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2.
Lancet ; 398(10303): 920-930, 2021 09 04.
Article in English | MEDLINE | ID: covidwho-1593950

ABSTRACT

The COVID-19 pandemic has heightened interest in how physician mental health can be protected and optimised, but uncertainty and misinformation remain about some key issues. In this Review, we discuss the current literature, which shows that despite what might be inferred during training, physicians are not immune to mental illness, with between a quarter and a third reporting increased symptoms of mental ill health. Physicians, particularly female physicians, are at an increased risk of suicide. An emerging consensus exists that some aspects of physician training, working conditions, and organisational support are unacceptable. Changes in medical training and health systems, and the additional strain of working through a pandemic, might have amplified these problems. A new evidence-informed framework for how individual and organisational interventions can be used in an integrated manner in medical schools, in health-care settings, and by professional colleagues is proposed. New initiatives are required at each of these levels, with an urgent need for organisational-level interventions, to better protect the mental health and wellbeing of physicians.


Subject(s)
Mental Disorders/epidemiology , Physicians/psychology , Suicide/statistics & numerical data , Burnout, Professional , COVID-19/epidemiology , Female , Humans , Male , Mental Disorders/prevention & control , Pandemics , Physicians, Women/psychology , Risk Factors , SARS-CoV-2 , Substance-Related Disorders/epidemiology , Suicide/prevention & control , Work Schedule Tolerance
4.
Ann Intern Med ; 174(10): 1474-1475, 2021 10.
Article in English | MEDLINE | ID: covidwho-1497807
5.
PLoS One ; 16(11): e0259213, 2021.
Article in English | MEDLINE | ID: covidwho-1496532

ABSTRACT

Healthcare workers have had the longest and most direct exposure to COVID-19 and consequently may suffer from poor mental health. We conducted one of the first repeated multi-country analysis of the mental wellbeing of medical doctors (n = 5,275) at two timepoints during the COVID-19 pandemic (June 2020 and November/December 2020) to understand the prevalence of anxiety and depression, as well as associated risk factors. Rates of anxiety and depression were highest in Italy (24.6% and 20.1%, June 2020), second highest in Catalonia (15.9% and 17.4%, June 2020), and lowest in the UK (11.7% and 13.7%, June 2020). Across all countries, higher risk of anxiety and depression symptoms were found among women, individuals below 60 years old, those feeling vulnerable/exposed at work, and those reporting normal/below-normal health. We did not find systematic differences in mental health measures between the two rounds of data collection, hence we cannot discard that the mental health repercussions of the pandemic are persistent.


Subject(s)
Anxiety/etiology , COVID-19/psychology , Depression/etiology , Occupational Diseases/psychology , Physicians/psychology , Adult , Female , Health Personnel/psychology , Humans , Italy , Male , Middle Aged , Pandemics
8.
Hong Kong Med J ; 26(3): 171-173, 2020 06.
Article in English | MEDLINE | ID: covidwho-1468758
9.
Ann Emerg Med ; 78(5): 587-592, 2021 11.
Article in English | MEDLINE | ID: covidwho-1439183

ABSTRACT

We, emergency physicians of color, are not okay. We are living and working through a pandemic that has disproportionately affected our communities and a year in which we cannot escape our lived experiences of police brutality. We see you, dear White people in emergency medicine, and are glad you want to support us. However, let us guide you in supporting our cause.


Subject(s)
African Americans/psychology , Emergency Medicine , Organizational Culture , Physicians/psychology , Racism , COVID-19/epidemiology , Humans , Pandemics , SARS-CoV-2 , United States/epidemiology , Violence
10.
J Infect Dev Ctries ; 15(8): 1080-1085, 2021 08 31.
Article in English | MEDLINE | ID: covidwho-1405474

ABSTRACT

INTRODUCTION: It has been noted that post-traumatic stress disorder symptoms could be common in physicians who have experienced a traumatic event. The aim of this study was to determine the prevalence of post-traumatic stress disorder and contributing risk factors among resident doctors working in a tertiary care hospital during the COVID-19 pandemic. METHODOLOGY: A cross-sectional study was conducted via an online survey from May to July 2020. Sociodemographic characteristics, exposure to the coronavirus, application of personal hygiene rules, presence and use of personal protective equipment, anxiety and prevalence of post-traumatic stress disorder were investigated. RESULTS: In total, 17.8% (n = 40) of 225 resident doctors who participated in the study had post-traumatic stress disorder. Working at a department serving to COVID-19 patients increased the risk of post-traumatic stress disorder by 2.9 times (OR = 2.936, p = 0.003) while contacting positive patients increased this risk by 2.6 times (OR = 2.607, p = 0.023) and lack of personal protective equipment by 3.6 times (OR = 3.656, p = 0.018). Anxiety scores were statistically significantly higher in women, married and those living with their parents or spouses and children (p = 0.049; p = 0.011; p = 0.004, respectively). CONCLUSIONS: Working in a department serving to COVID-19 patients, contact with positive patients and lack of personal protective equipment were risk factors in the emergence of post-traumatic stress disorder in resident doctors. Anxiety was also found to be greater in women, married and those living with their families.


Subject(s)
COVID-19/epidemiology , COVID-19/psychology , Internship and Residency , Physicians/psychology , Physicians/statistics & numerical data , Adult , Anxiety , COVID-19/prevention & control , Cross-Sectional Studies , Depression , Female , Humans , Male , Prevalence , Risk Factors , Sex Factors , Stress Disorders, Post-Traumatic , Surveys and Questionnaires , Turkey/epidemiology , Young Adult
11.
PLoS One ; 16(9): e0257109, 2021.
Article in English | MEDLINE | ID: covidwho-1394557

ABSTRACT

INTRODUCTION: Health care workers are the most affected part of the world population due to the COVID-19 pandemic. Countries prioritize vaccinating health workers against COVID-19 because of their susceptibility to the virus. However, the acceptability of the vaccine varies across populations. Thus, this study aimed to determine the health care worker's intentions to accept the COVID-19 vaccine and its associated factors in southwestern Ethiopia, 2021. METHODS: A facility-based cross-sectional study was conducted among health care workers in public hospitals in southwestern Ethiopia from March 15 to 28, 2021. A simple random sampling method was used to select 405 participants from each hospital. Data were collected using self-administered questionnaires. Descriptive statistics, such as frequency and percentage, were calculated. Multivariable logistic regression was also performed to identify factors associated with health care worker's intention to accept the COVID-19 vaccine. Statistically significant variables were selected based on p-values (<0.05) and the adjusted odds ratio was used to describe the strength of association with 95% confidence intervals. RESULT: Among the respondents, 48.4% [95% CI: 38.6, 58.2] of health care workers intended to accept COVID-19. Intention to accept COVID-19 vaccination was significantly associated with physicians (AOR = 9.27, 95% CI: 1.27-27.32), professionals with a history of chronic illness (AOR = 4.07, 95% CI: 2.02-8.21), perceived degree of risk of COVID-19 infection (AOR = 4.63, 95% CI: 1.26-16.98), positive attitude toward COVID-19 prevention (AOR = 6.08, 95% CI: 3.39-10.91) and good preventive practices (AOR = 2.83, 95% CI: 1.58-5.08). CONCLUSION: In this study, the intention of health care workers to accept the COVID-19 vaccine was low. Professional types, history of chronic illness, perceived degree of risk to COVID-19 infection, attitude toward COVID-19 and preventive practices were found to be factors for intention to accept COVID-19 vaccine in professionals. It is important to consider professional types, history of chronic illness, perceived degree of risk to COVID-19, attitude of professionals and preventive behaviors to improve the intention of professionals' vaccine acceptance.


Subject(s)
COVID-19 Vaccines/therapeutic use , COVID-19/psychology , Health Personnel/psychology , Pandemics , Adult , Aged , COVID-19/epidemiology , COVID-19/prevention & control , Ethiopia/epidemiology , Health Knowledge, Attitudes, Practice , Humans , Male , Middle Aged , Physicians/psychology , Risk Factors , SARS-CoV-2 , Surveys and Questionnaires
14.
PLoS One ; 16(8): e0256806, 2021.
Article in English | MEDLINE | ID: covidwho-1374156

ABSTRACT

Scientific evidence plays an important role in the therapeutic decision-making process. What happens when physicians are forced to make therapeutic decisions under uncertainty? The absence of scientific guidelines at the beginning of a pandemic due to an unknown virus, such as COVID-19, could influence the perceived legitimacy of the application of non-evidence-based therapeutic approaches. This paper reports on a test of this hypothesis, in which we administered an ad hoc questionnaire to a sample of 64 Italian physicians during the first wave of the COVID-19 pandemic in Italy (April 2020). The questionnaire statements regarding the legitimacy of off-label or experimental drugs were framed according to three different scenarios (Normality, Emergency and COVID-19). Furthermore, as the perception of internal bodily sensations (i.e., interoception) modulates the decision-making process, we tested participants' interoceptive sensibility using the Multidimensional Assessment of Interoceptive Awareness (MAIA). The results showed that participants were more inclined to legitimate non-evidence-based therapeutic approaches in the COVID-19 and Emergency scenarios than the Normality scenario. We also found that scores on the MAIA Trusting subscale positively predicted this difference. Our findings demonstrate that uncertain medical scenarios, involving a dramatic increase in patient volume and acuity, can increase risk-taking in therapeutic decision-making. Furthermore, individual characteristics of health care providers, such as interoceptive ability, should be taken into account when constructing models to prevent the breakdown of healthcare systems in cases of severe emergency.


Subject(s)
COVID-19/epidemiology , Physicians/psychology , Adult , Aged , COVID-19/virology , Decision Making , Drug Prescriptions , Emergency Treatment , Female , Humans , Interoception , Italy/epidemiology , Male , Middle Aged , Pandemics , Pharmaceutical Preparations/administration & dosage , Risk-Taking , SARS-CoV-2 , Surveys and Questionnaires
15.
Eur J Gen Pract ; 27(1): 235-240, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1371664

ABSTRACT

BACKGROUND: In March 2020, the WHO declared the SARS CoV-2 pandemic. This had an immediate and dramatic impact on Romanian physicians. OBJECTIVES: To analyse SARS-CoV-2 risk perception among Romanian physicians following the official WHO pandemic announcement. METHODS: A questionnaire was sent to Romanian physicians (n = 319) between 13 and 27 of March 2020 to determine the perceived threat of exposure to SARS CoV-2 infection, the assessment COVID-19 sources of documentation, physicians' access to personal protective equipment and the attitude towards a prospective vaccine against SARS CoV-2. RESULTS: Confronted with a new and unknown disease, the lack of appropriate information regarding disease management, media pressure and the lack of protective equipment, physicians experiencing a highly stressful a period. We found a significant relationship between the perceived level of fear and the risk of infection with SARS CoV-2 among respondents. A relationship was also found between the perceived level of fear related to COVID-19 and the acceptance of future vaccines against SARS CoV-2. Our data show that doctors working in urban areas considered the medical research on COVID-19 as clearer than those working in rural locations did. CONCLUSION: Pandemic preparedness should focus on measures that make medical practice safe (supplies, working protocols, experience sharing with experts/colleagues from other countries).


Subject(s)
Attitude of Health Personnel , COVID-19/epidemiology , Personal Protective Equipment/supply & distribution , Physicians/statistics & numerical data , Adult , COVID-19/prevention & control , COVID-19 Vaccines/administration & dosage , Disease Outbreaks , Fear , Female , Humans , Male , Middle Aged , Physicians/psychology , Romania , Surveys and Questionnaires
16.
J Biomol Tech ; 32(2): 74-82, 2021 07.
Article in English | MEDLINE | ID: covidwho-1365806

ABSTRACT

Across the United States, the number of staff scientists (master's- or doctoral-level professionals working in nonfaculty roles) has grown by 35% since 2010, and they play an increasingly important role in research efforts. However, few targeted resources are available, which potentially limits the effectiveness of this group. Launched in 2016, the staff scientist path at Emory has tripled in size over 4 y to 138 staff. The present case study evaluated the perceptions of staff scientists related to onboarding experiences and professional development needs, including those needs arising from coronavirus disease 2019 (COVID-19) impacts in the workplace. A survey of Emory staff scientists was conducted from May to June 2019 as part of a program evaluation initiative to assess perceptions of onboarding and professional development opportunities. Interviews with a subset of scientists informed the survey development and identified COVID-19-related impacts on daily work. Results indicated the need for targeted orientation resources specific to staff scientists, accurate and timely information and resources to support scientists' supervisors, and professional development for scientists in leadership and management-related skills. Remote work associated with COVID-19 accentuated the need for managerial skills, including team development in digital work environments. Findings from this case study can inform policies and practices at Emory and other institutions that employ a similar staff scientist model.


Subject(s)
COVID-19/epidemiology , Physicians/statistics & numerical data , SARS-CoV-2/genetics , Workplace , COVID-19/genetics , COVID-19/virology , Career Mobility , Female , Health Personnel , Humans , Male , Physicians/psychology , SARS-CoV-2/pathogenicity
17.
Isr J Health Policy Res ; 10(1): 48, 2021 08 18.
Article in English | MEDLINE | ID: covidwho-1365387

ABSTRACT

Among the challenges presented by the SARS-CoV2 pandemic are those related to balancing societal priorities with averting threats to population health. In this exceptional context a group of Israeli physicians and public health scholars (multidisciplinary academic group on children and coronavirus [MACC]) coalesced, examining the role of children in viral transmission and assessing the necessity and consequences of restricted in-class education. Combining critical appraisal and analytical skills with public health experience, MACC advocated for safe and monitored school re-opening, stressing the importance of education as a determinant of health, continuously weighing this stance against evolving COVID-19-risk data. MACC's activities included offering research-based advice to government agencies including Ministries of Health, Finance, and Education. In a setting where government bodies were faced with providing practical solutions to both decreasing disease transmission and maintaining society's vital activities, and various advisors presented decision-makers with disparate views, MACC contributed epidemiological, clinical and health policy expertise to the debate regarding school closure as a pandemic control measure, and adaptations required for safe re-opening. In this paper, we describe the evolution, activities, policy inputs and media profile of MACC, and discuss the role of academics in advocacy and activism in the midst of an unprecedented public health crisis. A general lesson learned is that academics, based on the rigor of their scientific work and their perceived objectivity, can and should be mobilized to pursue and promote policies based on shared societal values as well as empiric data, even when considerable uncertainty exists about the appropriate course of action. Mechanisms should be in place to open channels to multidisciplinary academic groups and bring their input to bear on decision-making.


Subject(s)
COVID-19/prevention & control , Interdisciplinary Communication , Pandemics/prevention & control , Schools/organization & administration , COVID-19/epidemiology , COVID-19/transmission , Child , Humans , Israel/epidemiology , Physicians/psychology , Public Health
18.
JAMA Netw Open ; 4(8): e2120642, 2021 08 02.
Article in English | MEDLINE | ID: covidwho-1355859

ABSTRACT

Importance: As medical faculty have central roles during the COVID-19 pandemic, it is important to study the pandemic's association with the vitality and careers of medical school faculty. Objective: To examine how the COVID-19 pandemic affected midcareer research faculty in academic medicine. Design, Setting, and Participants: This qualitative study included medical school faculty who participated in the C-Change Mentoring and Leadership Institute. All US medical school faculty recipients of recent National Institutes of Health (NIH) RO1, RO1-equivalent, and K awards were invited to apply to the institute. The 99 applicants who met inclusion criteria were stratified by degree (MD or MD/PhD vs PhD), gender, and race/ethnicity. Enrollment was offered to applicants randomly selected for 40 spots, demographically balanced by sex, underrepresented in medicine minority (URMM) status, and degree. In April 2020, an inquiry was emailed to faculty enrolled in the institute requesting responses to questions about meaning in work, career choice, and values. A qualitative analysis of narrative data responses, using grounded theory, was undertaken to determine key themes. This study is part of a NIH-funded randomized trial to test the efficacy of a group peer mentoring course for midcareer faculty and study the course's mechanisms of action. Main Outcomes and Measures: Key themes in data. Results: Of 40 enrolled participants, 39 responded to the inquiry, for a response rate of 97%. The analytic sample included 39 faculty members; 19 (47%) were women, 20 (53%) identified as URMM, and 20 (53%) had an MD or MD with PhD vs 19 (47%) with PhD degrees. Key themes in the data that emerged describing faculty lived experience of the pandemic included increased meaningfulness of work; professionalism and moral responsibility; enhanced relationships with colleagues; reassertion of career choice; disrupted research; impact on clinical work; attention to health disparities, social justice and advocacy; increased family responsibilities; psychological stress; and focus on leadership. Conclusions and Relevance: During the pandemic, diverse PhD and physician investigators reported increased meaningfulness in work and professionalism and enhanced relationships, all intrinsic motivators associated with vitality. Working during the pandemic appears to have produced intrinsic rewards positively associated with vitality, in addition to adverse mental health effects. These findings have implications for combatting burnout and retaining investigators in the future.


Subject(s)
COVID-19 , Faculty, Medical/psychology , Physicians/psychology , Professionalism , Research Personnel/psychology , Adult , Career Choice , Female , Humans , Male , Middle Aged , Qualitative Research , Randomized Controlled Trials as Topic , SARS-CoV-2 , United States
19.
Med Glas (Zenica) ; 18(2): 493-498, 2021 08 01.
Article in English | MEDLINE | ID: covidwho-1335469

ABSTRACT

Aim To evaluate and assess knowledge and perception, as well as factors related to the occurrence of anxiety among frontliners, especially resident doctors working in emergency room (ER). Methods This multivariate study was conducted with cross-sectional approach involving 80 eligible subjects (based on inclusion and exclusion criteria) that are consecutively assigned and assessed with GAD-7 questionnaire. The study was held in ER of Universitas Sumatera Utara affiliated teaching hospital from May to August 2020. Results Our study found that variables such as nuptial status (p=0.032), seniority level (p=0.037), history of direct exposure to COVID-19 patients (p=0.001) and weekly work duration(p=0.002) were all statistically significant to correlate with the occurrence of anxiety among resident doctors assigned to work in ER. Conclusion Acknowledgement of these factors might lead to proper and targeted support system strategies to address the anxiety issues among doctors, particularly those who work in ER during COVID-19 pandemic.


Subject(s)
Anxiety , COVID-19 , Emergency Service, Hospital , Physicians/psychology , Anxiety/epidemiology , COVID-19/psychology , Cross-Sectional Studies , Hospitals, Teaching , Humans , Indonesia , Occupational Stress/epidemiology , Pandemics
20.
JAMA ; 326(2): 127-128, 2021 Jul 13.
Article in English | MEDLINE | ID: covidwho-1328582
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