Division of Hospital Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA.
J Hosp Med. 2022 Apr;17(4):259-267. doi: 10.1002/jhm.12812. Epub 2022 Mar 24.
The early phase of the coronavirus disease 2019 (COVID-19) pandemic had a negative impact on the wellness of hospitalists and hospital medicine advanced practice providers (APPs). However, the burden of the pandemic has evolved and the change in hospitalist and hospital medicine APP wellness is unknown.
To evaluate the longitudinal trend in wellness of hospitalists and hospital medicine APPs during the COVID-19 pandemic and guide wellness interventions.
DESIGN, SETTING AND PARTICIPANTS: Between May 4, 2020, and June 6, 2021, we administered three surveys to Internal Medicine hospitalists (physicians) and hospital medicine APPs (nurse practitioners and physician assistants) at 16 Mayo Clinic hospitals in four U.S. states.
We evaluated the association of hospitalist and hospital medicine APP characteristics with PROMIS® measures of global wellbeing-mental health, global wellbeing-social activities and relationships, anxiety, social isolation, and emotional support, using logistic and linear regression models.
The response rates were 52.2% (n=154/295; May 2020), 37.1% (n=111/299; October 2020) and 35.5% (n=114/321; May 2021). In mixed models that included hospitalist and hospital medicine APP characteristics and survey period, APPs, compared with physicians, had lower odds of top global wellbeing-social activities and relationships (adjusted odds ratio 0.42 [0.22-0.82]; p = .01), whereas survey period showed no association. The survey period showed an independent association with higher anxiety (May 2020 vs. others) and higher social isolation (October 2020 vs. others), whereas profession showed no association. Concern about contracting COVID-19 at work was significantly associated with lower odds of top global wellbeing-mental health and global wellbeing-social activities and relationships, and with higher anxiety and social isolation. Hospitalist and hospital medicine APP characteristics showed no association with levels of emotional support.
In this longitudinal assessment of hospitalists and hospital medicine APPs, concern about contracting COVID-19 at work remained a determinant of wellness. The trend for global wellbeing, anxiety, and social isolation may guide wellness interventions.
2019 年冠状病毒病（COVID-19）大流行的早期阶段对医院医生和医院医学高级实践提供者（APP）的健康产生了负面影响。然而，大流行的负担已经发生了变化，医院医生和医院医学 APP 健康状况的变化尚不清楚。
评估 COVID-19 大流行期间医院医生和医院医学 APP 健康状况的纵向趋势，并指导健康干预措施。
设计、地点和参与者：在 2020 年 5 月 4 日至 2021 年 6 月 6 日期间，我们对美国四个州的 16 家梅奥诊所医院的内科医院医生（医生）和医院医学 APP（执业护士和医师助理）进行了三次调查。
我们使用逻辑和线性回归模型评估了医院医生和医院医学 APP 特征与 PROMIS®全球健康-心理健康、全球健康-社会活动和关系、焦虑、社交孤立和情感支持测量值之间的关联。
响应率分别为 52.2%（n=154/295；2020 年 5 月）、37.1%（n=111/299；2020 年 10 月）和 35.5%（n=114/321；2021 年 5 月）。在包括医院医生和医院医学 APP 特征和调查期间的混合模型中，与医生相比，APP 较低的可能性处于最佳全球健康-社会活动和关系（调整后的优势比 0.42[0.22-0.82]；p=0.01），而调查期间没有关联。调查期间与更高的焦虑（2020 年 5 月与其他时间相比）和更高的社交孤立（2020 年 10 月与其他时间相比）呈独立关联，而专业无关联。对在工作中感染 COVID-19 的担忧与较低的最佳全球健康-心理健康和全球健康-社会活动和关系以及较高的焦虑和社交孤立的可能性显著相关。医院医生和医院医学 APP 特征与情感支持水平无关。
在这项对医院医生和医院医学 APP 的纵向评估中，对在工作中感染 COVID-19 的担忧仍然是健康的决定因素。全球健康、焦虑和社交孤立的趋势可能指导健康干预措施。
