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Wellness and Coping of Physicians Who Worked in ICUs During the Pandemic: A Multicenter Cross-Sectional North American Survey
Journal article   Open access   Peer reviewed

Wellness and Coping of Physicians Who Worked in ICUs During the Pandemic: A Multicenter Cross-Sectional North American Survey

Karen E A Burns, Marc Moss, Edmund Lorens, Elizabeth Karin Ann Jose, Claudio M Martin, Elizabeth M Viglianti, Alison Fox-Robichaud, Kusum S Mathews, Kathleen Akgun, Snigdha Jain, …
Critical care medicine, Vol.50(12), pp.1689-1700
12/01/2022
DOI: 10.1097/CCM.0000000000005674
PMCID: PMC9668381
PMID: 36300945
url
https://doi.org/10.1097/CCM.0000000000005674View
Published (Version of record) Open Access

Abstract

Few surveys have focused on physician moral distress, burnout, and professional fulfilment. We assessed physician wellness and coping during the COVID-19 pandemic. Cross-sectional survey using four validated instruments. Sixty-two sites in Canada and the United States. Attending physicians (adult, pediatric; intensivist, nonintensivist) who worked in North American ICUs. None. We 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. Despite 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.
North America Adaptation, Psychological Adult Burnout, Professional - epidemiology Child COVID-19 Cross-Sectional Studies Female Humans Intensive Care Units Male Pandemics Physicians Surveys and Questionnaires United States - epidemiology

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