The Effect of the COVID-19 Pandemic on Pediatric Physician Wellness: A Cross-Sectional Study

Abstract

The COVID-19 pandemic has provided challenges to all healthcare workers. While the brunt of treating COVID-19 patients fell upon adult providers, pediatricians also experienced significant stressors and disruptions. Academic pediatricians and trainees (fellows and residents) were redeployed to manage adult patients in hospitalist and intensive care settings and/or had major changes to their clinical schedules. In this study, we aimed to describe levels of self-reported depression, anxiety, and burnout in pediatric physicians following the initial wave of the pandemic at the largest integrated health system in New York State. A cross-sectional study was conducted among pediatric physicians who cared for patients during the COVID-19 pandemic within the Northwell Health System as part of the Northwell Wellbeing Registry, a longitudinal registry assessing the psychological impact of COVID-19 on healthcare providers. A total of 99 pediatric physician respondents were included in this study; 72% of whom were attendings, 28% of whom were trainees. Compared to attendings, trainees reported significantly higher proportions of burnout–emotional exhaustion (p = 0.0007) and burnout–depersonalization (p = 0.0011) on the Abbreviated Maslach Burnout Inventory. There was not a similar trend in probable depression or probable anxiety using the Patient Health Questionnaire. In a multivariable logistic regression model, being a trainee was significantly associated with increased odds of burnout–emotional exhaustion (OR 5.94, 95% Confidence Interval: 1.85–19.02). These findings suggest that fellows and residents were a vulnerable population during the COVID-19 pandemic. Training programs should pay special attention to their trainees during times of crisis, and future studies can help to identify protective factors to reduce the risk of burnout during these times.

Burnout, Professional Self-Efficacy, and Life Satisfaction as Predictors of Job Performance in Health Care Workers: The Mediating Role of Work Engagement

“…During the COVID-19 pandemic, burnout was found to be higher in physicians and nurses than in other health care workers. 51 - 54 The findings of the present study showed that burnout is negatively related to work engagement. Findings from a survey of 212 health care workers in a Norwegian hospital found that emotional exhaustion had direct effects on job attitudes (job satisfaction and organizational engagement).…”

Physician challenges and supports during the first wave of the COVID-19 pandemic: A mixed methods study

“…Future studies should continue exploring the protective role of resilience and organizational support to identify interventional targets that address mental health outcomes of physicians. Future studies should also include the trajectories and longitudinal mental health impacts of physicians and other HCWs at the front lines of the COVID pandemic, particularly nurses, who typically have greater direct patient care involvement than physicians, and physician trainees, who have been shown to be particularly vulnerable to COVID-related stressors ( 5 , 49 ). Finally, future work should continue the evaluation of the many interventions directed at frontline care delivery, health care organization, external environment, individual mediating factors to address clinician burnout and other adverse mental health outcomes.…”

Examining ways to score the Epidemic–Pandemic Impacts Inventory in parents of young children.

“…The majority of studies that have used the EPII have summed participants’ responses to the items to create subscales and/or to create a total score of negative pandemic impacts and a total score of positive pandemic impacts (Belfer et al, 2022; Doom et al, 2021; Haydon & Salvatore, 2021; Hezel et al, 2022; Mayorga et al, 2022; Porter et al, 2021; A. Shah et al, 2021; Stone et al, 2021) or created a proportion score (Hussong et al, 2022), even in studies with large sample sizes (e.g., Doom et al, 2021; Haydon & Salvatore, 2021).…”

“…For instance, if an individual were to endorse “yes, me” and “no” response options for one item, the item would not be scorable. The most common method of scoring the EPII (referred to as Scoring Method 1 below) involves dichotomizing the responses by collapsing “yes, me” and “yes, person in home” into one category, and collapsing the “no” and “NA” responses into a second category (Belfer et al, 2022; Doom et al, 2021; Haydon & Salvatore, 2021; Hezel et al, 2022; Mayorga et al, 2022; Sargent et al, 2022; A. Shah et al, 2021; Stone et al, 2021).…”

“…Nevertheless, research examining the association of the summed EPII scores with stress and mood can be useful to consider. For example, a higher sum of negative pandemic impacts was associated with increased odds of emotional exhaustion and burnout among 99 pediatric physicians (Belfer et al, 2022), greater depression, anxiety, stress, and loneliness among 503 undergraduates (Doom et al, 2021), greater posttraumatic stress symptoms among 100 adults diagnosed with a psychotic disorder and 51 healthy controls (Stone et al, 2021), a greater likelihood of medical students screening positive for depression, anxiety, and posttraumatic stress disorder in February-March 2021 (Jenkins & Grasso, 2021), and a greater increase in depression, anxiety, and stress from before to after the pandemic among 416 adults assessed as a part of a longitudinal study (Haydon & Salvatore, 2021). Additionally, the number of pandemic-related negative emotional and physical health impacts reported on the EPII by parents was also associated with the emotional impact of the pandemic reported by their adolescent children (Porter et al, 2021).…”