A survey of Canadian respiratory therapists working in the COVID-19 pandemic: The RRT perspective.

Introduction: Registered respiratory therapists (RRTs) are heavily involved in the care of individuals infected with COVID-19. The experiences and challenges specific to the RRT profession during the pandemic have not been qualified and the aim of this study is to bridge that gap. Methods: With institutional ethics approval, a cross-sectional survey was created through the survey software Redcap and made available online from 29 May to 6 July 2020. Any RRT working in Canada during the COVID-19 pandemic was eligible to participate. Responses to yes/no questions were calculated as frequencies and percentages, and free-text responses were summarized. Results: In total, 345 RRTs working in 11/13 of the provinces and territories, with varying years of experience completed the survey. The results reflected impacts of the pandemic that affected RRTs in a variety of ways at work, from being reassigned (30.7%) to caring for COVID-19 positive patients (57.4%) and intubated COVID-19 positive patients (50.7%). RRTs experienced communication issues around guidelines (66.7%) and some departments had run out of personal protective equipment (PPE; 19%). RRTs were personally impacted, including feeling overwhelmed by new and frequently changing guidelines (89.6%) and feeling concerned for themselves or their family members becoming infected because of their proximity to COVID-19 positive patients (89%). Discussion: RRTs reported being required to work more during the pandemic. The unpredictability and constantly changing schedules were sources of stress and anxiety. RRTs were faced with issues of overwhelming amounts of new information and had difficulty in disseminating it in a timely manner. Lack of guidance and lack of confidence in the current protocols added to the confusion, anxiety, and stress. RRTs were at the center of many high-risk moments for contracting the virus (intubation, extubation), and PPE shortages were a major challenge reported. RRTs working during the pandemic have been concerned for their own health and the health of their family members. Conclusion: The COVID-19 pandemic adds another layer of stress for RRT professionals who are working in high-risk situations and feel anxious, overwhelmed, and concerned about their personal safety.

Pandemic-related factors predicting physician burnout beyond established organizational factors: cross-sectional results from the COPING survey.

The COVID-19 pandemic has increased physician burnout beyond high baseline levels. We aimed to determine whether pandemic-related factors contribute to physician burnout beyond known organizational factors. This was a cross-sectional survey of Canadian physicians using a convenience sample. Eligible participants included any physician currently holding a license to practice in Canada. Responses were gathered from May 13 to 12 June 2020. Risk factors measured included the newly developed Pandemic Experiences and Perceptions Scale (PEPS) subscales, contact with virus, pandemic preparation, and provincial caseload. The primary outcome was the Maslach Burnout Inventory (MBI). The primary outcome was completed by 309 respondents. Latent profile analysis found 107 (34.6%) respondents were burned out. In multivariate analysis, exhaustion was independently associated with PEPS adequacy, risk perception, and worklife subscales (adjusted R2 = 0.236, P < 0.001). Cynicism was associated with exhaustion, and PEPS worklife (adjusted R2 = 0.543, P < 0.001). Efficacy was associated with cynicism, PEPS worklife, and active cases (adjusted R2 = 0.152, P < 0.001). Structural equation modelling showed statistically significant direct paths between PEPS areas of worklife and all MBI subscales. Contact with virus, preparation, and PEPS risk perception added to the prediction of MBI exhaustion. Among a sample of Canadian physicians during the COVID-19 pandemic, adequacy of resources, risk perception, and quality of worklife were associated with burnout indices. To mitigate physician burnout organizations should work to improve working conditions, ensure adequate resources, and foster perceived control of risk of transmission.Trial Registration: NCT04379063.

COVID-19 impact and response by Canadian pain clinics: A national survey of adult pain clinics.

Background: As the result of public health authority responses to the COVID-19 pandemic, pain clinics have had to cease providing in-person appointments to reduce contact between patients and staff. Over the past decade, Canadians living with chronic pain have faced long waiting times for care within multidisciplinary pain clinics. We are concerned that ceasing in-person pain services exacerbates the daily hardships already faced by Canadians living with chronic pain. Aims: The aim of this study was to evaluate the impact of the COVID-19 pandemic on Canadian pain clinics, their responses, and changes to clinic practices that might be maintained when the pandemic is over. Methods: A survey of Canadian adult multidisciplinary pain clinics was conducted to determine impacts on medical and allied health care services and the strategies used to deliver care to patients during the COVID-19 pandemic. Results: Responses received from 17 adult pain clinics across Canada showed that adult multidisciplinary pain clinics had to cease or significantly reduce in-person patient contacts during the COVID-19 pandemic and responded by offering telehealth options. Despite their efforts, patients are waiting longer and have lost access to usual care. Increased levels of pain, stress, and medication use, particularly opioids and cannabinoids, were reported. Conclusions: Access to adaptable and innovative technologies, such as telehealth, can assist in the care of the one in five Canadians living with chronic pain during times of crises and must be included as a vital component of a comprehensive Canadian pain strategy.

Contexte: Suite aux mesures prises par les autorités de santé publique en réponse à la pandémie de COVID-19, les cliniques antidouleur ont dû cesser de proposer des rendez-vous en personne afin de réduire les contacts entre les patients et le personnel. Au cours de la dernière décennie, les Canadiens vivant avec la douleur chronique ont dû faire face à de longs délais d'attente pour obtenir des soins dans les cliniques antidouleur multidisciplinaires. Nous sommes préoccupés par le fait que l'arrêt des services antidouleur en personne exacerbe les difficultés quotidiennes auxquelles sont déjà confrontés les Canadiens qui vivent avec la douleur chronique.Objectifs: Cette étude visait à évaluer les repercussions de la pandémie de COVID-19 sur les cliniques antidouleur au Canada, leurs réactions et les changements dans leurs pratiques qui pourraient être maintenus en raison de la pandémie.Méthodes: Une enquête a été menée auprès des cliniques antidouleur multidisciplinaires pour adultes au Canada afin de determiner les répercussions sur les services médicaux et les services paramédicaux, ainsi que les strategies utilisées pout fournir des soins de santé aux patients pendant la pandémie de COVID-19.Résultats: Les réponses reçues de 17 cliniques antidouleur pour adultes au Canada ont montré que les cliniques antidouleur multidisciplinaires pour adultes avaient dû cesser ou réduire considérablement les contacts en personne avec les patients pendant la COVID-19 et qu'elles ont réagi en proposant des options de télésanté. Malgré leurs efforts, les patients attendent plus longtemps et n'ont plus accès aux soins habituels. L'augmentation des niveaux de douleur, de stress et de médication, en particulier les opioïdes et les cannabioïdes, a été signalée.Conclusion: L'accès à des technologies adaptables et innovantes, telles que la télésanté, peut contribuer aux soins des 20 % de Canadiens vivant avecla douleur chronique en période de crise et doit constituer un élément essentiel d'une stratégie canadienne globale de lutte contre la douleur.