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Samanth R, Khadilkar MN, Dosemane D. Academic Impact and Quality of Life Among Otorhinolaryngology Residents During COVID-19 Pandemic in South India. Indian J Otolaryngol Head Neck Surg 2024; 76:2422-2428. [PMID: 38883487 PMCID: PMC11169321 DOI: 10.1007/s12070-024-04514-0] [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: 10/21/2023] [Accepted: 01/05/2024] [Indexed: 06/18/2024] Open
Abstract
The COVID-19 pandemic has led to a major public health crisis. Residents entered the frontline in triaging and treating COVID-19 patients, working overtime to meet the growing demand. Surgical practice and educational activities were restricted, thus affecting resident training. There was also a great risk to their mental health. Our study aims to assess the academic impact and quality of life including mental health status among year I, year II and year III otorhinolaryngology residents during the pandemic. A cross-sectional study was conducted among postgraduates and junior residents working in otorhinolaryngology departments in institutions across South India in October 2020. Quality of life, severity of anxiety and depression, and academic impact were assessed using the WHOQOL-BREF, GAD-7, PHQ-8 and Academic impact questionnaires respectively via Google Forms. A total of 303 responses were obtained. Inpatient and outpatient clinical activity were affected irrespective of the year of training. Surgical training was also affected especially among the final-year residents (year III) with a mean score of 4.42. The maximum median WHOQOL-BREF score of 14.66 was found in the social domain and 13.33 in the psychological and social domains in men and women respectively. The majority (43%) of 114 men had mild anxiety, while among women, a slight preponderance (33.9%) of severe anxiety was noted. Most of the residents (75% of men and 66.6% of women) had no symptoms suggestive of depressive disorder, however, 19.3% of the men and 29.6% of the women were found to have major depression. The impact of the pandemic on resident training and mental health has been immense. The study outcome may help residents comprehend and perceive the extent of the same, and explore methods to be equipped and overcome similar circumstances in the future.
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Affiliation(s)
- Rakshitha Samanth
- Department of Otorhinolaryngology and Head & Neck Surgery, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, 575001 India
| | - Meera N Khadilkar
- Department of Otorhinolaryngology and Head & Neck Surgery, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, 575001 India
| | - Deviprasad Dosemane
- Department of Otorhinolaryngology and Head & Neck Surgery, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, 575001 India
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Lie JJ, Huynh C, Li J, Mak N, Wiseman SM. Psychological Impact of the COVID-19 Pandemic on Canadian Surgical Residents: A Province-Wide Study. JOURNAL OF SURGICAL EDUCATION 2024; 81:486-494. [PMID: 38388311 DOI: 10.1016/j.jsurg.2023.12.013] [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: 04/05/2023] [Revised: 09/22/2023] [Accepted: 12/22/2023] [Indexed: 02/24/2024]
Abstract
OBJECTIVES The objective of this study was to evaluate the psychological impact of the COVID-19 pandemic on surgical residents. DESIGN An online survey was distributed evaluating multiple domains: demographics, health and socioeconomic factors, clinical experience, educational experience, and psychological outcomes. The Mayo Clinic Resident Well-Being Index (RWBI) was used as a validated measure of resident mental health. SETTING AND PARTICIPANTS Surgical residents from University of British Columbia's surgical residency programs. RESULTS A total of 31/86 surgical residents responded to the survey. Of which, 57% and 46% reported feeling burned out or depressed, respectively. Residents who were concerned about personal protective equipment supply and who lived with family members with comorbidities had a higher risk of depression (p = 0.03, p = 0.04). The median Mayo Clinic Resident Well-Being Index was 2.5, higher than the median of 2 observed in the United States national survey of residents. CONCLUSIONS The pandemic had a considerable negative impact on the psychological well-being of surgical residents.
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Affiliation(s)
- Jessica J Lie
- Department of Surgery, St. Paul's Hospital & University of British Columbia, Vancouver, British Columbia, Canada
| | - Caroline Huynh
- Department of Surgery, St. Paul's Hospital & University of British Columbia, Vancouver, British Columbia, Canada
| | - Jennifer Li
- Department of Surgery, St. Paul's Hospital & University of British Columbia, Vancouver, British Columbia, Canada
| | - Nicole Mak
- Department of Surgery, St. Paul's Hospital & University of British Columbia, Vancouver, British Columbia, Canada
| | - Sam M Wiseman
- Department of Surgery, St. Paul's Hospital & University of British Columbia, Vancouver, British Columbia, Canada.
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Fronteira I, Mathews V, Dos Santos RLB, Matsumoto K, Amde W, Pereira A, de Oliveira APC, Craveiro I, Chança R, Boniol M, Ferrinho P, Poz MRD. Impacts for health and care workers of Covid-19 and other public health emergencies of international concern: living systematic review, meta-analysis and policy recommendations. HUMAN RESOURCES FOR HEALTH 2024; 22:10. [PMID: 38273317 PMCID: PMC10809470 DOI: 10.1186/s12960-024-00892-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 01/11/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND Health and care workers (HCW) faced the double burden of the SARS-CoV-2 pandemic: as members of a society affected by a public health emergency and as HWC who experienced fear of becoming infected and of infecting others, stigma, violence, increased workloads, changes in scope of practice, among others. To understand the short and long-term impacts in terms of the COVID-19 pandemic and other public health emergencies of international concern (PHEICs) on HCW and relevant interventions to address them, we designed and conducted a living systematic review (LSR). METHODS We reviewed literature retrieved from MEDLINE-PubMed, Embase, SCOPUS, LILACS, the World Health Organization COVID-19 database, the ClinicalTrials.org and the ILO database, published from January 2000 until December 2021. We included quantitative observational studies, experimental studies, quasi-experimental, mixed methods or qualitative studies; addressing mental, physical health and well-being and quality of life. The review targeted HCW; and interventions and exposures, implemented during the COVID-19 pandemic or other PHEICs. To assess the risk of bias of included studies, we used the Johanna Briggs Institute (JBI) Critical Appraisal Tools. Data were qualitatively synthetized using meta-aggregation and meta-analysis was performed to estimate pooled prevalence of some of the outcomes. RESULTS The 1013 studies included in the review were mainly quantitative research, cross-sectional, with medium risk of bias/quality, addressing at least one of the following: mental health issue, violence, physical health and well-being, and quality of life. Additionally, interventions to address short- and long-term impact of PHEICs on HCW included in the review, although scarce, were mainly behavioral and individual oriented, aimed at improving mental health through the development of individual interventions. A lack of interventions addressing organizational or systemic bottlenecks was noted. DISCUSSION PHEICs impacted the mental and physical health of HCW with the greatest toll on mental health. The impact PHEICs are intricate and complex. The review revealed the consequences for health and care service delivery, with increased unplanned absenteeism, service disruption and occupation turnover that subvert the capacity to answer to the PHEICs, specifically challenging the resilience of health systems.
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Affiliation(s)
- Inês Fronteira
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, 100, 1349-008, Lisbon, Portugal.
- National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, NOVA University of Lisbon, Avenida Padre Cruz, 1600-560, Lisbon, Portugal.
| | - Verona Mathews
- School of Public, Health University of the Western Cape, South Africa, Private Bag X17, Bellville, 7535, Republic of South Africa
| | - Ranailla Lima Bandeira Dos Santos
- Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Osvaldo Cruz, Rua Leopoldo Bulhões, 1480 - Manguinhos, Rio de Janeiro, Brazil
| | - Karen Matsumoto
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524 - 7º andar, Blocos D e E - Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
| | - Woldekidan Amde
- School of Public, Health University of the Western Cape, South Africa, Private Bag X17, Bellville, 7535, Republic of South Africa
| | - Alessandra Pereira
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524 - 7º andar, Blocos D e E - Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
| | - Ana Paula Cavalcante de Oliveira
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524 - 7º andar, Blocos D e E - Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
| | - Isabel Craveiro
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, 100, 1349-008, Lisbon, Portugal
| | - Raphael Chança
- Instituto Nacional de Cancer, Ministério da Saúde, Rua Marquês de Pombal, 125, Centro, Rio de Janeiro, RJ, 20230240, Brazil
| | - Mathieu Boniol
- Health Workforce Department, World Health Organization, Av. Appia 20, 1202, Geneva, Switzerland
| | - Paulo Ferrinho
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, 100, 1349-008, Lisbon, Portugal
| | - Mario Roberto Dal Poz
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524 - 7º andar, Blocos D e E - Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
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Navinés R, Olive V, Hidalgo-Mazzei D, Langohr K, Vieta E, Martin-Santos R. Burnout in residents during the first wave of the COVID-19 pandemic: a systematic review and meta-analysis. Front Psychiatry 2024; 14:1286101. [PMID: 38328517 PMCID: PMC10847582 DOI: 10.3389/fpsyt.2023.1286101] [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: 08/30/2023] [Accepted: 12/11/2023] [Indexed: 02/09/2024] Open
Abstract
Introduction The high prevalence of burnout in resident physicians is expected to have increased as a result of the expansion of the pandemic. We conducted a systematic review with a meta-analysis of studies conducted during the first wave of the COVID-19 pandemic on burnout in residents and potential associated risk factors. Methods The search was done in the Web of Science, MEDLINE, Scopus, and Lillac databases (April 2020-October 2021) using a priori protocol based on the PRISMA guidelines. The Newcastle Ottawa Scale was used to assess the risk of bias in the included studies. We estimated the pooled prevalence (95% CI) of burnout and the prevalence ratio (95% CI) of each risk factor associated. Results We included 23 studies from 451 potential initial articles and those written in the English language; all of the collected studies were cross-sectional with anonymous online surveys, involving 4,998 responders (34%), of which 53.2% were female responders, 51% were R1-2, and 71% were in direct contact with COVID-19 patients. Eighty-seven percent presented a low-to-moderate risk of bias. Publication bias was not shown. The estimated pooled prevalence of burnout was 40% (95% CI = 0.26 - 0.57). Burnout was associated with psychiatry history (PR = 4.60, 95% CI = 1.06 - 20.06). There were no differences by gender, civil status, children in-charge, year of residency, or time exposure to COVID-19. Discussion The overall prevalence of burnout in residents during the first wave of the pandemic was in line with the results described in this collective before the pandemic. The presence of a psychiatry history was a potential burnout risk factor, suggesting a high vulnerability during the peak of the stress period and the need to implement mental health surveillance for this subgroup.
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Affiliation(s)
- Ricard Navinés
- Department of Psychiatry and Psychology, Hospital Clinic, Institut d Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Centro de Investigación Biomédica en RED en Salud Mental (CIBERSAM), Barcelona, Spain
| | - Victoria Olive
- Functional Unit of Psychiatry, Department of Medicine, Neuroscience Institute, University of Barcelona (UB), Barcelona, Spain
- Department of Occupational Risk and Prevention, Hospital Clinic, University of Barcelona (UB), Barcelona, Spain
| | - Diego Hidalgo-Mazzei
- Department of Psychiatry and Psychology, Hospital Clinic, Institut d Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Centro de Investigación Biomédica en RED en Salud Mental (CIBERSAM), Barcelona, Spain
| | - Klaus Langohr
- Department of Statistics and Operations Research, Universitat Politècnica de Catalunya, Barcelona Tech, Barcelona, Spain
| | - Eduard Vieta
- Department of Psychiatry and Psychology, Hospital Clinic, Institut d Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Centro de Investigación Biomédica en RED en Salud Mental (CIBERSAM), Barcelona, Spain
- Functional Unit of Psychiatry, Department of Medicine, Neuroscience Institute, University of Barcelona (UB), Barcelona, Spain
| | - Rocio Martin-Santos
- Department of Psychiatry and Psychology, Hospital Clinic, Institut d Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Centro de Investigación Biomédica en RED en Salud Mental (CIBERSAM), Barcelona, Spain
- Functional Unit of Psychiatry, Department of Medicine, Neuroscience Institute, University of Barcelona (UB), Barcelona, Spain
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Szczerbińska K, Barańska I, Kijowska V, Stodolska A, Wójcik G, Różańska A, Wójkowska-Mach J. Factors associated with burnout among hospital-based healthcare workers during the COVID-19 pandemic: A cross-sectional CRACoV-HHS study. J Clin Nurs 2024; 33:304-321. [PMID: 36792068 DOI: 10.1111/jocn.16654] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/19/2022] [Accepted: 01/24/2023] [Indexed: 02/17/2023]
Abstract
AIMS To assess the prevalence of burnout and associated factors among healthcare workers (HCWs) working in a hospital admitting patients with COVID-19. BACKGROUND Burnout among HCWs is related to age, gender and occupation. However, little is known about organisational factors associated with burnout during the COVID-19 pandemic. DESIGN A cross-sectional study of 1412 hospital HCWs (748 nurses) was carried out via online survey during the COVID-19 pandemic between 4 and 19 January 2021. METHODS The Maslach Burnout Inventory-Human Services Survey, the Checklist Individual Strength questionnaire, the interRAI items covering mental health, the WHO questionnaire items assessing HCWs' preparedness and exposure to SARS-CoV-2 were used. Univariable and multivariable linear regression analyses were conducted to clarify factors associated with emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PA). This study adheres to the STROBE guidelines. RESULTS Burnout prevalence varied from 10.0% to 22.0%. Most respondents (83.6%) reported low PA, 22.9% high EE and 18.7% high DP. Nurses and physicians had the highest levels of EE and DP. Staff exposed or uncertain if exposed to contaminated patients' body fluids and materials had higher levels of burnout. Preparedness (training) (b = 1.15; 95%CI 0.26 to 2.05) and adherence to infection prevention and control procedures (b = 1.57; 95%CI 0.67 to 2.47) were associated with higher PA, and accessibility of personal protective equipment (PPE) (b = -1.37; 95%CI -2.17 to -0.47) was related to lower EE. HCWs working in wards for patients with COVID-19 reported lower EE (b = -1.39; 95%CI -2.45 to -0.32). HCWs who contracted COVID-19 reported lower DP (b = -0.71, 95%CI -1.30 to -0.12). CONCLUSIONS Organisational factors such as better access to PPE, training, and adherence to infection prevention and control procedures were associated with a lower level of burnout. RELEVANCE TO CLINICAL PRACTICE Healthcare managers should promote strategies to reduce burnout among HCWs with regard to preparedness of all staff.
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Affiliation(s)
- Katarzyna Szczerbińska
- Laboratory for Research on Aging Society, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair, Medical Faculty, Jagiellonian University Medical College, Kraków, Poland
- The University Hospital in Cracow, Kraków, Poland
| | - Ilona Barańska
- Laboratory for Research on Aging Society, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair, Medical Faculty, Jagiellonian University Medical College, Kraków, Poland
| | - Violetta Kijowska
- Laboratory for Research on Aging Society, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair, Medical Faculty, Jagiellonian University Medical College, Kraków, Poland
| | - Agata Stodolska
- Laboratory for Research on Aging Society, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair, Medical Faculty, Jagiellonian University Medical College, Kraków, Poland
| | - Grzegorz Wójcik
- Laboratory for Research on Aging Society, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair, Medical Faculty, Jagiellonian University Medical College, Kraków, Poland
- Faculty of Management and Social Communication, Institute of Applied Psychology, Jagiellonian University, Kraków, Poland
| | - Anna Różańska
- Chair of Microbiology Medical Faculty Jagiellonian University Medical College, Kraków, Poland
| | - Jadwiga Wójkowska-Mach
- Chair of Microbiology Medical Faculty Jagiellonian University Medical College, Kraków, Poland
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Brownell SE, Cooper KM. Reply to Salzer: A rebuttal to "A critical review of conclusions about disclosure of a mental illness on medical school applications". ADVANCES IN PHYSIOLOGY EDUCATION 2023; 47:891-892. [PMID: 37871174 DOI: 10.1152/advan.00185.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 09/11/2023] [Indexed: 10/25/2023]
Affiliation(s)
- Sara E Brownell
- School of Life Sciences, Arizona State University, Tempe, Arizona, United States
| | - Katelyn M Cooper
- School of Life Sciences, Arizona State University, Tempe, Arizona, United States
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Agrawal A, De La Torre K, Cooper C, Flores J, Miotto K, Wells K, Bromley E, Yano EM, Heldt J, Castillo EG, DeBonis K. Before and During the First COVID-19 Surge: Work Conditions, Burnout, and Mental Health Among Resident Physicians in a Department of Psychiatry in the USA. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2023; 47:504-509. [PMID: 37634240 PMCID: PMC10602943 DOI: 10.1007/s40596-023-01844-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 08/08/2023] [Indexed: 08/29/2023]
Abstract
OBJECTIVE Resident physicians are critical frontline workers during pandemics, and little is known about their health. The study examined occupational and mental health risks among US psychiatry residents before and during the first COVID-19 surge. METHODS Longitudinal data were collected from a cohort of US psychiatry residents at one academic medical center in October 2019, before the pandemic, and April 2020 after the initiation of a state-level stay-at-home order. Primary outcome measures were psychological work empowerment, defined as one's self-efficacy towards their work role, and occupational burnout. A secondary outcome was mental health. In May and June 2020, resident engagement sessions were conducted to disseminate study findings and consider their implications. RESULTS Fifty-seven out of 59 eligible residents participated in the study (97%). Half the study sample reported high burnout. From before to during the first COVID-19 surge, psychological work empowerment increased in the total sample (p = 0.03); and mental health worsened among junior residents (p = 0.004), not senior residents (p = 0.12). High emotional exhaustion and depersonalization were associated with worse mental health (p < 0.001). In engagement sessions, themes related to residents' work conditions, COVID-19, and racism emerged as potential explanations for survey findings. CONCLUSIONS The study is exploratory and novel. During early COVID, psychiatry residents' well-being was impacted by occupational and societal factors. Postpandemic, there is a growing psychiatrist shortage and high demand for mental health services. The findings highlight the potential importance of physician wellness interventions focused on early career psychiatrists who were first responders during COVID.
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Affiliation(s)
- Alpna Agrawal
- Geffen School of Medicine at University of California, Los Angeles Medical Center, Los Angeles, CA, USA.
| | | | - Conisha Cooper
- Geffen School of Medicine at University of California, Los Angeles Medical Center, Los Angeles, CA, USA
| | - Jeremy Flores
- Geffen School of Medicine at University of California, Los Angeles Medical Center, Los Angeles, CA, USA
| | - Karen Miotto
- Geffen School of Medicine at University of California, Los Angeles Medical Center, Los Angeles, CA, USA
| | - Kenneth Wells
- Geffen School of Medicine at University of California, Los Angeles Medical Center, Los Angeles, CA, USA
- VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- UCLA Fielding School of Public Health, Los Angeles Medical Center, Los Angeles, CA, USA
| | - Elizabeth Bromley
- Geffen School of Medicine at University of California, Los Angeles Medical Center, Los Angeles, CA, USA
| | - Elizabeth M Yano
- Geffen School of Medicine at University of California, Los Angeles Medical Center, Los Angeles, CA, USA
- VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- UCLA Fielding School of Public Health, Los Angeles Medical Center, Los Angeles, CA, USA
| | - Jonathan Heldt
- Geffen School of Medicine at University of California, Los Angeles Medical Center, Los Angeles, CA, USA
- VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Enrico G Castillo
- Geffen School of Medicine at University of California, Los Angeles Medical Center, Los Angeles, CA, USA
| | - Katrina DeBonis
- Geffen School of Medicine at University of California, Los Angeles Medical Center, Los Angeles, CA, USA
- VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
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Foster JR, Lee LA, Seabrook JA, Ryan M, Slumkoski C, Walls M, Betts LJ, Burgess SA, Moghadam N, Garros D. A survey of pediatric intensive care unit clinician experience with restricted family presence during COVID-19. Can J Anaesth 2023; 70:1669-1681. [PMID: 37610552 PMCID: PMC10600297 DOI: 10.1007/s12630-023-02547-7] [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: 11/07/2022] [Revised: 02/23/2023] [Accepted: 03/13/2023] [Indexed: 08/24/2023] Open
Abstract
PURPOSE Limiting family presence runs counter to the family-centred values of Canadian pediatric intensive care units (PICUs). This study explores how implementing and enforcing COVID-19-related restricted family presence (RFP) policies impacted PICU clinicians nationally. METHODS We conducted a cross-sectional, online, self-administered survey of Canadian PICU clinicians to assess experience and opinions of restrictions, moral distress (Moral Distress Thermometer, range 0-10), and mental health impacts (Impact of Event Scale [IES], range 0-75 and attributable stress [five-point Likert scale]). For analysis, we used descriptive statistics, multivariate regression modelling, and a general inductive approach for free text. RESULTS Representing 17/19 Canadian PICUs, 368 of 388 respondents (94%) experienced RFP policies and were predominantly female (333/368, 91%), English speaking (338/368, 92%), and nurses (240/368, 65%). The mean (standard deviation [SD]) reported moral distress score was 4.5 (2.4) and was associated with perceived differential impact on families. The mean (SD) total IES score was 29.7 (10.5), suggesting moderate traumatic stress with 56% (176/317) reporting increased/significantly increased stress from restrictions related to separating families, denying access, and concern for family impacts. Incongruence between RFP policies/practices and PICU values was perceived by 66% of respondents (217/330). Most respondents (235/330, 71%) felt their opinions were not valued when implementing policies. Though respondents perceived that restrictions were implemented for the benefit of clinicians (252/332, 76%) and to protect families (236/315, 75%), 57% (188/332) disagreed that their RFP experience was mainly positive. CONCLUSION Pediatric intensive care unit-based RFP rules, largely designed and implemented without bedside clinician input, caused increased psychological burden for clinicians, characterized as moderate moral distress and trauma triggered by perceived impacts on families.
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Affiliation(s)
- Jennifer R Foster
- Department of Pediatric Critical Care, IWK Health Centre, 5850/5980 University Ave., PO Box 9700, Halifax, NS, B3K 6R8, Canada.
- Department of Critical Care, Dalhousie University, Halifax, NS, Canada.
- Department of Pediatrics, Western University, London, ON, Canada.
- Children's Health Research Institute and Lawson Health Research Institute, London, ON, Canada.
| | - Laurie A Lee
- Department of Pediatrics, University of Calgary, Calgary, AB, Canada
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
- Department of Critical Care, Alberta Children's Hospital, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Jamie A Seabrook
- Department of Pediatrics, Western University, London, ON, Canada
- Children's Health Research Institute and Lawson Health Research Institute, London, ON, Canada
- School of Food and Nutritional Sciences, Brescia University College, London, ON, Canada
- Department of Epidemiology & Biostatistics, Western University, London, ON, Canada
- Human Environments Analysis Laboratory, Western University, London, ON, Canada
| | - Molly Ryan
- Department of Pediatric Critical Care, IWK Health Centre, Halifax, NS, Canada
| | - Corey Slumkoski
- Patient Partner, Department of Pediatric Critical Care, IWK Health, Halifax, NS, Canada
| | - Martha Walls
- Patient Partner, Department of Pediatric Critical Care, IWK Health, Halifax, NS, Canada
| | - Laura J Betts
- Department of Pediatric Critical Care, IWK Health Centre, Halifax, NS, Canada
| | - Stacy A Burgess
- Department of Pediatric Critical Care, IWK Health Centre, Halifax, NS, Canada
- Children's Health Program, IWK Health, Halifax, NS, Canada
| | - Neda Moghadam
- Patient Partner, Department of Pediatric Critical Care, IWK Health, Halifax, NS, Canada
| | - Daniel Garros
- Stollery Children's Hospital, Pediatric Intensive Care Unit, Edmonton, AB, Canada
- Division of Critical Care, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
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Shetty KR, Anderson BJ, Ahmad JG, Liu LX, Chow K, Erickson SG, Shetty S, Luong AU. Otolaryngology consultations for COVID-19 patients: A retrospective cohort study of indications, interventions, and considerations. Auris Nasus Larynx 2023; 50:292-298. [PMID: 35961807 PMCID: PMC9350678 DOI: 10.1016/j.anl.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 07/26/2022] [Accepted: 08/01/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To identify differences in inpatient otolaryngology consultations and interventions for patients based on COVID-19. METHODS Records were reviewed for all patients for whom otolaryngology was consulted at a high-volume tertiary care hospital from April 30, 2020 to October 1, 2020. Demographic information, length of stay, COVID-19 status, indication for consultation, and otolaryngology interventions were recorded. Statistical analysis was performed using R software. RESULTS Bleeding composed a significantly higher proportion of otolaryngology consults in COVID-19 positive patients (28% vs. 8.4%, p<0.0001). Management of bleeding was the most common procedure performed in positive patients (n=37, 35%), and they had a higher median number of interventions performed when compared to bleeding patients who tested negative (1, IQR 1-2 vs. 1, IQR 0-1, p=0.04). COVID-19 positive patients with bleeding were more likely to expire than those with other indications for otolaryngology consultation (50% vs. 7%, p<0.001). CONCLUSION Bleeding and associated interventions comprised the predominant discrepancy between COVID-19 positive and negative patients in our cohort. We encourage routine use of simple and cost-effective methods to decrease risk of bleeding.
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Affiliation(s)
- Kunal R Shetty
- Department of Otorhinolaryngology-Head and Neck Surgery, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States.
| | - Brady J Anderson
- Department of Otolaryngology-Head and Neck Surgery, The University of Iowa Hospitals and Clinics, Iowa City, IA, United States
| | - Jumah G Ahmad
- Department of Otorhinolaryngology-Head and Neck Surgery, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Lucy X Liu
- Department of Otolaryngology-Head and Neck Surgery, LSU Health Shreveport, Shreveport, LA, United States
| | - Kevin Chow
- Department of Otorhinolaryngology-Head and Neck Surgery, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Samuel G Erickson
- Department of Otolaryngology-Head and Neck Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Shohan Shetty
- Washington University in St. Louis, St. Louis, MO, United States
| | - Amber U Luong
- Department of Otorhinolaryngology-Head and Neck Surgery, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States; Center for Immunology and Autoimmune Diseases, Institute of Molecular Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States
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10
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Yesantharao LV, Joo H, Wei EX, Lin SY, Vohra V, Agrawal Y, Galaiya D. Factors related to wellness and burnout in academic otolaryngology: A pre- and Post-COVID-19 analysis. Laryngoscope Investig Otolaryngol 2023; 8:409-416. [PMID: 37090875 PMCID: PMC10116971 DOI: 10.1002/lio2.1033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 02/11/2023] [Accepted: 02/14/2023] [Indexed: 04/25/2023] Open
Abstract
Objectives Describe demographic and professional factors predictive of burnout in academic otolaryngology before and during the COVID-19 pandemic. Methods In 2018 and 2020, cross-sectional surveys on physician wellness and burnout were distributed to faculty members of a single academic institution's otolaryngology department. Faculty were dichotomized into low and high burnout groups for 2018 (n = 8 high burnout, 19%) and 2020 (n = 11 high burnout, 37%). To identify protective factors against burnout, three semi-structured interviews were conducted with faculty that reported no burnout. Results Forty-two participants (59%) in 2018 and 30 out of 49 participants (62%) in 2020 completed the survey. In multivariate analysis of 2018 survey data, full and associate professors had significantly lower odds of high burnout (OR 0.06, 95% CI 0.00-0.53; p = .03). Female gender was associated with increased in odds of high burnout (OR 15.55, 95% CI 1.86-231.74; p = .02). However, academic rank and gender did not remain independent predictors of high burnout in the 2020 survey. We identified significant differences in drivers of burnout brought on by the pandemic, including a shift from a myriad of work-related stressors in 2018 to a focus on patientcare and family obligations in 2020. Interview analysis identified three themes in faculty who reported no burnout: (1) focus on helping others, (2) happiness over compensation as currency, and (3) gratitude for the ability to have an impact. Conclusion Approximately 20% of faculty reported high burnout before the pandemic, and this proportion nearly doubled during the pandemic. The risk factors and themes identified in this study may help academic otolaryngologists prevent burnout. Lay Summary Factors driving burnout among academic otolaryngologists during the COVID-19 pandemic transitioned away from research, conferences, and work outside business hours toward family and patient responsibilities. Females report higher burnout and full professors report lower burnout. Level of evidence III.
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Affiliation(s)
- Lekha V. Yesantharao
- Department of Otolaryngology – Head and Neck SurgeryJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Hyonoo Joo
- Department of Otolaryngology – Head and Neck SurgeryJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Eric X. Wei
- Department of Otolaryngology – Head and Neck SurgeryStanford University School of MedicineStanfordCaliforniaUSA
| | - Sandra Y. Lin
- Department of Otolaryngology – Head and Neck SurgeryJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Varun Vohra
- Department of Otolaryngology – Head and Neck SurgeryJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Yuri Agrawal
- Department of Otolaryngology – Head and Neck SurgeryJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Deepa Galaiya
- Department of Otolaryngology – Head and Neck SurgeryJohns Hopkins University School of MedicineBaltimoreMarylandUSA
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11
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Adams GC, Reboe-Benjamin M, Alaverdashvili M, Le T, Adams S. Doctors' Professional and Personal Reflections: A Qualitative Exploration of Physicians' Views and Coping during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5259. [PMID: 37047874 PMCID: PMC10094024 DOI: 10.3390/ijerph20075259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/15/2023] [Accepted: 03/16/2023] [Indexed: 06/19/2023]
Abstract
Numerous studies have examined the risks for anxiety and depression experienced by physicians during the COVID-19 pandemic. Still, qualitative studies investigating physicians' views, and their discovered strengths, are lacking. Our research fills this gap by exploring professional and personal reflections developed by physicians from various specialties during the pandemic. Semi-structured interviews were conducted with physicians practicing in the province of Saskatchewan, Canada, during November 2020-July 2021. Thematic analysis identified core themes and subthemes. Seventeen physicians, including nine males and eight females, from eleven specialties completed the interviews. The pandemic brought to the forefront life's temporality and a new appreciation for life, work, and each other. Most physicians found strength in values, such as gratitude, solidarity, and faith in human potential, to anchor them professionally and personally. A new need for personal fulfilment and hybrid care emerged. Negative feelings of anger, fear, uncertainty, and frustration were due to overwhelming pressures, while feelings of injustice and betrayal were caused by human or system failures. The physicians' appreciation for life and family and their faith in humanity and science were the primary coping strategies used to build adaptation and overcome negative emotions. These reflections are summarized, and implications for prevention and resilience are discussed.
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12
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Alkhamees AA, Aljohani MS, Kalani S, Ali AM, Almatham F, Alwabili A, Alsughier NA, Rutledge T. Physician's Burnout during the COVID-19 Pandemic: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20054598. [PMID: 36901612 PMCID: PMC10001574 DOI: 10.3390/ijerph20054598] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/04/2022] [Accepted: 12/09/2022] [Indexed: 05/09/2023]
Abstract
The burnout rate among physicians is expected to be higher during COVID-19 period due to the additional sources of physical and emotional stressors. Throughout the current COVID-19 pandemic, numerous studies have evaluated the impacts of COVID-19 on physicians' burnout, but the reported results have been inconsistent. This current systematic review and meta-analysis aims to assess and estimate the epidemiology of burnout and the associated risk factors during the COVID-19 pandemic among physicians. A systematic search for studies targeting physicians' burnout was conducted using PubMed, Scopus, ProQuest, Cochrane COVID-19 registry, and pre-print services (PsyArXiv and medRχiv) for English language studies published within the time period of 1 January 2020 to 1 September 2021. Search strategies resulted in 446 possible eligible studies. The titles and abstracts of these studies were screened, which resulted in 34 probable studies for inclusion, while 412 studies were excluded based on the predetermined inclusion criteria. These 34 studies went through a full-text screening for eligibility, which resulted in 30 studies being included in the final reviews and subsequent analyses. Among them, the prevalence of physicians' burnout rate ranged from 6.0-99.8%. This wide variation could be due to the heterogeneity among burnout definitions, different applied assessment tools, and even cultural factors. Further studies may consider other factors when assessing burnout (e.g., the presence of a psychiatric disorders, other work-related and cultural factors). In conclusion, a consistent diagnostic indices for the assessment of burnout is required to enable consistent methods of scoring and interpretation.
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Affiliation(s)
- Abdulmajeed A. Alkhamees
- Department of Medicine, Unayzah College of Medicine and Medical Sciences, Qassim University, Unayzah 52571, Saudi Arabia
- Correspondence:
| | - Moath S. Aljohani
- Department of Family and Community Medicine, Unayzah College of Medicine and Medical Sciences, Qassim University, Unayzah 52571, Saudi Arabia
| | - Simindokht Kalani
- Department of Psychology, Faculty of Education and Psychology, University of Isfahan, Isfahan 8174673441, Iran
| | - Amira Mohammed Ali
- Department of Psychiatric Nursing and Mental Health, Faculty of Nursing, Alexandria University, Alexandria 5424041, Egypt
| | - Fahad Almatham
- Department of Medicine, Unayzah College of Medicine and Medical Sciences, Qassim University, Unayzah 52571, Saudi Arabia
| | - Afnan Alwabili
- Department of Medicine, Unayzah College of Medicine and Medical Sciences, Qassim University, Unayzah 52571, Saudi Arabia
| | - Naif Abdullah Alsughier
- Department of Medicine, Unayzah College of Medicine and Medical Sciences, Qassim University, Unayzah 52571, Saudi Arabia
| | - Thomas Rutledge
- VA San Diego Healthcare System, Department of Psychiatry, Psychology Service, University of California San Diego, San Diego, CA 92093, USA
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13
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Stodolska A, Wójcik G, Barańska I, Kijowska V, Szczerbińska K. Prevalence of burnout among healthcare professionals during the COVID-19 pandemic and associated factors - a scoping review. Int J Occup Med Environ Health 2023; 36:21-58. [PMID: 36727492 PMCID: PMC10464746 DOI: 10.13075/ijomeh.1896.02007] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 10/12/2022] [Indexed: 02/03/2023] Open
Abstract
The outbreak of the COVID-19 pandemic exerted significant mental burden on healthcare workers (HCWs) operating in the frontline of the COVID-19 care as they experienced high levels of stress and burnout. The aim of this scoping review was to identify prevalence and factors associated with burnout among HCWs during the first year of the COVID-19 pandemic. A literature search was performed in PubMed, Web of Science, and CINAHL. Studies were selected based on the following inclusion criteria: cross-sectional, longitudinal, case-control, or qualitative analyses, published in peer-reviewed journals, between January 1, 2020 and February 28, 2021. Studies carried out on other occupations than healthcare workers or related to other pandemics than COVID-19 were excluded. Following the abstract screen, from 141 original papers identified, 69 articles were eventually selected. A large variation in the reported burnout prevalence among HCWs (4.3-90.4%) was observed. The main factors associated with increase/ decrease of burnout included: demographic characteristics (age, gender, education level, financial situation, family status, occupation), psychological condition (psychiatric diseases, stress, anxiety, depression, coping style), social factors (stigmatisation, family life), work organization (workload, working conditions, availability of staff and materials, support at work), and factors related with COVID-19 (fear of COVID-19, traumatic events, contact with patients with COVID-19, having been infected with COVID-19, infection of a colleague or a relative with COVID-19, higher number of deaths observed by nurses during the COVID-19 pandemic). The findings should be useful for policy makers and healthcare managers in developing programs preventing burnout during the current and future pandemics. Int J Occup Med Environ Health. Int J Occup Med Environ Health. 2023;36(1):21-58.
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Affiliation(s)
- Agata Stodolska
- Jagiellonian University Medical College, Kraków, Poland (Medical Faculty, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair)
| | - Grzegorz Wójcik
- Jagiellonian University Medical College, Kraków, Poland (Medical Faculty, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair)
- Jagiellonian University, Kraków, Poland (Faculty of Management and Social Communication, Institute of Applied Psychology)
| | - Ilona Barańska
- Jagiellonian University Medical College, Kraków, Poland (Medical Faculty, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair)
| | - Violetta Kijowska
- Jagiellonian University Medical College, Kraków, Poland (Medical Faculty, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair)
| | - Katarzyna Szczerbińska
- Jagiellonian University Medical College, Kraków, Poland (Medical Faculty, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair)
- University Hospital in Krakow, Kraków, Poland
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14
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Fadle AA, Khalifa AA, Mahran DG, Khidr SS, Said HG, Farouk O. Burnout syndrome (BOS) among resident doctors in an Egyptian tertiary care university hospital: Prevalence and determinants during the COVID-19 pandemic. Int J Soc Psychiatry 2023; 69:396-405. [PMID: 35695719 PMCID: PMC10076172 DOI: 10.1177/00207640221104698] [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] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The current study aimed to detect the BOS prevalence and determinants among residents working during the second wave of the COVID-19 pandemic in an Egyptian tertiary university referral hospital. METHODS A cross-sectional study evaluating the working period from June to November 2020 during the COVID-19 pandemic second wave, through a five sections questionnaire evaluating: 1 - sociodemographic characteristics, 2 - job characteristics, 3 - negative thoughts related to their job, 4 - resident's health problems, and 5 - evaluating BOS through Maslach Burnout Inventory (MBI) scale (including emotional exhaustion [EE], depersonalization [DP], and personal accomplishment [PA] as subscales). RESULTS We included 230 residents with a median age of 27 years. The median MBI sub-scales (IQ Range) values were 30.0 (20, 39), 21.0 (15, 30), and 29.5 (22, 36) for EE, DP, and PA, respectively. About 51.0% and 83.0% of the residents were high in EE and DP, while 8.7% were low in PA. The median EE and DP were higher in younger age (⩽27 years; p = .002 and .024), males (p = .001 and <.001), working >90 hours weekly (p = .016 and <.001), exposure to harassment (p < .001), and having COVID-19 infection (p = .002 and .001). Residents working in surgical departments reported higher DP scores than those in non-surgical departments (p = .03). There was a mild positive correlation between working hours per week and the total scores in EE and DP, r = .24 (p < .001) and r = .23 (p = .001) respectively, while it was found to have a negative correlation with the PA (r = -.133 and p = .044). CONCLUSIONS The BOS is evident and considerably high among the residents working during the COVID-19 pandemic. Younger age, males, working in surgical departments, and those who got COVID-19 infection were most vulnerable.
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Affiliation(s)
- Amr A Fadle
- Orthopaedic Department, Assiut University Hospital, Egypt
| | - Ahmed A Khalifa
- Orthopaedic Department, Assiut University Hospital, Egypt.,Orthopaedic Department, Qena Faculty of Medicine and University Hospital, South Valley University, Qena, Egypt
| | - Dalia G Mahran
- Department of Public Health and Community Medicine, Faculty of Medicine, Assiut University, Egypt
| | | | - Hatem G Said
- Orthopaedic Department, Assiut University Hospital, Egypt
| | - Osama Farouk
- Orthopaedic Department, Assiut University Hospital, Egypt
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15
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Mani K, Canarick J, Ruan E, Liu J, Kitsis E, Jariwala SP. Effect of Telemedicine and the COVID-19 Pandemic on Medical Trainees' Usage of the Electronic Health Record in the Outpatient Setting. Appl Clin Inform 2023; 14:309-320. [PMID: 36758613 PMCID: PMC10132927 DOI: 10.1055/a-2031-9437] [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: 07/29/2022] [Accepted: 02/06/2023] [Indexed: 02/11/2023] Open
Abstract
OBJECTIVES This study aimed to (1) determine the impact of COVID-19 (coronavirus disease 2019) and the corresponding increase in use of telemedicine on volume, efficiency, and burden of electronic health record (EHR) usage by residents and fellows; and (2) to compare these metrics with those of attending physicians. METHODS We analyzed 11 metrics from Epic's Signal database of outpatient physician user logs for active residents/fellows at our institution across three 1-month time periods: August 2019 (prepandemic/pre-telehealth), May 2020 (mid-pandemic/post-telehealth implementation), and July 2020 (follow-up period) and compared these metrics between trainees and attending physicians. We also assessed how the metrics varied for medical trainees in primary care as compared with subspecialties. RESULTS Analysis of 141 residents/fellows and 495 attendings showed that after telehealth implementation, overall patient volume, Time in In Basket per day, Time outside of 7 a.m. to 7 p.m., and Time in notes decreased significantly compared with the pre-telehealth period. Female residents, fellows, and attendings had a lower same day note closure rate before and during the post-telehealth implementation period and spent greater time working outside of 7 a.m. to 7 p.m. compared with male residents, fellows, and attendings (p < 0.01) compared with the pre-telehealth period. Attending physicians had a greater patient volume, spent more time, and were more efficient in the EHR compared with trainees (p < 0.01) in both the post-telehealth and follow-up periods as compared with the pre-telehealth period. CONCLUSION The dramatic change in clinical operations during the pandemic serves as an inflection point to study changes in physician practice patterns in the EHR. We observed that (1) female physicians closed fewer notes the same day and spent more time in the EHR outside of normal working hours compared with male physicians, and (2) attending physicians had higher patient volumes and also higher efficiency in the EHR compared with resident physicians.
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Affiliation(s)
- Kyle Mani
- Department of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, United States
| | - Jay Canarick
- Department of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, United States
| | - Elise Ruan
- Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, United States
| | - Jianyou Liu
- Division of Biostatistics, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, United States
| | - Elizabeth Kitsis
- Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, United States
| | - Sunit P. Jariwala
- Division of Allergy/Immunology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, United States
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16
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Chen F, Isaak R, Afroze F, Mulaikal TA, Licatino LK, Ladlie B, Jain A, Willie C, Bairde E, Hayes BH, Carter T, Zisblatt L, Diachun C, Martin TW, Marshall JM, Huffmyer J, Hindle AK, Stahl DL, Liu Y, Martinelli SM. A Multi-Site Survey Study on the Association Between the COVID-19 Pandemic and United States Anesthesiology Residents' Mental Health. Cureus 2023; 15:e34782. [PMID: 36915835 PMCID: PMC10005895 DOI: 10.7759/cureus.34782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND At the onset of the coronavirus disease 2019 (COVID-19) pandemic, anesthesiology residency programs were impacted differently due to various factors such as the local severity of COVID-19, exposure to patient suffering, and inability to complete rotations. We sought to investigate the impact of local-level pandemic severity on the well-being of anesthesiology residents. METHODS This multi-site study surveyed postgraduate year two residents from 15 United States (US) anesthesiology programs using the Perceived Stress Scale, Mini-Z, Patient Health Questionnaire-9,WHO-5 Well-Being Index,and the Multidimensional Scale of Perceived Social Support before the pandemic (baseline survey) and during the first COVID-19 surge (post survey). RESULTS A total of 144 (65%) residents responded to the initial baseline survey; 73 (33%) responded to the post survey, and 49 (22%) completed both surveys. There was not a statistically significant difference in any well-being outcomes of participants between the surveys, nor was there a significant difference based on the severity of COVID-19 impact at the program's hospital. Male participants had higher perceived stress scores (β = 4.05, 95%CI: 0.42, 7.67, P = 0.03) and lower social support from family (β = -6.57, 95%CI: -11.64, -1.51, P = 0.01) at the post survey compared to female participants after controlling for baseline scores. Additionally, married participants or those with domestic partners reported higher perceived social support in the post survey (β = 5.79, 95%CI: -0.65, 12.23, P = 0.03). CONCLUSION The local COVID-19 severity at a residency program did not disproportionately impact well-being scores among anesthesiology residents. Those most vulnerable to diminished well-being appeared to be male and single participants. As a result, targeted well-being interventions, including those aiming to increase social support, to higher-risk resident groups may be indicated. Future work is needed to assess the longstanding COVID-19 pandemic impacts on resident well-being.
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Affiliation(s)
- Fei Chen
- Department of Anesthesiology, University of North Carolina School of Medicine, Chapel Hill, USA
| | - Robert Isaak
- Department of Anesthesiology, University of North Carolina School of Medicine, Chapel Hill, USA
| | - Farzana Afroze
- Department of Anesthesiology, Albany Medical Center, Albany, USA
| | - Teresa A Mulaikal
- Department of Anesthesiology, Columbia University, New York City, USA
| | - Lauren K Licatino
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, USA
| | - Beth Ladlie
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, USA
| | - Ankit Jain
- Department of Anesthesiology and Perioperative Medicine, Medical College of Georgia, Augusta University, Augusta, USA
| | - Chelsea Willie
- Department of Anesthesiology and Pediatrics, Medical College of Wisconsin, Milwaukee, USA
| | - Emily Bairde
- Department of Anesthesiology, Oregon Health & Science University, Portland, USA
| | - Blair H Hayes
- Department of Anesthesiology, The Ohio State University, Columbus, USA
| | - Tekuila Carter
- Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, Birmingham, USA
| | - Lara Zisblatt
- Department of Anesthesiology, University of Michigan, Ann Arbor, USA
| | - Carol Diachun
- Department of Anesthesiology, University of Florida College of Medicine, Jacksonville, USA
| | - Timothy W Martin
- Department of Anesthesiology, University of Florida, Gainesville, USA
| | - Julie M Marshall
- Department of Anesthesiology, University of Missouri, Columbia, USA
| | - Julie Huffmyer
- Department of Anesthesiology, University of Virginia School of Medicine, Charlottesville, USA
| | - Anna K Hindle
- Department of Anesthesiology, The George Washington University, Washington, D.C., USA
| | - David L Stahl
- Department of Anesthesiology, The Ohio State University, Columbus, USA
| | - Yutong Liu
- Department of Biostatistics, University of North Carolina, Chapel Hill, USA
| | - Susan M Martinelli
- Department of Anesthesiology, University of North Carolina School of Medicine, Chapel HIll, USA
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17
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Shah HP, Salehi PP, Ihnat J, Kim DD, Salehi P, Judson BL, Azizzadeh B, Lee YH. Resident Burnout and Well-being in Otolaryngology and Other Surgical Specialties: Strategies for Change. Otolaryngol Head Neck Surg 2023; 168:165-179. [PMID: 35133919 DOI: 10.1177/01945998221076482] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 01/07/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To perform a literature review on burnout prevalence, factors that affect burnout and well-being, and solutions to address burnout in otolaryngology-head and neck surgery (OTO-HNS) residents and residents in other surgical specialties. DATA SOURCES Ovid Medline, Embase, and article reference lists. REVIEW METHODS A literature search was performed to identify articles on resident burnout, distress, wellness, well-being, and quality of life. Articles deemed outside the scope of the current work were excluded. Search was limited to the past 5 years. CONCLUSIONS Moderate to high burnout has been reported in 35% to 86% of OTO-HNS residents. Among other surgical specialties, resident burnout ranges between 58% and 66% in plastics, 11% and 67% in neurosurgery, 38% and 68% in urology, and 31% and 56% in orthopedics. Highest burnout rates were seen in postgraduate year 2 residents. Factors significantly associated with burnout included hours worked (>80 h/wk), level of autonomy, exercise, and program support. Reported resident work hours have steadily increased: 8% of OTO-HNS residents in 2005 vs 26% in 2019 reported averaging >80 h/wk. Practical implications of resident burnout include decreased empathy, moral distress and injury, poor health, decreased quality of life, increased attrition, decreased desire to pursue fellowship, and increased likelihood of medical errors. Structured mentorship programs, wellness initiatives, and increased ancillary support have been associated with lower burnout rates and improvements in resident well-being across specialties. IMPLICATIONS FOR PRACTICE Addressing burnout, which is prevalent in OTO-HNS residents, is critical to improving patient care and physician well-being. Surgical specialties can share strategies to effectively address resident burnout through institutional interventions, which can be essential quality improvement initiatives, to promote well-being.
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Affiliation(s)
- Hemali P Shah
- Connecticut Department of Surgery, Otolaryngology-Head and Neck Surgery, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Parsa P Salehi
- Connecticut Department of Surgery, Otolaryngology-Head and Neck Surgery, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Jacqueline Ihnat
- Connecticut Department of Surgery, Otolaryngology-Head and Neck Surgery, Yale University School of Medicine, New Haven, Connecticut, USA
| | - David D Kim
- Connecticut Department of Surgery, Otolaryngology-Head and Neck Surgery, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Pauniz Salehi
- College of Human Ecology, Department of Nutritional Sciences, Cornell University, Ithaca, New York, USA
| | - Benjamin L Judson
- Connecticut Department of Surgery, Otolaryngology-Head and Neck Surgery, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Babak Azizzadeh
- Center for Advanced Facial Plastic Surgery, Beverly Hills, California, USA.,Department of Otolaryngology-Head and Neck Surgery, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California, USA
| | - Yan Ho Lee
- Connecticut Department of Surgery, Otolaryngology-Head and Neck Surgery, Yale University School of Medicine, New Haven, Connecticut, USA
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18
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Lechien JR, Chebib E, Zelenik K, Maniaci A, Molteni G, Maza-Solano JM, Hans S. Impact of mobilization of residents in otolaryngology-head-neck surgery in COVID-19 units on mental health status. Eur Arch Otorhinolaryngol 2023; 280:907-911. [PMID: 36006516 PMCID: PMC9406264 DOI: 10.1007/s00405-022-07617-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 08/14/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND To investigate mental health, sleep, and addiction features of young otolaryngologists (YO) according to the mobilization in COVID-19 units at the end of the third European wave of infections. METHODS A cross-sectional survey was sent to 220 YO of 6 European University hospitals. The following outcomes were evaluated: postgraduate year; age; management of COVID-19 patients; workload; nights on call; stress; Beck depression inventory; Insomnia severity index; sleep and mental health status evolutions throughout pandemic; consumption of alcohol, tobacco, and drugs before and during pandemic. RESULTS A total of 128 YO completed the evaluations (58.2%). Twenty responders (15.6%) did not manage COVID-19 patients, while 65 (50.8%), 20 (15.6%), and 23 (18%) managed rarely, frequently or daily COVID-19 patients during the pandemic, respectively. The management of COVID-19 patients was associated with increases of workload (p = 0.023) and number of nights on-call (p < 0.001). At the end of the third wave, the depression rates were 34% (N = 31/68) and 57% (N = 34/60) in YO who worked less and more than 50 h weekly, respectively. Sleep disturbance concerned 39% (N = 26/66) and 55% (N = 27/60) of YO who worked less and more than 50 h weekly, respectively. Mobilized YO reported a significant increase of alcohol consumption compared with control group (p = 0.002). Tobacco and drugs consumptions did not evolve. The consumption of alcohol was positively correlated with the number of nights on-call (p = 0.036) and the total hours of work (p = 0.009). CONCLUSIONS Young otolaryngologists (YO) mobilized in COVID-19 units reported higher hours worked, nights on call, and alcohol consumption compared with others. Future large cohort-studies are needed to confirm our observations.
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Affiliation(s)
- Jerome R. Lechien
- Department of Otolaryngology, Elsan Hospital, Paris, France ,Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Avenue du Champ de mars, 6, 7000 Mons, Belgium ,Department of Otolaryngology-Head Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, Brussels, Belgium ,Department of Otolaryngology-Head Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France ,COVID-19 Task Force of Young Otolaryngologists of International Federation of Otorhinolaryngological Societies (YO-IFOS), Paris, France
| | - Emilien Chebib
- Department of Otolaryngology-Head Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France ,COVID-19 Task Force of Young Otolaryngologists of International Federation of Otorhinolaryngological Societies (YO-IFOS), Paris, France
| | - Karol Zelenik
- COVID-19 Task Force of Young Otolaryngologists of International Federation of Otorhinolaryngological Societies (YO-IFOS), Paris, France ,Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine, University Hospital of Ostrava, Ostrava, Czech Republic
| | - Antonino Maniaci
- COVID-19 Task Force of Young Otolaryngologists of International Federation of Otorhinolaryngological Societies (YO-IFOS), Paris, France ,Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, ENT Department of University of Catania, Catania, Italy ,Department of Biomedical and Biotechnological Sciences (BIOMETEC), University of Catania, Catania, Italy
| | - Gabriele Molteni
- COVID-19 Task Force of Young Otolaryngologists of International Federation of Otorhinolaryngological Societies (YO-IFOS), Paris, France ,Division of Otolaryngology-Head and Neck Surgery, University Hospital of Verona, Verona, Italy
| | - Juan M. Maza-Solano
- COVID-19 Task Force of Young Otolaryngologists of International Federation of Otorhinolaryngological Societies (YO-IFOS), Paris, France ,Department of Otolaryngology, Hospital Universitario Virgen Macarena, Seville, Spain
| | - Stéphane Hans
- COVID-19 Task Force of Young Otolaryngologists of International Federation of Otorhinolaryngological Societies (YO-IFOS), Paris, France
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Failla G, Caminiti M, Chen-Xu J, Lo Moro G, Berselli N, Cabral Ferreira M, Malcata F, Peyre-Costa D, Croci R, Soldà G, Capodici A, Morcavallo C, Traglia F, Cedrone F, Storti I, Jaquete AA, Antinozzi M, Vasiliu A. Impact of the COVID pandemic on mental health and training opportunities of Public Health Residents from 4 European countries: A cross-sectional study. Front Public Health 2023; 11:1044171. [PMID: 36960373 PMCID: PMC10028077 DOI: 10.3389/fpubh.2023.1044171] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 02/06/2023] [Indexed: 03/09/2023] Open
Abstract
Objectives There is little evidence on the impact of the COVID-19 pandemic on Public Health Residents' (PHR) mental health (MH). This study aims at assessing prevalence and risk factors for depression, anxiety and stress in European PHR during the COVID-19 pandemic. Methods Between March and April 2021, an online survey was administered to PHR from France, Italy, Portugal and Spain. The survey assessed COVID-19 related changes in working conditions, training opportunities and evaluated MH outcomes using the Depression Anxiety Stress Scales-21. Multivariable logistic regressions were applied to identify risk factors. Results Among the 443 respondents, many showed symptoms of depression (60.5%), anxiety (43.1%) and stress (61.2%). The main outcome predictors were: female gender for depression (adjOR = 1.59, 95%CI [1.05-2.42]), anxiety (adjOR = 2.03, 95%CI [1.33-3.08]), and stress (adjOR = 2.35, 95%CI [1.53-3.61]); loss of research opportunities for anxiety (adjOR = 1.94, 95%CI [1.28-2.93]) and stress (adjOR = 1.98, 95%CI [1.26-3.11]); and COVID-19 impact on training (adjOR = 1.78, 95%CI [1.12-2.80]) for depression. Conclusions The pandemic had a significant impact on PHR in terms of depression, anxiety and stress, especially for women and who lost work-related opportunities. Training programs should offer PHR appropriate MH support and training opportunities.
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Affiliation(s)
- Giovanna Failla
- Department of Life Sciences and Public Health, Catholic University of the Sacred Heart, Rome, Italy
- *Correspondence: Giovanna Failla
| | - Marta Caminiti
- Department of Public Health Sciences, University of Perugia, Perugia, Italy
| | - José Chen-Xu
- Public Health Unit, Primary Health Care Cluster Baixo Mondego, Coimbra, Portugal
| | | | - Nausicaa Berselli
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Filipa Malcata
- Public Health Unit, Primary Health Care Cluster Porto Ocidental, Porto, Portugal
| | - David Peyre-Costa
- Public Health Unit, University Hospital of Montpellier, Montpellier, France
| | - Roberto Croci
- School of Medicine, University Vita-Salute San Raffaele, Milan, Italy
| | - Giorgia Soldà
- School of Hygiene and Preventive Medicine, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, Bologna, Italy
| | - Angelo Capodici
- School of Hygiene and Preventive Medicine, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, Bologna, Italy
| | - Caterina Morcavallo
- Department of Biomedical Sciences and Human Oncology, School of Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Francesco Traglia
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Fabrizio Cedrone
- Health Management of “SS. Spirito” Hospital of Pescara, Local Health Authority of Pescara, Pescara, Italy
| | - Ilaria Storti
- Department of Cardiothoracic and Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Alfonso Alonso Jaquete
- Preventive Medicine and Public Health Unit, Health Department of the Government of Cantabria, Santander, Spain
| | | | - Anca Vasiliu
- Department of Pediatrics, Global Tuberculosis Program, Baylor College of Medicine, Houston, TX, United States
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Gaughan AA, Rush LJ, MacEwan SR, Panchal AR, McAlearney AS. Perspectives of Volunteer Firefighters during the COVID-19 Pandemic: Stumbling Blocks and Silver Linings. CHALLENGES 2022; 13:46. [PMID: 36213181 PMCID: PMC9540602 DOI: 10.3390/challe13020046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The COVID-19 pandemic has profoundly affected the lives of almost every individual in every nation, with numbers of infections continuing to grow. Across these nations, first responders are essential in their roles addressing emergencies, despite their risk of exposure to COVID-19 in the course of their work. We sought to understand the impacts of the COVID-19 pandemic on the lives of volunteer firefighters in the United States, an understudied group of these first responders. Interviews were conducted with volunteer firefighters between September and November 2021. Interviews were analyzed using deductive dominant thematic analysis. Thirty-three firefighters were interviewed who had an average of 22 years of service and a mean age of 52 years. Interviewees described pandemic-related challenges including the fear of COVID exposure and frustrations with work and personal relationships. They also identified unexpected work-related benefits including a deepened commitment to serve and improvements to training and safety. Further, some volunteers noted personal benefits such as developing stronger connections with others, having a new outlook on life, and observing goodwill. Our findings provide insight into the multifaceted and complex impact of the COVID-19 pandemic on volunteer firefighters.
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Affiliation(s)
- Alice A. Gaughan
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Laura J. Rush
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Sarah R. MacEwan
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, OH 43210, USA
- Division of General Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Ashish R. Panchal
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, OH 43210, USA
- Department of Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
| | - Ann Scheck McAlearney
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, OH 43210, USA
- Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
- Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
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21
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Tarrash M, Nelson D, Gabbur N, Goldberg GL. Assessing burnout among Obstetrics & Gynecology residents during night float versus day float in a large academic hospital. BMC MEDICAL EDUCATION 2022; 22:809. [PMID: 36424600 PMCID: PMC9686460 DOI: 10.1186/s12909-022-03897-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The prevalence estimates of burnout among residents vary widely. Resident physicians working overnight have additional stressors and therefore, may be at higher risk of developing burnout. OBJECTIVE To determine the rates of burnout among residents working night rotations versus day rotations. METHODS This is a prospective, cross sectional, survey-based assessment of the prevalence of burnout among Obstetrics and Gynecology (OBGYN) residents on nights versus days rotations conducted at a large academic residency program that spans two separate hospitals in New York. All residents in the residency program were asked to complete the Maslach Burnout Inventory - Human Services Survey for Medical Personnel (MBI-HSS (MP)) after the first rotation of the academic year in 2018, 2019, and 2020. The results for each of the three aspects of the MBI-HSS (MP): emotional exhaustion, depersonalization, and personal accomplishment, were then compared for those on nights versus day rotations using students t-test. RESULTS A total of 76 responses were received, 13 from residents on night rotations and 63 from residents on day rotations with a response rate of 61.8%. Comparing resident responses for a night versus day rotation, the residents averaged a low level of emotional exhaustion (a score of 17 ± 9) on day shift, compared to a moderate level of emotional exhaustion (a score of 18 ± 14) on nights (p = 0.37). Similarly, 55.6% of respondents reports low personal accomplishment on days, compared to 76.9% while on nights. CONCLUSIONS Emotional exhaustion scores were lower for residents on daytime rotations (mean score 17, SD 9), compared to those on nights rotations (mean 18, SD 14). Although there was no difference in depersonalization when comparing the day and night shift, 45% of the responses indicated high levels of depersonalization regardless of the type of shift. These results highlight the need to continue efforts to minimize burnout in medical training.
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Affiliation(s)
- Miriam Tarrash
- Department of Obstetrics & Gynecology, Zucker School of Medicine at Hofstra/Northwell and Northwell Health, New York, USA
| | - David Nelson
- Department of Obstetrics & Gynecology, Zucker School of Medicine at Hofstra/Northwell and Northwell Health, New York, USA
| | - Nagaraj Gabbur
- Department of Obstetrics & Gynecology, Zucker School of Medicine at Hofstra/Northwell and Northwell Health, New York, USA
| | - Gary L Goldberg
- Department of Obstetrics & Gynecology, Zucker School of Medicine at Hofstra/Northwell and Northwell Health, New York, USA.
- Department of Obstetrics & Gynecology LIJ Medical Center, Ob/Gyn Admin Suite Room C221, 270-05 76th Avenue, New Hyde Park, New York, NY, 11040, USA.
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22
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Peñaranda A, García E, Pérez-Herrera LC, Trojan A, Peñaranda D, Molina J, Moreno-López S. Effect of the COVID-19 pandemic on the mental health, daily and occupational activities among health professionals in Colombia: a national study. BMC Psychiatry 2022; 22:682. [PMID: 36333782 PMCID: PMC9635125 DOI: 10.1186/s12888-022-04337-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 09/27/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has placed an unprecedented physical and mental burden on healthcare workers who are frequently at high risk of infection, particularly in low-income countries. This study aimed to assess the prevalence and associated factors of anxiety, depression, and stress, as well as changes in daily and occupational activities among healthcare professionals due to the COVID-19 pandemic in Colombia. METHODS An observational, cross-sectional study was conducted between February and June 2021. The survey incorporated validated mental health tools such as the Generalized Anxiety Disorder-7, the Patient Health Questionnaire-9, and the Perceived Stress Scale-10. Multivariable ordinal logistic regression analysis was performed to determine the factors associated with severe mental health outcomes. RESULTS Among 1345 healthcare workers the prevalence of anxiety, depression, and stress were 75.61, 59.18, and 53.09%, respectively. Anxiety (OR:1.44; 95%CI:1.16-1.8), depression (OR:1.74; 95%CI:1.27-2.37), and stress (OR:1.51; 95%CI:1.18-1.94) were more frequent in women, and individuals who expressed fear of a negative outcome (death, sequelae) (OR:2.25; 95%CI:1.60-3.25), (OR:1.49; 95%CI:1.03-2.16) and (OR:2.36; 95%CI:1.69-3.29) respectively. Age was negatively associated with anxiety (OR:0.98; 95%CI:0.98-0.99), stress (OR:0.98; 95%CI:0.97-0.99), and depression (OR:0.97; 95% CI:0.96-0.98). Reduction in consultations and surgeries (OR:1.01; 95%CI:1.0-1.01) was positively associated with anxiety. Due to the pandemic, most specialists expected to incorporate drastic long-term (> 1 year) changes in their clinical setting and daily activities. CONCLUSIONS The prevalence of anxiety, depression, and stress is higher among Colombian healthcare workers compared to previous reports. Further research regarding these psychological outcomes is needed to achieve early mental health intervention strategies. TRIAL REGISTRATION Hospital Universitario Fundación Santa Fe, Ethical Committee Registration ID: CCEI-12992-2021.
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Affiliation(s)
- Augusto Peñaranda
- Otolaryngology Department, Fundación Santa Fe de Bogotá, Avenida 9 No. 116 -20, office 207, Bogotá, 110111, Colombia. .,School of Medicine, Universidad de Los Andes, Bogotá, Colombia. .,Otolaryngology and Allergy Research Groups, Unidad Médico Quirúrgica de Otorrinolaringología (UNIMEQ-ORL), Bogotá, Colombia.
| | - Elizabeth García
- grid.7247.60000000419370714School of Medicine, Universidad de Los Andes, Bogotá, Colombia ,Otolaryngology and Allergy Research Groups, Unidad Médico Quirúrgica de Otorrinolaringología (UNIMEQ-ORL), Bogotá, Colombia ,grid.418089.c0000 0004 0620 2607Allergy Section, Department of Pediatrics, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Lucia C. Pérez-Herrera
- grid.7247.60000000419370714School of Medicine, Universidad de Los Andes, Bogotá, Colombia ,Otolaryngology and Allergy Research Groups, Unidad Médico Quirúrgica de Otorrinolaringología (UNIMEQ-ORL), Bogotá, Colombia
| | - Annabelle Trojan
- Otolaryngology and Allergy Research Groups, Unidad Médico Quirúrgica de Otorrinolaringología (UNIMEQ-ORL), Bogotá, Colombia ,grid.412885.20000 0004 0486 624XInstituto de Investigaciones Inmunológicas, Universidad de Cartagena, Cartagena, Colombia
| | - Daniel Peñaranda
- Otolaryngology and Allergy Research Groups, Unidad Médico Quirúrgica de Otorrinolaringología (UNIMEQ-ORL), Bogotá, Colombia ,grid.442070.5Otolaryngology Section, Fundación Universitaria de Ciencias de la Salud – Hospital de San José, Bogotá, Colombia
| | - Juan Molina
- grid.412195.a0000 0004 1761 4447Fellow Consultation-Liaison Psychiatry, Universidad El Bosque, Bogotá, Colombia
| | - Sergio Moreno-López
- grid.7247.60000000419370714School of Medicine, Universidad de Los Andes, Bogotá, Colombia ,Otolaryngology and Allergy Research Groups, Unidad Médico Quirúrgica de Otorrinolaringología (UNIMEQ-ORL), Bogotá, Colombia
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Andhavarapu S, Yardi I, Bzhilyanskaya V, Lurie T, Bhinder M, Patel P, Pourmand A, Tran QK. Post-traumatic stress in healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Psychiatry Res 2022; 317:114890. [PMID: 36260970 PMCID: PMC9573911 DOI: 10.1016/j.psychres.2022.114890] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 10/02/2022] [Accepted: 10/06/2022] [Indexed: 01/05/2023]
Abstract
The SARS-CoV-2 (COVID-19) pandemic has increased healthcare worker (HCW) susceptibility to mental illness. We conducted a meta-analysis to investigate the prevalence and possible factors associated with post-traumatic stress disorder (PTSD) symptoms among HCW during the COVID-19 pandemic. We searched PubMed, SCOPUS and EMBASE databases up to May 4th, 2022. We performed random effects meta-analysis and moderator analyses for the prevalence of PTSD-relevant symptoms and severe PTSD symptoms. We identified 1276 studies, reviewed 209 full-text articles, and included 119 studies (117,143 participants) with a total of 121 data points in our final analysis. 34 studies (24,541 participants) reported prevalence of severe PTSD symptoms. Approximately 25.2% of participants were physicians, 42.8% nurses, 12.4% allied health professionals, 8.9% auxiliary health professionals, and 10.8% "other". The pooled prevalence of PTSD symptoms among HCWs was 34% (95% CI, 0.30-0.39, I2 >90%), and 14% for severe PTSD (95% CI, 0.11 - 0.17, I2 >90%). The introduction of COVID vaccines was associated with a sharp decline in the prevalence of PTSD, and new virus variants were associated with small increases in PTSD rates. It is important that policies work towards allocating adequate resources towards protecting the well-being of healthcare workers to minimize adverse consequences of PTSD.
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Affiliation(s)
- Sanketh Andhavarapu
- The Research Associate Program, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Isha Yardi
- The Research Associate Program, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Vera Bzhilyanskaya
- The Research Associate Program, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Tucker Lurie
- The Research Associate Program, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Mujtaba Bhinder
- The Research Associate Program, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Priya Patel
- The Research Associate Program, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Ali Pourmand
- Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, United States
| | - Quincy K Tran
- Department of Emergency Medicine, University of Maryland School of Medicine, 22 South Greene Street, Suite T3N45, Baltimore, MD 21043, United States; Program in Trauma, The R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, United States.
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24
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Peñaranda A, Moreno-López S, Peñaranda D, Pérez-Herrera LC. Effect of the COVID-19 pandemic on the mental health, daily and occupational activities of pediatric otolaryngologists in Latin America. Front Public Health 2022; 10:735073. [PMID: 36339173 PMCID: PMC9630938 DOI: 10.3389/fpubh.2022.735073] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 10/04/2022] [Indexed: 01/21/2023] Open
Abstract
Background Otolaryngologists have a higher risk of physical/psychological problems due to their frequent exposure to SARS-CoV-2. There is no information about the impact of COVID-19 on the mental health of these specialists in low/middle-income countries from Latin America. This study aimed to assess the frequency of anxiety, depression, and stress, as well as the changes in occupational and daily activities due to the COVID-19 pandemic in a group of pediatric otolaryngologists in Latin America. Methods Observational, cross-sectional study conducted between October and December 2020. Mental health tools such as the Generalized Anxiety Disorder-7, the Patient Health Questionnaire-9, and the Perceived Stress Scale-10 were applied. Fear to COVID-19 scale and questionnaires about occupational and daily activities were also applied. Results Among 55 pediatric otolaryngologists, the frequency of anxiety, depression, and stress were 67.3%, 45.5, and 40%, respectively. Up to 27.3% of the specialists reported moderate to severe symptoms of anxiety, while 7.3 and 40% presented moderate depression and stress symptoms. The specialists reported a reduction of 58.3% of their consultations, as well as a 51.7% reduction in their monthly income compared to the same period before the pandemic. Up to 14.6% of the specialists expect to incorporate long-term (>1 year) drastic changes in their daily activities due to the pandemic. Conclusions The frequency of anxiety, depression, and stress was high among pediatric otolaryngologists in Latin America compared to previous studies performed in high-income countries. Further research on these psychological outcomes is needed to achieve early mental health strategies.
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Affiliation(s)
- Augusto Peñaranda
- Otolaryngology and Allergy Research Groups, Unidad Médico Quirúrgica de Otorrinolaringología (UNIMEQ-ORL), Bogotá, Colombia
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia
- Department of Otolaringology, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Sergio Moreno-López
- Otolaryngology and Allergy Research Groups, Unidad Médico Quirúrgica de Otorrinolaringología (UNIMEQ-ORL), Bogotá, Colombia
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia
| | - Daniel Peñaranda
- Department of Otolaryngology, Fundación Universitaria de Ciencias de la Salud-Hospital de San José, Bogotá, Colombia
| | - Lucía C. Pérez-Herrera
- Otolaryngology and Allergy Research Groups, Unidad Médico Quirúrgica de Otorrinolaringología (UNIMEQ-ORL), Bogotá, Colombia
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia
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25
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Lee E, Lo J, Zhu P, Fernandez Sweeny Y, Fuchs S. Mental health outcomes among osteopathic physicians during COVID-19. INT J OSTEOPATH MED 2022; 46:6-11. [PMID: 36268534 PMCID: PMC9562608 DOI: 10.1016/j.ijosm.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 09/04/2022] [Accepted: 10/08/2022] [Indexed: 11/05/2022]
Abstract
Background SARS-CoV-2 infection responsible for the COVID-19 pandemic has demonstrated a significant burden on the mental health of health care providers. The purpose of the study is to evaluate the mental health symptoms among osteopathic physicians from a single academic institution during the COVID-19 pandemic. Methods This was a cross-sectional, survey-based study conducted during the COVID-19 pandemic from January 2021 to March 2021. The survey was emailed to 4239 alumni physicians from the single medical school in California, USA. Burnout, anxiety, and depression were assessed by the single-item Mini-Z Burnout Assessment, 7-item Generalized Anxiety Disorder Scale, and 2-item Patient Health Questionnaire, respectively. Results A total of 104 survey responses were analyzed. Of them, 53 (51.0%) were attending physicians and 51 (49.0%) were residents or fellow physicians. Anxiety, burnout, and depression were reported in 29 (29.9%), 31 (32%), and 11 (11.3%), respectively. Females had increased anxiety (OR 1.66, CI 1.21-2.27; P = 0.002). Resident had higher burnout symptoms (OR 1.28, CI 1.06-1.53; p = 0.009) and depression symptoms (OR 1.15, CI 1.01-1.30; p = 0.032) compared to attending physicians. Physicians who encountered >50 COVID-19 patients had higher depression symptoms (OR 1.17, CI 1.02-1.35; p = 0.027). Conclusion Our survey study demonstrated that osteopathic physicians graduated from a single academic institution experienced symptoms of anxiety, burnout, and depression during the COVID-19 pandemic based on the validated questionnaires. A higher prevalence was shown in the lesser experienced group of residents and fellow physicians compared to more experienced attending physicians. In addition, adjustments to the pandemic have caused a financial burden among osteopathic physicians. Future studies are warranted to assess the long-term effects of the pandemic on mental health among osteopathic physicians.
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Affiliation(s)
- Esther Lee
- Corresponding author. Western University of Health Sciences, 309 E 2nd St, Pomona, CA, USA
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26
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Northcraft H, Bai J, Griffin AR, Hovsepian S, Dobalian A. Association of the COVID-19 Pandemic on VA Resident and Fellow Training Satisfaction and Future VA Employment: A Mixed Methods Study. J Grad Med Educ 2022; 14:593-598. [PMID: 36274776 PMCID: PMC9580318 DOI: 10.4300/jgme-d-22-00168.1] [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: 02/18/2022] [Revised: 06/27/2022] [Accepted: 07/12/2022] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic altered learning experiences of residents and fellows worldwide, including at the US Department of Veterans Affairs (VA). Because the VA is the largest training provider in the United States, understanding VA trainee experiences is vital to understanding the pandemic's impact on graduate medical education nationwide. Additionally, understanding the pandemic's potential impacts on future employment allows for a better understanding of any future disruptions in the supply of physicians. OBJECTIVE To examine whether COVID-19 affected the satisfaction with VA training experiences and likelihood to consider future VA employment among residents and fellows. METHODS Responses from the VA Trainee Satisfaction Survey were collected for 3 academic years (2018-2021). Quantitative analysis (bivariate logistic regression) and qualitative content analysis were conducted to determine COVID-19's impact on satisfaction and likelihood of future VA employment. RESULTS Across 3 academic years, 17 900 responses from a total of 140 933 physician trainees were analyzed (12.7%). Following COVID-19, respondents expressed decreased satisfaction (84.58% vs 86.01%, P=.008) and decreased likelihood to consider future VA employment compared to prior to the pandemic (53.42% vs 55.32%, P=.013). COVID-19-related causes of dissatisfaction included the onboarding process, which slowed due to the pandemic, limited workspace that precluded social distancing, and reduced learning opportunities. CONCLUSIONS Since the pandemic, physician trainees expressed decreased training satisfaction and decreased likelihood to seek future VA employment. Causes of dissatisfaction included increased difficulties with onboarding, further limitations to accessible workspaces, and the direct obstruction of learning opportunities including decreased patient volume or case mix.
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Affiliation(s)
- Heather Northcraft
- Heather Northcraft, MA, is a Statistician, Veterans Emergency Management Evaluation Center (VEMEC), US Department of Veterans Affairs
| | - Jia Bai
- Jia Bai, MPH, is a Project Manager, VEMEC, US Department of Veterans Affairs
| | - Anne R. Griffin
- Anne R. Griffin, RN, MPH, is a Senior Clinical Project Director, VEMEC, US Department of Veterans Affairs
| | - Sona Hovsepian
- Sona Hovsepian, LCSW, is a Senior Clinical Project Director, VEMEC, US Department of Veterans Affairs
| | - Aram Dobalian
- Aram Dobalian, PhD, JD, MPH, is the Founding Director, VEMEC, US Department of Veterans Affairs, and Associate Dean of Academic Affairs and Chair, Division of Health Services Management and Policy, College of Public Health, The Ohio State University
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Nelson A, Eliasz KL. Combining desirable difficulty learning strategies to address the amount-to-learn vs. time-to-learn imbalance in residency training. MEDICAL TEACHER 2022; 44:1037-1043. [PMID: 35430933 DOI: 10.1080/0142159x.2022.2058389] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE Residents have limited time and much to learn. Mounting evidence shows that Desirable Difficulty (DD) learning strategies can ease that imbalance, but few studies have specifically studied combinations of these strategies. METHODS We tested two different combinations of DD strategies: a double combination of distributed practice and retrieval practice and a triple combination additionally including interleaved practice. We compared residents' annual In-Training Exam (ITE) scores and graduates' board certification performance between both DD curricula and a historical baseline. RESULTS Average ITE scores rose from 149.06 in the historical baseline to 160.04 under the combined DD curricula (p < 0.001). Average ITE scores fell from 162.50 under the double combination to 155.11 under the triple combination (p = 0.03). There were no significant changes in graduates' board performance between any of the curricula. CONCLUSIONS These results add to the evidence that DD strategies can enhance residents' learning. The drop in ITE scores under the triple DD combination may suggest that it pushed learners past beneficial desirable difficulty into detrimental overwhelming difficulty. Further research should apply this framework in larger and more diverse settings to clarify how these DD strategies can be optimally used to enhance residents' learning.
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Affiliation(s)
| | - Kinga L Eliasz
- New York University Grossman School of Medicine, New York, NY, USA
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Rodríguez-Rey R, Vega-Marín V, Bueno-Guerra N, Garrido-Hernansaiz H. Evolution of Posttraumatic Symptoms and Related Factors in Healthcare Workers During the COVID-19 Pandemic: A Longitudinal Study. J Occup Environ Med 2022; 64:e535-e544. [PMID: 35902370 PMCID: PMC9426314 DOI: 10.1097/jom.0000000000002605] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
OBJECTIVE This study aimed to (1) evaluate the evolution of mental health (posttraumatic stress symptoms [PTSSs], depression, and burnout) of healthcare workers during the second wave of the pandemic (November to December 2020) and compare it with the first wave (March to May 2020), and (2) ascertain the predictors of PTSSs. METHODS In March to May 2020 (T1), 269 healthcare professionals working in Spain completed PTSSs, sadness, resilience, and coping questionnaires. In November to December 2020 (T2, N = 58), we assessed PTSSs, sadness, burnout, and depression. RESULTS Among the healthcare professionals, 63.8% displayed severe PTSSs, 51.7% depressive symptoms, and 79.3% emotional exhaustion (T2). Some risk factors were caring for patients who were severely ill or dying and using rumination, thinking avoidance, self-isolation, emotional expression, and self-blaming as coping strategies. CONCLUSIONS The pandemic has had a deep and long-lasting impact on the healthcare workers' mental health.
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Shaikh CF, Palmer Kelly E, Paro A, Cloyd J, Ejaz A, Beal EW, Pawlik TM. Burnout Assessment Among Surgeons and Surgical Trainees During the COVID-19 Pandemic: A Systematic Review. JOURNAL OF SURGICAL EDUCATION 2022; 79:1206-1220. [PMID: 35659443 PMCID: PMC9091165 DOI: 10.1016/j.jsurg.2022.04.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/22/2022] [Accepted: 04/30/2022] [Indexed: 05/07/2023]
Abstract
BACKGROUND The objective of the current study was to summarize current research on burnout among surgical trainees and surgeons during the COVID-19 pandemic. METHODS PubMed, SCOPUS, Embase, and Psych INFO were systematically searched for studies that evaluated burnout during the COVID-19 pandemic among surgical trainees and surgeons. RESULTS A total of 29 articles met inclusion criteria, most of which originated from the United States (n = 18, 62.1%). Rates of burnout ranged from 6.0% to 86.0%. Personal factors responsible for burnout were fear of contracting/transmitting COVID-19 (8 studies, 27.6%), female gender (8, 27.6%), and younger age (5, 17.2%). Professional factors contributing to burnout included increased COVID-19 patient clinical load (6, 20.7%), limited work experience (6, 20.7%), reduction in operative cases (5, 17.2%) and redeployment to COVID-19 wards (4, 13.8%). The COVID-19 pandemic negatively impacted surgical education due to reduced number of operative cases (11, 37.9%), decreased hands-on experience (4, 13.8%), and not being able to complete case requirements (3, 10.34%). The shift of didactics to virtual formats (3, 10.3%), increased use of telemedicine (2, 6.9%), and improved camaraderie among residents (1, 3.4%) were viewed as positive consequences. CONCLUSION COVID-19 related burnout was reported in as many as 1 in 2 surgical trainees and attending surgeons. Intrinsic- (i.e., gender, age), family- (i.e., family/being married/having children or being single/not having children), as well as work-related extrinsic- (i.e., work-force deployment, risk of infection/spread, changes in educational format) factors were strongly associated with risk of burnout. These factors should be considered when designing interventions to ameliorate burnout among surgical trainees and surgeons.
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Affiliation(s)
- Chanza Fahim Shaikh
- Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio
| | - Elizabeth Palmer Kelly
- Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio
| | - Alessandro Paro
- Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio
| | - Jordan Cloyd
- Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio
| | - Aslam Ejaz
- Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio
| | - Eliza W Beal
- Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio
| | - Timothy M Pawlik
- Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio.
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Sauder M, Zagales I, Zagales R, Das S, Sen-Crowe B, Bilski T, Kornblith L, Elkbuli A. Comprehensive Assessment of Burnout Among Surgical Trainees and Practicing Surgeons: A Systematic Review. JOURNAL OF SURGICAL EDUCATION 2022; 79:1188-1205. [PMID: 35624025 DOI: 10.1016/j.jsurg.2022.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 04/14/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Surgeon burnout has received increasing attention due to evidence of high prevalence across specialties. We aimed to (1) systematically characterize existing definitions of burnout, (2) evaluate tools to measure burnout, and (3) determine risk factors of surgical burnout. DESIGN PubMed, Google Scholar, and Embase databases were searched to identify burnout rates and tools used to measure the quality of life (QoL) published from January 2000-December 2021. PARTICIPANTS Surgical Trainees and Practicing Surgeons. RESULTS We identified 39 studies that defined surgical burnout, with 9 separate tools used to measure QoL. Surgeon burnout rates were found to be highest among general surgery trainees (20%-95%). Burnout among general surgery attendings ranged from 25% to 44%. Those most likely to experience burnout were younger and female. High rates of surgeon burnout were reported among all surgical specialties; however, these rates were lower than those of general surgeons. CONCLUSION Definitions of burnout vary throughout the surgical literature, but are consistently characterized by emotional exhaustion, depersonalization, and lack of personal accomplishment. The most utilized tool to measure surgical burnout has been the Maslach Burnout Inventory. Across specialties, there are high rates of burnout in both surgical trainees and attendings, indicating that this is a systemic issue within the field of surgery. Given the wide-scale nature of the problem, it is recommended that institutions provide support to surgical trainees and attending surgeons and that individual surgeons take steps toward mitigating burnout.
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Affiliation(s)
- Matthew Sauder
- Dr. Kiran.C. Patel College of Allopathic Medicine, NSU NOVA Southeastern University, Fort Lauderdale, Florida
| | - Israel Zagales
- Universidad Iberoamericana (UNIBE) Escuela de Medicina, Santo Domingo, Dominican Republic
| | - Ruth Zagales
- Florida International University, Miami, Florida
| | - Snigdha Das
- Dr. Kiran.C. Patel College of Allopathic Medicine, NSU NOVA Southeastern University, Fort Lauderdale, Florida
| | - Brendon Sen-Crowe
- Dr. Kiran.C. Patel College of Allopathic Medicine, NSU NOVA Southeastern University, Fort Lauderdale, Florida
| | - Tracy Bilski
- Department of Surgery, Division of Trauma and Surgical Critical Care, Orlando Regional Medical Center, Orlando, Florida; Department of Surgical Education, Orlando Regional Medical Center, Orlando, Florida
| | - Lucy Kornblith
- Department of Surgery, Division of Trauma and Surgical Critical Care, Zuckerberg San Francisco General Hospital, San Francisco, California; University of San Francisco, San Francisco, California
| | - Adel Elkbuli
- Department of Surgery, Division of Trauma and Surgical Critical Care, Orlando Regional Medical Center, Orlando, Florida; Department of Surgical Education, Orlando Regional Medical Center, Orlando, Florida.
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Kimpe V, Sabe M, Sentissi O. No increase in burnout in health care workers during the initial COVID-19 outbreak: Systematic review and meta-analysis. World J Meta-Anal 2022; 10:206-219. [DOI: 10.13105/wjma.v10.i4.206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/21/2022] [Accepted: 07/27/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND For decades and before the coronavirus disease 2019 (COVID-19) pandemic, for health care workers (HCWs) burnout can be experienced as an upsetting confrontation with their self and the result of a complex a multifactorial process interacting with environmental and personal features.
AIM To literature review and meta-analysis was to obtain a comprehensive understanding of burnout and work-related stress in health care workers around the world during the first outbreak of the COVID-19 pandemic.
METHODS We performed a database search of Embase, Google Scholar and PubMed from June to October 2020. We analysed burnout risk factors and protective factors in included studies published in peer-reviewed journals as of January 2020, studying a HCW population during the first COVID-19 wave without any geographic restrictions. Furthermore, we performed a meta-analysis to determine overall burnout levels. We studied the main risk factors and protective factors related to burnout and stress at the individual, institutional and regional levels.
RESULTS Forty-one studies were included in our final review sample. Most were cross-sectional, observational studies with data collection windows during the first wave of the COVID-19 surge. Of those forty-one, twelve studies were included in the meta-analysis. Of the 27907 health care professionals who participated in the reviewed studies, 70.4% were women, and two-thirds were either married or living together. The most represented age category was 31-45 years, at 41.5%. Approximately half of the sample comprised nurses (47.6%), and 44.4% were working in COVID-19 wards (intensive care unit, emergency room and dedicated internal medicine wards). Indeed, exposure to the virus was not a leading factor for burnout. Our meta-analytic estimate of burnout prevalence in the HCW population for a sample of 6784 individuals was 30.05%.
CONCLUSION There was a significant prevalence of burnout in HCWs during the COVID-19 pandemic, and some of the associated risk factors could be targeted for intervention, both at the individual and organizational levels. Nevertheless, COVID-19 exposure was not a leading factor for burnout, as burnout levels were not notably higher than pre-COVID-19 levels.
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Affiliation(s)
- Vincent Kimpe
- Faculty of Medicine, Geneva University, Geneva 1208, Geneva, Switzerland
| | - Michel Sabe
- Division of Adult Psychiatry, Department of Psychiatry, Geneva University Hospitals, Geneva 1205, Geneva, Switzerland
| | - Othman Sentissi
- Division of Adult Psychiatry, Department of Psychiatry, Geneva University Hospitals, Geneva 1205, Geneva, Switzerland
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Burnout Syndrome among Otorhinolaryngologists during the COVID-19 Pandemic. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58081089. [PMID: 36013556 PMCID: PMC9415072 DOI: 10.3390/medicina58081089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 08/07/2022] [Accepted: 08/09/2022] [Indexed: 11/17/2022]
Abstract
Background and Objectives: To determine the prevalence of burnout syndrome among otorhinolaryngologists in Lithuania and investigate associations with sociodemographic and professional factors during the COVID-19 pandemic. Materials and Methods: Burnout was measured using the validated Lithuanian version of the Maslach Burnout Inventory. Demographic characteristics and professional characteristics were collected utilizing an anonymous questionnaire. Results: Eighty otorhinolaryngologists (ORL group) and 30 information technology professionals (the control group) were enrolled in this study. A high level of professional burnout in at least one of the subscales was observed in 82.5% of the ORL group subjects. Depersonalization and burnout syndrome were more frequently detected with increasing age in the ORL group (r = 0.2, p < 0.04). Greater satisfaction with salary and working environment resulted in a lower burnout incidence (r = 0.31, p = 0.001). Conclusions: During the COVID-19 pandemic, the incidence of burnout syndrome has been high among Lithuanian otorhinolaryngologists. Demographic and professional characteristics are significantly related to burnout syndrome among Lithuanian otorhinolaryngologists.
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The Impact of the COVID-19 Pandemic on the Orthopedic Residents: A Pan-Romanian Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159176. [PMID: 35954536 PMCID: PMC9368229 DOI: 10.3390/ijerph19159176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 07/24/2022] [Accepted: 07/26/2022] [Indexed: 12/07/2022]
Abstract
The COVID-19 pandemic has brought unprecedented challenges, with a potential stress which might affect the education of resident doctors in the field of orthopedics and traumatology. Its repercussion on the residents’ strain and training routes is not well known. After two years of pandemic, this paper aims to analyze the repercussion of the coronavirus disease 2019 (COVID-19) on education, medical training, and the mental well-being of Romanian resident doctors in orthopedics and traumatology. In January–February 2022, an electronic questionnaire was distributed to all orthopedic resident doctors in the 12 residential training centers in Romania. Participants (n = 236) were resident doctors with an employment contract and professional activity during the COVID-19 pandemic. Resident doctors who did not work during this period were excluded. An online survey generator was used to electronically create the questionnaire. Statistical analysis was performed in Matlab version R2022a, with the support of Statistics and Machine Learning Toolbox Version 12.3. Descriptive statistics were performed for the standardized questions, while for the open questions, answers were collected by topic. The results of the Chi-square test indicate that there is a statistically significant association regarding the prevalence of infection among residents involved in the treatment of patients with COVID-19 (p = 0.028), and the influence of secondment in COVID-19 sections (p = 0.0003). The infection of residents is not related to their affiliation with a particular medical training center (p = 0.608), gender (p = 0.175), the year of study in residency (p = 0.733), the age group (p = 0.178), and the secondment period (p = 0.114). Residents who participated in the study had an overall well-being index of 13.8 ± 5.7, which indicates a low level of well-being for a large number of residents. Residents who would like to choose a new residency specialization, or would choose a non-medical career, had reduced average WHO wellness rates, as the risk of infection is associated with the treatment of patients with COVID-19 and secondment in COVID-19 sections. The findings of this study may help residency training centers to develop robust programs that can alleviate the impact of this pandemic. Some major changes will be needed to be integrated into residency training programs around the world. Emphasis should be placed on electronic educational portfolios, simulation of surgical processes, and distance learning, all of which have a high potential for health and safety, as well as for the moral support of residents.
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Gustafson DR, Yucel R, Apple SJ, Cirrone G, Gao H, Huang AJ, Ma X, Saad A, Wilson J, Kabariti S, Motov S. Mental Health of Emergency Department Healthcare Workers During COVID-19 in Brooklyn, New York. MEDICAL RESEARCH ARCHIVES 2022; 10:2903. [PMID: 36465877 PMCID: PMC9718537 DOI: 10.18103/mra.v10i7.2903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
BACKGROUND Maintaining good mental health among Emergency Department healthcare workers (ED HCW) is paramount to well-functioning healthcare. We measured mental health and COVID-19 symptoms in ED HCW at a COVID-19 epicenter. METHODS A cross-sectional, convenience sample of adult (≥18 years) ED HCW in Brooklyn, New York, USA, who were employed at ≥50% of a full-time effort, was surveyed September-December, 2020 with reference period March-May 2020. An anonymous email-distributed survey assessed gender, age, race, healthcare worker status (clinical versus non-clinical), SARS-CoV-2 testing, number of people to talk to, COVID-19-related home problems, mental health care interruption during COVID-19, loneliness, and survey date. Outcomes included symptoms of depression, psychological distress, perceived stress, post-traumatic stress disorder (PTSD), anxiety, and resilience measured using validated scales. RESULTS Of 774 HCW, 247 (31.9%) responded (mean age 38.2±10.8 years; 59.4% White; 52.5% men; 80.1% clinical; 61.6% SARS-CoV-2 tested). Average mental health scores were significantly higher among clinical vs non-clinical HCW (P's<0.0001-0.019). The proportion reporting a clinically-relevant psychological distress symptom burden was higher among clinical vs non-clinical HCW (35.8% vs 13.8%, p=0.019); and suggested for depression (53.9% clinical vs 35.7% non-clinical, p=0.072); perceived stress (63.6% clinical vs 44.8% non-clinical, p=0.053); and PTSD (18.2% clinical vs 3.6% non-clinical, p=0.064). Compared to non-clinical staff, Medical Doctors and Doctors of Osteopathy reported 4.8-fold higher multivariable-adjusted odds of clinically-relevant perceived stress (95%CI 1.8-12.9, p=0.002); Emergency Medical Technicians reported 15.5-fold higher multivariable-adjusted odds of clinically-relevant PTSD (95%CI 1.6-150.4, p=0.018). Increasing age, number of COVID-19-related home problems and people to talk to, loneliness and mental health care interruption were adversely associated with mental health; being male and SARS-CoV-2 testing were beneficial. CONCLUSIONS COVID-19-related mental health burden was high among ED HCW in Brooklyn. Mental health support services are essential for ED HCW.
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Affiliation(s)
- Deborah R Gustafson
- Department of Neurology, State University of New York Downstate Health Sciences University, Brooklyn, New York
| | - Recai Yucel
- Department of Biostatistics, Temple University, Philadelphia, Pennsylvania
| | - Samuel J Apple
- State University of New York Downstate Health Sciences University, College of Medicine, Brooklyn, New York
| | - Gianna Cirrone
- State University of New York Downstate Health Sciences University, College of Medicine, Brooklyn, New York
| | - Haoyuan Gao
- Department of Biostatistics, Temple University, Philadelphia, Pennsylvania
| | - Aaron J Huang
- State University of New York Downstate Health Sciences University, College of Medicine, Brooklyn, New York
| | - Xinrui Ma
- Department of Biostatistics, Temple University, Philadelphia, Pennsylvania
| | - Ayesha Saad
- State University of New York Downstate Health Sciences University, College of Medicine, Brooklyn, New York
| | - Jeremy Wilson
- State University of New York Downstate Health Sciences University, College of Medicine, Brooklyn, New York
| | - Sarah Kabariti
- Department of Emergency Medicine, Maimonides Medical Center, Brooklyn, New York
- Department of Emergency Medicine, State University of New York Downstate Health Sciences University, Brooklyn New York
| | - Sergey Motov
- Department of Emergency Medicine, Maimonides Medical Center, Brooklyn, New York
- Department of Emergency Medicine, State University of New York Downstate Health Sciences University, Brooklyn New York
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Qi G, Yuan P, Qi M, Hu X, Shi S, Shi X. Influencing factors of high PTSD among medical staff during COVID-19: evidences from both meta-analysis and subgroup analysis. Saf Health Work 2022; 13:269-278. [PMID: 35784492 PMCID: PMC9233879 DOI: 10.1016/j.shaw.2022.06.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 06/11/2022] [Accepted: 06/16/2022] [Indexed: 11/25/2022] Open
Abstract
Background PTSD (Post-traumatic stress disorder, PTSD) had a great impact on health care workers during the COVID-19 (Corona Virus Disease 2019, COVID-19). Better knowledge of the prevalence of PTSD and its risk factors is a major public health problem. This study was conducted to assess the prevalence and important risk factors of PTSD among medical staff during the COVID-19. Methods The databases were searched for studies published during the COVID-19, and a PRISMA (preferred reporting items for systematic review and meta-analysis) compliant systematic review (PROSPERO-CRD 42021278970) was carried out to identify articles from multiple databases reporting the prevalence of PTSD outcomes among medical staff. Proportion random effect analysis, I2 statistic, quality assessment, subgroup analysis, and sensitivity analysis were carried out. Results A total of 28 cross-sectional studies and the PTSD results of doctors and nurses were summarized from 14 and 27 studies: the prevalences were 31% (95% CI [confidence interval, CI]: 21%–40%) and 38% (95% CI: 30%–45%) in doctors and nurses, respectively. The results also showed seven risks (p < 0.05): long working hours, isolation wards, COVID-19 symptoms, nurses, women, fear of infection, and pre-existing mental illness. Two factors were of borderline significance: higher professional titles and married. Conclusion Health care workers have a higher prevalence of PTSD during COVID-19. Health departments should provide targeted preventive measures for medical staff away from PTSD.
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Affiliation(s)
- Guojia Qi
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, China
| | - Ping Yuan
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, China
| | - Miao Qi
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, China
| | - Xiuli Hu
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, China
| | - Shangpeng Shi
- Department of Quality Management, The Third Affiliated Hospital of Zunyi Medical University (The First People’s Hospital of Zunyi), Zunyi, Guizhou, China
| | - Xiuquan Shi
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, China
- Center for Injury Research and Policy & Center for Pediatric Trauma Research, The Research Institute at Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus, OH, USA
- Corresponding author. Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi 563006, Guizhou, China.
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Symptoms of Burnout Syndrome among Physicians during the Outbreak of COVID-19 Pandemic—A Systematic Literature Review. Healthcare (Basel) 2022; 10:healthcare10060979. [PMID: 35742031 PMCID: PMC9223230 DOI: 10.3390/healthcare10060979] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/20/2022] [Accepted: 05/21/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Studies in the recent decades show that the medical profession has a high risk to develop burnout due to constant exposure to mental and physical suffering or death. The pandemic period induced additional stress for healthcare professionals due to the likelihood of a high rate of infection, long working shifts, using protective equipment, staying away from family, implementing new medical procedures. The present study is focusing on assessing the prevalence of burnout among physicians working in the healthcare system during the COVID-19 pandemic, and discovering the main factors associated with burnout syndrome among the population of physicians. Material and methods: A systematic review was conducted by searching PubMed, Wiley, and Google Scholar in November 2021. A total of 35 studies were eligible for the evaluation. Results: The samples ranged from 39 to 3071 physicians, and the overall burnout ranged from 14.7% to 90.4%. Sociodemographic characteristics associated with a high prevalence of burnout were the female gender, less experienced, not having children, and single marital status, associated with high levels of anxiety, depression, and stress in the female gender. The highest level of burnout among all the studies was 90.4% on a sample of physicians from the Republic of Korea, 80.2% among psychiatrists in Saudi Arabia, followed by a study in Ireland with a 77% level of burnout among senior and specialist physicians, and 74.7% prevalence of burnout for emergency physicians in USA. Conclusions: During the pandemic, the factors that contribute to burnout are the lack of personal protective equipment and the violence of issues related to organizational health; the high prevalence of burnout symptoms is associated with anxiety, depression, and stress.
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Peck JA, Porter TH. Pandemics and the Impact on Physician Mental Health: A Systematic Review. Med Care Res Rev 2022; 79:772-788. [PMID: 35549938 DOI: 10.1177/10775587221091772] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Physician mental health is a major area of concern with physician burnout on the rise, while at the same time pandemics are becoming more frequent and serious in nature. This combination of physician burnout and pandemics has the potential for serious negative implications for physicians, patients, and health care organizations. Thus, we conduct a systematic review that examines the effect of pandemics on physician mental health using the burnout cascade as a framework. We identified 30 quantitative studies for inclusion. We find that Stages 4 and 5 of the burnout cascade are particularly troublesome with physicians experiencing high levels of anxiety and depression. Furthermore, we find in the degradation phase that physicians experience stigma which may intensify other negative effects. Physicians who are women, younger, and have less training are more susceptible to the negative effects of pandemics. We discuss overall implications and recommendations for future research.
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Stark N, Hayirli T, Bhanja A, Kerrissey M, Hardy J, Peabody CR. Unprecedented Training: Experience of Residents During the COVID-19 Pandemic. Ann Emerg Med 2022; 79:488-494. [PMID: 35277294 PMCID: PMC8784436 DOI: 10.1016/j.annemergmed.2022.01.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Indexed: 01/25/2023]
Affiliation(s)
- Nicholas Stark
- Department of Emergency Medicine, University of California, San Francisco, CA.
| | | | | | | | - James Hardy
- Department of Emergency Medicine, University of California, San Francisco, CA
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Ali SK, Shah J, Du K, Leekha N, Talib Z. Mental health disorders among post graduate residents in Kenya during the COVID-19 pandemic. PLoS One 2022; 17:e0266570. [PMID: 35377909 PMCID: PMC8979452 DOI: 10.1371/journal.pone.0266570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 03/12/2022] [Indexed: 12/23/2022] Open
Abstract
Background
Healthcare workers, including residents, are prone to various mental health disorders especially given the context of the COVID-19 pandemic. Residents, particularly, are already under undue stress due to their respective training program demands.
Methods
This cross-sectional, online survey-based study from August to November 2020 collected demographic and mental health measurements from all residents at the Aga Khan University Hospital, Nairobi. The questionnaire investigated demographic variables, information regarding direct care of COVID-19 patients, prior history of mental health and mental health outcomes using the Patient Health Questionnaire, Generalized Anxiety Disorder scale, Insomnia Severity Index, Impact of Event Scale–Revised Questionnaire and Stanford Professional Fulfillment Index Questionnaire.
Results
A total of 100 residents completed the survey (participation rate 77.5%). Participants were about equal in gender (women [53%]), with a median age of 31.28 years, and majority were single (66.7%). A total of 66 participants (66%) were directly engaged in COVID-19 care. Depression: 64.3%, anxiety: 51.5%, insomnia: 40.5%, distress: 35.4%, and burnout: 51.0% were reported in all participants. Statistical significance was found in median depression, professional fulfillment and interpersonal disengagement when comparing frontline resident directly involved in care of COVID-19 patient versus second line residents.
Conclusion
Residents directly involved with caring for COVID-19 patients had statistically higher incidences of depression and interpersonal disengagement and lower professional fulfillment compared to second line residents. Keeping in mind the limited resources in sub-Saharan Africa, urgent and geographically specific strategies are needed to help combat mental health disorders in this specific population.
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Affiliation(s)
- Sayed K. Ali
- Department of Medicine, Aga Khan University Hospital, Nairobi, Kenya
- * E-mail:
| | - Jasmit Shah
- Department of Medicine, Aga Khan University Hospital, Nairobi, Kenya
- Brain and Mind Institute, Aga Khan University, Nairobi, Kenya
| | - Katie Du
- Department of Medicine, Aga Khan University Hospital, Nairobi, Kenya
| | - Nidhi Leekha
- Department of Radiology, Aga Khan University Hospital, Nairobi, Kenya
| | - Zohray Talib
- Department of Medical Education, California University of Science and Medicine, Colton, CA, United States of America
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Lawlor SK, Low CM, Carlson ML, Rajasekaran K, Choby G. Burnout and well‐being in otolaryngology trainees: A systematic review. World J Otorhinolaryngol Head Neck Surg 2022; 8:118-125. [PMID: 35782400 PMCID: PMC9242424 DOI: 10.1002/wjo2.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 11/05/2021] [Indexed: 11/25/2022] Open
Abstract
Objective To comprehensively review the recent published literature to characterize current trends of burnout and well‐being among otolaryngology trainees. Methods Study design: systematic review and meta‐analysis. A comprehensive literature review from 2000 to 2021 of studies related to otolaryngology resident burnout and well‐being, as well as the general topic of well‐being among surgical residents was completed. All included studies were summarized qualitatively. For the quantitative analysis, only articles reporting a Maslach burnout inventory (MBI), modified MBI or Mini‐Z‐ Burnout assessment were included. Results Twenty‐five articles were included in the qualitative summary and nine articles in the quantitative analysis. In the qualitative summary, trainees were reported to have increased levels of distress and emotional hardening compared to attending otolaryngologists. Total hours worked per week and female gender were associated with worsened well‐being. Residency program strategies to improve trainee well‐being include program‐sponsored wellness activities, dedicated wellness champions, and assistance with clerical burden. Implementation of protected nonclinical time has been shown to decrease burnout and increase well‐being among trainees. Moreover, formal trainee mentorship programs have also been shown to reduce trainee burnout and stress. In the quantitative analysis, rates of trainee burnout ranged from 29.7% to 86% with an overall trend towards reduced rates of burnout from 2006 to 2021. Utilizing a weighted average, the overall burnout among otolaryngology residents was 58.6%. Conclusions Rates of burnout remain high among otolaryngology trainees. Implementing formal mentorship programs and providing protected time during regular work hours appear to be effective tools to improve resident well‐being. Question: What is the current state of the literature in regard to otolaryngology trainee well‐being and burnout? Findings: In this systematic review of 34 articles, otolaryngology trainees were reported to have increased levels of distress and emotional hardening compared to attending otolaryngologists. Total hours worked per week and female gender were associated with worsened well‐being. Utilizing a weighted average, the overall burnout rate among otolaryngology residents was 58.6%. Implementation of protected nonclinical time has been shown to decrease burnout and increase well‐being among trainees. Meaning: Rates of burnout among otolaryngology trainees remains high but have improved over time. Formal mentorship programs and introduction of protected non‐clinical time may help to improve well‐being.
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Affiliation(s)
- Skye K. Lawlor
- Department of Otolaryngology‐Head and Neck Surgery Mayo Clinic Rochester Minnesota USA
| | - Christopher M. Low
- Department of Otolaryngology‐Head and Neck Surgery Mayo Clinic Rochester Minnesota USA
| | - Matthew L. Carlson
- Department of Otolaryngology‐Head and Neck Surgery Mayo Clinic Rochester Minnesota USA
- Department of Neurologic Surgery Mayo Clinic Rochester Minnesota USA
| | - Karthik Rajasekaran
- Department of Otolaryngology‐Head and Neck Surgery University of Pennsylvania Pennsylvania USA
| | - Garret Choby
- Department of Otolaryngology‐Head and Neck Surgery Mayo Clinic Rochester Minnesota USA
- Department of Neurologic Surgery Mayo Clinic Rochester Minnesota USA
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Wong CR, Moltaji S, Cross K, Wanzel KR. Impact of the COVID-19 Pandemic on the Wellness of Canadian Plastic Surgery Residents. Plast Reconstr Surg Glob Open 2022; 10:e4259. [PMID: 35345392 PMCID: PMC8945395 DOI: 10.1097/gox.0000000000004259] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 03/24/2022] [Accepted: 02/22/2022] [Indexed: 01/23/2023]
Abstract
On top of preexisting burnout, depression, and anxiety among trainees, the COVID-19 pandemic has introduced novel stressors. The objectives of this study were to determine the effects of the COVID-19 pandemic on Canadian plastic surgery residents’ practice, wellness, and overall training.
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Affiliation(s)
- Chloe R Wong
- University of Toronto, Department of Surgery, Division of Plastic, Reconstructive and Aesthetic Surgery, Toronto, ON, Canada
| | - Syena Moltaji
- University of Toronto, Department of Surgery, Division of Plastic, Reconstructive and Aesthetic Surgery, Toronto, ON, Canada
| | - Karen Cross
- University of Toronto, Department of Surgery, Division of Plastic, Reconstructive and Aesthetic Surgery, Toronto, ON, Canada
| | - Kyle R Wanzel
- University of Toronto, Department of Surgery, Division of Plastic, Reconstructive and Aesthetic Surgery, Toronto, ON, Canada
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Nelson V, Dubov A, Morton K, Fraenkel L. Using nominal group technique among resident physicians to identify key attributes of a burnout prevention program. PLoS One 2022; 17:e0264921. [PMID: 35303009 PMCID: PMC8932600 DOI: 10.1371/journal.pone.0264921] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 02/19/2022] [Indexed: 01/09/2023] Open
Abstract
PURPOSE To identify preferred burnout interventions within a resident physician population, utilizing the Nominal Group Technique. The results will be used to design a discrete choice experiment study to inform the development of resident burnout prevention programs. METHODS Three resident focus groups met (10-14 participants/group) to prioritize a list of 23 factors for burnout prevention programs. The Nominal Group Technique consisted of three steps: an individual, confidential ranking of the 23 factors by importance from 1 to 23, a group discussion of each attribute, including a group review of the rankings, and an opportunity to alter the original ranking across participants. RESULTS The total number of residents (36) were a representative sample of specialty, year of residency, and sex. There was strong agreement about the most highly rated attributes which grouped naturally into themes of autonomy, meaning, competency and relatedness. There was also disagreement on several of the attributes that is likely due to the differences in residency specialty and subsequently rotation requirements. CONCLUSION This study identified the need to address multiple organizational factors that may lead to physician burnout. There is a clear need for complex interventions that target systemic and program level factors rather than focus on individual interventions. These results may help residency program directors understand the specific attributes of a burnout prevention program valued by residents. Aligning burnout interventions with resident preferences could improve the efficacy of burnout prevention programs by improving adoption of, and satisfaction with, these programs. Physician burnout is a work-related syndrome characterized by emotional exhaustion, depersonalization, and a sense of reduced personal accomplishment [1]. Burnout is present in epidemic proportions and was estimated to occur in over 50 percent of practicing physicians and in up to 89 percent of resident physicians pre-COVID 19. The burnout epidemic is growing; a recent national survey of US physicians reported an 8.9 percent increase in burnout between 2011 and 2014 [2]. Rates of physician burnout have also increased [3] during the COVID-19 pandemic with a new classification of "pandemic burnout" experienced by over 52 percent of healthcare workers as early as June of 2020 [4]. Physician burnout can lead to depression, suicidal ideation, and relationship problems that may progress to substance abuse, increased interpersonal conflicts, broken relationships, low quality of life, major depression, and suicide [5-7]. The estimated rate of physician suicide is 300-400 annually [8-10].
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Affiliation(s)
- Vicki Nelson
- School of Religion, Loma Linda University Health, Loma Linda, California, United States of America
- * E-mail:
| | - Alex Dubov
- School of Behavioral Health, Loma Linda University Health, Loma Linda, California, United States of America
| | - Kelly Morton
- School of Behavioral Health, Loma Linda University Health, Loma Linda, California, United States of America
- Research Department, Family Medicine, School of Medicine, Loma Linda University Health, Redlands, California, United States of America
| | - Liana Fraenkel
- Rheumatology Department, Berkshire Medical Center, Pittsfield, Massachusetts, United States of America
- Patient Centered Population Health Research, Berkshire Health Systems, Pittsfield, Massachusetts, United States of America
- Yale University School of Medicine, New Haven, Connecticut, United States of America
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Bouiller K, Peiffer-Smadja N, Cevik M, Last K, Antunović IA, Šterbenc A, Lopes MJ, Barac A, Schweitzer V, Dellière S. Role and perception of clinical microbiology and infectious diseases trainees during the COVID-19 crisis. Future Microbiol 2022; 17:411-416. [PMID: 35285247 PMCID: PMC8958984 DOI: 10.2217/fmb-2021-0129] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To evaluate the role and perceptions of trainees during the COVID-19 pandemic. Method: An online survey was designed to provide an insight into the significance of the COVID-19 pandemic on working conditions of infectious diseases and clinical microbiology trainees. Results: The main roles of trainees included management of patients hospitalized for COVID-19 (55%), research (53%) and diagnostic procedures (43%). The majority (82%) of trainees felt useful in managing the crisis. However, more than two-thirds felt more stressed and more tired compared with other rotations. Only 39% of the participants had access to psychological support. Conclusion: Due to the significant impact of the pandemic on infectious diseases and clinical microbiology trainees, further research should focus on their health and welfare in the post-pandemic period.
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Affiliation(s)
- Kevin Bouiller
- Infectious disease department, University hospital of Jean-Minjoz, Besancon, France.,UMR-CNRS 6249 Chrono-environnement, Université Bourgogne Franche-Comté, Besançon, France.,Network of young French infectious diseases specialists (RéJIF)
| | - Nathan Peiffer-Smadja
- Network of young French infectious diseases specialists (RéJIF).,Université de Paris, Service de maladies infectieuses et tropicales, Hôpital Bichat, AP-HP, Paris, France
| | - Muge Cevik
- Division of Infection & Global Health Research, School of Medecine, University of St Andrews, St Andrews, UK.,Trainee association of European Society of Clinical Microbiology & Infectious Diseases (ESCMID)
| | - Katharina Last
- Trainee association of European Society of Clinical Microbiology & Infectious Diseases (ESCMID).,Center for Infectious Diseases, Institute of Medical Microbiology & Hygiene, Saarland University Hospital, Homburg, Germany
| | - Ivana A Antunović
- Trainee association of European Society of Clinical Microbiology & Infectious Diseases (ESCMID).,Hospital for Infections Diseases, Clinical Microbiology, Mirogojska 8, Zagreb, Croatia
| | - Anja Šterbenc
- Trainee association of European Society of Clinical Microbiology & Infectious Diseases (ESCMID).,Institute of Microbiology & Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Maria J Lopes
- Trainee association of European Society of Clinical Microbiology & Infectious Diseases (ESCMID).,Infectious Diseases Department, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal
| | - Aleksandra Barac
- Trainee association of European Society of Clinical Microbiology & Infectious Diseases (ESCMID).,Clinic for Infectious & Tropical Diseases, University Clinical Center of Serbia, Belgrade, Serbia
| | - Valentijn Schweitzer
- Trainee association of European Society of Clinical Microbiology & Infectious Diseases (ESCMID).,Department of Medical Microbiology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Sarah Dellière
- Trainee association of European Society of Clinical Microbiology & Infectious Diseases (ESCMID).,Université de Paris, Laboratoire de Parasitologie-Mycologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, AP-HP, Paris, France
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Moerdler S, Steinberg DM, Jin Z, Cole PD, Kesselheim J, Levy AS, Roth M, Rosenthal SL. Provider and staff crisis well-being associated with trust in leadership and baseline burnout. Pediatr Blood Cancer 2022; 69:e29497. [PMID: 34890105 DOI: 10.1002/pbc.29497] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/02/2021] [Accepted: 11/05/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND The impact of the coronavirus 2019 (COVID-19) pandemic on the emotional health of health care workers continues to be an area of active research. However, few studies have focused on those working in pediatrics and its subspecialties, as well as ancillary and non-patient-facing staff. The purpose of this study was to determine the prevalence and associated predictors of burnout and emotional well-being of providers and staff. METHODS An anonymous electronic survey was developed evaluating demographics, pandemic experiences, possible predictor variables, and three main outcomes of burnout, psychological distress, and perceived stress. Pediatric hematology oncology (PHO) chiefs and program directors across the country were invited to participate and disseminate the survey to their programs. RESULTS A total of 682/1950 (35% of invited) individuals responded to all predictor and outcome variables. Over half reported high levels of burnout and some reported moderate/high levels of distress. Prepandemic burnout and decreased trust in leadership were associated with all three outcomes. Additional predictors included having a child ≤18 years at home, hospital role, and worrying about patient care or relationship with their patients. The majority (n = 444/682, 65.5%) reported that their institution had made COVID-19-related mental health resources available. However, only 6.5% (n = 44/682) reported utilizing these resources. CONCLUSIONS While the majority of PHO providers and staff were resilient during the early stages of the COVID-19 pandemic, many reported high levels of burnout, yet few are utilizing institutional resources. This study has highlighted several actionable areas to help identify and address factors that are wearing down the emotional well-being of providers and staff.
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Affiliation(s)
- Scott Moerdler
- Pediatric Hematology Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA.,Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Dara M Steinberg
- Department of Pediatrics, Division of Hematology, Oncology and Stem Cell Transplantation, Columbia University Irving Medical Center, New York City, New York, USA.,Department of Psychiatry, Division of Child & Adolescent Psychiatry, Columbia University Irving Medical Center, New York City, New York, USA
| | - Zhezhen Jin
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York City, New York, USA
| | - Peter D Cole
- Pediatric Hematology Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA.,Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Jennifer Kesselheim
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Adam S Levy
- Division of Pediatric Hematology, Oncology and Cellular Therapy, Children's Hospital at Montefiore, Brons, New York City, New York, USA
| | - Michael Roth
- Division of Pediatrics, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Susan L Rosenthal
- Department of Psychiatry, Division of Child & Adolescent Psychiatry, Columbia University Irving Medical Center, New York City, New York, USA.,Department of Pediatrics, Columbia University Irving Medical Center, New York City, New York, USA
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45
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The Impact of the COVID-19 Pandemic on Burnout, Compassion Fatigue, and Compassion Satisfaction in Healthcare Personnel: A Systematic Review of the Literature Published during the First Year of the Pandemic. Healthcare (Basel) 2022; 10:healthcare10020364. [PMID: 35206978 PMCID: PMC8872521 DOI: 10.3390/healthcare10020364] [Citation(s) in RCA: 82] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 01/29/2022] [Accepted: 02/10/2022] [Indexed: 11/16/2022] Open
Abstract
This literature review aimed to determine the level of burnout, compassion fatigue, and compassion satisfaction, as well as their associated risks and protective factors, in healthcare professionals during the first year of the COVID-19 pandemic. We reviewed 2858 records obtained from the CINAHL, Cochrane Library, Embase, PsycINFO, PubMed, and Web of Science databases, and finally included 76 in this review. The main results we found showed an increase in the rate of burnout, dimensions of emotional exhaustion, depersonalization, and compassion fatigue; a reduction in personal accomplishment; and levels of compassion satisfaction similar to those before the pandemic. The main risk factors associated with burnout were anxiety, depression, and insomnia, along with some sociodemographic variables such as being a woman or a nurse or working directly with COVID-19 patients. Comparable results were found for compassion fatigue, but information regarding compassion satisfaction was lacking. The main protective factors were resilience and social support.
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Mody L, Akinboyo IC, Babcock HM, Bischoff WE, Cheng VCC, Chiotos K, Claeys KC, Coffey KC, Diekema DJ, Donskey CJ, Ellingson KD, Gilmartin HM, Gohil SK, Harris AD, Keller SC, Klein EY, Krein SL, Kwon JH, Lauring AS, Livorsi DJ, Lofgren ET, Merrill K, Milstone AM, Monsees EA, Morgan DJ, Perri LP, Pfeiffer CD, Rock C, Saint S, Sickbert-Bennett E, Skelton F, Suda KJ, Talbot TR, Vaughn VM, Weber DJ, Wiemken TL, Yassin MH, Ziegler MJ, Anderson DJ. Coronavirus disease 2019 (COVID-19) research agenda for healthcare epidemiology. Infect Control Hosp Epidemiol 2022; 43:156-166. [PMID: 33487199 PMCID: PMC8160487 DOI: 10.1017/ice.2021.25] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 01/07/2021] [Indexed: 02/07/2023]
Abstract
This SHEA white paper identifies knowledge gaps and challenges in healthcare epidemiology research related to coronavirus disease 2019 (COVID-19) with a focus on core principles of healthcare epidemiology. These gaps, revealed during the worst phases of the COVID-19 pandemic, are described in 10 sections: epidemiology, outbreak investigation, surveillance, isolation precaution practices, personal protective equipment (PPE), environmental contamination and disinfection, drug and supply shortages, antimicrobial stewardship, healthcare personnel (HCP) occupational safety, and return to work policies. Each section highlights three critical healthcare epidemiology research questions with detailed description provided in supplementary materials. This research agenda calls for translational studies from laboratory-based basic science research to well-designed, large-scale studies and health outcomes research. Research gaps and challenges related to nursing homes and social disparities are included. Collaborations across various disciplines, expertise and across diverse geographic locations will be critical.
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Affiliation(s)
- Lona Mody
- Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, United States
- Geriatrics Research Education and Clinical Center, Veterans’ Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, United States
| | - Ibukunoluwa C. Akinboyo
- Division of Infectious Diseases, Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, United States
| | - Hilary M. Babcock
- Washington University School of Medicine, St. Louis, Missouri, United States
| | - Werner E. Bischoff
- Wake Forest School of Medicine, Winston Salem, North Carolina, United States
| | - Vincent Chi-Chung Cheng
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
- Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China
| | - Kathleen Chiotos
- Division of Critical Care Medicine, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
| | - Kimberly C. Claeys
- University of Maryland School of Pharmacy, Baltimore, Maryland, United States
| | - K. C. Coffey
- University of Maryland School of Medicine, Baltimore, Maryland, United States
| | - Daniel J. Diekema
- Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States
| | - Curtis J. Donskey
- Infectious Diseases Section, Louis Stokes Cleveland Veterans’ Affairs Medical Center, Cleveland, Ohio, United States
- Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
| | - Katherine D. Ellingson
- Department of Epidemiology and Biostatistics, College of Public Health, University of Arizona, Tucson, Arizona, United States
| | - Heather M. Gilmartin
- Veterans’ Affairs Eastern Colorado Healthcare System, Aurora, Colorado, United States
- Colorado School of Public Health, University of Colorado, Aurora, Colorado, United States
| | - Shruti K. Gohil
- Division of Infectious Diseases, University of California Irvine School of Medicine, Irvine, California, United States
- Epidemiology and Infection Prevention, UC Irvine Health, Irvine, California, United States
| | - Anthony D. Harris
- University of Maryland School of Medicine, Baltimore, Maryland, United States
| | - Sara C. Keller
- Division of Infectious Diseases, John Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Eili Y. Klein
- Department of Emergency Medicine, Johns Hopkins University, Baltimore, Maryland, Unites States
| | - Sarah L. Krein
- Veterans’ Affairs Ann Arbor Center for Clinical Management Research, Ann Arbor, Michigan, United States
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, United States
| | - Jennie H Kwon
- Washington University School of Medicine, St. Louis, Missouri, United States
| | - Adam S. Lauring
- Division of Infectious Diseases, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, United States
| | - Daniel J. Livorsi
- Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States
- Iowa City Veterans’ Affairs Health Care System, Iowa City, Iowa, United States
| | - Eric T. Lofgren
- Paul G. Allen School for Global Animal Health, Washington State University, Pullman, Washington, United States
| | | | - Aaron M. Milstone
- Division of Pediatric Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Elizabeth A. Monsees
- Children’s Mercy Kansas City, Kansas City, Missouri, United States
- University of Missouri–Kansas City School of Medicine, Kansas City, Missouri, United States
| | - Daniel J. Morgan
- University of Maryland School of Medicine, Baltimore, Maryland, United States
- Veterans’ Affairs Maryland Healthcare System, Baltimore, Maryland, United States
| | - Luci P. Perri
- Infection Control Results, Wingate, North Carolina, United States
| | - Christopher D. Pfeiffer
- Veterans’ Affairs Portland Health Care System, Portland, Oregon, United States
- Oregon Health & Science University, Portland, Oregon, United States
| | - Clare Rock
- Division of Infectious Diseases, John Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Sanjay Saint
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, United States
- Veterans’ Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, United States
| | - Emily Sickbert-Bennett
- Department of Infection Prevention, University of North Carolina Medical Center, Chapel Hill, North Carolina, United States
| | - Felicia Skelton
- Michael E. DeBakey Veterans’ Affairs Medical Center, Houston, Texas, United States
- H. Ben Taub Department of Physical Medicine & Rehabilitation, Baylor College of Medicine, Houston, Texas, United States
| | - Katie J. Suda
- Center for Health Equity Research and Promotion, Veterans’ Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, United States
- Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Thomas R. Talbot
- Vanderbilt University School of Medicine, Nashville, Tennessee, United States
| | - Valerie M. Vaughn
- Division of General Internal Medicine, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, United States
| | - David J. Weber
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Timothy L. Wiemken
- Division of Infectious Diseases, Allergy, and Immunology, Department of Medicine, Saint Louis University School of Medicine, St Louis, Missouri, United States
| | - Mohamed H. Yassin
- School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
- Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Matthew J. Ziegler
- Infectious Diseases Division, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Deverick J. Anderson
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Duke University School of Medicine, Durham, North Carolina, United States
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The global prevalence of depression and anxiety among doctors during the covid-19 pandemic: Systematic review and meta-analysis. J Affect Disord 2022; 298:431-441. [PMID: 34785264 PMCID: PMC8596335 DOI: 10.1016/j.jad.2021.11.026] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 11/09/2021] [Accepted: 11/11/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND This review provides an estimate of the global prevalence of depression and anxiety symptoms among doctors, based on analysis of evidence from the first year of the COVID-19 pandemic. METHODS A systematic review was conducted to identify suitable studies. Final searches were conducted on 3rd March 2021. Papers were initially screened by title and abstract, based on pre-agreed inclusion criteria, followed by full-text review of eligible studies. Risk of bias was assessed using the Joanna Briggs Checklist for Prevalence Studies. Data from studies rated as low or medium risk of bias were pooled using a random-effects meta-analysis. Sensitivity and subgroup analyses were conducted to explore heterogeneity. RESULTS Fifty-five studies were included after full-text review. Of these, thirty studies were assessed as low or medium risk of bias and were included in primary analyses. These comprised twenty-six studies of depression (31,447 participants) and thirty studies of anxiety (33,281 participants). Pooled prevalence of depression and anxiety was 20.5% (95% CI 16.0%-25.3%) and 25.8% (95% CI 20.4%-31.5%) respectively. INTERPRETATION Evidence from the first year of the pandemic suggests that a significant proportion of doctors are experiencing high levels of symptoms of depression and anxiety, although not conclusively more so than pre-pandemic levels. Differences in study methodology and variation in job demands may account for some of the observed heterogeneity. LIMITATIONS Findings must be interpreted with caution due to the high heterogeneity and moderate risk of bias evident in the majority of included studies.
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Drager LF, Pachito DV, Moreno CR, Tavares AR, Conway SG, Assis M, Sguillar DA, Moreira GA, Bacelar A, Genta PR. Insomnia episodes, new-onset pharmacological treatments, and other sleep disturbances during the COVID-19 pandemic: a nationwide cross-sectional study in Brazilian health care professionals. J Clin Sleep Med 2022; 18:373-382. [PMID: 34314346 PMCID: PMC8805011 DOI: 10.5664/jcsm.9570] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
STUDY OBJECTIVES To evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on insomnia and other sleep disturbances in health care professionals. METHODS A survey was distributed using social media and organizational emails to Brazilian active health care professionals during the COVID-19 outbreak. We explored potential associated factors including age, sex, occupation, workplace, work hours, income, previous infection with COVID-19, recent/current contact with COVID-19 patients, regional number of incident deaths, anxiety, and burnout. We evaluated new-onset/previous insomnia worsening episodes (primary outcome), new pharmacological treatments, sleep quality, duration, nightmares, and snoring (secondary outcomes). RESULTS A total of 4,384 health professionals from all regions of the country were included in the analysis (44 ± 12 years, 76% females, 53.8% physicians). Overall, 55.7% were assisting patients with COVID-19, and 9.2% had a previous COVID-19 infection. The primary outcome occurred in 32.9% of respondents in parallel to 13% new pharmacological treatments for insomnia. The sleep quality worsened for 61.4%, while 43.5% and 22.8% reported ≥ 1-hour sleep duration reduction and worsening or new-onset nightmares, respectively. Multivariate analyses showed that age (odds ratio [OR]: 1.008; 95% confidence interval [CI] 1.001-1.015), females (OR: 1.590; 95% CI 1.335-1.900), weight change (decrease: OR: 1.772; 95% CI 1.453-2.161; increase: OR: 1.468; 95% CI 1.249-1.728), prevalent anxiety (OR: 3.414; 95% CI 2.954-3.948), new-onset burnout (OR: 1.761; 95% CI 1.489-2.083), family income reduction > 30% (OR: 1.288; 95% CI 1.069-1.553), and assisting patients with COVID-19 (OR: 1.275; 95% CI 1.081-1.506) were independently associated with new-onset or worsening of previous insomnia episodes. CONCLUSIONS We observed a huge burden of insomnia episodes and other sleep disturbances in health care professionals during the COVID-19 pandemic. CITATION Drager LF, Pachito DV, Moreno CRC, et al. Insomnia episodes, new-onset pharmacological treatments, and other sleep disturbances during the COVID-19 pandemic: a nationwide cross-sectional study in Brazilian health care professionals. J Clin Sleep Med. 2022;18(2):373-382.
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Affiliation(s)
- Luciano F. Drager
- Unidade de Hipertensão, Departamento de Clinica Medica, Disciplina de Nefrologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil,Unidade de Hipertensão, Instituto do Coração (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil,Address correspondence to: Luciano F. Drager, MD, PhD, Associate Professor of Medicine, University of São Paulo Medical School, Brazil;
| | - Daniela V. Pachito
- Núcleo de Avaliação de Tecnologias em Saúde, Hospital Sírio-Libanês, São Paulo, Brazil,Fundação Getúlio Vargas, São Paulo, Brazil
| | - Claudia R.C. Moreno
- School of Public Health, University of São Paulo, São Paulo, Brazil,Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Almir R. Tavares
- Neurosciences Postgraduate Program, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Silvia G. Conway
- Akasa—Formação e Conhecimento, São Paulo, Brazil,Psychiatry Department, University of São Paulo Medical School, São Paulo, Brazil
| | - Márcia Assis
- Clínica do Sono de Curitiba, Hospital São Lucas, Curitiba Paraná, Brazil
| | | | - Gustavo A. Moreira
- Department of Pediatrics and Psychobiology, Universidade Federal de Sao Paulo, São Paulo, Brazil
| | | | - Pedro R. Genta
- Laboratório do Sono, LIM 63, Pulmonary Division, Heart Institute (InCor), Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, Brazil
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Mensinger JL, Brom H, Havens DS, Costello A, D'Annunzio C, Durning JD, Bradley PK, Copel L, Maldonado L, Smeltzer S, Yost J, Kaufmann P. Psychological responses of hospital-based nurses working during the COVID-19 pandemic in the United States: A cross-sectional study. Appl Nurs Res 2022; 63:151517. [PMID: 35034708 PMCID: PMC8549528 DOI: 10.1016/j.apnr.2021.151517] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 09/13/2021] [Accepted: 10/24/2021] [Indexed: 11/20/2022]
Abstract
Studies show decreased well-being during the COVID-19 pandemic, especially for healthcare providers from Asia. Less is known about the psychological responses of working during the pandemic on hospital-based registered nurses (RNs) in the United States (US). Therefore, the purpose of this paper is to report the well-being of U.S.-based hospital RNs working during the initial acute phase of COVID-19 and compare it with well-being among healthcare workers described in two global meta-analyses. We conducted a cross-sectional survey in May–June 2020 (N = 467). Well-being was measured using the following tools: Generalized Anxiety Disorder-7, Patient Health Questionnaire-2 for depressive symptoms, Impact of Events Scale-Revised for traumatic stress, and the Insomnia Severity Index. Compared with global rates from two meta-analyses, US-based RNs reported significantly more traumatic stress (54.6% vs. 11.4% and 21.5%; p < .001) and depressive symptoms (54.6% vs. 31.8% and 21.7%; p < .001). Rates of insomnia were also higher in U.S.-based RNs than in the meta-analysis that reported insomnia (32.4% vs 27.8%; p < .033). Rates of anxiety symptoms among US-based RNs did not differ from that reported in one meta-analysis (37.3% vs. 34.4%), while it was significantly higher in the other (37.3% vs. 22.1%; p < .001). Hospital-based RNs from the US exhibited over twice the rates of trauma and nearly double the rates of depressive symptoms than shown in reports from hospital workers globally during the acute phase of the COVID-19 pandemic. The lasting effects of this distress are unknown and warrant ongoing evaluation and solutions to better support emotional well-being and prevent burnout in the workplace.
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Affiliation(s)
| | - Heather Brom
- M. Louise Fitzpatrick College of Nursing, United States of America.
| | - Donna S Havens
- M. Louise Fitzpatrick College of Nursing, United States of America.
| | - Alexander Costello
- M. Louise Fitzpatrick College of Nursing, United States of America; Department of Applied Mathematics and Statistics, College of Liberal Arts and Sciences, United States of America.
| | | | - Jennifer Dean Durning
- M. Louise Fitzpatrick College of Nursing, United States of America; Massachusetts General Hospital Institute of Health Professions, United States of America.
| | | | - Linda Copel
- M. Louise Fitzpatrick College of Nursing, United States of America.
| | - Linda Maldonado
- M. Louise Fitzpatrick College of Nursing, United States of America.
| | - Suzanne Smeltzer
- M. Louise Fitzpatrick College of Nursing, United States of America.
| | - Jennifer Yost
- M. Louise Fitzpatrick College of Nursing, United States of America.
| | - Peter Kaufmann
- M. Louise Fitzpatrick College of Nursing, United States of America.
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50
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Singh V, Young JQ, Malhotra P, McCann-Pineo M, Rasul R, Corley SS, Yacht AC, Friedman K, Barone S, Schwartz RM. Evaluating burnout during the COVID-19 pandemic among physicians in a large health system in New York. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2022; 77:819-827. [PMID: 35000576 DOI: 10.1080/19338244.2021.2023084] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE The COVID-19 pandemic has generated significant psychological distress among health care workers worldwide. New York State, particularly New York City and surrounding counties, were especially affected, and experienced over 430,000 COVID-19 cases and 25,000 deaths by mid-August 2020. We hypothesized that physicians and trainees (residents/fellows) who were redeployed outside of their specialty to treat COVID-19 inpatients would have higher burnout. METHODS We conducted a cross-sectional survey to assess burnout among attending and trainee physicians who provided patient care during the COVID-19 pandemic between March-May 2020 across a diverse health care system in New York. Separate multivariable logistic regressions were performed to determine the association between redeployment and measures of burnout: Emotional Exhaustion (EE) and Depersonalization. Burnout measures were also compared by physician vs trainee status. The differential association between redeployment and outcomes with respect to trainee status was also evaluated. RESULTS Redeployment was significantly associated with increased odds of EE {OR =1.53, 95% CI: 1.01-2.31} after adjusting for gender and Epidemic-Pandemic Impacts Inventory (EPII) score. Similarly, being a trainee, especially a junior level trainee, was associated with increased odds of EE {OR = 1.59, 95% CI: 1.01-2.51} after adjusting for gender and EPII scores. However, neither redeployment nor trainee status were significantly associated with Depersonalization. Interactions between redeployment and trainee status were not significant for any of the outcomes (p>.05). CONCLUSION Physicians who were redeployed to treat COVID-19 patients had higher reported measures of EE. Trainees, irrespective of redeployment status, had higher EE as compared with attendings. Additional research is needed to understand the long-term impact of redeployment on burnout among redeployed physicians. Programs to identify and address potential burnout among physicians, particularly trainees, during pandemics may be beneficial.
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Affiliation(s)
- Vansha Singh
- Infectious Disease Department, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - John Q Young
- Department of Psychiatry, Zucker Hillside Hospital at Northwell Health, Manhasset, NY, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Prashant Malhotra
- Infectious Disease Department, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Molly McCann-Pineo
- Department of Occupational Medicine, Epidemiology and Prevention, The Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Rehana Rasul
- Biostatistics Unit, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Samantha S Corley
- Department of Occupational Medicine, Epidemiology and Prevention, The Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Andrew C Yacht
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Karen Friedman
- Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Stephen Barone
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Cohen Children's Medical Center, New Hyde Park, NY, USA
| | - Rebecca M Schwartz
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Occupational Medicine, Epidemiology and Prevention, The Feinstein Institutes for Medical Research, Manhasset, NY, USA
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