology, College of Medicine, University of Nebraska Medical Center, NE 68198-3255 Omaha, USA
| | - Laura Cudzilo-Kelsey
- Olson Center for Women’s Health, Department of Obstetrics and Gynecology, College of Medicine, University of Nebraska Medical Center, NE 68198-3255 Omaha, USA
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