Front-line physicians stressed and anxious at work and home
New study reports moderate to severe stress levels in ER doctors during
the frenetic early phase of COVID-19 pandemic

Date:
July 21, 2020
Source:
University of California - San Francisco
Summary:
Amid the COVID-19 chaos in many hospitals, emergency medicine
physicians in seven cities around the country experienced rising
levels of anxiety and emotional exhaustion, regardless of the
intensity of the local surge, according to a new analysis.



FULL STORY ==========================================================================
Amid the COVID-19 chaos in many hospitals, emergency medicine physicians
in seven cities around the country experienced rising levels of anxiety
and emotional exhaustion, regardless of the intensity of the local surge, according to a new analysis led by UC San Francisco.


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In the first known study to assess stress levels of U.S. physicians
during the coronavirus pandemic, doctors reported moderate to severe
levels of anxiety at both work and home, including worry about exposing relatives and friends to the virus. Among the 426 emergency physicians surveyed, most reported changes in behavior toward family and friends, especially decreased signs of affection.

"Occupational exposure has changed the vast majority of physicians'
behavior at both work and home," said lead author Robert M. Rodriguez,
MD, a professor of Emergency Medicine at UCSF. "At home, doctors are
worried about exposing family members or roommates, possibly needing
to self-quarantine, and the effects of excess social isolation because
of their work on the front line." The results, which appear July 21,
2020, in Academic Emergency Medicine, found slight differences between
men and women, with women reporting higher stress.

Among male physicians, the median reported effect of the pandemic on
both work and home stress levels was 5 on a scale of 1 to 7 (1=not
at all, 4=somewhat, and 7=extremely). For women, the median was 6 in
both areas. Both men and women also reported that levels of emotional exhaustion or burnout increased from a pre-pandemic median of 3 to a
median of 4 after the pandemic started.

Lack of PPE was associated with the highest level of concern and was also
the measure most often cited that would provide greatest relief. The
doctors also voiced anxiety about inadequate rapid diagnostic testing,
the risk of community spread by discharged patients, and the well-being
of coworkers diagnosed with COVID-19.

But the survey also showed clear-cut ways of mitigating anxiety:
* Improve access to PPE; * Increase availability of rapid turnaround
testing; * Clearly communicate COVID-19 protocol changes; * Assure
access to self-testing and personal leave for front line
providers.

The responses came from faculty (55 percent), fellows (4.5 percent), and residents (about 39 percent), with a median age of 35. Most physicians
lived with a partner (72 percent), while some lived alone (nearly 15
percent) or with roommates (11 percent). Nearly 39 percent had a child
under age 18.

The study involved healthcare providers at seven academic emergency
departments and affiliated institutions in California, Louisiana and
New Jersey.

Researchers noted that the majority of study sites were in California,
which at the time of the survey had not yet experienced the large surges
of patients seen in other areas of the country. But the study found that
median levels of anxiety in the California sites were similar to those
in the New Orleans and Camden sites, which were experiencing surges at
the time.

"This suggests that the impact of COVID-19 on anxiety levels is pervasive
and that measures to mitigate stress should be enacted universally,"
Rodriguez said. "Some of our findings may be intuitive, but this research provides a critical early template for the design and implementation of interventions that will address the mental health needs of emergency
physicians in the COVID-19 pandemic era." The study is longitudinal,
with this first phase focused on the early "acceleration" phase of
the pandemic. Subsequent studies will address stressors that have
arisen throughout the course of the pandemic, including childcare and homeschooling demands, the economic impact of fewer patients overall in
the ER, and possible development of long-term post-traumatic stress.

Authors: From the University of California, co-authors are Anthony Medak,
MD, of UC San Diego; Brian Chinnock, MD, of the UCSF-Fresno Medical
Education Program; Remi Frazier, MS, of UCSF; and Richelle Cooper, MD,
of UCLA.


========================================================================== Story Source: Materials provided by
University_of_California_-_San_Francisco. Original written by Elizabeth Fernandez. Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Robert M. Rodriguez, Anthony J. Medak, Brigitte M. Baumann,
Stephen Lim,
Brian Chinnock, Remi Frazier, Richelle J. Cooper. Academic Emergency
Medicine Physicians' Anxiety Levels, Stressors, and Potential
Stress Mitigation Measures During the Acceleration Phase of the
COVID‐19 Pandemic. Academic Emergency Medicine, 2020; DOI:
10.1111/acem.14065 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/07/200721084205.htm

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