Disciplina de Medicina de Urgência and Medicina Baseada em Evidências, Departamento de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.
Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil.
PLoS One. 2022 Mar 31;17(3):e0266228. doi: 10.1371/journal.pone.0266228. eCollection 2022.
Medical residents' mental health is currently an issue of concern for medical educators worldwide. The COVID-19 pandemic has raised the greatest concerns given the psychological effects of this scenario on medical residents on the frontlines of the pandemic. To assess the psychological impact of the COVID-19 pandemic on physicians in residency training, the collective symptoms of burnout, depression and anxiety are used to identify the residents' beliefs and clinical practices related to COVID-19 patients and their behaviors concerning disease prevention.
This observational study involved 3071 medical residents from all regions of Brazil. An online questionnaire assessed the presence of burnout using the Oldenburg Burnout Inventory, depressive symptoms using the Patient Health Questionaire-9, anxiety symptoms using the Generalized Anxiety Disorder-7, and COVID-19 Impact Questions to assess the residents' beliefs and clinical practices related to COVID-19 patients. Exploratory analyses, logistic regression and multinomial regression analysis were performed in this investigation.
Moderate and severe depressive symptoms were the most common (67.7%) followed by anxiety symptoms (52.8%) and burnout (48.6%). The difference between residents with or without contact with COVID-19 patients was significant increased when analyzing different aspects of clinical practice, behavior, substance use and mental health.
These results suggest an increase in depression and anxiety symptoms among medical residents dealing with COVID-19, upstaging previous concerns about medical residents' mental health. The prevalence of burnout is similar to that of a nonpandemic scenario. Considering the severity of the pandemic scenario and the overburden of healthcare services, medical residents' mental health deserves special care.
医学住院医师的心理健康目前是全球医学教育者关注的问题。鉴于这种情况对处于大流行一线的医学住院医师的心理影响，COVID-19 大流行引起了最大的关注。为了评估 COVID-19 大流行对住院医师培训中的医师的心理影响，使用倦怠、抑郁和焦虑的集体症状来确定住院医师对 COVID-19 患者的信念和临床实践以及他们与疾病预防有关的行为。
本观察性研究涉及来自巴西所有地区的 3071 名医学住院医师。在线问卷调查使用奥登堡倦怠量表评估倦怠的存在，使用患者健康问卷-9 评估抑郁症状，使用广泛性焦虑症-7 评估焦虑症状，以及 COVID-19 影响问卷评估住院医师对 COVID-19 患者的信念和临床实践。在这项研究中进行了探索性分析、逻辑回归和多项回归分析。
中度和重度抑郁症状最为常见（67.7%），其次是焦虑症状（52.8%）和倦怠（48.6%）。在分析不同的临床实践、行为、物质使用和心理健康方面时，与接触或未接触 COVID-19 患者的住院医师之间的差异具有统计学意义。
这些结果表明，与 COVID-19 患者打交道的医学住院医师中抑郁和焦虑症状增加，加剧了之前对医学住院医师心理健康的担忧。倦怠的患病率与非大流行情况下相似。考虑到大流行情况的严重程度和医疗服务的负担过重，医学住院医师的心理健康值得特别关注。
