1
|
Acker RC, Sharpe J, Shea JA, Ginzberg SP, Bakillah E, Rosen CB, Finn CB, Roberts SE, Ajmera S, Kelz RR. Belonging in Surgery: A Validated Instrument and Single Institutional Pilot. Ann Surg 2024; 280:345-352. [PMID: 38348669 DOI: 10.1097/sla.0000000000006234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2024]
Abstract
OBJECTIVE The aim of this study was to develop and validate an instrument to measure Belonging in Surgery among surgical residents. BACKGROUND Belonging is the essential human need to maintain meaningful relationships and connections to one's community. Increased belongingness is associated with better well-being, job performance, and motivation to learn. However, no tools exist to measure belonging among surgical trainees. METHODS A panel of experts adapted a belonging instrument for use among United States surgery residents. After administration of the 28-item instrument to residents at a single institution, a Cronbach alpha was calculated to measure internal consistency, and exploratory principal component analyses were performed. Multiple iterations of analyses with successively smaller item samples suggested the instrument could be shortened. The expert panel was reconvened to shorten the instrument. Descriptive statistics measured demographic factors associated with Belonging in Surgery. RESULTS The overall response rate was 52% (114 responses). The Cronbach alpha among the 28 items was 0.94 (95% CI: 0.93-0.96). The exploratory principal component analyses and subsequent Promax rotation yielded 1 dominant component with an eigenvalue of 12.84 (70% of the variance). The expert panel narrowed the final instrument to 11 items with an overall Cronbach alpha of 0.90 (95% CI: 0.86, 0.92). Belonging in Surgery was significantly associated with race (Black and Asian residents scoring lower than White residents), graduating with one's original intern cohort (residents who graduated with their original class scoring higher than those that did not), and inversely correlated with resident stress level. CONCLUSIONS An instrument to measure Belonging in Surgery was validated among surgical residents. With this instrument, Belonging in Surgery becomes a construct that may be used to investigate surgeon performance and well-being.
Collapse
Affiliation(s)
- Rachael C Acker
- Department of Surgery, Center for Surgery and Health Economics, Department of Surgery, Philadelphia, PA
- Department of Surgery, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA
| | - James Sharpe
- Department of Surgery, Center for Surgery and Health Economics, Department of Surgery, Philadelphia, PA
- Department of Surgery, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA
| | - Judy A Shea
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Leonard Davis Institute of Healthcare Economics, Wharton School, University of Pennsylvania, PA
| | - Sara P Ginzberg
- Department of Surgery, Center for Surgery and Health Economics, Department of Surgery, Philadelphia, PA
- Department of Surgery, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA
| | - Emna Bakillah
- Department of Surgery, Center for Surgery and Health Economics, Department of Surgery, Philadelphia, PA
- Department of Surgery, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA
| | - Claire B Rosen
- Department of Surgery, Center for Surgery and Health Economics, Department of Surgery, Philadelphia, PA
- Department of Surgery, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA
| | - Caitlin B Finn
- Leonard Davis Institute of Healthcare Economics, Wharton School, University of Pennsylvania, PA
- Department of Surgery, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, NY
| | - Sanford E Roberts
- Department of Surgery, Center for Surgery and Health Economics, Department of Surgery, Philadelphia, PA
- Department of Surgery, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA
| | - Sonia Ajmera
- Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Rachel R Kelz
- Department of Surgery, Center for Surgery and Health Economics, Department of Surgery, Philadelphia, PA
- Department of Surgery, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA
- Leonard Davis Institute of Healthcare Economics, Wharton School, University of Pennsylvania, PA
| |
Collapse
|
2
|
Lippert JF, Lewis T, Bruce D, Trifunović N, Singh M, Prachand N. Work-related factors of mental health among Chicago residents two years into the COVID-19 pandemic. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2024; 21:365-377. [PMID: 38560920 DOI: 10.1080/15459624.2024.2323108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
The COVID-19 pandemic led to widespread consequences for economic, social, and general wellbeing with rates of anxiety and depression increasing across the population and disproportionately for some workers. This study explored which factors were the most salient contributors to mental health through a cross-sectional 68-item questionnaire that addressed topics related to the pandemic. Data were collected through an address-based sampling frame over the two months from April 2022 to June 2022. A total of 2,049 completed surveys were collected throughout Chicago's 77 Community Areas. Descriptive statistics including frequency and percentages were generated to describe workplace characteristics, work-related stress, and sample demographics and their relationship to psychological distress. Independent participant and workplace factors associated with the outcomes were identified using multivariable logistic regression. The weighted prevalence of persons experiencing some form of psychological distress from mild to serious was 32%. After adjusting for potential confounding factors, certain marginalized communities experienced psychological distress more than others including females, adults over the age of 25 years of age, and people with higher income levels. Those who had been laid off, lost pay, or had reduced hours had increased odds of psychological distress (aOR = 1.71, CI95% 1.14-2.56; p = 0.009) as did people that reported that their work-related stress was somewhat or much worse as compared to before the COVID-19 pandemic (aOR = 2.22, CI95% 1.02-4.82; p = 0.04, aOR = 11.0, CI95% 4.65-26.1; p < 0.001, respectively). These results warrant further investigation and consideration in developing workplace and mental health interventions.
Collapse
Affiliation(s)
- Julia F Lippert
- Department of Health Sciences, DePaul University, Chicago, Illinois
| | - Taylor Lewis
- RTI International, Washington, District of Columbia
| | - Douglas Bruce
- Department of Health Sciences, DePaul University, Chicago, Illinois
| | - Nena Trifunović
- Department of Health Sciences, DePaul University, Chicago, Illinois
| | - Meha Singh
- Office of Epidemiology, Chicago Department of Public Health, Chicago, Illinois
| | - Nik Prachand
- Office of Epidemiology, Chicago Department of Public Health, Chicago, Illinois
| |
Collapse
|
3
|
El Boghdady M, Ewalds-Kvist BM. Surgeons' personality, characteristics and presence of meaning in life. Surgeon 2024; 22:67-73. [PMID: 37925229 DOI: 10.1016/j.surge.2023.10.007] [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: 08/29/2023] [Revised: 10/16/2023] [Accepted: 10/17/2023] [Indexed: 11/06/2023]
Abstract
BACKGROUND Surgeons work long shifts and are frequently on call. Pressure to make quick and accurate decisions along with the responsibility of performing complex procedures contribute to surgeons' high stress-levels, anxiety and altered empathy level. We aimed to study surgeons' personality and meaning in life at two different centres. METHODS General surgeons completed 47 questions. Visual analogous scale-items with controlled internal consistency (Cronbach alpha) coefficients varying from .77 to .85 were used from the following scales: Global Measure of Perceived Stress; Hostility Questionnaire; Jefferson Scale of Physician Empathy; Meaning in Life Questionnaire-SF; Rosenberg Self-Esteem Scale; Spielberger State Anxiety Scale and Quality of Work life Scale. Multiple linear regression analyses, parametric or non-parametric tests were employed when considered adequate. RESULTS Fifty-four participants were recruited from 3 different levels of training. Gender differences in Anxiety, Physician Empathy and presence of meaning in life (MIL-P) were revealed. Junior trainees differed from senior trainees and consultants as regards MIL-P, Anxiety, Stress and work-related factors. The surgeons' self-rated self-esteem was work-related. Surgeons' Quality of Work Life was best predicted by Physician Empathy but also their self-rated Self-Esteem contributed significantly to the prediction. Surgeons' MIL-P was significantly predicted by Physician Empathy and State Anxiety. CONCLUSION Surgeons' current personality attributes might not apply to all of them. Female surgeons were more empathetic and felt more presence of meaning in life than male surgeons, and men were less anxious than female surgeons. Junior trainees experienced less anxiety than senior trainees but were more stressed than consultants. The most significant predictors of surgeons' personality were their experience of presence of meaning in life along with their level of empathy.
Collapse
Affiliation(s)
- Michael El Boghdady
- Department of General Surgery, St George's University Hospitals NHS Foundation Trust, London, UK; University of Edinburgh, Edinburgh, UK.
| | | |
Collapse
|
4
|
Finn CB, Syvyk S, Bakillah E, Brown DE, Mesiti AM, Highet A, Bergmark RW, Yeo HL, Waljee JF, Wick EC, Shea JA, Kelz RR. Barriers and Facilitators to Clinical Practice Development in Men and Women Surgeons. JAMA Surg 2024; 159:43-50. [PMID: 37851422 PMCID: PMC10585584 DOI: 10.1001/jamasurg.2023.5125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 07/17/2023] [Indexed: 10/19/2023]
Abstract
Importance Many early-career surgeons struggle to develop their clinical practices, leading to high rates of burnout and attrition. Furthermore, women in surgery receive fewer, less complex, and less remunerative referrals compared with men. An enhanced understanding of the social and structural barriers to optimal growth and equity in clinical practice development is fundamental to guiding interventions to support academic surgeons. Objective To identify the barriers and facilitators to clinical practice development with attention to differences related to surgeon gender. Design, Setting, and Participants A multi-institutional qualitative descriptive study was performed using semistructured interviews analyzed with a grounded theory approach. Interviews were conducted at 5 academic medical centers in the US between July 12, 2022, and January 31, 2023. Surgeons with at least 1 year of independent practice experience were selected using purposeful sampling to obtain a representative sample by gender, specialty, academic rank, and years of experience. Main Outcomes and Measures Surgeon perspectives on external barriers and facilitators of clinical practice development and strategies to support practice development for new academic surgeons. Results A total of 45 surgeons were interviewed (23 women [51%], 18 with ≤5 years of experience [40%], and 20 with ≥10 years of experience [44%]). Surgeons reported barriers and facilitators related to their colleagues, department, institution, and environment. Dominant themes for both genders were related to competition, case distribution among partners, resource allocation, and geographic market saturation. Women surgeons reported additional challenges related to gender-based discrimination (exclusion, questioning of expertise, role misidentification, salary disparities, and unequal resource allocation) and additional demands (related to appearance, self-advocacy, and nonoperative patient care). Gender concordance with patients and referring physicians was a facilitator of practice development for women. Surgeons suggested several strategies for their colleagues, department, and institution to improve practice development by amplifying facilitators and promoting objectivity and transparency in resource allocation and referrals. Conclusions and Relevance The findings of this qualitative study suggest that a surgeon's external context has a substantial influence on their practice development. Academic institutions and departments of surgery may consider the influence of their structures and policies on early career surgeons to accelerate practice development and workplace equity.
Collapse
Affiliation(s)
- Caitlin B. Finn
- Department of Surgery, Weill Cornell Medicine, New York, New York
- Center for Surgery and Health Economics, Department of Surgery, University of Pennsylvania, Philadelphia
- Leonard David Institute of Health Economics, University of Pennsylvania, Philadelphia
| | - Solomiya Syvyk
- Center for Surgery and Health Economics, Department of Surgery, University of Pennsylvania, Philadelphia
| | - Emna Bakillah
- Center for Surgery and Health Economics, Department of Surgery, University of Pennsylvania, Philadelphia
- Leonard David Institute of Health Economics, University of Pennsylvania, Philadelphia
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Danielle E. Brown
- Center for Surgery and Health Economics, Department of Surgery, University of Pennsylvania, Philadelphia
| | - Andrea M. Mesiti
- Department of Surgery, Weill Cornell Medicine, New York, New York
| | | | - Regan W. Bergmark
- Department of Otolaryngology–Head and Neck Surgery, Harvard Medical School and Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Heather L. Yeo
- Department of Surgery, Weill Cornell Medicine, New York, New York
| | | | | | - Judy A. Shea
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Rachel R. Kelz
- Center for Surgery and Health Economics, Department of Surgery, University of Pennsylvania, Philadelphia
- Leonard David Institute of Health Economics, University of Pennsylvania, Philadelphia
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| |
Collapse
|
5
|
Marston WA. The vascular surgeon in 2022: What is "the right stuff"? J Vasc Surg 2023; 78:1351-1358. [PMID: 37981399 DOI: 10.1016/j.jvs.2023.01.212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 11/21/2023]
Affiliation(s)
- William A Marston
- Division of Vascular Surgery, University of North Carolina School of Medicine, Chapel Hill, NC.
| |
Collapse
|
6
|
Hu Z, Zhu Y, Li J, Liu J, Fu M. The COVID-19 related stress and social network addiction among Chinese college students: A moderated mediation model. PLoS One 2023; 18:e0290577. [PMID: 37624773 PMCID: PMC10456156 DOI: 10.1371/journal.pone.0290577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
Based on social cognitive theory and gender differences, this study verified a moderated mediation model to explore the relationship between the COVID-19 related stress (CRS) and social network addiction (SNA) and evaluate the mediating role of fear of missing out (FoMO) and the moderating role of gender. A questionnaire survey was conducted, including 702 Chinese university students.This study used PROCESS to test the hypothesis model.The results showed that the CRS significantly and positively affected the SNA of college students and FoMO played a complementary mediating role. Moreover, the analysis of the moderated mediation model showed that gender moderated the relationship between FoMO and SNA; the effect of FoMO was stronger on the SNA of male college students than that of females. The results not only enhanced our understanding of the internal influencing mechanism of the relationship between CRS and SNA but also considered gender differences. In addition, some suggestions were proposed.
Collapse
Affiliation(s)
- Ziao Hu
- School of Finance and Economics, Hainan Vocational University of Science and Technology, Haikou, China
| | - Yangli Zhu
- Student Affairs Office, Yunnan Normal University, Kunming, China
| | - Jun Li
- School of Finance and Economics, Hainan Vocational University of Science and Technology, Haikou, China
| | - Jiafu Liu
- Guizhou Education University, Guiyang, China
| | - Maozheng Fu
- School of Finance and Economics, Hainan Vocational University of Science and Technology, Haikou, China
| |
Collapse
|
7
|
Dietrich LG, Vögelin E, Deml MJ, Pastor T, Gueorguiev B, Pastor T. Quality of Life and Working Conditions of Hand Surgeons-A National Survey. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1450. [PMID: 37629740 PMCID: PMC10456479 DOI: 10.3390/medicina59081450] [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: 06/29/2023] [Revised: 08/04/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023]
Abstract
Background and Objectives: Providing high-quality care for patients in hand surgery is an everyday endeavor. However, the quality of life (QoL) and working conditions of hand surgeons ensuring these high-quality services need to be investigated. The aim of this study was to evaluate the QoL and working conditions of Swiss hand surgeons. Materials and Methods: A national survey with Swiss hand surgeons was conducted. Standardized questionnaires were completed anonymously online. Core topics included working conditions, QoL, satisfaction with the profession, and aspects of private life. Results: A total of 250 hand surgeons were invited to participate, of which 110 (44.0%) completed the questionnaire. Among all participants, 43.6% stated that they are on call 4-7 days per month, versus 8.2% never being on call. Overall, 84.0% of the residents, 50.0% of the senior physicians, 27.6% of the physicians in leading positions, and 40.6% of the senior consultants/practice owners, as well as 55.1% of the female and 44.3% of the male respondents, felt stressed by their job, even during holidays and leisure time. Out of all participants, 85.4% felt that work affects private relationships negatively. Despite the reported stress, 89.1% would choose hand surgery as a profession again. Less on-call duty (29.1%) and better pay (26.4%) are the most prioritized factors for attractiveness of a position at a hospital. Conclusions: The QoL of Swiss hand surgeons is negatively affected by their workload and working hours. Residents, senior physicians and female surgeons suffer significantly more often from depression, burnout or chronic fatigue in comparison to leading positions, senior consultants/practice owners and male surgeons. Better pay or less on-call duty would make the work more attractive in acute care hospitals.
Collapse
Affiliation(s)
- Léna G. Dietrich
- Department for Plastic and Hand Surgery, Inselspital University Hospital Bern, University of Bern, 3012 Bern, Switzerland; (L.G.D.); (E.V.); (T.P.)
| | - Esther Vögelin
- Department for Plastic and Hand Surgery, Inselspital University Hospital Bern, University of Bern, 3012 Bern, Switzerland; (L.G.D.); (E.V.); (T.P.)
| | - Michael J. Deml
- Department of Sociology, Institute of Sociological Research, University of Geneva, 1211 Geneva, Switzerland;
- Division of Social and Behavioural Sciences, School of Public Health, University of Cape Town, Cape Town 7925, South Africa
| | - Torsten Pastor
- Department of Orthopaedic and Trauma Surgery, Lucerne Cantonal Hospital, 6002 Lucerne, Switzerland;
| | | | - Tatjana Pastor
- Department for Plastic and Hand Surgery, Inselspital University Hospital Bern, University of Bern, 3012 Bern, Switzerland; (L.G.D.); (E.V.); (T.P.)
- AO Research Institute Davos, 7270 Davos, Switzerland
| |
Collapse
|
8
|
Tsang M, Banerjee R, Quiroga D, Idossa D, Schoenbeck KL. Where the Sidewalk Ends: Parenting as a trainee during COVID-19. Cancer Invest 2023:1-14. [PMID: 37243573 DOI: 10.1080/07357907.2023.2219747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/20/2023] [Accepted: 05/25/2023] [Indexed: 05/29/2023]
Abstract
Physicians who are also parents have faced significant difficulties during the COVID-19 pandemic. However, most studies of the physician-parent workforce have focused on the experiences of attending physicians. In this commentary, we highlight the ways that trainee parents have uniquely experienced three major stressors during the pandemic: (1) childcare challenges, (2) scheduling difficulties, and (3) career uncertainties. We discuss potential solutions to mitigate these challenges for the future hematology/oncology workforce. As the pandemic continues, we hope that these steps can improve the ability of trainee parents to care both for their patients and their families.
Collapse
Affiliation(s)
- Mazie Tsang
- Division of Hematology and Oncology, Department of Medicine, Mayo Clinic, Phoenix, AZ
| | - Rahul Banerjee
- Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, WA
| | - Dionisia Quiroga
- Division of Hematology/Oncology, Department of Medicine, Ohio State University
| | - Dame Idossa
- Division of Hematology, Oncology, and Transplantation Department of Medicine, University of Minnesota, Minneapolis, MN
| | - Kelly L Schoenbeck
- Division of Hematology/Oncology, Department of Medicine, San Francisco Veteran Affairs Medical Center, San Francisco, CA
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, San Francisco, CA
| |
Collapse
|
9
|
Valenzuela JY, Robitsek RJ, James MK, McKenzie K, Esposito TJ. COVID Stressed, but Not due to the Virus. J Surg Res 2023; 283:523-531. [PMID: 36436289 PMCID: PMC9686124 DOI: 10.1016/j.jss.2022.10.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 09/17/2022] [Accepted: 10/16/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Acute care surgeons can experience posttraumatic stress disorder (PTSD) due to the cumulative stress of practice. This study sought to document the potential impact of the COVID-19 pandemic on PTSD in acute care surgeons and to identify potential contributing factors. METHODS The six-item brief version of the PTSD Checklist-Civilian Version (PCL-6), a validated instrument capturing PTSD symptomology, was used to screen Eastern Association for the Surgery of Trauma members. Added questions gauged pandemic effects on professional and hospital systems-level factors. Regression modeling used responses from attending surgeons that fully completed the PCL-6. RESULTS Complete responses from 334 of 360 attending surgeons were obtained, with 58 of 334 (17%) screening positive for PTSD symptoms. Factors significantly contributing to both higher PCL-6 scores and meeting criteria for PTSD symptomology included decreasing age, increased administrative duties, reduced research productivity, nonurban practice setting, and loss of annual bonuses. Increasing PCL-6 score was also affected by perceived illness risk and higher odds of PTSD symptomology with elective case cancellation. For most respondents, fear of death and concerns of illness from COVID-19 were not associated with increased odds of PTSD symptomology. CONCLUSIONS The prevalence of PTSD symptomology in this sample was similar to previous reports using surgeon samples (15%-22%). In the face of the COVID-19 pandemic, stress was not directly related to infectious concerns but rather to the collateral challenges caused by the pandemic and unrelated demographic factors. Understanding factors increasing stress in acute care surgeons is critical as part of pandemic planning and management to reduce burnout and maintain a healthy workforce.
Collapse
Affiliation(s)
- Julie Y Valenzuela
- Department of Surgery, Jamaica Hospital Medical Center, Jamaica, New York.
| | | | - Melissa K James
- Department of Surgery, Jamaica Hospital Medical Center, Jamaica, New York
| | - Katherine McKenzie
- Department of Surgery, Jamaica Hospital Medical Center, Jamaica, New York
| | - Thomas J Esposito
- Department of Medicine, University of Illinois College of Medicine, Peoria, Illinois
| |
Collapse
|
10
|
Galhotra S, Smith RB, Norton T, Mahnert ND. The surgical gender gap: the impact of surgeon gender in medicine and gynecologic surgery. Curr Opin Obstet Gynecol 2022; 34:256-261. [PMID: 35895969 DOI: 10.1097/gco.0000000000000788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review is to summarize the current literature evaluating the effect of surgeon gender on patient outcomes and satisfaction, and the impact of gender bias on female surgeons. RECENT FINDINGS The proportion of female physicians has increased in recent years, especially in Obstetrics and Gynecology. Recent literature assessing this impact supports equivalent or superior medical and surgical outcomes for women surgeons and physicians. It also reveals superior counseling and communication styles as perceived by patients. However, women in medicine receive lower patient ratings in competence, medical knowledge, and technical skills despite the existing evidence. Additionally, female physicians experience pay inequality, limited advancement opportunities, higher prevalence of microaggressions, and higher rates of burnout. SUMMARY Recognition of gender bias is essential to correcting this issue and improving the negative impact it has on female physicians, our patients, and the field of women's health.
Collapse
Affiliation(s)
- Sheena Galhotra
- Banner University Medical Center Phoenix, University of Arizona College of Medicine Phoenix, Phoenix, Arizona, USA
| | | | | | | |
Collapse
|
11
|
Occupational Stress among Operation Room Clinicians at Ethiopian University Hospitals. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2022; 2022:2077317. [PMID: 35903183 PMCID: PMC9325338 DOI: 10.1155/2022/2077317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 06/17/2022] [Accepted: 06/20/2022] [Indexed: 11/17/2022]
Abstract
Background. The surgical operation room is a known stressor workplace. Occupational stress can cause negative impacts on the personal well-being of healthcare professionals, health services, and patient care. Since there was limited research evidence in Ethiopia and the developing world, we aimed to determine the prevalence and factors associated with occupational stress among operation room clinicians at university hospitals in Northwest Ethiopia, 2021. Methodology. After ethical approval was obtained, a cross-sectional census was conducted from May 10 to June 10, 2021. The United Kingdom Health and Safety Executive’s Management Standards Work-Related Stress Indicator Tool was used to assess occupational stress. Data were collected from 388 operation room clinicians and analysed by using binary logistic regression analysis. Results. The prevalence of occupational stress was 78.4%. Rotating work shifts (AOR: 2.1, CI: 1.1–4.7), working more than 80 hours per week (AOR: 3.3, CI: 1.5–3.8), use of recreational substances (AOR: 2.1, CI: 1.1–3.8), being an anesthetist (AOR: 4.1, CI: 1.7–10.0), and being a nurse (AOR: 4.0, CI: 1.7–9.7) were found significantly associated with occupational stress. Conclusion. We found that there was high prevalence of occupational stress among operation room clinicians and factors associated with occupational stress were rotating work shifts, working more than 80 hours per week, use of recreational substances, being an anesthetist, and being a nurse. Hospitals are advised to arrange occupational health services for operation room clinicians, prepare sustainable training focused on occupational health, and reorganize shifts, working hours, and staffing.
Collapse
|
12
|
Abouelazayem M, Viswanath YKS, Bangash AH, Herrera Kok JH, Cheruvu C, Parmar C, Atici SD, Yang W, Galanis M, Di Maggio F, Isik A, Bandyopadhyay SK. The global level of harm among surgical professionals during the COVID-19 pandemic: A multinational cross-sectional cohort study. Surgery 2022; 171:1494-1499. [PMID: 35287957 PMCID: PMC8916612 DOI: 10.1016/j.surg.2022.01.039] [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: 07/03/2021] [Revised: 01/25/2022] [Accepted: 01/27/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Health care workers, including surgical professionals, experienced psychological burnout and physical harm during the coronavirus 2019 pandemic. This global survey investigated the coronavirus 2019 pandemic impact on psychological and physical health. METHODS We conducted a global cross-sectional survey between February 18, 2021 and March 13, 2021. The primary outcome was to assess the psychological burnout, fulfillment, and self-reported physical level of harm. A validated Stanford Professional Fulfilment Index score with a self-reported physical level of harm was employed. We used a practical overall composite level of harm score to calculate the level of harm gradient 1-4, combining psychological burnout with self-reported physical level of harm score. RESULTS A total of 545 participants from 66 countries participated. The final analysis included 520 (95.4%) surgical professionals barring medical students. Most of the participants (81.3%) were professionally unfulfilled. The psychological burnout was evident in 57.7% and was significantly common in those <50 years (P = .002) and those working in the public sector (P = .005). Approximately 41.7% of respondents showed changes in the physical health with self-remedy and no impact on work, whereas 14.9% reported changes to their physical health with <2 weeks off work, and 10.1% reported changes in physical health requiring >2 weeks off work. Severe harm (level of harm 4) was detected in 10.6%, whereas moderate harm (level of harm 3) affected 40.2% of the participants. Low and no harm (level of harm 2 and level of harm 1) represented 27.5% and 21.7%, respectively. CONCLUSION Our study showed that high levels of psychological burnout, professional unfulfillment, work exhaustion, and severe level of harm was more frequent in younger professionals working in the public sector. The findings correlated with a high level of harm in surgical professionals impacting surgical services.
Collapse
Affiliation(s)
- Mohamed Abouelazayem
- Department of Surgery, St George's University Hospitals NHS Foundation Trust, London, UK; Department of Surgery, National Cancer Institute, Cairo University, Egypt
| | | | | | - Johnn Henry Herrera Kok
- Department of General and Digestive Surgery, Complejo Asistencial Universitario de León, Spain
| | - Chandra Cheruvu
- Department of Surgery, University Hospital North Midlands, Stoke-on-Trent, UK
| | - Chetan Parmar
- Department of Surgery, Whittington Health NHS Trust, London, UK
| | - Semra Demirli Atici
- Department of Surgery, University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey
| | - Wah Yang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Michail Galanis
- Department of Surgery, University Hospital Bielefeld, Germany
| | - Francesco Di Maggio
- Department of Surgery, Barking Havering and Redbridge University Hospital NHS Trust, Romford, UK
| | - Arda Isik
- Department of Surgery, Istanbul Medeniyet University, Turkey
| | | |
Collapse
|
13
|
Obeng-Gyasi S. We need to talk about Covid-19 pandemic related stress. Am J Surg 2022; 224:1197-1198. [PMID: 35660084 PMCID: PMC9148442 DOI: 10.1016/j.amjsurg.2022.05.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 05/23/2022] [Indexed: 12/03/2022]
|
14
|
Longitudinal evaluation of the surgical workforce experience during the Covid-19 pandemic. Am J Surg 2022; 224:1199-1206. [PMID: 35491244 PMCID: PMC9049639 DOI: 10.1016/j.amjsurg.2022.04.015] [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] [Received: 12/20/2021] [Revised: 03/20/2022] [Accepted: 04/14/2022] [Indexed: 11/22/2022]
Abstract
Background An updated examination of the surgeon experience during the Covid-19 pandemic is lacking. This study sought to describe how surgeon stress levels and sources of stress evolved over the pandemic. Methods An electronic survey was administered to surgeons at four academic hospitals at 6-months and 12-months following an initial telephone survey. The primary outcome was stress level and secondary outcomes were the individual stressors. Thematic analysis was applied to free text responses. Results A total of 103 and 53 responses were received at 6-months and 12-months, respectively. The mean overall stress level was 5.35 (SD 1.89) at 6-months and 4.83 (SD 2.19) at 12-months. Mean number of stressors declined from 3.77 (SD 2.39) to 2.06 (SD 1.60, P < 0.001), though the “finances” stressor increased frequency (27.2% to 34.0%). Similar qualitative themes were identified, however codes for financial and capacity challenges were more prominent at 12-months. Conclusions The surgical workforce continues to report elevated levels of stress, though the sources of this stress have changed. Targeted interventions are imperative to protect surgeons from long-term psychological and financial harm.
Collapse
|
15
|
Levine H, Baranchuk N, Li T, Garra G, Nagarajan MS, Garg N. An emergency medicine physician well-being study focusing on gender differences and years of practice during the COVID-19 pandemic. Am J Emerg Med 2022; 55:84-88. [PMID: 35287093 PMCID: PMC8891117 DOI: 10.1016/j.ajem.2022.02.055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/22/2022] [Accepted: 02/26/2022] [Indexed: 12/20/2022] Open
Affiliation(s)
- Heidi Levine
- South Shore University Hospital, Department of Emergency Medicine, 301 East Main Street, Bay Shore, New York 11706, United States of America.
| | - Nadia Baranchuk
- South Shore University Hospital, Department of Emergency Medicine, 301 East Main Street, Bay Shore, New York 11706, United States of America.
| | - Timmy Li
- North Shore University Hospital/Northwell Health Zucker School of Medicine, 300 Community Drive, Manhasset, NY 11030, United States of America.
| | - Gabrielle Garra
- South Shore University Hospital, Department of Emergency Medicine, 301 East Main Street, Bay Shore, New York 11706, United States of America
| | - Mohanapriya Sayeen Nagarajan
- South Shore University Hospital, Department of Emergency Medicine, 301 East Main Street, Bay Shore, New York 11706, United States of America.
| | - Nidhi Garg
- South Shore University Hospital, Department of Emergency Medicine, 301 East Main Street, Bay Shore, New York 11706, United States of America.
| |
Collapse
|
16
|
COVID-19 induced PTSD: Stressors for trauma and acute care surgeons. Am J Surg 2022; 224:843-848. [PMID: 35277241 PMCID: PMC8896861 DOI: 10.1016/j.amjsurg.2022.02.060] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/17/2022] [Accepted: 02/25/2022] [Indexed: 11/23/2022]
Abstract
Background At the peak of the pandemic, acute care surgeons at many hospitals were reassigned to treat COVID-19 patients. However, the effect of the pandemic on this population who are well versed in stressful practice has not been fully explored. Methods A web-based survey was distributed to the members of the Eastern Association for the Surgery of Trauma (EAST). PTSD and the personal and professional impact of the pandemic were assessed. A positive screen was defined as a severity score of ≥14 or a symptomatic response to at least 5 of the 6 questions on the screen. Results A total of 393 (17.8%) participants responded to the survey. The median age was 43 (IQR: 38-52) and 238 (60.6%) were male. The majority of participants were surgeons (351, 89.3%), specializing in general surgery/trauma (379, 96.4%). The main practice type and setting were hospital-based (350, 89%) and university hospital (238, 60.6%), respectively. The incidence of PTSD was 16.3% when a threshold severity score of ≥14 was used and 5.6% when symptomatic responses were assessed. Risk factors for a positive PTSD screen included being single/unmarried (p = 0.02), having others close to you contract COVID-19 (p = 0.02), having family issues due to COVID-19 (p = 0.0004), rural (p = 0.005) and suburban (p = 0.047) practice settings, a fear of going to work (p = 0.001), and not having mental health resources provided at work (p = 0.03). Conclusion The COVID-19 pandemic had a psychological impact on surgeons. Although acute care surgeons are well versed in stressful practice, the pandemic nevertheless induced PTSD symptoms in this population, suggesting the need for mental health resources.
Collapse
|
17
|
Parlangeli O, Palmitesta P, Bracci M, Marchigiani E, Di Pomponio I, Guidi S. University Teachers During the First Lockdown Due to SARS-CoV-2 in Italy: Stress, Issues and Perceptions of Misconduct. SCIENCE AND ENGINEERING ETHICS 2022; 28:9. [PMID: 35166946 PMCID: PMC8847283 DOI: 10.1007/s11948-022-00362-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 01/13/2022] [Indexed: 06/14/2023]
Abstract
With the spread of the pandemic and the introduction of measures aimed at its containment, it is necessary to understand in specific national contexts how home quarantine has affected the psychophysical well-being of academics, and their ability to maintain integrity. To this end we constructed an online questionnaire to investigate the levels of stress, well-being, and work-life balance in relationship with living and working conditions. Moreover, the questionnaire was designed to obtain information about the perceived occurrence, increase or decrease of misconduct in research (e.g., research misconduct by colleagues) and professional relationships (e.g., misbehaviors between colleagues, from students and toward students). The questionnaire was administered online by contacting faculty at three universities in Tuscany, Italy, asking them to relate their experience during the first lockdown (March-May 2020). Faculty members were invited to complete the questionnaire by their institutional e-mail account. The final sample consisted of 581 respondents. The results showed that inadequacies of the equipment, and particularly poor internet connection, were significantly correlated with main issues reported, such as relationships with students and research activities. Female teachers primarily suffered from stressful conditions, lacked well-being, and experienced work-life imbalance. Stress levels were related to perceptions of the frequency of misconduct and of an increase in their frequency during the period of home quarantine. Female professors, when compared to their male counterparts, perceived misconduct from students as increased and more frequent in the period of quarantine. Results point to a gender issue that is likely to arise from conditions of domestic activities imbalance and that increases stress and misconduct perception.
Collapse
Affiliation(s)
- Oronzo Parlangeli
- Department of Social, Political and Cognitive Sciences, University of Siena, Via Roma 56, 53100, Siena, Italy.
| | - Paola Palmitesta
- Department of Social, Political and Cognitive Sciences, University of Siena, Via Roma 56, 53100, Siena, Italy
| | - Margherita Bracci
- Department of Social, Political and Cognitive Sciences, University of Siena, Via Roma 56, 53100, Siena, Italy
| | - Enrica Marchigiani
- Department of Social, Political and Cognitive Sciences, University of Siena, Via Roma 56, 53100, Siena, Italy
| | - Ileana Di Pomponio
- Department of Social, Political and Cognitive Sciences, University of Siena, Via Roma 56, 53100, Siena, Italy
| | - Stefano Guidi
- Department of Social, Political and Cognitive Sciences, University of Siena, Via Roma 56, 53100, Siena, Italy.
| |
Collapse
|
18
|
Cobianchi L, Dal Mas F, Massaro M, Fugazzola P, Coccolini F, Kluger Y, Leppäniemi A, Moore EE, Sartelli M, Angelos P, Catena F, Ansaloni L. Team dynamics in emergency surgery teams: results from a first international survey. World J Emerg Surg 2021; 16:47. [PMID: 34530891 PMCID: PMC8443910 DOI: 10.1186/s13017-021-00389-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 08/20/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Emergency surgery represents a unique context. Trauma teams are often multidisciplinary and need to operate under extreme stress and time constraints, sometimes with no awareness of the trauma's causes or the patient's personal and clinical information. In this perspective, the dynamics of how trauma teams function is fundamental to ensuring the best performance and outcomes. METHODS An online survey was conducted among the World Society of Emergency Surgery members in early 2021. 402 fully filled questionnaires on the topics of knowledge translation dynamics and tools, non-technical skills, and difficulties in teamwork were collected. Data were analyzed using the software R, and reported following the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). RESULTS Findings highlight how several surgeons are still unsure about the meaning and potential of knowledge translation and its mechanisms. Tools like training, clinical guidelines, and non-technical skills are recognized and used in clinical practice. Others, like patients' and stakeholders' engagement, are hardly implemented, despite their increasing importance in the modern healthcare scenario. Several difficulties in working as a team are described, including the lack of time, communication, training, trust, and ego. DISCUSSION Scientific societies should take the lead in offering training and support about the abovementioned topics. Dedicated educational initiatives, practical cases and experiences, workshops and symposia may allow mitigating the difficulties highlighted by the survey's participants, boosting the performance of emergency teams. Additional investigation of the survey results and its characteristics may lead to more further specific suggestions and potential solutions.
Collapse
Affiliation(s)
- Lorenzo Cobianchi
- Department of Clinical, Diagnostic and Pediatric Sciences, University of Pavia, Polo Didattico "Cesare Brusotti" Viale Brambilla, 74, 27100, Pavia, Italy.
- IRCCS Policlinico San Matteo Foundation, General Surgery, Viale Camillo Golgi, 19, 27100, Pavia, Italy.
| | - Francesca Dal Mas
- Department of Management, Lincoln International Business School, University of Lincoln, Lincoln, UK
| | | | - Paola Fugazzola
- IRCCS Policlinico San Matteo Foundation, General Surgery, Viale Camillo Golgi, 19, 27100, Pavia, Italy
| | - Federico Coccolini
- Department of Surgery, University of Pisa, Pisa, Italy
- General, Emergency and Trauma Surgery, Pisa University Hospital, Pisa, Italy
| | - Yoram Kluger
- Department of General Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Ari Leppäniemi
- Abdominal Center, University Hospital Meilahti, Helsinki, Finland
| | | | - Massimo Sartelli
- Department of General Surgery, Macerata's Hospital, Macerata, Italy
| | - Peter Angelos
- Department of Surgery and MacLean Center for Clinical Medical Ethics, The University of Chicago, Chicago, IL, USA
| | - Fausto Catena
- General and Emergency Surgery, Bufalini Hospital, Cesena, Italy
| | - Luca Ansaloni
- Department of Clinical, Diagnostic and Pediatric Sciences, University of Pavia, Polo Didattico "Cesare Brusotti" Viale Brambilla, 74, 27100, Pavia, Italy
- IRCCS Policlinico San Matteo Foundation, General Surgery, Viale Camillo Golgi, 19, 27100, Pavia, Italy
| | | |
Collapse
|
19
|
Response to COMMENT on: "The Relationship between Surgeon Gender and Stress During the Covid-19 Pandemic". Ann Surg 2021; 274:e915-e916. [PMID: 34225293 DOI: 10.1097/sla.0000000000005039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
20
|
Comment on "The Relationship Between Surgeon Gender and Stress During the Covid-19 Pandemic" Mavrouidis C L et al. Ann Surg 2021; 274:e915. [PMID: 34171861 DOI: 10.1097/sla.0000000000005020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|