Several studies have examined the effects of burnout, stress, depression, and anxiety on frontline medical staff during the global pandemic. However, most have only included frontline workers or physician trainees. Few of these studies have addressed important family-work balance issues, such as childcare needs during the pandemic, which contribute significantly to the stress and burnout of staff. Now, according to a new University of Utah Health study, up to one in five employees at an academic medical institution are considering leaving their professions due to the strains of coping with the pandemic in their own lives. Individuals who had caregiving responsibilities were among those most likely to contemplate leaving or reducing hours. The findings suggest that retaining highly trained doctors, nurses, and scientists in the aftermath of the COVID-19 pandemic could be the next great health care challenge. The study appears in the specialistic journal JAMA Network Open.
Professor Angela Fagerlin, PhD, study’s senior author and chair of the Department of Population Health Sciences at the University of Utah School of Medicine, explained thoroughly: “It’s sobering to learn that, during a time of economic recession, at least one-fifth of our workforce were considering leaving their jobs because of the severe levels of stress they were experiencing. Many of these are people who have spent five to ten years of their adult lives training to do this kind of work. Yet, it’s so overwhelming and burdensome that they were potentially thinking about giving it all up. Although we conducted at a single health care system, these findings could have broader implications. We suspect these disturbing trends likely exist within other health care systems nationwide. These findings are alarming and a warning sign about the morale and well-being of doctors and nurses, as well as non-clinical health care scientists and staff.”
To remedy this oversight, scientists distributed a web-based survey of all 27,700 clinical and non-clinical U of U Health faculty, staff, and trainees in August 2020. Survey items measured childcare needs, work-life balance needs, career development impact, and stress related to the pandemic. Overall, 18% (n=5,030) completed the entire survey. The data was consistent across clinical and non-clinical respondents, confirming that everyone–men, women, those with and without children–were struggling with the impact of COVID-19, Delaney says. Nearly half (48 percent) reported having at least one child 18 years old or younger. In addition, the researchers found:
- 49% of those who had children reported that parenting and managing virtual education for children was causing them stress
- Faculty (55 percent) and trainees (60 percent) reported decreased productivity
- 47% of participants expressed concern about COVID-19 affecting their career development, with 64 percent of trainees being highly concerned
- 30% reported considering reducing hours
- 21% reported considering leaving the workforce
In addition to being a single health care system survey, other study limitations included the possibility of selection bias among those who chose to complete the survey. It’s also possible that more employees with children aged 18 or younger responded than those without children. Although the researchers found that burnout, depression, and anxiety were important, they concluded that greater emphasis on work-life balance, accessibility to dependent care, and ongoing psychological and social support could prevent thousands of medical caregivers from joining this potentially devastating exodus. Researchers argues that health care systems must develop effective ways to ensure that well-trained clinicians, support staff, and non-clinical scientists are supported during this unprecedented time as well as after it. If they do that, then health systems will be more likely to retain a diverse and effective workforce.
The growing incidence of psychological and behavioral problems following this pandemic is accumulating more and more data regarding the strong impact it has had and is having on healthcare professionals, especially those on the front lines. A very recent study led by University of Utah Health scientists, suggested more than half of doctors, nurses, and emergency responders involved in COVID-19 care could be at risk for one or more mental health problems, including acute traumatic stress, depression, anxiety, problematic alcohol use, and insomnia. The researchers found that the risk of these mental health conditions was comparable to rates observed during natural disasters, such as 9/11 and Hurricane Katrina. In particular, the scientists found that health care workers who were exposed to the virus or who were at greater risk of infection because they were immunocompromised had a significantly increased risk of acute traumatic stress, anxiety, and depression.
The prevalence for each specific disorder ranged from 15% to 30% of the respondents, with problematic alcohol use, insomnia, and depression topping the list. Alcohol abuse was another area of concern. About 36% of health care workers reported risky alcohol usage. In comparison, estimates suggest that less than 21% of physicians and 23% of emergency responders abuse alcohol in typical circumstances. Caregivers who provided direct patient care or who were in supervisory positions were at greatest risk, according to the researchers.
- Edited by Dr. Gianfrancesco Cormaci, PhD; specialist in Clinical Biochemistry.
Delaney RK et al. JAMA Network Open 2021 Apr 1; 4(4):e213997.
Rodriguez RM et al. Ann Emerg Med. 2021 Feb 5:S0196-0644(21)00108-6.
Wright HM et al. J Psychiatr Res 2020 Nov 4; S0022-3956(20)31066-9.
Dott. Gianfrancesco Cormaci
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