School of Psychology, University of Queensland, Brisbane, QLD, Australia.
School of Clinical Medicine, University of Queensland, Brisbane, QLD, Australia.
Anaesthesia. 2023 Feb;78(2):197-206. doi: 10.1111/anae.15879. Epub 2022 Oct 31.
The COVID-19 pandemic has imposed substantial burdens on clinicians and there is a need to better understand the impact on mental health and well-being. This scoping review investigates the prevalence of mental health concerns in anaesthetists, risk and protective factors for mental well-being, and anaesthetists' pandemic-related concerns and support. We searched online databases for articles published between January 2020 and May 2022, using search terms related to: anaesthesia; burnout, well-being, mental health or stress; and COVID-19. We identified 20 articles comprising 19 different populations of anaesthetists (n = 8680) from 14 countries. Studies identified the prevalence of the following condition in anaesthetists: burnout (14-59%); stress (50-71%); anxiety (11-74%); depression (12-67%); post-traumatic stress (17-25%); psychological distress (52%); and insomnia (17-61%). Significant risk factors for poorer mental health included: direct COVID-19-related issues (fear of self and family exposure to infection; requirement for quarantine); practitioner health factors (insomnia; comorbidities); psychosocial factors (loneliness; isolation; perceived lack of support at home and work); demographic factors (female gender; non-white ethnicity; LGBTQIA+); and workplace factors (redeployment outside area of clinical practice; increased work effort; personal protective equipment shortages). Protective factors identified included: job satisfaction; perceived organisational justice; older age; and male sex. Anaesthetists' self-reported concerns related to: personal protective equipment; resource allocation; fear of infection; fear of financial loss; increased workload; and effective communication of protocols for patient treatment. Support from family, colleagues and hospital management was identified as an important coping mechanism. Findings from this review may support the design of interventions to enhance anaesthetists' psychological health during pandemic conditions and beyond. Future research should include consistent psychological outcome measures and rigorous experimental design beyond cross-sectional studies.
新型冠状病毒肺炎大流行给临床医生带来了巨大负担，因此需要更好地了解其对心理健康和幸福感的影响。本范围综述调查了麻醉师的心理健康问题的流行程度、心理健康的风险和保护因素，以及麻醉师与大流行相关的关注和支持。我们使用与麻醉学、倦怠、幸福感、心理健康或压力以及 COVID-19 相关的搜索词，在在线数据库中搜索了 2020 年 1 月至 2022 年 5 月期间发表的文章。我们确定了 20 篇文章，这些文章包含了来自 14 个国家的 19 个不同的麻醉师人群（n=8680）。研究确定了麻醉师中以下疾病的流行程度：倦怠（14-59%）；压力（50-71%）；焦虑（11-74%）；抑郁（12-67%）；创伤后应激（17-25%）；心理困扰（52%）；和失眠（17-61%）。心理健康状况较差的显著风险因素包括：与 COVID-19 直接相关的问题（担心自己和家人感染；需要隔离）；从业人员健康因素（失眠；合并症）；社会心理因素（孤独；隔离；在家和工作中感到缺乏支持）；人口统计学因素（女性；非白种人；LGBTQIA+）；和工作场所因素（重新部署到临床实践以外的领域；工作量增加；个人防护设备短缺）。确定的保护因素包括：工作满意度；感知组织公正；年龄较大；和男性性别。麻醉师自我报告的关注包括：个人防护设备；资源分配；感染恐惧；财务损失恐惧；工作量增加；以及患者治疗方案的有效沟通。家人、同事和医院管理层的支持被认为是一种重要的应对机制。本综述的研究结果可能支持设计干预措施，以在大流行期间及以后增强麻醉师的心理健康。未来的研究应包括一致的心理结果测量和超越横断面研究的严格实验设计。
