Wellness and Coping of Physicians Who Worked in ICUs During the Pandemic: A Multicenter Cross-Sectional North American Survey

被引：20

作者：

Burns, Karen E. A. ^{[1
,2
,3
]}

Moss, Marc ^{[4
,5
]}

Lorens, Edmund ^{[2
,3
]}

Jose, Elizabeth Karin Ann ^{[6
]}

Martin, Claudio M. ^{[7
]}

Viglianti, Elizabeth M. ^{[8
]}

Fox-Robichaud, Alison ^{[9
]}

Mathews, Kusum S. ^{[10
]}

Akgun, Kathleen ^{[11
]}

Jain, Snigdha ^{[12
]}

Gershengorn, Hayley ^{[13
]}

Mehta, Sangeeta ^{[14
]}

Han, Jenny E. ^{[15
]}

Martin, Gregory S. ^{[15
]}

Liebler, Janice M. ^{[16
]}

Stapleton, Renee D. ^{[17
]}

Trachuk, Polina ^{[18
]}

Vranas, Kelly C. ^{[19
]}

Chua, Abigail ^{[20
]}

Herridge, Margaret S. ^{[21
]}

Tsang, Jennifer L. Y. ^{[22
]}

Biehl, Michelle ^{[23
,24
]}

Burnham, Ellen L. ^{[25
]}

Chen, Jen-Ting ^{[26
]}

Attia, Engi F. ^{[27
]}

Mohamed, Amira ^{[28
]}

Harkins, Michelle S. ^{[29
]}

Soriano, Sheryll M. ^{[30
]}

Maddux, Aline ^{[4
,5
]}

West, Julia C. ^{[31
]}

Badke, Andrew R. ^{[32
]}

Bagshaw, Sean M. ^{[33
]}

Binnie, Alexandra ^{[34
]}

Carlos, W. Graham ^{[35
]}

Coruh, Basak ^{[36
]}

Crothers, Kristina ^{[37
]}

D'Aragon, Frederick ^{[38
]}

Denson, Joshua Lee ^{[39
]}

Drover, John W. ^{[40
]}

Eschun, Gregg ^{[41
]}

Geagea, Anna ^{[42
]}

Griesdale, Donald ^{[43
]}

Hadler, Rachel ^{[44
]}

Hancock, Jennifer ^{[45
]}

Hasmatali, Jovan ^{[46
]}

Kaul, Bhavika ^{[47
]}

Kerlin, Meeta Prasad ^{[48
]}

Kohn, Rachel ^{[48
]}

Kutsogiannis, D. James ^{[49
]}

Matson, Scott M. ^{[50
]}

机构：

[1] Unity Hlth Toronto St Michaels Hosp, Toronto, ON, Canada

[2] Univ Toronto, Dept Med, Toronto, ON, Canada

[3] Univ Toronto, Interdept Div Crit Care Med, Toronto, ON, Canada

[4] Univ Colorado, Anschutz Med Campus, Aurora, CO USA

[5] Childrens Hosp Colorado, Aurora, CO USA

[6] Royal Coll Surg Ireland, Bahrain Campus, Adiiya, Bahrain

[7] London Hlth Sci, Div Crit Care, London Hlth Sci Ctr, London, ON, Canada

[8] Univ Michigan, Dept Internal Med, Div Pulm & Crit Care Med, Med Sch, Ann Arbor, MI USA

[9] McMaster Univ, Dept Med, Div Crit Care, Hamilton, ON, Canada

[10] Icahn Sch Med Mt Sinai, Dept Med, Div Pulm Crit Care & Sleep Med, New York, NY 10029 USA

[11] VA Connecticut Healthcare Syst, Sect Pulm Crit Care & Sleep Med, West Haven, CT USA

[12] Yale Sch Med, Sect Pulm Crit Care & Sleep Med, New Haven, CT USA

[13] Univ Miami, Miller Sch Med, Div Pulm Crit Care & Sleep Med, Miami, FL 33136 USA

[14] Sinai Hlth, Toronto, ON, Canada

[15] Emory Univ, Dept Med, Div Pulm Allergy Crit Care & Sleep Med, Atlanta, GA 30322 USA

[16] Univ Southern Calif, Div Pulm Crit Care & Sleep Med, Los Angeles, CA 90007 USA

[17] Univ Vermont, Dept Med, Div Pulm & Crit Care Med, Larner Coll Med, Burlington, VT USA

[18] New York Univ Langone Hlth, Dept Med, Div Pulm Crit Care & Sleep Med, New York, NY USA

[19] Oregon Hlth & Sci Univ, Div Pulm Allergy & Crit Care Med, Portland, OR 97201 USA

[20] Stony Brook Sch Med, Stony Brook, NY USA

[21] Univ Toronto, Univ Hlth Network, Interdept Div Crit Care Med, Toronto, ON, Canada

[22] Niagara Hlth, St Catharines, ON, Canada

[23] Cleveland Clin, Resp Inst, Dept Crit Care Med, Cleveland, OH 44106 USA

[24] Cleveland Clin, Resp Inst, Dept Pulm Med, Cleveland, OH 44106 USA

[25] Montefiore Med Ctr, Dept Med, Div Pulm Sci & Crit Care Med, Bronx, NY USA

[26] Univ Washington, Harborview Med Ctr, 325 9th Ave, Seattle, WA 98104 USA

[27] Univ Washington, Harborview Med Ctr, Dept Med, Div Crit Care Med, Seattle, WA 98104 USA

[28] Montefiore Med Ctr, Dept Internal Med, Div Pulm Crit Care & Sleep, 111 E 210th St, Bronx, NY 10467 USA

[29] Univ New Mexico, Dept Med, Div Pulm Crit Care & Sleep Med, Albuquerque, NM 87131 USA

[30] Order St Francis OSF Healthcare, OSF Med Grp, Pulm & Crit Care Div, Peoria, IL USA

[31] Dartmouth Hitchcock Med Ctr, Dept Pediat, Sect Crit Care Med, Lebanon, NH 03766 USA

[32] Intermt Healthcare, LDS Hosp, Pulm & Crit Care, Salt Lake City, UT USA

[33] Univ Alberta, Dept Crit Care Med, Edmonton, AB, Canada

[34] William Osler Hlth Syst, Dept Crit Care Med, Toronto, ON, Canada

[35] Indiana Univ Sch Med, Dept Med, Indianapolis, IN 46202 USA

[36] Univ Washington, Div Pulm Crit Care & Sleep Med, Seattle, WA 98195 USA

[37] Vet Affairs Puget Sound Hlth Care, Div Pulm Crit Care & Sleep Med, Dept Med, Seattle, WA USA

[38] Univ Sherbrooke, Dept Anesthesia, Sherbrooke, PQ, Canada

[39] Tulane Univ, Sch Med, Sect Pulm Dis Crit Care & Environm Med, 1430 Tulane Ave, New Orleans, LA 70112 USA

[40] Queens Univ, Dept Crit Care Med, Kingston, ON, Canada

[41] Univ Manitoba, Sect Crit Care, Winnipeg, MB, Canada

[42] North York Gen Hosp, Dept Med, Div Crit Care, Toronto, ON, Canada

[43] Univ British Columbia, Dept Anesthesiol Pharmacol & Therapeut, Vancouver, BC, Canada

[44] Univ Iowa Hosp & Clin, Dept Anesthesia, Iowa City, IA 52242 USA

[45] Dalhousie Univ, Dept Crit Care, Halifax, NS, Canada

[46] Hlth Sci Ctr, Dept Crit Care, Winnipeg, MB, Canada

[47] Univ Calif San Francisco, Div Pulm & Crit Care Med, San Francisco, CA 94143 USA

[48] Univ Penn, Dept Med, Perelman Sch Med, Philadelphia, PA 19104 USA

[49] Univ Alberta, Fac Med & Dent, Dept Crit Care Med, Edmonton, AB, Canada

[50] Univ Kansas, Dept Med, Sch Med, Div Pulm Crit Care & Sleep Med, Kansas City, KS USA

来源：

CRITICAL CARE MEDICINE | 2022年 / 50卷 / 12期

关键词：

burnout; coping; moral distress; pandemic; wellness; BURNOUT; GUIDE;

D O I：

10.1097/CCM.0000000000005674

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

OBJECTIVES: Few surveys have focused on physician moral distress, burnout, and professional fulfilment. We assessed physician wellness and coping during the COVID-19 pandemic. DESIGN: Cross-sectional survey using four validated instruments. SETTING: Sixty-two sites in Canada and the United States. SUBJECTS: Attending physicians (adult, pediatric; intensivist, nonintensivist) who worked in North American ICUs. INTERVENTION: None. MEASUREMENTS AND MAIN RESULTS: We analysed 431 questionnaires (43.3% response rate) from 25 states and eight provinces. Respondents were predominantly male (229 [55.6%]) and in practice for 11.8 +/- 9.8 years. Compared with prepandemic, respondents reported significant intrapandemic increases in days worked/mo, ICU bed occupancy, and self-reported moral distress (240 [56.9%]) and burnout (259 [63.8%]). Of the 10 top-ranked items that incited moral distress, most pertained to regulatory/organizational (n = 6) or local/institutional (n = 2) issues or both (n = 2). Average moral distress (95.6 +/- 66.9), professional fulfilment (6.5 +/- 2.1), and burnout scores (3.6 +/- 2.0) were moderate with 227 physicians (54.6%) meeting burnout criteria. A significant dose-response existed between COVI D-19 patient volume and moral distress scores. Physicians who worked more days/mo and more scheduled in-house nightshifts, especially combined with more unscheduled in-house nightshifts, experienced significantly more moral distress. One in five physicians used at least one maladaptive coping strategy. We identified four coping profiles (active/social, avoidant, mixed/ambivalent, infrequent) that were associated with significant differences across all wellness measures. CONCLUSIONS: Despite moderate intrapandemic moral distress and burnout, physicians experienced moderate professional fulfilment. However, one in five physicians used at least one maladaptive coping strategy. We highlight potentially modifiable factors at individual, institutional, and regulatory levels to enhance physician wellness.

引用

页码：1689 / 1700

页数：12

共 32 条

[1]

[Anonymous], 2018, TRIC POL STAT ETH CO

[2] Clinician Wellness During the COVID-19 Pandemic: Extraordinary Times and Unusual Challenges for the Allergist/Immunologist [J].

Bansal, Priya ;

Bingemann, Theresa A. ;

Greenhawt, Matthew ;

Mosnaim, Giselle ;

Nanda, Anil ;

Oppenheimer, John ;

Sharma, Hemant ;

Stukus, David ;

Shaker, Marcus .

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE, 2020, 8 (06) :1781-+

[3] A Qualitative Study Exploring Moral Distress in the ICU Team: The Importance of Unit Functionality and Intrateam Dynamics [J].

Bruce, Courtenay R. ;

Miller, Susan M. ;

Zimmerman, Janice L. .

CRITICAL CARE MEDICINE, 2015, 43 (04) :823-831

[4] A guide for the design and conduct of self-administered surveys of clinicians [J].

Burns, Karen E. A. ;

Duffett, Mark ;

Kho, Michelle E. ;

Meade, Maureen O. ;

Adhikari, Neill K. J. ;

Sinuff, Tasnim ;

Cook, Deborah J. .

CANADIAN MEDICAL ASSOCIATION JOURNAL, 2008, 179 (03) :245-252

[5] The impact of organizational culture on professional fulfillment and burnout in an academic department of medicine [J].

Burns, Karen E. A. ;

Pattani, Reena ;

Lorens, Edmund ;

Straus, Sharon E. ;

Hawker, Gillian A. .

PLOS ONE, 2021, 16 (06)

[6]

Burns KEA, 2019, CAN J ANESTH, V66, P503, DOI 10.1007/s12630-019-01321-y

[7] How to assess a survey report: a guide for readers and peer reviewers [J].

Burns, Karen E. A. ;

Kho, Michelle E. .

CANADIAN MEDICAL ASSOCIATION JOURNAL, 2015, 187 (06) :E198-E205

[8] Professional Quality of Life and Mental Health Outcomes among Health Care Workers Exposed to Sars-Cov-2 (Covid-19) [J].

Buselli, Rodolfo ;

Corsi, Martina ;

Baldanzi, Sigrid ;

Chiumiento, Martina ;

Del Lupo, Elena ;

Dell'Oste, Valerio ;

Bertelloni, Carlo Antonio ;

Massimetti, Gabriele ;

Dell'Osso, Liliana ;

Cristaudo, Alfonso ;

Carmassi, Claudia .

INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, 2020, 17 (17) :1-12

[9] ASSESSING COPING STRATEGIES - A THEORETICALLY BASED APPROACH [J].

CARVER, CS ;

SCHEIER, MF ;

WEINTRAUB, JK .

JOURNAL OF PERSONALITY AND SOCIAL PSYCHOLOGY, 1989, 56 (02) :267-283

[10] Predicting Brain Death After Out-of-Hospital Cardiac Arrest With a Score Is It Possible? Response [J].

Cour, Martin ;

Cariou, Alain ;

Argaud, Laurent .

CHEST, 2021, 160 (06) :E673-E674

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