Beyond PPE: a mixed qualitative–quantitative study capturing the wider issues affecting doctors’ well-being during the COVID-19 pandemic

Abstract

The COVID-19 pandemic has brought unprecedented challenges to the medical workforce. This has put them at increased risk of burnout at a time when levels are already worryingly high in the profession, with recent studies consistently showing that around half of doctors meet the validated criteria for burnout.ObjectivesTo understand the wider factors influencing and impacting upon hospital doctors’ well-being during the COVID-19 pandemic in England.DesignCross-sectional survey and mixed quantitative–qualitative analysis.SettingAcute National Health Service (NHS) Foundation Trust in England.ParticipantsAn online survey was circulated in early June 2020 to all 449 doctors employed by the Trust. 242 doctors completed the survey (54% response rate).Primary outcome measuresQuestions assessed occupational details, self-reported changes in physical and mental health, satisfaction with working hours and patterns, availability of personal protective equipment (PPE), medication and facilities, communication and sought to identify areas seen as having a significant effect on doctors’ well-being.Results96% of respondents requiring PPE were able to access it. Nearly half of the respondents felt that their mental health had deteriorated since the start of the pandemic. Over a third stated that their physical health had also declined. Issues identified as having a negative impact on doctors included increased workload, redeployment, loss of autonomy, personal issues affecting family members, anxiety around recovery plans, inadequate access to changing and storage facilities and to rest areas that allow for social distancing. Doctors appreciated access to ‘calm rooms’ that were made available for staff, access to clinical psychology support, free drinks and free car parking on site.ConclusionThe emerging themes are suggestive of increased burnout risk among doctors during the COVID-19 pandemic and encompass factors well beyond shortage of PPE. Small organisational initiatives and the implementation of changes suggested by survey respondents can have a positive impact on doctors’ well-being.

Associations between the working experiences at frontline of COVID-19 pandemic and mental health of Korean public health doctors

“…The current study result is in concordance with recent studies of healthcare workers in German or Italy during COVID-19 that showed associations between working at COVID-19 frontline versus higher level of perceived stress or post-traumatic symptoms [ 44 , 49 ]. Further, other studies that examined mental health of medical professionals at frontline of COVID-19 pandemic also demonstrated increased odds of mental health worsening (depressive mood, anxiety, or burnout) in presence of working environments such as insufficient supply of personal protective equipment [ 50 – 54 ], endorsed barriers at working [ 55 ], increased physical and psychological workload [ 51 , 56 , 57 ], reduced amount of day-off and successive period of active duty after 24-h shifts [ 50 ]. Collectively, sufficient and timely supply of personal protective equipment and efficient distribution of rest period between the active duty are required for protection of mental health for PHDs at frontline of pandemic.…”

Risk of burnout and stress in physicians working in a COVID team: A longitudinal survey

“… 31 Cubitt et al identified a decline in mental health common to all medical specialties, however, less expressed in those who worked in acute care medicine. 32 Habit in managing complex situations may in fact mitigate the effect of the pandemic on physicians' mental health. Similarly, it is conceivable that the broader scope of work of the internists in our hospital that work in inpatient unit, rather than outpatient settings, and manage patients with more comorbidities (as the ones with coronavirus disease usually show), could make physicians board‐certified in internal medicine less vulnerable to burnout and stress when managing this type of patient.…”

The Experience of a Single NHS England Trust on the Impact of the COVID-19 Pandemic on Junior and Middle-Grade Doctors: What Is Next?

“…Since 2020, the COVID-19 pandemic has affected approximately 150 million people and taken over 3 million lives [ 6 ]. Furthermore, it has posed an unprecedented challenge to the healthcare profession worldwide and increased the existing risk of burnout for doctors [ 7 ]. Similar to studies conducted in China and Italy, the BMA reported that more than 50% of doctors have had progressive worsening of general health and well-being since the first wave [ 8 ].…”