Dr. Lou: Postdoctoral Fellow, Research Institute of the McGill University Health Centre, Montreal, CA. Dr. Montreuil: Assistant professor, Department of Educational and Counselling Psychology, McGill University, Montreal, CA; Associate Member, Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, CA; and Associate Investigator, Research Institute of the McGill University Health Centre, Montreal, CA. Dr. Feldman: Professor and Chair, Department of Surgery, Faculty of Medicine and Health Sciences, and Chair, The Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University, Montreal, CA. Dr. Fried: Professor, Department of Surgery, Faculty of Medicine and Health Sciences, Director, Steinberg Centre for Simulation and Interactive Learning, McGill University, Montreal, CA. Dr. Lavoie-Tremblay: Associate Professor, Ingram School of Nursing, McGill University, Montreal, CA. Dr. Bhanji: Director of Education, Steinberg Centre for Simulation and Interactive Learning, Professor, Department of Pediatrics, Faculty of Medicine and Health Sciences, and Associate member, Institute for Health Sciences Education, McGill University, Montreal, CA. Ms. Kaneva: Program coordinator, The Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University, Montreal, CA. Ms. Kennedy: Doctoral student, Department of Educational and Counselling Psychology, Faculty of Education, McGill University, Montreal, CA. Dr. Harley: Assistant professor, Department of Surgery, Faculty of Medicine and Health Sciences, McGill University, Montreal, CA, Scientist, Research Institute of the McGill University Health Centre, Montreal, CA; Associate Member, Department of Educational and Counselling Psychology; Director of Research, Steinberg Centre for Simulation and Interactive Learning; and Associate Member, Institute for Health Sciences Education, McGill University, Montreal, CA.
J Contin Educ Health Prof. 2022 Jan 1;42(1):e44-e52. doi: 10.1097/CEH.0000000000000365.
Health care providers (HCPs) have experienced more stress and burnout during COVID-19 than before. We compared sources and levels of stress, distress, and approaches to coping between nurses and physicians, and examined whether coping strategies helped mitigate the negative impact of stress and intentions to quit.
Using a cross-sectional study design, burnout was measured with the Maslach Burnout Inventory. Psychological distress was measured using the Depression, Anxiety, and Stress Scale. A self-reported survey was used to evaluate stressors, impact on perceived performance, and intentions to quit. The data were analyzed using t-tests and linear regression models.
Responses of 119 HCPs were analyzed. Findings suggest that (1) compared to physicians, nurses experienced a higher level of distress and burnout, and used more maladaptive coping strategies. (2) Both nurses and physicians experienced more distress and burnout during COVID-19 than before. (3) Adaptive coping strategies moderated the negative impact of stress on work performance (4) Adaptive coping strategies moderated the negative effect of stress on burnout, which in turn reduced intentions to quit. Stress negatively impacted work performance and burnout only for those with low, but not high, levels of adaptive coping strategies.
The current findings of HCPs' challenges, risks, and protective factors provide valuable information (1) on COVID-19's impact on HCPs, (2) to guide the distribution of institutional supportive efforts and recommend adaptive coping strategies, and (3) to inform medical education, such as resilience training, focusing on adaptive coping approaches.
在 COVID-19 期间，医疗保健提供者（HCP）比以往经历了更多的压力和倦怠。我们比较了护士和医生之间压力、困扰和应对方式的来源和水平，并研究了应对策略是否有助于减轻压力和离职意愿的负面影响。
使用横断面研究设计，使用 Maslach 倦怠量表测量倦怠。使用抑郁、焦虑和压力量表测量心理困扰。使用自我报告调查评估压力源、对感知绩效的影响和离职意愿。使用 t 检验和线性回归模型分析数据。
分析了 119 名 HCP 的回复。研究结果表明：（1）与医生相比，护士经历了更高水平的困扰和倦怠，并且使用了更多的适应不良应对策略。（2）护士和医生在 COVID-19 期间比以前经历了更多的困扰和倦怠。（3）适应性应对策略调节了压力对工作绩效的负面影响。（4）适应性应对策略调节了压力对倦怠的负面影响，从而降低了离职意愿。只有那些适应性应对策略水平较低的人，而不是那些水平较高的人，压力才会对工作绩效和倦怠产生负面影响。
HCP 面临的挑战、风险和保护因素的当前发现提供了有价值的信息：（1）关于 COVID-19 对 HCP 的影响；（2）指导机构支持努力的分配，并推荐适应性应对策略；（3）为医学教育提供信息，例如专注于适应性应对方法的弹性培训。
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