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1.
Br J Surg ; 108(10): 1162-1180, 2021 10 23.
Article in English | MEDLINE | ID: covidwho-1462296

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) was declared a pandemic by the WHO on 11 March 2020 and global surgical practice was compromised. This Commission aimed to document and reflect on the changes seen in the surgical environment during the pandemic, by reviewing colleagues' experiences and published evidence. METHODS: In late 2020, BJS contacted colleagues across the global surgical community and asked them to describe how severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had affected their practice. In addition to this, the Commission undertook a literature review on the impact of COVID-19 on surgery and perioperative care. A thematic analysis was performed to identify the issues most frequently encountered by the correspondents, as well as the solutions and ideas suggested to address them. RESULTS: BJS received communications for this Commission from leading clinicians and academics across a variety of surgical specialties in every inhabited continent. The responses from all over the world provided insights into multiple facets of surgical practice from a governmental level to individual clinical practice and training. CONCLUSION: The COVID-19 pandemic has uncovered a variety of problems in healthcare systems, including negative impacts on surgical practice. Global surgical multidisciplinary teams are working collaboratively to address research questions about the future of surgery in the post-COVID-19 era. The COVID-19 pandemic is severely damaging surgical training. The establishment of a multidisciplinary ethics committee should be encouraged at all surgical oncology centres. Innovative leadership and collaboration is vital in the post-COVID-19 era.


Subject(s)
COVID-19/prevention & control , Perioperative Care/trends , Practice Patterns, Physicians'/trends , Surgical Procedures, Operative/trends , Adult , Biomedical Research/organization & administration , COVID-19/diagnosis , COVID-19/economics , COVID-19/epidemiology , Education, Medical, Graduate/methods , Education, Medical, Graduate/trends , Female , Global Health , Health Resources/supply & distribution , Health Services Accessibility/trends , Humans , Infection Control/economics , Infection Control/methods , Infection Control/standards , International Cooperation , Male , Middle Aged , Pandemics , Perioperative Care/education , Perioperative Care/methods , Perioperative Care/standards , Practice Patterns, Physicians'/standards , Surgeons/education , Surgeons/psychology , Surgeons/trends , Surgical Procedures, Operative/education , Surgical Procedures, Operative/methods , Surgical Procedures, Operative/standards
2.
Medicine (Baltimore) ; 100(37): e27240, 2021 Sep 17.
Article in English | MEDLINE | ID: covidwho-1434546

ABSTRACT

ABSTRACT: During the coronavirus disease 2019 (COVID-19) pandemic, the mandatory use of personal protective equipment (PPE) has resulted in a significant reduction in the infection rate among health care workers (HCWs). However, there are some ongoing concerns about the negative impact of using PPE for prolonged periods.This study examined the impact of wearing PPE on surgeons' performance and decision making during the COVID-19 pandemic.In this cross-sectional study, an anonymous online questionnaire was created and disseminated to surgeons all over the Eastern Province of Saudi Arabia. The questionnaire included the demographic data, the local hospital policies, the non-technical skills (e.g., communication, vision, and comfort) and the technical skills, and the process of decision making.From June 2020 to August 2020, 162 surgeons participated in this questionnaire. Of them, 80.2% were aged from 26 to 45 years, 70.4% have received a special training for PPE, and 59.3% of participants have operated on COVID-19 confirmed cases. A negative impact of wearing PPE was reported on their overall comfort, vision, and communication skills (92.6%, 95.1%, and 82.8%, respectively). The technical skills and decision making were not significantly affected (60.5% and 72.8%, respectively). More preference for conservative approach, damage control procedures, and/or open approach was reported.Despite its benefits, PPE is associated with a significant negative impact on the non-technical skills (including vision, communication, and comfort) as well as a non-significant negative impact on technical skills and decision making of surgeons. Extra efforts should be directed to improve PPE, especially during lengthy pandemics.


Subject(s)
COVID-19/prevention & control , Decision Making , Personal Protective Equipment/standards , Surgeons/psychology , Adult , COVID-19/psychology , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Personal Protective Equipment/statistics & numerical data , Saudi Arabia , Surgeons/statistics & numerical data , Surveys and Questionnaires
7.
BJS Open ; 5(4)2021 07 06.
Article in English | MEDLINE | ID: covidwho-1331540

ABSTRACT

INTRODUCTION: Core surgical training programmes are associated with a high risk of burnout. This study aimed to assess the influence of a novel enhanced stress-resilience training (ESRT) course delivered at the start of core surgical training in a single UK statutory education body. METHOD: All newly appointed core surgical trainees (CSTs) were invited to participate in a 5-week ESRT course teaching mindfulness-based exercises to develop tools to deal with stress at work and burnout. The primary aim was to assess the feasibility of this course; secondary outcomes were to assess degree of burnout measured using Maslach Burnout Inventory (MBI) scoring. RESULTS: Of 43 boot camp attendees, 38 trainees completed questionnaires, with 24 choosing to participate in ESRT (63.2 per cent; male 13, female 11, median age 28 years). Qualitative data reflected challenges delivering ESRT because of arduous and inflexible clinical on-call rotas, time pressures related to academic curriculum demands and the concurrent COVID-19 pandemic (10 of 24 drop-out). Despite these challenges, 22 (91.7 per cent) considered the course valuable and there was unanimous support for programme development. Of the 14 trainees who completed the ESRT course, nine (64.3 per cent) continued to use the techniques in daily clinical work. Burnout was identified in 23 trainees (60.5 per cent) with no evident difference in baseline MBI scores between participants (median 4 (range 0-11) versus 5 (1-11), P = 0.770). High stress states were significantly less likely, and mindfulness significantly higher in the intervention group (P < 0.010); MBI scores were comparable before and after ESRT in the intervention cohort (P = 0.630, median 4 (range 0-11) versus 4 (1-10)). DISCUSSION: Despite arduous emergency COVID rotas ESRT was feasible and, combined with protected time for trainees to engage, deserves further research to determine medium-term efficacy.


Subject(s)
Burnout, Professional/prevention & control , Curriculum , General Surgery/education , Resilience, Psychological , Stress, Psychological/prevention & control , Surgeons/psychology , Adult , Anxiety/prevention & control , COVID-19/epidemiology , Depression/prevention & control , Feasibility Studies , Female , Humans , Male , Mindfulness , Pandemics , Surveys and Questionnaires , United Kingdom , Work Schedule Tolerance
8.
Ann Surg ; 273(4): 625-629, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-1304016

ABSTRACT

OBJECTIVE: To investigate the relationship between surgeon gender and stress during the Covid-19 pandemic. BACKGROUND: Although female surgeons face difficulties integrating work and home in the best of times, the Covid-19 pandemic has presented new challenges. The implications for the female surgical workforce are unknown. METHODS: This cross-sectional, multi-center telephone survey study of surgeons was conducted across 5 academic institutions (May 15-June 5, 2020). The primary outcome was maximum stress level, measured using the validated Stress Numerical Rating Scale-11. Mixed-effects generalized linear models were used to estimate the relationship between surgeon stress level and gender. RESULTS: Of 529 surgeons contacted, 337 surgeons responded and 335 surveys were complete (response rate 63.7%). The majority of female respondents were housestaff (58.1%), and the majority of male respondents were faculty (56.8%) (P = 0.008). A greater proportion of male surgeons (50.3%) than female surgeons (36.8%) had children ≤18 years (P = 0.015). The mean maximum stress level for female surgeons was 7.51 (SD 1.49) and for male surgeons was 6.71 (SD 2.15) (P < 0.001). After adjusting for the presence of children and training status, female gender was associated with a significantly higher maximum stress level (P < 0.001). CONCLUSIONS: Our findings that women experienced more stress than men during the Covid-19 pandemic, regardless of parental status, suggest that there is more to the gendered differences in the stress experience of the pandemic than the added demands of childcare. Deliberate interventions are needed to promote and support the female surgical workforce during the pandemic.


Subject(s)
COVID-19/psychology , Occupational Diseases/etiology , Physicians, Women/psychology , Stress, Psychological/etiology , Surgeons/psychology , Adult , COVID-19/epidemiology , Cross-Sectional Studies , Female , Health Surveys , Humans , Linear Models , Male , Middle Aged , Occupational Diseases/diagnosis , Occupational Diseases/epidemiology , Pandemics , Risk Factors , Sex Factors , Stress, Psychological/diagnosis , Stress, Psychological/epidemiology , United States/epidemiology
9.
Ann R Coll Surg Engl ; 103(7): 520-523, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1288675

ABSTRACT

INTRODUCTION: In light of the COVID-19 recommendations from the Association of Coloproctology of Great Britain and Ireland, we aimed to study patient and clinician satisfaction with a newly established telephone (TP) colorectal clinic service in lieu of traditional face-to-face (FTF) appointments. Comparative outcomes included patient versus clinician satisfaction; patient versus clinician desire to continue TP clinics postpandemic; and views of Specialty Trainee 3+ (ST3+)/Specialty Associate Specialist (SAS) doctors versus consultants on TP compared with FTF appointments. METHODS: We conducted a prospective service evaluation of patient and clinician satisfaction with colorectal surgery TP clinics between 1 June 2020 and 30 June 2020 in a British District General Hospital. RESULTS: Patients had higher satisfaction than clinicians with TP clinics: 91.5% versus 66.6% reported above-average experience [odds ratio (OR) = 5.35, 95% confidence interval (CI) 1.53 to 18.75, p = 0.01]. Clinicians had lower demand to continue TP clinics post-COVID-19 versus patients, with a trend towards significance (60% versus 82.9%, OR = 0.31, 95% CI 0.10 to 0.97, p = 0.08). ST3+/SAS doctors were more likely than consultants to find TP clinics inferior to FTF consultation for patient assessment (48.3% versus 23.7%, OR = 3.00, 95% CI 1.17 to 7.71, p = 0.03). CONCLUSIONS: While clinicians may be concerned that patient assessment suffers, patient satisfaction with TP clinics is high. There should be a place for TP clinics post-COVID-19 but there must be a robust process for patient selection as well as adequate training for current and future generations of clinicians.


Subject(s)
COVID-19/prevention & control , Colorectal Neoplasms/diagnosis , Medical Oncology/methods , Remote Consultation/methods , Telephone , Aftercare/methods , Aftercare/standards , Aftercare/statistics & numerical data , COVID-19/epidemiology , COVID-19/transmission , Colorectal Neoplasms/therapy , Humans , Infection Control/standards , Job Satisfaction , Medical Oncology/standards , Medical Oncology/statistics & numerical data , Patient Satisfaction/statistics & numerical data , Prospective Studies , Remote Consultation/standards , Remote Consultation/statistics & numerical data , Surgeons/psychology , Surgeons/statistics & numerical data , Surveys and Questionnaires/statistics & numerical data , United Kingdom/epidemiology
10.
Plast Reconstr Surg ; 148(1): 133e-139e, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1284960

ABSTRACT

SUMMARY: The coronavirus disease of 2019 pandemic became a global threat in a matter of weeks, with its future implications yet to be defined. New York City was swiftly declared the epicenter of the pandemic in the United States as case numbers grew exponentially in a matter of days, quickly threatening to overwhelm the capacity of the health care system. This burgeoning crisis led practitioners across specialties to adapt and mobilize rapidly. Plastic surgeons and trainees within the New York University Langone Health system faced uncertainty in terms of future practice, in addition to immediate and long-term effects on undergraduate and graduate medical education. The administration remained vigilant and adaptive, enacting departmental policies prioritizing safety and productivity, with early deployment of faculty for clinical support at the front lines. The authors anticipate that this pandemic will have far-reaching effects on the future of plastic surgery education, trends in the pursuit of elective surgical procedures, and considerable consequences for certain research endeavors. Undoubtedly, there will be substantial impact on the physical and mental well-being of health care practitioners across specialties. Coordinated efforts and clear lines of communication between the Department of Plastic Surgery and its faculty and trainees allowed a concerted effort toward the immediate challenge of tempering the spread of coronavirus disease of 2019 and preserving structure and throughput for education and research. Adaptation and creativity have ultimately allowed for early rebooting of in-person clinical and surgical practice. The authors present their coordinated efforts and lessons gleaned from their experience to inform their community's preparedness as this formidable challenge evolves.


Subject(s)
COVID-19/epidemiology , Communicable Disease Control/standards , Pandemics/prevention & control , Surgery, Plastic/trends , Academic Medical Centers/standards , Academic Medical Centers/statistics & numerical data , Academic Medical Centers/trends , COVID-19/prevention & control , COVID-19/transmission , Education, Medical, Graduate/organization & administration , Education, Medical, Graduate/standards , Education, Medical, Graduate/trends , Elective Surgical Procedures/education , Elective Surgical Procedures/standards , Elective Surgical Procedures/trends , Faculty/organization & administration , Faculty/psychology , Faculty/statistics & numerical data , Forecasting , Humans , Internship and Residency/statistics & numerical data , New York City/epidemiology , Personnel Staffing and Scheduling/organization & administration , Personnel Staffing and Scheduling/trends , Reconstructive Surgical Procedures/education , Reconstructive Surgical Procedures/standards , Reconstructive Surgical Procedures/trends , Surgeons/organization & administration , Surgeons/psychology , Surgeons/statistics & numerical data , Surgery, Plastic/education , Surgery, Plastic/organization & administration , Surgery, Plastic/standards , Surveys and Questionnaires/statistics & numerical data , Uncertainty , Universities/standards , Universities/statistics & numerical data , Universities/trends
12.
Sci Prog ; 104(2): 368504211023282, 2021.
Article in English | MEDLINE | ID: covidwho-1277842

ABSTRACT

The surgical theatre is associated with the highest mortality rates since the onslaught of the COVID-19 pandemic. However, Operating Department Practitioners (ODPs) are neglected human resources for health in regards to both professional development and research for patient safety; even though they are key practitioners with respect to infection control during surgeries. Therefore, this study aims to describe challenges faced by ODPs during the pandemic. The secondary aim is to use empirical evidence to inform the public health sector management about both ODP professional development and improvement in surgical procedures, with a specific focus on pandemics. A qualitative study has been conducted. Data collection was based on an interview guide with open-ended questions. Interviews with 39 ODPs in public sector teaching hospitals of Pakistan who have been working during the COVID-19 pandemic were part of the analysis. Content analysis was used to generate themes. Ten themes related to challenges faced by ODPs in delivering services during the pandemic for securing patient safety were identified: (i) Disparity in training for prevention of COVID-19; (ii) Shortcomings in COVID-19 testing; (iii) Supply shortages of personal protective equipment; (iv) Challenges in maintaining physical distance and prevention protocols; (v) Human resource shortages and role burden; (vi) Problems with hospital administration; (vii) Exclusion and hierarchy; (viii) Teamwork limitations and other communication issues; (ix) Error Management; and (x) Anxiety and fear. The public health sector, in Pakistan and other developing regions, needs to invest in the professional development of ODPs and improve resources and structures for surgical procedures, during pandemics and otherwise.


Subject(s)
COVID-19/epidemiology , Infection Control/organization & administration , Pandemics , Surgeons/organization & administration , Surgery Department, Hospital/organization & administration , Adult , Anxiety/psychology , COVID-19/diagnosis , COVID-19/psychology , COVID-19 Testing , Female , Humans , Male , Middle Aged , Pakistan/epidemiology , Personal Protective Equipment/ethics , Personal Protective Equipment/supply & distribution , Public Health , SARS-CoV-2/pathogenicity , Surgeons/psychology , Surgical Procedures, Operative/statistics & numerical data , Surveys and Questionnaires , Workforce/organization & administration
14.
Int J Surg ; 91: 105987, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1253037

ABSTRACT

BACKGROUND: Multiple industries and organisations are afflicted by and respond to institutional crises daily. As surgeons, we respond to crisis frequently and individually such as with critically unwell patients or in mass casualty scenarios; but rarely, do we encounter institutional or multi-institutional crisis with multiple actors as we have seen with the COVID-19 pan-demic. Businesses, private industry and the financial sector have been in a more precar-ious position regarding crisis and consequently have developed rapid response strate-gies employing foresight to reduce risk to assets and financial liquidity. Moreover, large nationalised governmental organisations such as the military have strategies in place ow-ing to a rapidly evolving geopolitical climate with the expectation of immediate new chal-lenges either in the negotiating room or indeed the field of conflict. Despite both nation-alised and privatised healthcare systems existing, both appeared ill-prepared for the COVID-19 global crisis. METHODS: A narrative review of the literature was undertaken exploring the approach to crisis man-agement and models used in organisations exposed to institutional crises outside the field of medicine. RESULTS: There are many parallels between the organisational management of private business institutions, large military organisations and surgical organisational management in healthcare. Models from management consultancies and the armed forces were ex-plored discussed and adapted for the surgical leader providing a framework through which the surgical leader can bring about an successful response to an institutional crisis and ensure future resilience. CONCLUSION: We believe that healthcare, and surgeons (as leaders) in particular, can learn from these other organisations and industries to engage appropriate generic operational plans and contingencies in preparation for whatever further crises may arise in the future, both near and distant. As such, following a review of the literature, we have explored a number of models we believe are adaptable for the surgical community to ensure we remain a dy-namically responsive and ever prepared profession.


Subject(s)
COVID-19 , General Surgery/organization & administration , Models, Organizational , Patient Care Team/organization & administration , Surgeons/organization & administration , Humans , Leadership , Resilience, Psychological , SARS-CoV-2 , Surgeons/psychology
15.
J Plast Reconstr Aesthet Surg ; 74(9): 2311-2318, 2021 09.
Article in English | MEDLINE | ID: covidwho-1252519

ABSTRACT

BACKGROUND: The COVID-19 pandemic has transformed the delivery of medical and surgical services globally. Subsequently, all elective and aesthetic procedures have been cancelled or deferred in accordance with government-mandated quarantine measures. The Cosmetic Surgery Governance Forum (CSGF) is a network of aesthetic plastic surgery consultants which has enabled a sharing of expertise during challenging times. We conducted a cross-sectional survey to assess the impact of the COVID-19 pandemic on aesthetic plastic surgeons and their practice in the UK. METHODS: On 15 June 2020, 131 respondents from the CSGF and wider aesthetic plastic surgeons in the UK were invited to respond to an online survey. An anonymised questionnaire was created using SmartSurveyTM and distributed at the end of the quarantine period. Questions regarding their current scope of practice, willingness to recommence face-to-face consultations, financial loss and psychological impact were asked. RESULTS: A total of 101 Consultant Plastic surgeons (76%) completed the questionnaire. If strict protocols and adequate personal protective equipment were available, 50-55% of respondents would consider offering non-surgical treatments as soon as the private clinic was open. Furthermore, 51% would consider procedures under general anaesthetic, whilst 89% of respondents would offer local anaesthetic only in the initial phase. Moreover, 66% reported experiencing a psychological impact and 100% of respondents reported a significant financial impact. CONCLUSIONS: This survey aims to give an account of the current state (May-July 2020) of aesthetic plastic surgery in the UK. There is ongoing uncertainty and deliberation regarding the timing and organisational changes required for aesthetic practice to restart.


Subject(s)
Attitude of Health Personnel , COVID-19/prevention & control , Cosmetic Techniques/trends , Practice Patterns, Physicians'/trends , Surgeons/trends , COVID-19/economics , Cosmetic Techniques/economics , Cross-Sectional Studies , Health Policy , Humans , Infection Control/methods , Infection Control/trends , Practice Patterns, Physicians'/economics , Quarantine , Surgeons/economics , Surgeons/psychology , Surveys and Questionnaires , United Kingdom
16.
Semin Vasc Surg ; 34(2): 43-50, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1240792

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has placed significant strain on the health and welfare of all health care professionals, including vascular surgeons. This review summarizes the implications of the pandemic on the health and wellness of surgeons and trainees, with a particular focus on those in vascular surgery (VS). A literature review was completed using common resource databases. We provide a brief history of burnout in VS and explore burnout and wellness in VS during this unprecedented pandemic. We then offer recommendations to address mental health needs by the VS workforce and highlight opportunities to address the gaps in the literature. The impact of COVID-19 on the professional and personal lives of surgeons and trainees in VS is notable. More than half of vascular surgeons reported some degree of anxiety. Factors associated with anxiety and burnout include COVID-19 exposure, moral injury, practice changes, and financial impacts. Trainees appeared to have more active coping strategies with dampened rates of anxiety compared to those in practice. Women appear to be disproportionately affected by the pandemic, with higher rates of anxiety and burnout. Groups underrepresented in medicine seemed to have more resilience when it came to burnout, but struggled with other inequities in the health care environment, such as structural racism and isolation. Strategies for addressing burnout include mindfulness practices, exercise, and peer and institutional support. The COVID-19 pandemic has had a substantial mental health impact on the VS workforce globally, as shifts were made in patient care, surgical practice, and work-home life concerns.


Subject(s)
Burnout, Professional/epidemiology , COVID-19/epidemiology , Mental Health/statistics & numerical data , Surgeons/psychology , Vascular Surgical Procedures/statistics & numerical data , Burnout, Professional/prevention & control , COVID-19/prevention & control , COVID-19/transmission , Humans
17.
Ophthalmic Epidemiol ; 28(4): 322-329, 2021 08.
Article in English | MEDLINE | ID: covidwho-1221337

ABSTRACT

Purpose: To assess the magnitude of mental health problems among ophthalmologists in India post lockdown during COVID pandemic.Method: Cross-sectional survey conducted online on registered practising ophthalmologists of India, post lockdown at the start of elective surgeries (20th to 25th May, 2020). The degree of symptoms of depression, anxiety and stress was assessed by DASS -21 questionnaire. DASS -Subscales: DASS- D (depression), DASS- A (anxiety) and DASS-S (stress) and grading of severity (mild, moderate, severe) were analysed.Results: A total of 144 ophthalmologists aged 29-72 years responded to online survey. Of all participants, 94 (64.2%) of ophthalmologists suffered from mental health problems. Seventy six (52.7%) ophthalmologists had depression and anxiety whereas 20 (14%) reported stress. Women ophthalmologists scored highest total DASS mean score and DASS-stress mean score (p = .04 and p = .03). Results of DASS-D and DASS-A showed female preponderance (men vs women 42.5% vs 61.5%, p = .02; 42.5% vs 60%, p = .04). Severity of symptoms revealed that ophthalmologists above 40 years of age with more than 10 years' experienced severe stress (p = .005). Comprehensive ophthalmologists presented with severe stress and ophthalmologists practicing speciality with severe anxiety. Pearson's correlation analysis showed positive correlation between total DASS-21 score with each of the three subscales scores (DASS D, r-0.88: p < .001; DASS-A, r = 0.96: p = <0.001; DASS-S, r = 0.95: p < .001).Conclusion: Screening by Dass-21 scale has brought noticeable transient mental health issue among ophthalmologist to the fore. Few with high risk may require professional mental care to alleviate it.


Subject(s)
Anxiety/epidemiology , COVID-19 , Depression/epidemiology , Ophthalmologists/psychology , Stress, Psychological/epidemiology , Surgeons/psychology , Adult , Communicable Disease Control , Cross-Sectional Studies , Female , Humans , India , Male , Pandemics , Surveys and Questionnaires
18.
Surgery ; 170(2): 587-595, 2021 08.
Article in English | MEDLINE | ID: covidwho-1213531

ABSTRACT

BACKGROUND: Coronavirus disease 2019 provided the impetus for unprecedented adoption of telemedicine. This study aimed to understand video visit adoption by plastic surgery providers; and patient and surgeon perceptions about its efficacy, value, accessibility, and long-term viability. A secondary aim was to develop the proposed 'Triage Tool for Video Visits in Plastic Surgery' to help determine visit video eligibility. METHODS: This mixed-methods evaluation assessed provider-level scheduling data from the Division of Plastic and Reconstructive Surgery at Stanford Health Care to quantify telemedicine adoption and semi-structured phone interviews with patients (n = 20) and surgeons (n = 10) to explore stakeholder perspectives on video visits. RESULTS: During the 13-week period after the local stay-at-home orders due to coronavirus disease 2019, 21.4% of preoperative visits and 45.5% of postoperative visits were performed via video. Video visits were considered acceptable by patients and surgeons in plastic surgery in terms of quality of care but were limited by the inability to perform a physical examination. Interviewed clinicians reported that long-term viability needs to be centered around technology (eg, connection, video quality, etc) and physical examinations. Our findings informed a proposed triage tool to determine the appropriateness of video visits for individual patients that incorporates visit type, anesthesia, case, surgeon's role, and patient characteristics. CONCLUSION: Video technology has the potential to facilitate and improve preoperative and postoperative patient care in plastic surgery but the following components are needed: patient education on taking high-quality photos; standardized clinical guidelines for conducting video visits; and an algorithm-assisted triage tool to support scheduling.


Subject(s)
COVID-19 , Surgeons/statistics & numerical data , Surgery, Plastic/statistics & numerical data , Telemedicine/statistics & numerical data , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Patient Satisfaction , Physical Examination , Physician-Patient Relations , Surgeons/psychology , Surgery, Plastic/psychology , Young Adult
19.
Surgery ; 170(3): 719-726, 2021 09.
Article in English | MEDLINE | ID: covidwho-1169289

ABSTRACT

BACKGROUND: The coronavirus disease 2019 pandemic led to major changes in health care and education options for all health care employees. The aim of this study is to achieve insight into coronavirus disease-care participation of surgical residents in the Netherlands, the impact of coronavirus disease 2019 on the experienced quality of surgical training, and the influence on Burn-out and Work Engagement compared with the non-coronavirus disease 2019 period in January 2020. METHODS: In this study, we have conducted 2 digital surveys immediately before and 2 months after the start of the coronavirus disease 2019 pandemic. We surveyed a validated Dutch questionnaire 'Utrecht Burn-out Scale,' derived from the Maslach Burn-out Inventory, and also collected the 'Utrecht Work Engagement Scale' measuring work engagement. Additionally, we describe the coronavirus disease-care participation of surgical residents, the impact on how they experienced the quality of their surgical training, and the influence on 'Burn-out and Work Engagement' compared with the pre-coronavirus disease 2019 period for surgical residents in the Netherlands. RESULTS: In January 2020, a total of 317 residents completed the online survey, and in April 2020, a total of 313 residents completed the online survey. Of the responders, 48.6%, in April, participated in coronavirus disease-care in both the coronavirus disease ward as well as the coronavirus disease intensive care unit. Residents experienced that the coronavirus disease 2019 influenced their surgical training in 85.2% of responders. In only 5% of the residents did the pandemic not affect the exposure to surgical training in the operating theater. More burn-out symptoms were noted amongst coronavirus disease ward deployed residents versus no coronavirus disease ward deployment, (16.0% vs 7.6%, P = .06). The Work-Engagement questionnaire showed a significantly lower work engagement score of 4.2 for residents who were deployed in a coronavirus disease-care intensive care unit versus a score of 4.6 for residents scheduled in a coronavirus disease ward (P = .02). CONCLUSION: This study shows a significant impact of the first months of the coronavirus disease 2019 pandemic on the Dutch surgical trainee program, with a major redistribution of residents with a decrease of surgical exposure and education. We emphasize the need for adequate guidance of all surgical residents and potentially lengthening the surgical training program.


Subject(s)
Burnout, Professional/epidemiology , COVID-19 , Surgeons/psychology , Work Engagement , Adult , Female , Humans , Internship and Residency , Male , Netherlands/epidemiology , Surgeons/education , Surgeons/statistics & numerical data , Surveys and Questionnaires
20.
BMJ Open ; 11(4): e045699, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-1166508

ABSTRACT

BACKGROUND: The COVID-19 pandemic represents the greatest biopsychosocial emergency the world has faced for a century. The pandemic has changed how individuals live and work, and in particular, frontline healthcare professionals have been exposed to alarming levels of stress. OBJECTIVE: The aim of this study was to understand the professional and personal effects of COVID-19 pandemic on surgeons working in the UK National Health Service (NHS). SETTING: Surgical departments in the NHS. DESIGN: Between May and July 2020, as part of an ongoing study, we asked surgeons two open-ended questions: 'What challenges are the COVID-19 crisis currently presenting to you in your work and home life?' and 'How is this stress affecting you personally?' Thematic analysis was used for the qualitative data. Responses to the second question were also categorised into four groups reflecting valence: positive, neutral, mildly negative and strongly negative. RESULTS: A total of 141 surgeons responded to the survey and the results indicated that 85.8% reported that they were generally negatively affected by the COVID-19 pandemic, of which 7.8% were strongly affected in a negative way. Qualitative thematic analysis identified four key themes from responses relating to the impact of the pandemic: (1) changing and challenging work environment as a result of COVID-19; (2) challenges to professional life and development; (3) management of change and loss in the respondents' personal lives; (4) emotional and psychological impacts. CONCLUSION: The results highlighted the substantial emotional and psychological effects of the COVID-19 pandemic on surgeons' mental health, particularly in relation to fear and anxiety, loss of motivation, low mood, stress and burnout. There is an urgent need for workplace support and mental health interventions to help surgeons cope with the difficulties they face during the ongoing COVID-19 pandemic.


Subject(s)
COVID-19/psychology , Occupational Stress/epidemiology , Surgeons/psychology , Humans , Mental Health , Pandemics , State Medicine , United Kingdom/epidemiology
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