Health-care Professionals' Perceptions of Critical Care Resource Availability and Factors Associated With Mental Well-being During Coronavirus Disease 2019 (COVID-19): Results from a US Survey.

COVID-19 burnout critical care resources health-care provider mental health personal protective equipment

Journal

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
ISSN: 1537-6591
Titre abrégé: Clin Infect Dis
Pays: United States
ID NLM: 9203213

Informations de publication

Date de publication:
18 05 2021
Historique:
received: 01 07 2020
accepted: 31 08 2020
pubmed: 3 9 2020
medline: 21 5 2021
entrez: 3 9 2020
Statut: ppublish

Résumé

Assessing the impact of coronavirus disease 2019 (COVID-19) on intensive care unit (ICU) providers' perceptions of resource availability and evaluating the factors associated with emotional distress/burnout can inform interventions to promote provider well-being. Between 23 April and 7 May 2020, we electronically administered a survey to physicians, nurses, respiratory therapists (RTs), and advanced practice providers (APPs) caring for COVID-19 patients in the United States. We conducted a multivariate regression to assess associations between concerns, a reported lack of resources, and 3 outcomes: a primary outcome of emotional distress/burnout and 2 secondary outcomes of (1) fear that the hospital is unable to keep providers safe; and (2) concern about transmitting COVID-19 to their families/communities. We included 1651 respondents from all 50 states: 47% were nurses, 25% physicians, 17% RTs, and 11% APPs. Shortages of intensivists and ICU nurses were reported by 12% and 28% of providers, respectively. The largest supply restrictions reported were for powered air purifying respirators (56% reporting restricted availability). Provider concerns included worries about transmitting COVID-19 to their families/communities (66%), emotional distress/burnout (58%), and insufficient personal protective equipment (PPE; 40%). After adjustment, emotional distress/burnout was significantly associated with insufficient PPE access (adjusted relative risk [aRR], 1.43; 95% confidence interval [CI], 1.32-1.55), stigma from community (aRR, 1.32; 95% CI, 1.24-1.41), and poor communication with supervisors (aRR, 1.13; 95% CI, 1.06-1.21). Insufficient PPE access was the strongest predictor of feeling that the hospital is unable to keep providers safe and worries about transmitting infection to their families/communities. Addressing insufficient PPE access, poor communication from supervisors, and community stigma may improve provider mental well-being during the COVID-19 pandemic.

Sections du résumé

BACKGROUND
Assessing the impact of coronavirus disease 2019 (COVID-19) on intensive care unit (ICU) providers' perceptions of resource availability and evaluating the factors associated with emotional distress/burnout can inform interventions to promote provider well-being.
METHODS
Between 23 April and 7 May 2020, we electronically administered a survey to physicians, nurses, respiratory therapists (RTs), and advanced practice providers (APPs) caring for COVID-19 patients in the United States. We conducted a multivariate regression to assess associations between concerns, a reported lack of resources, and 3 outcomes: a primary outcome of emotional distress/burnout and 2 secondary outcomes of (1) fear that the hospital is unable to keep providers safe; and (2) concern about transmitting COVID-19 to their families/communities.
RESULTS
We included 1651 respondents from all 50 states: 47% were nurses, 25% physicians, 17% RTs, and 11% APPs. Shortages of intensivists and ICU nurses were reported by 12% and 28% of providers, respectively. The largest supply restrictions reported were for powered air purifying respirators (56% reporting restricted availability). Provider concerns included worries about transmitting COVID-19 to their families/communities (66%), emotional distress/burnout (58%), and insufficient personal protective equipment (PPE; 40%). After adjustment, emotional distress/burnout was significantly associated with insufficient PPE access (adjusted relative risk [aRR], 1.43; 95% confidence interval [CI], 1.32-1.55), stigma from community (aRR, 1.32; 95% CI, 1.24-1.41), and poor communication with supervisors (aRR, 1.13; 95% CI, 1.06-1.21). Insufficient PPE access was the strongest predictor of feeling that the hospital is unable to keep providers safe and worries about transmitting infection to their families/communities.
CONCLUSIONS
Addressing insufficient PPE access, poor communication from supervisors, and community stigma may improve provider mental well-being during the COVID-19 pandemic.

Identifiants

pubmed: 32877508
pii: 5900684
doi: 10.1093/cid/ciaa1311
pmc: PMC7499503
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e566-e576

Subventions

Organisme : NCATS NIH HHS
ID : UL1 TR001863
Pays : United States

Commentaires et corrections

Type : CommentIn

Informations de copyright

© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Auteurs

Monisha Sharma (M)

Department of Global Health, University of Washington, Seattle, Washington, USA.

Claire J Creutzfeldt (CJ)

Department of Neurology, Harborview Medical Center, University of Washington, Seattle, Washington, USA.
Cambia Palliative Care Center of Excellence, University of Washington, Seattle, Washington, USA.
Cambia Health Foundation, Seattle, Washington, USA.

Ariane Lewis (A)

Departments of Neurology and Neurosurgery, New York University, New York, New York, USA.

Pratik V Patel (PV)

Department of Anesthesiology and Pain Medicine, Harborview Medical Center, University of Washington, Seattle, Washington, USA.

Christiane Hartog (C)

Klinik für Anaesthesie und Operative Intensivmedizin, Charité Universitaetsmedizin Berlin, Berlin, Germany.
Klinik Bavaria Kreischa, Kreischa, Germany.

Gemi E Jannotta (GE)

Department of Anesthesiology and Pain Medicine, Harborview Medical Center, University of Washington, Seattle, Washington, USA.

Patricia Blissitt (P)

Department of Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, Washington, USA.

Erin K Kross (EK)

Cambia Palliative Care Center of Excellence, University of Washington, Seattle, Washington, USA.
Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington, Seattle, Washington, USA.

Nicholas Kassebaum (N)

Department of Global Health, University of Washington, Seattle, Washington, USA.
Department of Anesthesiology and Pain Medicine, Harborview Medical Center, University of Washington, Seattle, Washington, USA.

David M Greer (DM)

Department of Neurology, Boston University, Boston, Massachusetts, USA.

J Randall Curtis (JR)

Cambia Palliative Care Center of Excellence, University of Washington, Seattle, Washington, USA.
Cambia Health Foundation, Seattle, Washington, USA.
Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington, Seattle, Washington, USA.

Sarah Wahlster (S)

Department of Neurology, Harborview Medical Center, University of Washington, Seattle, Washington, USA.
Department of Anesthesiology and Pain Medicine, Harborview Medical Center, University of Washington, Seattle, Washington, USA.
Department of Neurological Surgery, Harborview Medical Center, University of Washington, Seattle, Washington, USA.

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