COVID-19 pandemic: Psychological impact on anaesthesiologists

Abstract

Background and Aim: The anaesthesiologists are at the highest risk of contracting infection of coronavirus disease 2019 (COVID-19) in emergency room, operation theatres and intensive care units. This overwhelming situation can make them prone for psychological stress leading to anxiety and insomnia. MATERIALS AND METHODS We did an online self-administered questionnaire-based observational cross-sectional study amongst anaesthesiologists across India. The objectives were to find out the main causes for anxiety and insomnia in COVID-19 pandemic. Generalised Anxiety Disorder-7 (GAD-7) scale and Insomnia Severity Index (ISI) were used for assessing anxiety and insomnia. Results: Of 512 participants, 74.2% suffered from anxiety and 60.5% suffered from insomnia. The age <35 years, female sex, being married, resident doctors, fear of infection to self or family, fear of salary deductions, increase in working hours, loneliness due to isolation, food and accommodation issues and posting in COVID-19 duty were risk factors for anxiety. ISI scores ≥8 was observed in <35 years, unmarried, those with stress because of COVID-19, fear of loneliness, issues of food and accommodation, increased working hours and with GAD-7 score ≥5. Adjusted odd's ratio of insomnia in participants having GAD-7 score ≥5 was 10.499 (95% confidence interval 6.097–18.080; P < 0.001). Conclusion: The majority of anaesthesiologists on COVID-19 duty suffer from anxiety and insomnia. Addressing risk factors identified during this study with targeted interventions and psychosocial support will help them to cope better with the stress.

Factors Associated With Psychological Distress in Health-Care Workers During an Infectious Disease Outbreak: A Rapid Systematic Review of the Evidence

“…In a study during the H1N1 outbreak, hospital staff who were in their 20's had greater anxiety about becoming infected than did older staff ( 103 ). During COVID-19, HCW who were younger were more likely to experience higher levels of post-traumatic stress symptoms, depression, anxiety, and acute stress compared to older HCW ( 23 , 26 – 28 , 30 , 32 , 42 , 49 , 54 , 55 , 57 , 61 , 65 , 71 , 75 , 78 , 89 , 90 , 117 , 118 , 121 , 123 , 127 , 131 , 149 , 153 , 154 ). In contrast, eight studies conducted during COVID found that HCW who were older were at greater risk of experiencing higher levels of psychological distress ( 40 , 66 , 86 , 95 , 102 , 114 , 122 , 132 ).…”

Experiences and management of physician psychological symptoms during infectious disease outbreaks: a rapid review

“…Sixty-one studies reported on fear related to an infectious disease outbreak [ 29 – 31 , 35 – 37 , 43 , 46 , 53 , 55 , 61 , 64 , 72 , 74 , 78 – 83 , 85 – 87 , 94 , 95 , 99 , 100 , 107 – 109 , 115 , 117 , 119 , 123 , 128 , 131 , 132 , 134 , 142 , 146 , 147 , 155 – 173 ]. Most of the studies ( n = 52) reported physician’s fear of infecting themselves or their family.…”

“…One hundred studies reported on factors associated with psychological symptoms during infectious disease outbreaks. Female sex (compared to male) was the factor most commonly associated with worse psychological symptoms in physicians [ 30 , 41 , 44 , 48 , 63 , 66 , 71 , 77 , 89 , 98 , 112 , 122 , 127 , 128 , 138 , 142 , 144 , 148 , 163 , 165 , 170 , 174 – 189 ]. Other factors associated with poorer psychological outcomes included direct patient contact [ 28 , 32 , 34 , 44 , 46 , 53 , 59 , 64 , 71 , 81 , 95 , 98 , 112 , 122 , 130 , 163 , 169 , 175 , 182 , 183 , 186 , 190 – 192 ] [ 30 , 34 , 41 , 44 , 48 , 59 , 63 , 66 , 71 , 77 , 89 ], single marital status (compared to married) [ 39 , 44 , 59 , 63 , 98 , 122 ], younger age [ 33 ...…”

“…Physicians working more days, with higher patient volumes, or with increased duties than before than pandemic also had an increased prevalence of psychological symptoms [ 96 , 101 , 122 , 128 , 149 , 187 , 192 , 195 , 198 ]. Eighteen studies reported on insomnia [ 32 , 35 , 36 , 54 , 65 , 69 , 88 , 114 , 128 , 145 , 149 , 163 , 175 , 177 , 181 , 188 , 192 , 194 ], which is associated with psychiatric disorders and is a risk factor for depression and anxiety [ 15 , 32 , 54 , 65 , 69 , 199 , 200 ]. During the SARS outbreak, physicians of Asian descent felt more stigmatized than their Caucasian colleagues (Canada) [ 15 , 32 , 35 , 36 , 46 , 54 , 65 , 69 , 88 , 114 , 128 , 145 , 149 , 163 , 175 , 177 , 181 , 188 , 192 , 194 , 199 , 200 ].…”

A cross-sectional analysis of prevalence and factors related to depression, anxiety, and stress in health care workers amidst the COVID-19 pandemic

“…This could be attributed to increased personal and professional commitments in this time of various new-normal changes in the COVID-19 pandemic. [ 9 ]…”