Dataset Information

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

ABSTRACT:

Objectives

Few surveys have focused on physician moral distress, burnout, and professional fulfilment. We assessed physician wellness and coping during the COVID-19 pandemic.

Design

Cross-sectional survey using four validated instruments.

Setting

Sixty-two sites in Canada and the United States.

Subjects

Attending physicians (adult, pediatric; intensivist, nonintensivist) who worked in North American ICUs.

Intervention

None.

Measurements and main results

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.

Conclusions

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.

SUBMITTER: Burns KEA

PROVIDER: S-EPMC9668381 | biostudies-literature | 2022 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

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

Burns Karen E A KEA Moss Marc M Lorens Edmund E Jose Elizabeth Karin Ann EKA Martin Claudio M CM Viglianti Elizabeth M EM Fox-Robichaud Alison A Mathews Kusum S KS Akgun Kathleen K Jain Snigdha S Gershengorn Hayley H Mehta Sangeeta S Han Jenny E JE Martin Gregory S GS Liebler Janice M JM Stapleton Renee D RD Trachuk Polina P Vranas Kelly C KC Chua Abigail A Herridge Margaret S MS Tsang Jennifer L Y JLY Biehl Michelle M Burnham Ellen L EL Chen Jen-Ting JT Attia Engi F EF Mohamed Amira A Harkins Michelle S MS Soriano Sheryll M SM Maddux Aline A West Julia C JC Badke Andrew R AR Bagshaw Sean M SM Binnie Alexandra A Carlos W Graham WG Çoruh Başak B Crothers Kristina K D'Aragon Frederick F Denson Joshua Lee JL Drover John W JW Eschun Gregg G Geagea Anna A Griesdale Donald D Hadler Rachel R Hancock Jennifer J Hasmatali Jovan J Kaul Bhavika B Kerlin Meeta Prasad MP Kohn Rachel R Kutsogiannis D James DJ Matson Scott M SM Morris Peter E PE Paunovic Bojan B Peltan Ithan D ID Piquette Dominique D Pirzadeh Mina M Pulchan Krishna K Schnapp Lynn M LM Sessler Curtis N CN Smith Heather H Sy Eric E Thirugnanam Subarna S McDonald Rachel K RK McPherson Katie A KA Kraft Monica M Spiegel Michelle M Dodek Peter M PM

Critical care medicine 20221027 12

<h4>Objectives</h4>Few surveys have focused on physician moral distress, burnout, and professional fulfilment. We assessed physician wellness and coping during the COVID-19 pandemic.<h4>Design</h4>Cross-sectional survey using four validated instruments.<h4>Setting</h4>Sixty-two sites in Canada and the United States.<h4>Subjects</h4>Attending physicians (adult, pediatric; intensivist, nonintensivist) who worked in North American ICUs.<h4>Intervention</h4>None.<h4>Measurements and main results</h4 ...[more]

PMID: 36300945

Similar Datasets

Project description:BackgroundLow tidal volume ventilation (LTVV; < 8 mL/kg predicted body weight [PBW]) is a well-established standard of care associated with improved outcomes. This study used data collated in multicenter electronic health record ICU databases from the United Kingdom and the United States to analyze the use of LTVV in routine clinical practice.Research questionWhat factors are associated with adherence to LTVV in the United Kingdom and North America?Study designThis was a retrospective, multicenter study across the United Kingdom and United States of patients who were mechanically ventilated.MethodsFactors associated with adherence to LTVV were assessed in all patients in both databases who were mechanically ventilated for > 48 h. We observed trends over time and investigated whether LTVV was associated with patient outcomes (30-day mortality and duration of ventilation) and identified strategies to improve adherence to LTVV.ResultsA total of 5,466 (Critical Care Health Informatics Collaborative [CCHIC]) and 7,384 electronic ICU collaborative research database [eICU-CRD] patients were ventilated for > 48 h and had data of suitable quality for analysis. The median tidal volume (VT) values were 7.48 mL/kg PBW (CCHIC) and 7.91 mL/kg PBW (eICU-CRD). The patients at highest risk of not receiving LTVV were shorter than 160 cm (CCHIC) and 165 cm (eICU-CRD). Those with BMI > 30 kg/m2 (CCHIC OR, 1.9 [95% CI, 1.7-2.13]; eICU-CRD OR, 1.61 [95% CI, 1.49-1.75]) and female patients (CCHIC OR, 2.39 [95% CI, 2.16-2.65]; eICU-CRD OR, 2.29 [95% CI, 2.26-2.31]) were at increased risk of having median VT > 8 mL/kg PBW. Patients with median VT < 8 mL/kg PBW had decreased 30-day mortality in the CCHIC database (CCHIC cause-specific hazard ratio, 0.86 [95% CI, 0.76-0.97]; eICU-CRD cause-specific hazard ratio, 0.9 [95% CI, 0.86-1.00]). There was a significant reduction in VT over time in the CCHIC database.InterpretationThere has been limited implementation of LTVV in routine clinical practice in the United Kingdom and the United States. VT > 8 mL/kg PBW was associated with worse patient outcomes.

Project description:We sought to define trends in and predictors of carbapenem consumption across community, teaching, and university-affiliated hospitals in the United States and Canada. We conducted a retrospective multicenter survey of carbapenem and broad-spectrum noncarbapenem beta-lactam consumption between January 2011 and December 2013. Consumption was tabulated as defined daily doses (DDD) or as days of therapy (DOT) per 1,000 patient days (PD). Multivariate mixed-effects models were explored, and final model goodness of fit was assessed by regressions of observed versus predicted values and residual distributions. A total of 20 acute-care hospitals responded. The centers treated adult patients (n = 19/20) and pediatric/neonatal patients (n = 17/20). The majority of the centers were nonprofit (n = 17/20) and not affiliated with medical/teaching institutions (n = 11/20). The median (interquartile range [IQR]) carbapenem consumption rates were 38.8 (17.4 to 95.7) DDD/1,000 PD and 29.7 (19.2 to 40.1) DOT/1,000 PD overall. Carbapenem consumption was well described by a multivariate linear mixed-effects model (fixed effects, R2 = 0.792; fixed plus random effects, R2 = 0.974). Carbapenem consumption increased by 1.91-fold/quarter from 48.6 DDD/1,000 PD (P = 0.004) and by 0.056-fold/quarter from 45.7 DOT/1,000 PD (P = 0.93) over the study period. Noncarbapenem consumption was independently related to increasing carbapenem consumption (beta = 0.31 for increasing noncarbapenem beta-lactam consumption; P < 0.001). Regular antibiogram publication and promotion of conversion from intravenous (i.v.) to oral (p.o.) administration independently affected carbapenem consumption rates. In the final model, 58.5% of the observed variance in consumption was attributable to between-hospital differences. Rates of carbapenem consumption across 20 North American hospitals differed greatly, and the observed differences were correlated with hospital-specific demographics. Additional studies focusing on the drivers of hospital-specific carbapenem consumption are needed to determine whether these rates are justifiable.

Dataset Information

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

Objectives

Design

Setting

Subjects

Intervention

Measurements and main results

Conclusions

Publications

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

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets