Belfer Joshua, Feld Lance, Jan Sophia, Fishbein Joanna, Young John Q, Barone Stephen
Pediatrics, Steven and Alexandra Cohen Children's Medical Center, New Hyde Park, New York, NY 11040, USA.
The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York, NY 11030, USA.
Int J Environ Res Public Health. 2022 Mar 21;19(6):3745. doi: 10.3390/ijerph19063745.
The COVID-19 pandemic has provided challenges to all healthcare workers. While the brunt of treating COVID-19 patients fell upon adult providers, pediatricians also experienced significant stressors and disruptions. Academic pediatricians and trainees (fellows and residents) were redeployed to manage adult patients in hospitalist and intensive care settings and/or had major changes to their clinical schedules. In this study, we aimed to describe levels of self-reported depression, anxiety, and burnout in pediatric physicians following the initial wave of the pandemic at the largest integrated health system in New York State. A cross-sectional study was conducted among pediatric physicians who cared for patients during the COVID-19 pandemic within the Northwell Health System as part of the Northwell Wellbeing Registry, a longitudinal registry assessing the psychological impact of COVID-19 on healthcare providers. A total of 99 pediatric physician respondents were included in this study; 72% of whom were attendings, 28% of whom were trainees. Compared to attendings, trainees reported significantly higher proportions of burnout-emotional exhaustion ( = 0.0007) and burnout-depersonalization ( = 0.0011) on the Abbreviated Maslach Burnout Inventory. There was not a similar trend in probable depression or probable anxiety using the Patient Health Questionnaire. In a multivariable logistic regression model, being a trainee was significantly associated with increased odds of burnout-emotional exhaustion (OR 5.94, 95% Confidence Interval: 1.85-19.02). These findings suggest that fellows and residents were a vulnerable population during the COVID-19 pandemic. Training programs should pay special attention to their trainees during times of crisis, and future studies can help to identify protective factors to reduce the risk of burnout during these times.
新冠疫情给所有医护人员都带来了挑战。虽然治疗新冠患者的主要任务落在了成年医护人员身上，但儿科医生也经历了巨大的压力源和工作干扰。学术型儿科医生和实习生（专科住院医生和住院医师）被重新调配，去管理住院医师和重症监护病房的成年患者，和/或其临床工作安排发生了重大变化。在本研究中，我们旨在描述纽约州最大的综合医疗系统在疫情第一波期间儿科医生自我报告的抑郁、焦虑和职业倦怠水平。作为诺斯韦尔健康登记处的一部分，对在新冠疫情期间在诺斯韦尔健康系统中照顾患者的儿科医生进行了一项横断面研究，该登记处是一个纵向登记处，评估新冠疫情对医护人员的心理影响。本研究共纳入了99名儿科医生受访者；其中72%是主治医生，28%是实习生。与主治医生相比，实习生在简明马氏职业倦怠量表上报告的职业倦怠——情感耗竭（P = 0.0007）和职业倦怠——去个性化（P = 0.0011）比例显著更高。使用患者健康问卷评估时，在可能的抑郁或可能的焦虑方面没有类似趋势。在多变量逻辑回归模型中，作为实习生与职业倦怠——情感耗竭几率增加显著相关（比值比5.94，95%置信区间：1.85 - 19.02）。这些发现表明，专科住院医生和住院医师在新冠疫情期间是弱势群体。培训项目在危机时期应特别关注其学员，未来的研究有助于确定保护因素，以降低这些时期职业倦怠的风险。
