Mental health and well‐being of anaesthetists during the COVID‐19 pandemic: a scoping review

Abstract

The COVID-19 pandemic has imposed substantial burdens on clinicians and there is a need to better understand the impact on mental health and well-being. This scoping review investigates the prevalence of mental health concerns in anaesthetists, risk and protective factors for mental well-being, and anaesthetists' pandemic-related concerns and support. We searched online databases for articles published between January 2020 and May 2022, using search terms related to: anaesthesia; burnout, well-being, mental health or stress; and COVID-19. We identified 20 articles comprising 19 different populations of anaesthetists (n = 8680) from 14 countries. Studies identified the prevalence of the following condition in anaesthetists: burnout (14-59%); stress (50-71%); anxiety (11-74%); depression (12-67%); post-traumatic stress (17-25%); psychological distress (52%); and insomnia (17-61%). Significant risk factors for poorer mental health included: direct COVID-19-related issues (fear of self and family exposure to infection; requirement for quarantine); practitioner health factors (insomnia; comorbidities); psychosocial factors (loneliness; isolation; perceived lack of support at home and work); demographic factors (female gender; non-white ethnicity; LGBTQIA+); and workplace factors (redeployment outside area of clinical practice; increased work effort; personal protective equipment shortages). Protective factors identified included: job satisfaction; perceived organisational justice; older age; and male sex. Anaesthetists' self-reported concerns related to: personal protective equipment; resource allocation; fear of infection; fear of financial loss; increased workload; and effective communication of protocols for patient treatment. Support from family, colleagues and hospital management was identified as an important coping mechanism. Findings from this review may support the design of interventions to enhance anaesthetists' psychological health during pandemic conditions and beyond. Future research should include consistent psychological outcome measures and rigorous experimental design beyond cross-sectional studies.

Proteomic Analysis of Human Saliva via Solid-Phase Microextraction Coupled with Liquid Chromatography–Mass Spectrometry

“…Due to the limited access to updated databases at the time of the project, this work stands as a proof-of-concept study demonstrating that matrix-compatible SPME devices with porous extraction phases are a viable option for peptide and protein analysis. The logistics of personal protective equipment (PPE) for frontline healthcare professionals has improved drastically since the pandemic, , enabling significant improvements to the reproducibility and reliability of sample collection under clinical settings. Variabilities accrued during the self-collection, transportation, storage, and treatment of biofluids can, therefore, be greatly reduced in future studies.…”

U.S. Attending Anesthesiologist Burnout in the Postpandemic Era

“…11,12 Evidence suggests the pandemic may have led to increased burnout prevalence in anesthesiologists as well as other mental health conditions such as posttraumatic stress disorder, anxiety, and depression. 13,14 There was a relative shortage of U.S. attending anesthesiologists before the COVID-19 pandemic, partially due to increased demand from the aging baby boomer generation, 15 which was previously associated with burnout in anesthesiologists. 9 As the COVID-19 pandemic has likely worsened anesthesiologist and anesthesia team member shortages, the impact that insufficient staffing has had on the field remains unclear.…”

“…11,12 Evidence suggests the pandemic may have led to increased burnout prevalence in anesthesiologists as well as other mental health conditions such as posttraumatic stress disorder, anxiety, and depression. 13,14…”

Resource allocation

“…In short-lived disasters, this strategy has proven it's worth [11]. However, the COVID pandemic has shown that there may be a very steep price to pay when such an approach is taken over long periods of time: psychopathologies, which may express both during the acute phase [12,13] and after the event [14][15][16]17 & ]. In terms of space and equipment, one may use the ICU as an excellent model for highlighting the difficulties of determining what resources are needed.…”

“…In short-lived disasters, this strategy has proven it's worth [11]. However, the COVID pandemic has shown that there may be a very steep price to pay when such an approach is taken over long periods of time: psychopathologies, which may express both during the acute phase [12,13] and after the event [14–16,17 ▪ ].…”