Infectious Disease Department, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
Department of Psychiatry, Zucker Hillside Hospital at Northwell Health, Manhasset, NY, USA.
Arch Environ Occup Health. 2022;77(10):819-827. doi: 10.1080/19338244.2021.2023084. Epub 2022 Jan 8.
The COVID-19 pandemic has generated significant psychological distress among health care workers worldwide. New York State, particularly New York City and surrounding counties, were especially affected, and experienced over 430,000 COVID-19 cases and 25,000 deaths by mid-August 2020. We hypothesized that physicians and trainees (residents/fellows) who were redeployed outside of their specialty to treat COVID-19 inpatients would have higher burnout.
We conducted a cross-sectional survey to assess burnout among attending and trainee physicians who provided patient care during the COVID-19 pandemic between March-May 2020 across a diverse health care system in New York. Separate multivariable logistic regressions were performed to determine the association between redeployment and measures of burnout: Emotional Exhaustion (EE) and Depersonalization. Burnout measures were also compared by physician vs trainee status. The differential association between redeployment and outcomes with respect to trainee status was also evaluated.
Redeployment was significantly associated with increased odds of EE {OR =1.53, 95% CI: 1.01-2.31} after adjusting for gender and Epidemic-Pandemic Impacts Inventory (EPII) score. Similarly, being a trainee, especially a junior level trainee, was associated with increased odds of EE {OR = 1.59, 95% CI: 1.01-2.51} after adjusting for gender and EPII scores. However, neither redeployment nor trainee status were significantly associated with Depersonalization. Interactions between redeployment and trainee status were not significant for any of the outcomes (>.05).
Physicians who were redeployed to treat COVID-19 patients had higher reported measures of EE. Trainees, irrespective of redeployment status, had higher EE as compared with attendings. Additional research is needed to understand the long-term impact of redeployment on burnout among redeployed physicians. Programs to identify and address potential burnout among physicians, particularly trainees, during pandemics may be beneficial.
COVID-19 大流行在全球范围内给医护人员带来了巨大的心理困扰。纽约州，特别是纽约市及其周边县，受到的影响尤其严重，截至 2020 年 8 月中旬，已累计出现超过 43 万例 COVID-19 病例和 2.5 万例死亡病例。我们假设，被重新部署到其专业以外治疗 COVID-19 住院患者的医生和受训者（住院医师/研究员）会出现更高的倦怠感。
我们进行了一项横断面调查，以评估 2020 年 3 月至 5 月期间在纽约州一个多元化医疗保健系统中为 COVID-19 患者提供护理的主治医生和受训医生的倦怠感。分别进行多变量逻辑回归，以确定重新部署与倦怠感测量指标（情绪耗竭和去人格化）之间的关联。还比较了医生和受训者之间的倦怠感测量指标。还评估了重新部署与受训者状态之间的关系的差异关联。
调整性别和流行病影响量表（EPII）得分后，重新部署与情绪耗竭的可能性增加显著相关（OR=1.53，95%CI：1.01-2.31）。同样，作为受训者，特别是初级受训者，与情绪耗竭的可能性增加相关（OR=1.59，95%CI：1.01-2.51），调整性别和 EPII 得分后。然而，重新部署和受训者状态都与去人格化无显著关联。重新部署和受训者状态之间的相互作用对于任何结果都不显著（>.05）。
被重新部署治疗 COVID-19 患者的医生报告的情绪耗竭测量指标更高。与主治医生相比，受训者，无论是否被重新部署，情绪耗竭的可能性更高。需要进一步研究以了解重新部署对重新部署医生倦怠感的长期影响。在大流行期间，可能需要制定计划以识别和解决医生，特别是受训者的潜在倦怠感。
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