A prolonged pandemic impacts the mental health of orthopaedic patients

Background and aimsMajority of elective orthopaedic operations are postponed to accommodate the reallocation of healthcare resources to combat the pandemic. The aim of this paper is to evaluate the mental state of orthopaedic patients amidst limited orthopaedic management options. The secondary aim of this paper is to identify areas of significant stressors and to provide avenues for improvements.MethodsA survey was administered on patients in outpatient clinics within a tertiary institution from 31 May to 13 June 2021 where government interventions prevented elective orthopaedic surgeries from being performed. Individuals' fatigue level were assessed with Chalder fatigue scale (CFS) and they were surveyed on their areas of stressors.ResultsA total of 160 orthopaedic patients (67 males and 93 females) were surveyed with an average age of 48.3 years old (range 17-88). 65 out of 160 (40.6%) were deemed to be severely fatigued (CFS > 4) with a higher prevalence amongst females than males (47.3% vs 31.3% respectively.) The top three areas identified as stressors included transmitting to family/friends, travel restrictions/quarantine orders and limitation on recreational/social activities (67.5%, 45.6% and 57.5% respectively). 25.6% of the patients indicated that the increased difficulty in accessing healthcare was a stress factor.Discussion and conclusionThere is a high proportion of severe fatigue amongst orthopaedic patients. Combined with postponement of orthopaedic care and treatment, the detrimental effects of a prolong pandemic can be more pronounced on orthopaedic patients. Identified areas of stressors provide avenues for improvements to safeguard the mental health of orthopaedic patients.

Increased psychological strain among orthopaedic healthcare workers is associated with longer working hours and has potential impacts on family related adjustments

Objective: To investigate the psychological strain experienced by orthopaedic healthcare workers and attributing factors during the COVID-19 pandemic. Methods: We surveyed healthcare workers in an outpatient musculoskeletal clinic with a questionnaire based on the validated Caregiver Strain Index1 . We have previously shown the prevalence of psychological strain during the pre-peak phase of the pandemic.2 The same group was followed up 6 months later (post-peak phase) to evaluate the downstream psychological strain. Results: Of the 57 participants who were followed up, 30 (52.6%) experienced a greater level of strain (Group A), similar to the prevalence in our previous study (51.6%). Significantly, participants in Group A work longer hours per day compared to Group B (8.8±1.6 vs. 8.0±1.5;mean difference, 0.8;95%CI, 0.0 to 1.6;p=0.043). “Family adjustments” (84.2%) garnered the most positive responses. Conclusion: Longer working hours contributes to psychological strain and measures should be designed to mitigate this. Potential impact on family life of healthcare workers is an unrecognised toll which should receive more attention. Health ministries should ensure measures to safeguard the mental health of healthcare workers to avoid reactive strategies during a pandemic. (Figure Presented).