NewYork-Presbyterian Queens Hospital, Flushing, NY 11355, USA.
Department of Medicine, Weill Cornell Medical College, New York, NY 10065, USA.
Int J Environ Res Public Health. 2023 Feb 8;20(4):2930. doi: 10.3390/ijerph20042930.
Frontline clinicians responding to the COVID-19 pandemic are at increased risk of burnout, but less is known about the trajectory of clinician burnout as caseloads increase and decrease. Personal and professional resources, including self-efficacy and hospital support, can attenuate the risk of burnout. Yet, empirical data documenting how burnout and resources changed as the pandemic waxed and waned are limited. This intensive longitudinal prospective study employed ecological momentary assessment methods to examine trajectories of burnout and resources over the pandemic's first year in a New York City hospital. A 10-item survey was emailed every 5 days to frontline clinicians (physicians, nurses, and physician assistants). The primary outcome was a single-item validated measure of burnout; predictors included daily hospital COVID-19-related caseloads and personal and professional resources. Clinicians ( = 398) completed the initial survey and an average of 12 surveys over the year. Initially, 45.3% of staff reported burnout; over the year, 58.7% reported burnout. Following the initial COVID peak, caseloads declined, and burnout levels declined. During the second wave of COVID, as caseloads increased and remained elevated and personal and professional resource levels decreased, burnout increased. This novel application of intensive longitudinal assessment enabled ongoing surveillance of burnout and permitted us to evaluate how fluctuations in caseload intensity and personal and professional resources related to burnout over time. The surveillance data support the need for intensified resource allocation during prolonged pandemics.
参与应对 COVID-19 大流行的一线临床医生面临更高的倦怠风险，但对于随着病例数量的增加和减少，临床医生倦怠的轨迹知之甚少。个人和专业资源，包括自我效能感和医院支持，可以降低倦怠的风险。然而，记录大流行期间倦怠和资源如何变化的经验数据有限。这项密集的纵向前瞻性研究采用生态瞬时评估方法，在纽约市一家医院的大流行第一年期间，研究了倦怠和资源的轨迹。每 5 天向一线临床医生（医生、护士和医师助理）发送一份包含 10 个项目的调查。主要结果是一项倦怠的单一项目验证措施；预测因素包括每天医院与 COVID-19 相关的病例数以及个人和专业资源。临床医生（n = 398）完成了初始调查，并在一年内平均完成了 12 次调查。最初，45.3%的员工报告倦怠；在这一年中，有 58.7%的员工报告倦怠。在最初的 COVID-19 高峰过后，病例数下降，倦怠水平下降。在 COVID-19 的第二波中，随着病例数的增加和持续增加以及个人和专业资源水平的下降，倦怠加剧。这种密集纵向评估的新应用使我们能够持续监测倦怠情况，并评估病例数量强度和个人与专业资源随时间的波动与倦怠之间的关系。监测数据支持在长期大流行期间需要加强资源分配。
