1
|
Mathews M, Idrees S, Ryan D, Hedden L, Lukewich J, Marshall EG, Brown JB, Gill P, McKay M, Wong E, Meredith L, Moritz L, Spencer S. System-Based Interventions to Address Physician Burnout: A Qualitative Study of Canadian Family Physicians' Experiences During the COVID-19 Pandemic. Int J Health Policy Manag 2024; 13:8166. [PMID: 39099487 PMCID: PMC11365089 DOI: 10.34172/ijhpm.8166] [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: 06/14/2023] [Accepted: 05/29/2024] [Indexed: 08/06/2024] Open
Abstract
BACKGROUND Medical professionals experienced high rates of burnout and moral distress during the COVID-19 pandemic. In Canada, burnout has been linked to a growing number of family physicians (FPs) leaving the workforce, increasing the number of patients without access to a regular doctor. This study explores the different factors that impacted FPs' experience with burnout and moral distress during the pandemic, with the goal of identifying system-based interventions aimed at supporting FP well-being and improving retention. METHODS We conducted semi-structured qualitative interviews with FPs across four health regions in Canada. Participants were asked about the roles they assumed during different stages of the pandemic, and they were also encouraged to describe their well-being, including relevant supports and barriers. We used thematic analysis to examine themes relating to FP mental health and well-being. RESULTS We interviewed 68 FPs across the four health regions. We identified two overarching themes related to moral distress and burnout: (1) inability to provide appropriate care, and (2) system-related stressors and buffers of burnout. FPs expressed concern about the quality of care their patients were able to receive during the pandemic, citing instances where pandemic restrictions limited their ability to access critical preventative and diagnostic services. Participants also described four factors that alleviated or exacerbated feelings of burnout, including: (1) workload, (2) payment model, (3) locum coverage, and (4) team and peer support. CONCLUSION The COVID-19 pandemic limited FPs' ability to provide quality care to patients, and contributed to increased moral distress and burnout. These findings highlight the importance of implementing system-wide interventions to improve FP well-being during public health emergencies. These could include the expansion of interprofessional team-based models of care, alternate remuneration models for primary care (ie, non-fee-for-service), organized locum programs, and the availability of short-term insurance programs to cover fixed practice operating costs.
Collapse
Affiliation(s)
- Maria Mathews
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Samina Idrees
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Dana Ryan
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Faculty of Nursing, Memorial University, St. John’s, NL, Canada
| | - Lindsay Hedden
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Julia Lukewich
- Faculty of Nursing, Memorial University, St. John’s, NL, Canada
| | - Emily Gard Marshall
- Department of Family Medicine Primary Care Research Unit, Dalhousie University, Halifax, NS, Canada
| | - Judith Belle Brown
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Paul Gill
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | | | - Eric Wong
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Leslie Meredith
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Lauren Moritz
- Department of Family Medicine Primary Care Research Unit, Dalhousie University, Halifax, NS, Canada
| | - Sarah Spencer
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| |
Collapse
|
2
|
Tajki AV, Miroševič Š, Gomezelj MC, Bunc KT, Van Poel E, Willems S, Klemenc-Ketiš Z. Well-being of family physicians during COVID-19 pandemic in Slovenia. BMC PRIMARY CARE 2024; 24:289. [PMID: 38822251 PMCID: PMC11143559 DOI: 10.1186/s12875-024-02416-2] [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: 11/14/2022] [Accepted: 04/30/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND During the COVID-19 pandemic, family physicians (FPs) served as the the initial point of contact for patients potentially infected with the virus, necessitating frequent updates to treatment protocols. However, practices also faced organizational challenges in providing care to other patients who also needed their medical attention. The pressure on FPs increased and affected their well-being. The international PRICOV-19 study, titled "Primary care in times of COVID-19 pandemic," investigated how FPs functioned during the COVID-19 pandemic. This article examines the correlation between various organizational and structural COVID-19-related variables and the well-being of FPs in Slovenia. METHODS Between October 2020 and January 2021, we conducted an online cross-sectional survey. The questionnaire was distributed to 1040 Slovenian FPs and 218 family medicine (FM) trainees. Part of the questionnaire assessed the cooperation and well-being of FPs. The Mayo Clinic Well-being Index was used for the assessment. FP's well-being was also assessed descriptively by asking open-ended questions about maintaining mental health during the pandemic. Potential factors associated with FPs' well-being were identified using a multivariate linear regression method. RESULTS The final sample comprised 191 participants (response rate 14.1%). The mean value ± standard deviation of the Mayo Well-being Index was 3.3 ± 2.6 points. The FPs with the poorest well-being had 5-15 years of work experience and worked in a practice where work could not be distributed in the absence of a co-worker without compromising the well-being of colleagues. Physical activity was identified as the most common method of maintaining mental health among FPs. CONCLUSIONS The results of the study suggest that targeted interventions are needed to support FPs mid-career, increase resilience in practice, promote strong team dynamics, and prioritise physical activity in healthcare. Addressing these aspects can contribute to the well-being of individual FPs and the overall health of the healthcare workers.
Collapse
Affiliation(s)
- Alina Verdnik Tajki
- Maribor Community Health Centre, Maribor, Slovenia.
- Ljubljana Community Health Centre, Ljubljana, Slovenia.
| | - Špela Miroševič
- Department of Family Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Maja Cvetko Gomezelj
- Department of Family Medicine, University of Ljubljana, Ljubljana, Slovenia
- Piran Community Health Centre, Piran, Slovenia
| | - Ksenija Tušek Bunc
- Maribor Community Health Centre, Maribor, Slovenia
- Department of Family Medicine, University of Maribor, Maribor, Slovenia
| | - Esther Van Poel
- Department of Public Health and Primary care, Ghent Univesity, Ghent, Belgium
- Quality and Safety Ghent, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Sara Willems
- Department of Public Health and Primary care, Ghent Univesity, Ghent, Belgium
- Quality and Safety Ghent, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Zalika Klemenc-Ketiš
- Ljubljana Community Health Centre, Ljubljana, Slovenia
- Department of Family Medicine, University of Ljubljana, Ljubljana, Slovenia
- Department of Family Medicine, University of Maribor, Maribor, Slovenia
| |
Collapse
|
3
|
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.
Collapse
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
| |
Collapse
|
4
|
Månsson Sandberg H, Landstad BJ, Tjulin Å, Brulin E. COVID-19- related work, managerial factors and exhaustion among general practitioners in Sweden: a cross-sectional study. BMC PRIMARY CARE 2023; 24:269. [PMID: 38087223 PMCID: PMC10717449 DOI: 10.1186/s12875-023-02228-w] [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: 01/24/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023]
Abstract
INTRODUCTION A significant number of international studies show that general practitioners (GPs) suffered from burnout when working during the COVID-19 pandemic. A Swedish study found that more than 16% of GPs had exhaustion in spring 2021. Exhaustion can be regarded as an initial stage of burnout. A knowledge gap remains on GPs´ working conditions, the impact of management during the pandemic and how it was associated with exhaustion. This study aims to explore the association between severe symptoms of exhaustion and COVID-19 pandemic-related work and managerial factors among Swedish GPs and whether managerial factors have an impact on the association between exhaustion and COVID-19-related work factors. METHODS Cross-sectional data was drawn from the Longitudinal Occupational Health survey in Health Care Sweden (LOHHCS), which included a representative sample of practicing doctors in Sweden. The sample consisted of 6699 doctors with a response rate of 41.2%. This study constitutes a sample of doctors who reported working in primary care facilities at the time of data collection, i.e. 1013 GPs. The Burnout Assessment Tool (BAT) was used to assess severe symptoms of exhaustion. Questions were also asked about pandemic-related work and managerial factors. The data was analysed using descriptive statistics and multivariate logistic regression to identify the association between exhaustion, work and managerial factors. RESULTS The multivariate analysis showed that GPs who managed COVID-19 patients were about twice as likely to report severe symptoms of exhaustion. Further, GPs who reported that management was unsupportive, provided unsatisfactory working conditions and unsatisfactory policies for patient prioritisation were between two and four times more likely to report severe symptoms of exhaustion. CONCLUSIONS COVID-19-related work and managerial factors had a significant impact on the mental health of GPs. Furthermore, the potentially protective effect that satisfactory management actions had on mental health was limited. In the aftermath of the COVID-19 pandemic and in preparation for future major crises that have a high impact on healthcare, there is a need to investigate the measures that can be taken to enable GPs to carry out their work, while maintaining their wellbeing.
Collapse
Affiliation(s)
- Helena Månsson Sandberg
- Department of Health Sciences, Mid Sweden University, Östersund, Sweden.
- Unit of Occupational Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Bodil J Landstad
- Faculty of Human Sciences, Mid Sweden University, Östersund, Sweden
- Unit of Research, Education and Development, Östersund Hospital, Östersund, Sweden
| | - Åsa Tjulin
- Department of Health Sciences, Mid Sweden University, Östersund, Sweden
| | - Emma Brulin
- Unit of Occupational Medicine, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
5
|
Xu Y, Deng J, Tan W, Yang W, Deng H. Mental health of general practitioners in Chongqing, China during COVID-19: a cross-sectional study. BMJ Open 2023; 13:e068333. [PMID: 38035743 PMCID: PMC10689386 DOI: 10.1136/bmjopen-2022-068333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 10/31/2023] [Indexed: 12/02/2023] Open
Abstract
OBJECTIVES In the context of the COVID-19 pandemic, general practitioners (GPs) continue to face unprecedented challenges that affect their mental health. However, few studies have assessed the mental health status of GPs. This study aimed to provide preliminary understanding of stress, job burn-out and well-being levels among GPs to train and manage them during public health emergencies. DESIGN We conducted a cross-sectional online self-report survey. SETTING The survey was conducted in Chongqing, China from July to August 2022. PARTICIPANTS Data were collected from 2145 GPs, with an effective response rate of 91.0%. PRIMARY AND SECONDARY OUTCOME MEASURES The main evaluation indicators were stress (Cohen's Perceived Stress Scale), job burn-out (Maslach Burnout Inventory-Human Services Survey Scale) and well-being (WHO-5 Well-Being Index). Multiple linear regression analysis was used to compare the effect of different demographic characteristics on the impact of stress, job burn-out and decreased well-being. RESULTS Stress, job burn-out and decreased well-being were common among GPs. In this study, 59.7% experienced job burn-out, 76.1% experienced high levels of stress and 52.0% may have experienced depression. The main factors that influenced stress, burn-out and well-being were differences in age, working hours per week, title, part-time management work, work-life balance, sleep disorders, whether GPs received adequate recognition by patients and the work team and mental toughness (p<0.05). CONCLUSION This survey is the first to investigate stress, job burn-out and well-being levels among local GPs in China during the COVID-19 pandemic. Curbing stress and job burn-out levels and ensuring well-being among GPs could be achieved by reducing paperwork, management work and working hours; promoting life and work balance; and increasing resilience among GPs. The findings provide a basis for policy-makers to formulate strategies for developing general practice.
Collapse
Affiliation(s)
- Yang Xu
- Department of General Practice, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - JingZhi Deng
- Department of General Practice, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wenhao Tan
- Department of General Practice, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wen Yang
- Department of General Practice, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Huisheng Deng
- Department of General Practice, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| |
Collapse
|
6
|
The Motivation of Medical Staff and the Work Interestedness in the Context of the COVID-19 Pandemic, in a Tertiary Hospital in Romania. Healthcare (Basel) 2023; 11:healthcare11060813. [PMID: 36981470 PMCID: PMC10048156 DOI: 10.3390/healthcare11060813] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/05/2023] [Accepted: 03/08/2023] [Indexed: 03/12/2023] Open
Abstract
The purpose of this study was to evaluate the impact of the COVID-19 pandemic on the motivation and work interestedness of employees in a tertiary hospital located in the northwest of Romania. In the study, 2230 employee satisfaction questionnaires distributed during 2019–2021 in the Oradea Emergency County Clinical Hospital (CCEHO) were analyzed. The percentage of those who declare themselves motivated at the hospital level remains relatively constant, at around 75%. There were differences between staff categories. The percentage of those who evaluate work interestedness with the qualifier “high” decreased from 45.45% for the year 2019 to 41.78% for the year 2021. The degree of motivation and work interestedness showed a significant increase for TESA staff during the pandemic period compared to the year 2019. A non-significant statistical increase in the percentage of motivated staff was observed among physicians, auxiliary staff and the radiology department staff. The motivation of nurses and laboratory staff decreased, but statistically insignificantly. The COVID-19 pandemic brought statistically significant changes at the level of motivation of the hospital staff only for the administrative staff, and the work interestedness for physicians and nurses decreased statistically significantly, especially in the second year of the pandemic. Older staff with an average level of education are more likely to be unmotivated, as shown by the regression model.
Collapse
|
7
|
Jefferson L, Heathcote C, Bloor K. General practitioner well-being during the COVID-19 pandemic: a qualitative interview study. BMJ Open 2023; 13:e061531. [PMID: 36813497 PMCID: PMC9950583 DOI: 10.1136/bmjopen-2022-061531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVES The COVID-19 pandemic presented new challenges for general practitioners' (GPs') mental health and well-being, with growing international evidence of its negative impact. While there has been a wide UK commentary on this topic, research evidence from a UK setting is lacking. This study sought to explore the lived experience of UK GPs during COVID-19, and the pandemic's impact on their psychological well-being. DESIGN AND SETTING In-depth qualitative interviews, conducted remotely by telephone or video call, with UK National Health Service GPs. PARTICIPANTS GPs were sampled purposively across three career stages (early career, established and late career or retired GPs) with variation in other key demographics. A comprehensive recruitment strategy used multiple channels. Data were analysed thematically using Framework Analysis. RESULTS We interviewed 40 GPs; most described generally negative sentiment and many displayed signs of psychological distress and burnout. Causes of stress and anxiety related to personal risk, workload, practice changes, public perceptions and leadership, team working and wider collaboration and personal challenges. GPs described potential facilitators of their well-being, including sources of support and plans to reduce clinical hours or change career path, and some described the pandemic as offering a catalyst for positive change. CONCLUSIONS A range of factors detrimentally affected the well-being of GPs during the pandemic and we highlight the potential impact of this on workforce retention and quality of care. As the pandemic progresses and general practice faces continued challenges, urgent policy measures are now needed.
Collapse
Affiliation(s)
- Laura Jefferson
- Department of Health Sciences, University of York, York, North Yorkshire, UK
| | - Claire Heathcote
- Department of Health Sciences, University of York, York, North Yorkshire, UK
| | - Karen Bloor
- Department of Health Sciences, University of York, York, North Yorkshire, UK
| |
Collapse
|
8
|
McCammon LC, Gillen P, Kernohan WG. Explaining and addressing the limitations in usefulness of available estimated prevalence figures relating to burnout in family doctors: Evidence from a systematic scoping literature review. J Psychiatr Res 2023; 158:261-272. [PMID: 36621182 DOI: 10.1016/j.jpsychires.2022.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 11/06/2022] [Accepted: 12/11/2022] [Indexed: 12/15/2022]
Abstract
Burnout in family doctors (FDs) affects their well-being, patient care, and healthcare organizations, and is considered common worldwide. However, its measurement has been so inconsistent that whether the widely divergent prevalence figures can be meaningfully interpreted has been questioned. Our aim was to go further than previous systematic reviews to explore the meaning contribution and usefulness of FD-burnout prevalence estimates. Worldwide literature was systematically reviewed using Levac's scoping framework, with 249 papers undergoing full-text review. Of 176 studies measuring burnout, 78% used the Maslach Burnout Inventory (MBI), which measures burnout as now defined by the World Health Organization. We, therefore, concentrated on the MBI. Its burnout measurement was markedly inconsistent, with prevalence estimates ranging from 2.8% to 85.7%. Researchers made prevalence claims relating to burnout severity and implied diagnoses based on participants' MBI scores, even though the MBI has not been validated as a clinical or diagnostic tool. Except when comparisons were possible between certain studies, prevalence figures provided limited meaning and added little to the understanding of burnout in FDs. Our review revealed a lack of research-supported meaningful information about the prevalence of FD burnout and that care is required to avoid drawing unsubstantiated conclusions from prevalence results. This paper's overall purpose is to propose how obtaining meaningful prevalence estimates can begin, which are recognized as key to developing improved prevention policies and interventions. Researchers must adopt a consistent means to measure burnout, use the MBI as its authors intended, and explore making progress through quantitative and qualitative collaboration.
Collapse
Affiliation(s)
- Leonard C McCammon
- Ulster University, School of Nursing and Paramedic Science, Faculty of Life and Health Sciences, York Street, Belfast, Co. Antrim, Northern Ireland, BT15 1ED, UK.
| | - Patricia Gillen
- Ulster University, School of Nursing and Paramedic Science, Faculty of Life and Health Sciences, York Street, Belfast, Co. Antrim, Northern Ireland, BT15 1ED, UK; Southern Health and Social Care Trust, Gilford, Co. Armagh, Northern Ireland, BT63 5JX, UK
| | - W George Kernohan
- Ulster University, School of Nursing and Paramedic Science, Faculty of Life and Health Sciences, York Street, Belfast, Co. Antrim, Northern Ireland, BT15 1ED, UK
| |
Collapse
|
9
|
Shahabi N, Hosseini Z, Homayuni A, Ezati Rad R, Gharibzadeh A. Explaining the factors affecting women's life during COVID‐19 lockdown: A qualitative study among women in Southern Iran. Health Sci Rep 2022; 5:e957. [PMCID: PMC9686351 DOI: 10.1002/hsr2.957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/26/2022] [Accepted: 11/15/2022] [Indexed: 11/26/2022] Open
Affiliation(s)
- Nahid Shahabi
- Student Research Committee, Faculty of Health Hormozgan University of Medical Sciences Bandar Abbas Iran
| | - Zahra Hosseini
- Tobacco and Health Research Center Hormozgan university of Medical Sciences Bandar abbas Iran
| | - Atefeh Homayuni
- Student Research Committee, Faculty of Health Hormozgan University of Medical Sciences Bandar Abbas Iran
| | - Roghayeh Ezati Rad
- Student Research Committee, Faculty of Health Hormozgan University of Medical Sciences Bandar Abbas Iran
| | - Abdollah Gharibzadeh
- Tobacco and Health Research Center Hormozgan university of Medical Sciences Bandar abbas Iran
| |
Collapse
|
10
|
Ulfa M, Azuma M, Steiner A. Burnout status of healthcare workers in the world during the peak period of the COVID-19 pandemic. Front Psychol 2022; 13:952783. [PMID: 36211838 PMCID: PMC9532965 DOI: 10.3389/fpsyg.2022.952783] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 08/30/2022] [Indexed: 11/13/2022] Open
Abstract
During the COVID-19 pandemic, healthcare workers have a high workload and have been exposed to various psychosocial stressors. This study aimed to evaluate health workers during the COVID-19 pandemic in the world. The method used in this research is qualitative with a literature review approach. The data sources in this study were taken from the Scopus database using the keywords "health workers," "burnout," AND "coronavirus" from the time range of 2020 to April 25, 2022. From the determination of the time range, 150 documents emerged. This study revealed that the Pearson correlation between total burnout scale scores on healthcare workers, professionals, exhaustion, mental, stress, personal, depression, symptoms, emergency, system, job, and impact indicated that overall burnout scores were associated with depression and anxiety. Stress symptoms had correlation values ranging from 0.84 to 0.73. Job burnout had a significant relationship with exhaustion at 0.89; depression r = 0.73), impacting a score of 0.66. At the same time, the fulfillment of professional and interpersonal disengagement showed a Pearson correlation between the total burnout scale scores on health workers, professionals, exhaustion, mental, stress, personal, depression, symptoms, emergency, system, job, and impact. Overall, the participants in health care workers worldwide experienced high levels of psychological distress. We also found that health workers dealing with COVID-19 pandemic patients were more likely to experience depression, stress, and burnout than health staff who were not personally involved in medical work. Furthermore, this study will be a follow-up study using the Work Ability Index (WAI) to measure work ability and work satisfaction.
Collapse
Affiliation(s)
- Maria Ulfa
- Postgraduate Program, Master of Hospital Administration, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
| | - Momoyo Azuma
- Department of Infection Control and Prevention, Tokushima University Hospital, Tokushima, Japan
| | - Andrea Steiner
- Department for Occupational Health, Jena University Hospital/Friedrich-Schiller-University, Jena, Germany
| |
Collapse
|
11
|
Iqbal SA, Abubakar IR. Hospital Outdoor Spaces as Respite Areas for Healthcare Staff During the COVID-19 Pandemic. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2022; 15:343-353. [PMID: 35831995 DOI: 10.1177/19375867221111530] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The COVID-19 pandemic has created considerable implications for healthcare staff around the globe. During the pandemic, the frontline healthcare workers experience intense anxiety, stress, burnout, and psychological breakdown, with severe implications on their mental and physical well-being. In addition to these implications, anxiety and stress can hinder their productivity and ability to perform their duties efficiently. The literature indicates that hospital gardens and contact with nature can help alleviate psychological distress among hospital staff. However, few studies investigated the role of outdoor spaces as areas for respite and work breaks in healthcare facilities during the pandemic. The present opinion paper highlights the challenges of job stress and psychological distress health workers face during the pandemic. This article also underscores the role of hospital outdoor spaces and garden facilities in coping with the challenges. While other measures to reduce stress among hospital staff and ensure their health and safety are important, hospital administrators and relevant government agencies should also emphasize the provision of gardens and open spaces in healthcare facilities. These spaces can act as potential areas for respite for hospital staff to help them cope with the stress and anxiety accumulated through working under crises.
Collapse
Affiliation(s)
- Saad Arslan Iqbal
- Department of Educational Policy Studies, Faculty of Education, University of Alberta, Edmonton, Canada
| | - Ismaila Rimi Abubakar
- College of Architecture and Planning, Imam Abdulrahman Bin Faisal University (Formerly, University of Dammam), Dammam, Saudi Arabia
| |
Collapse
|
12
|
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.
Collapse
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
| |
Collapse
|
13
|
Aragonès E, Cura-González ID, Hernández-Rivas L, Polentinos-Castro E, Fernández-San-Martín MI, López-Rodríguez JA, Molina-Aragonés JM, Amigo F, Alayo I, Mortier P, Ferrer M, Pérez-Solà V, Vilagut G, Alonso J. Psychological impact of the COVID-19 pandemic on primary care workers: a cross-sectional study. Br J Gen Pract 2022; 72:e501-e510. [PMID: 35440468 PMCID: PMC9037185 DOI: 10.3399/bjgp.2021.0691] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/28/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has had a major impact on the mental health of healthcare workers, yet studies in primary care workers are scarce. AIM To investigate the prevalence of and associated factors for psychological distress in primary care workers during the first COVID-19 outbreak. DESIGN AND SETTING This was a multicentre, cross-sectional, web-based survey conducted in primary healthcare workers in Spain, between May and September 2020. METHOD Healthcare workers were invited to complete a survey to evaluate sociodemographic and work-related characteristics, COVID-19 infection status, exposure to patients with COVID-19, and resilience (using the Connor-Davidson Resilience Scale), in addition to being screened for common mental disorders (depression, anxiety disorders, post-traumatic stress disorder, panic attacks, and substance use disorder). Positive screening for any of these disorders was analysed globally using the term 'any current mental disorder'. RESULTS A total of 2928 primary care professionals participated in the survey. Of them, 43.7% (95% confidence interval [CI] = 41.9 to 45.4) tested positive for a current mental disorder. Female sex (odds ratio [OR] 1.61, 95% CI = 1.25 to 2.06), having previous mental disorders (OR 2.58, 95% CI = 2.15 to 3.10), greater occupational exposure to patients with COVID-19 (OR 2.63, 95% CI = 1.98 to 3.51), having children or dependents (OR 1.35, 95% CI = 1.04 to 1.76 and OR 1.59, 95% CI = 1.20 to 2.11, respectively), or having an administrative job (OR 2.24, 95% CI = 1.66 to 3.03) were associated with a higher risk of any current mental disorder. Personal resilience was shown to be a protective factor. CONCLUSION Almost half of primary care workers showed significant psychological distress. Strategies to support the mental health of primary care workers are necessary, including designing psychological support and resilience-building interventions based on risk factors identified.
Collapse
Affiliation(s)
- Enric Aragonès
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Barcelona
| | - Isabel Del Cura-González
- Research Network on Health Services in Chronic Diseases, Madrid; Department of Medical Specialties and Public Health, Universidad Rey Juan Carlos, Madrid; Primary Care Research Unit (GAAP-SERMAS), Madrid Health Service, Madrid; Gregorio Marañón Health Research Institute, Madrid
| | | | - Elena Polentinos-Castro
- Research Network on Health Services in Chronic Diseases, Madrid; Department of Medical Specialties and Public Health, Universidad Rey Juan Carlos, Madrid; Primary Care Research Unit (GAAP-SERMAS), Madrid Health Service, Madrid; Gregorio Marañón Health Research Institute, Madrid
| | | | - Juan A López-Rodríguez
- Research Network on Health Services in Chronic Diseases, Madrid; Department of Medical Specialties and Public Health, Universidad Rey Juan Carlos, Madrid; Primary Care Research Unit (GAAP-SERMAS), Madrid Health Service, Madrid; Gregorio Marañón Health Research Institute, Madrid
| | | | - Franco Amigo
- Health Services Research Unit, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona; CIBERESP, Madrid
| | - Itxaso Alayo
- Health Services Research Unit, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona; CIBERESP, Madrid
| | - Philippe Mortier
- Health Services Research Unit, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona; CIBERESP, Madrid
| | - Montse Ferrer
- Health Services Research Unit, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona; CIBERESP, Madrid; Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona
| | - Víctor Pérez-Solà
- Department of Psychiatry and Legal Medicine, Autonomous University of Barcelona, Barcelona; CIBER Mental Health (CIBERSAM), Madrid; Institut de Neuropsiquiatria i Addiccions, Parc de Salut Mar, Barcelona
| | - Gemma Vilagut
- Health Services Research Unit, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona; CIBERESP, Madrid
| | - Jordi Alonso
- Health Services Research Unit, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona; CIBERESP, Madrid; Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona
| |
Collapse
|
14
|
Tang R, Feng O, Chong JJ, Wang A. Evaluating the impact of coronavirus disease on burnout among healthcare workers using maslach burnout inventory tool: A systematic review. PROCEEDINGS OF SINGAPORE HEALTHCARE 2022. [DOI: 10.1177/20101058221117390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Burnout has been prevalent among healthcare workers (HCWs). However, the effect of the Coronavirus Disease (COVID-19) pandemic on this phenomenon in HCWs is unclear. Objective This systematic review aims to evaluate the impact of COVID-19 on burnout of HCWs using Maslach Burnout Inventory (MBI). Methods A systematic search was performed on PubMed database for articles published between 1 December 2019 and 30 June 2021. Search strategy combined terms for HCWs, COVID-19, burnout, and MBI. The main outcome of interest was burnout, including both mean prevalence and MBI scores for high emotional exhaustion (EE), high depersonalisation (DP) and low personal accomplishment (PA). Results Four cohort studies, 90 cross-sectional studies and one randomised-controlled trial were included for review. Only one cohort study compared burnout data among HCWs before and during COVID-19. It reported a statistically significant increase in mean EE and PA scores from 21.9 to 24.8 ( p = .001), and 42.7 to 48.7 ( p = .001), respectively. The remaining studies only evaluated burnout data during COVID-19 but were missing burnout data prior to the pandemic for comparison. Across these studies, the overall mean prevalence of burnout among HCWs was 39.95%, with mean MBI EE scores of 22.07, DP scores of 7.83, and PA scores of 32.53. Burnout outcomes were generally comparable across specific healthcare professions such as doctors and nurses. Conclusion Whilst quality research elucidating the effect of pandemic on burnout is lacking, current burnout prevalence among HCWs during COVID-19 is notable.
Collapse
Affiliation(s)
- Reanne Tang
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
- Department of Pharmacy, Singapore General Hospital, Singapore, Singapore
| | - Ouyuan Feng
- Department of Pharmacy, Singapore General Hospital, Singapore, Singapore
| | - Jin Jian Chong
- Department of Pharmacy, Singapore General Hospital, Singapore, Singapore
| | - Aiwen Wang
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
- Department of Pharmacy, Singapore General Hospital, Singapore, Singapore
| |
Collapse
|
15
|
Collins C, Clays E, Van Poel E, Cholewa J, Tripkovic K, Nessler K, de Rouffignac S, Šantrić Milićević M, Bukumiric Z, Adler L, Ponsar C, Murauskiene L, Ožvačić Adžić Z, Windak A, Asenova R, Willems S. Distress and Wellbeing among General Practitioners in 33 Countries during COVID-19: Results from the Cross-Sectional PRICOV-19 Study to Inform Health System Interventions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5675. [PMID: 35565070 PMCID: PMC9101443 DOI: 10.3390/ijerph19095675] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/29/2022] [Accepted: 05/03/2022] [Indexed: 11/17/2022]
Abstract
Emerging literature is highlighting the huge toll of the COVID-19 pandemic on frontline health workers. However, prior to the crisis, the wellbeing of this group was already of concern. The aim of this paper is to describe the frequency of distress and wellbeing, measured by the expanded 9-item Mayo Clinic Wellbeing Index (eWBI), among general practitioners/family physicians during the COVID-19 pandemic and to identify levers to mitigate the risk of distress. Data were collected by means of an online self-reported questionnaire among GP practices. Statistical analysis was performed using SPSS software using Version 7 of the database, which consisted of the cleaned data of 33 countries available as of 3 November 2021. Data from 3711 respondents were included. eWBI scores ranged from -2 to 9, with a median of 3. Using a cutoff of ≥2, 64.5% of respondents were considered at risk of distress. GPs with less experience, in smaller practices, and with more vulnerable patient populations were at a higher risk of distress. Significant differences in wellbeing scores were noted between countries. Collaboration from other practices and perception of having adequate governmental support were significant protective factors for distress. It is necessary to address practice- and system-level organizational factors in order to enhance wellbeing and support primary care physicians.
Collapse
Affiliation(s)
- Claire Collins
- Research Centre, Irish College of General Practitioners, D02 XR68 Dublin, Ireland
| | - Els Clays
- Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium; (E.C.); (E.V.P.); (S.W.)
| | - Esther Van Poel
- Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium; (E.C.); (E.V.P.); (S.W.)
| | - Joanna Cholewa
- Institute of Health and Society, Catholic University of Louvain, 1348 Louvain-la-Neuve, Belgium; (J.C.); (S.d.R.); (C.P.)
| | - Katica Tripkovic
- City Institute of Public Health Belgrade, 11000 Belgrade, Serbia;
| | - Katarzyna Nessler
- Department of Family Medicine, Jagiellonian University Medical College, 31-061 Krakow, Poland; (K.N.); (A.W.)
| | - Ségolène de Rouffignac
- Institute of Health and Society, Catholic University of Louvain, 1348 Louvain-la-Neuve, Belgium; (J.C.); (S.d.R.); (C.P.)
| | | | - Zoran Bukumiric
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.Š.M.); (Z.B.)
| | - Limor Adler
- Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Cécile Ponsar
- Institute of Health and Society, Catholic University of Louvain, 1348 Louvain-la-Neuve, Belgium; (J.C.); (S.d.R.); (C.P.)
| | - Liubove Murauskiene
- Public Health Department, Faculty of Medicine, Vilnius University, LT-01513 Vilnius, Lithuania;
| | - Zlata Ožvačić Adžić
- Department of Family Medicine, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia;
| | - Adam Windak
- Department of Family Medicine, Jagiellonian University Medical College, 31-061 Krakow, Poland; (K.N.); (A.W.)
| | - Radost Asenova
- Department of General Practice, Medical University Plovdiv, 4003 Plovdiv, Bulgaria;
| | - Sara Willems
- Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium; (E.C.); (E.V.P.); (S.W.)
| |
Collapse
|
16
|
Jefferson L, Golder S, Heathcote C, Avila AC, Dale V, Essex H, van der Feltz Cornelis C, McHugh E, Moe-Byrne T, Bloor K. GP wellbeing during the COVID-19 pandemic: a systematic review. Br J Gen Pract 2022; 72:e325-e333. [PMID: 35314428 PMCID: PMC8966782 DOI: 10.3399/bjgp.2021.0680] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 01/31/2022] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Doctors' organisations in the UK have reported worrying levels of work-related stress and burnout in the GP workforce for some time, and the COVID-19 pandemic has presented clear new challenges. AIM To synthesise international evidence exploring the impact of COVID-19 on primary care doctors' mental health and wellbeing, and identify risk factors associated with their psychological wellbeing during this time. DESIGN AND SETTING Mixed-methods systematic review. METHOD Six bibliographic databases, Google Scholar, and MedRxiv were searched on 19 November 2020 and 3 June 2021 to identify studies of GP psychological wellbeing during the pandemic. Reference checking was also conducted. Two reviewers selected studies, extracted data, and assessed the quality of studies using standardised tools. Heterogeneity in outcomes, setting, and design prohibited statistical pooling; studies were combined using a convergent integrated thematic synthesis. RESULTS Thirty-one studies were included. Multiple sources of stress were identified including changed working practices; risk, exposure, and inadequate personal protective equipment (PPE); information overload; pandemic preparedness; and cohesion across sectors. Studies demonstrated an impact on psychological wellbeing, with some GPs experiencing stress, burnout, anxiety, depression, fear of COVID-19, lower job satisfaction, and physical symptoms. Studies reported gender and age differences: women GPs had poorer psychological outcomes across all domains, and older GPs reported greater stress and burnout. Use of outcome measures and reporting practice varied greatly. CONCLUSION This review of international evidence demonstrates that the COVID-19 pandemic has adversely affected GPs' wellbeing around the world. Further research could explore gender and age differences, identifying interventions targeted to these groups.
Collapse
Affiliation(s)
| | - Su Golder
- Department of Health Sciences, University of York, York
| | | | | | - Veronica Dale
- Department of Health Sciences, University of York, York
| | - Holly Essex
- Department of Health Sciences, University of York, York
| | | | | | | | - Karen Bloor
- Department of Health Sciences, University of York, York
| |
Collapse
|
17
|
Carmassi C, Dell’Oste V, Barberi FM, Bertelloni CA, Pedrinelli V, Dell’Osso L. Mental Health Symptoms among General Practitioners Facing the Acute Phase of the COVID-19 Pandemic: Detecting Different Reaction Groups. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074007. [PMID: 35409690 PMCID: PMC8998411 DOI: 10.3390/ijerph19074007] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 03/13/2022] [Accepted: 03/24/2022] [Indexed: 01/13/2023]
Abstract
During the 2020 first wave of the COVID-19 pandemic, general practitioners (GPs) represented the first line of primary care and were highly exposed to the pandemic risks, with a consequent risk of developing a wide range of mental health symptoms. However, scant data are still available on factors associated with a worse outcome. The aim of the present study was to investigate mental health symptoms in 139 GPs in the aftermath of the first COVID-19 national lockdown in Italy, detecting groups of subjects with different depressive, anxiety, and post-traumatic stress symptom severity. The impact of the mental health symptoms on quality of life and individual functioning were also evaluated. A cluster analysis identified three groups with mild (44.6%), moderate (35.3%), and severe psychopathological burden (20.1%). Higher symptom severity was related to younger age, fewer years in service as GPs, working in a high incidence area for the pandemic, having a relative at risk of medical complications due to COVID-19, besides more severe global functioning impairment, burnout, and secondary traumatic stress. The present findings showed that GPs, forced to perform their professional activity in extremely stressful conditions during the COVID-19 pandemic, were at high risk of developing mental health problems and a worse quality of life.
Collapse
Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (C.C.); (F.M.B.); (C.A.B.); (V.P.); (L.D.)
| | - Valerio Dell’Oste
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (C.C.); (F.M.B.); (C.A.B.); (V.P.); (L.D.)
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, 53100 Siena, Italy
- Correspondence: ; Tel.: +39-050-2219760; Fax: +39-050-2219787
| | - Filippo Maria Barberi
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (C.C.); (F.M.B.); (C.A.B.); (V.P.); (L.D.)
| | - Carlo Antonio Bertelloni
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (C.C.); (F.M.B.); (C.A.B.); (V.P.); (L.D.)
| | - Virginia Pedrinelli
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (C.C.); (F.M.B.); (C.A.B.); (V.P.); (L.D.)
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, 53100 Siena, Italy
| | - Liliana Dell’Osso
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (C.C.); (F.M.B.); (C.A.B.); (V.P.); (L.D.)
| |
Collapse
|
18
|
Barré T, Ramier C, Mounir I, David R, Menvielle L, Marcellin F, Carrieri P, Protopopescu C, Cherikh F. Mindfulness as a Protective Factor Against Increased Tobacco and Alcohol Use in Hospital Workers Following the First COVID-19-Related Lockdown: a Study in Southern France. Int J Ment Health Addict 2022; 21:1-21. [PMID: 35095351 PMCID: PMC8783775 DOI: 10.1007/s11469-021-00739-0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/11/2021] [Indexed: 10/27/2022] Open
Abstract
COVID-19-related national lockdowns worldwide have had repercussions on people's well-being and have led to increased substance use. Mindfulness has previously been associated with reduced psychological distress and benefits in terms of addictive behaviors. We aimed to assess whether dispositional mindfulness protected against increased tobacco and alcohol use in hospital workers after France's first lockdown started. All workers in two French hospitals were contacted by email to participate in an online survey. Three hundred eighty-five workers answered. We ran two separate logistic regression models to test for associations between the level of dispositional mindfulness and both increased tobacco and alcohol use, after adjusting for affect deterioration. Dispositional mindfulness was associated with a lower likelihood of increased tobacco (adjusted odds ratio (AOR) [95% CI] 0.71 [0.51; 0.99], p = 0.046) and alcohol (0.66 [0.50; 0.87], p = 0.004) use. The effect of mindfulness on tobacco use was partially mediated by affect deterioration. Dispositional mindfulness appeared to be a protective factor against lockdown-related tobacco and alcohol use increases in French hospital workers.
Collapse
Affiliation(s)
- Tangui Barré
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L’Information Médicale, ISSPAM, 27 Bd Jean Moulin, 13385 Cedex 5 Marseille, France
| | - Clémence Ramier
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L’Information Médicale, ISSPAM, 27 Bd Jean Moulin, 13385 Cedex 5 Marseille, France
| | - Izza Mounir
- Addictology Unit, University Hospital of Nice, Archet 2 Hospital, 151 Route de Saint-Antoine, 06200 Nice, France
| | - Renaud David
- Centre Hospitalier Universitaire de Nice, Centre Mémoire de Ressources Et de Recherche, Institut Claude Pompidou, 10 rue Molière, 06100 Nice, France
| | | | - Fabienne Marcellin
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L’Information Médicale, ISSPAM, 27 Bd Jean Moulin, 13385 Cedex 5 Marseille, France
- SESSTIM, Faculté de Médecine de La Timone, aile bleue, 27 Bd Jean Moulin , 13385 Cedex 5 Marseille, France
| | - Patrizia Carrieri
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L’Information Médicale, ISSPAM, 27 Bd Jean Moulin, 13385 Cedex 5 Marseille, France
| | - Camelia Protopopescu
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L’Information Médicale, ISSPAM, 27 Bd Jean Moulin, 13385 Cedex 5 Marseille, France
| | - Faredj Cherikh
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L’Information Médicale, ISSPAM, 27 Bd Jean Moulin, 13385 Cedex 5 Marseille, France
- Addictology Unit, University Hospital of Nice, Archet 2 Hospital, 151 Route de Saint-Antoine, 06200 Nice, France
| |
Collapse
|
19
|
Caliandro M, Fabiana G, Surgo A, Carbonara R, Ciliberti MP, Bonaparte I, Caputo S, Fiorentino A. Impact on mental health of the COVID-19 pandemic in a radiation oncology department. Radiol Med 2022; 127:220-224. [PMID: 35034319 PMCID: PMC8761247 DOI: 10.1007/s11547-021-01440-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 12/03/2021] [Indexed: 01/08/2023]
Abstract
Aim To evaluate the emotional state and organizational well-being of healthcare workers in radiation oncology departments, during the COVID pandemic. Methods A survey was carried out with three questionnaires: Impact of Event Scale—Revised (IES-R); Italian ANAC questionnaire; and Maslach Burnout Inventory (MBI). Comparisons between groups were done by Student’s t test. Results Seventy-eight questionnaires for 26 workers were analyzed. Thirty-three percent of the sample obtained an IES-R high score, such as post-traumatic syndrome. In terms of organizational well-being, younger age and lower working seniority were statistically significant for higher score of ANAC items (p < 0.5). Regarding MBI, 0, 27 and 50% high scores of emotional exhaustion, depersonalization and personal accomplishment were reported, respectively. Low working seniority and male sex were correlated with high score of personal accomplishment (p:0.05; p:0.03). Conclusion Intervention to promote mental health well-being should be implemented in radiation oncology department.
Collapse
Affiliation(s)
- Morena Caliandro
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, 70020, Acquaviva delle fonti (BA), Italy
| | - Gregucci Fabiana
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, 70020, Acquaviva delle fonti (BA), Italy
| | - Alessia Surgo
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, 70020, Acquaviva delle fonti (BA), Italy.
| | - Roberta Carbonara
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, 70020, Acquaviva delle fonti (BA), Italy
| | - Maria Paola Ciliberti
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, 70020, Acquaviva delle fonti (BA), Italy
| | - Ilaria Bonaparte
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, 70020, Acquaviva delle fonti (BA), Italy
| | - Sergio Caputo
- General Regional Hospital F. Miulli, Acquaviva delle fonti (BA), Italy
| | - Alba Fiorentino
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, 70020, Acquaviva delle fonti (BA), Italy
| |
Collapse
|