학술논문
Wellness and Coping of Physicians Who Worked in ICUs During the Pandemic: A Multicenter Cross-Sectional North American Survey*
Document Type
article
Author
Burns, Karen EA; Moss, Marc; Lorens, Edmund; Jose, Elizabeth Karin Ann; Martin, Claudio M; Viglianti, Elizabeth M; Fox-Robichaud, Alison; Mathews, Kusum S; Akgun, Kathleen; Jain, Snigdha; Gershengorn, Hayley; Mehta, Sangeeta; Han, Jenny E; Martin, Gregory S; Liebler, Janice M; Stapleton, Renee D; Trachuk, Polina; Vranas, Kelly C; Chua, Abigail; Herridge, Margaret S; Tsang, Jennifer LY; Biehl, Michelle; Burnham, Ellen L; Chen, Jen-Ting; Attia, Engi F; Mohamed, Amira; Harkins, Michelle S; Soriano, Sheryll M; Maddux, Aline; West, Julia C; Badke, Andrew R; Bagshaw, Sean M; Binnie, Alexandra; Carlos, W Graham; Çoruh, Başak; Crothers, Kristina; D’Aragon, Frederick; Denson, Joshua Lee; Drover, John W; Eschun, Gregg; Geagea, Anna; Griesdale, Donald; Hadler, Rachel; Hancock, Jennifer; Hasmatali, Jovan; Kaul, Bhavika; Kerlin, Meeta Prasad; Kohn, Rachel; Kutsogiannis, D James; Matson, Scott M; Morris, Peter E; Paunovic, Bojan; Peltan, Ithan D; Piquette, Dominique; Pirzadeh, Mina; Pulchan, Krishna; Schnapp, Lynn M; Sessler, Curtis N; Smith, Heather; Sy, Eric; Thirugnanam, Subarna; McDonald, Rachel K; McPherson, Katie A; Kraft, Monica; Spiegel, Michelle; Dodek, Peter M; Society, for the Diversity-Related Research Committee of the Women in Critical Care Interest Group of the American Thoracic
Source
Critical Care Medicine. 50(12)
Subject
Language
Abstract
ObjectivesFew surveys have focused on physician moral distress, burnout, and professional fulfilment. We assessed physician wellness and coping during the COVID-19 pandemic.DesignCross-sectional survey using four validated instruments.SettingSixty-two sites in Canada and the United States.SubjectsAttending physicians (adult, pediatric; intensivist, nonintensivist) who worked in North American ICUs.InterventionNone.Measurements and main resultsWe 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 COVID-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.ConclusionsDespite 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.