Trauma and orthopaedic team members’ mental health during the COVID-19 pandemic

Abstract

Aims Healthcare systems have been rapidly restructured to meet COVID-19 demand. Clinicians are working to novel clinical guidelines, treating new patient cohorts and working in unfamiliar environments. Trauma and orthopaedics (T&O) has experienced cancellation of routine clinics and operating, with redistribution of the workload and human resources. To date, no studies have evaluated the mental health impact of these changes on the T&O workforce. We report the results of a novel survey on the impact of the pandemic on the mental health of our orthopaedic workforce and the contributory factors. Methods A 20-question survey-based cross-sectional study of orthopaedic team members was conducted during the COVID-19 pandemic. The primary objective was to identify the impact of the pandemic on mental health in the form of major depressive disorder (MDD) and general anxiety disorder (GAD). The survey incorporated the patient health questionnaire (PHQ-2), which is validated for screening of MDD, and the generalized anxiety disorder questionnaire (GAD-2), which is validated for screening of GAD. Results There were 62 respondents (18 females and 44 males). As compared to the general population, we noted a greater estimated prevalence of GAD (17.7% vs 5.9%, p = 0.0009297) and MDD (19.4% vs 3.3%, p = 0.0000007731). The prevalence of MDD symptoms was greatest among senior house officers (SHOs) (p = 0.02216). Female respondents scored higher for symptoms of MDD (p = 0.03583) and GAD (p = 0.0001086). Those identifying as ‘Black, African, Caribbean or Black British’ displayed a higher prevalence of GAD symptoms (p = 0.001575) and felt least supported at work (p = 0.001341). Conclusion Our study, in the first of its kind, shows a significant prevalence of GAD and MDD in the workforce. We found that SHOs, females and those of Black, African, Caribbean, or Black British origin were disproportionately affected. Action should be taken to help prevent adverse mental health outcomes for our colleagues during the pandemic. Cite this article: Bone Joint Open 2020;1-6:316–325.

Impact of COVID-19 pandemic on orthopaedic surgeons in terms of anxiety, sleep outcomes and change in management practices: A cross-sectional study from India

“…The impact of fellowship training or a senior post is another significant stressor that remains inconclusive. Thakrar et al 11 demonstrated a lesser level of psychological impact in associate consultants as compared to station health officer or other junior staff. The extrapolation of this scenario in the context of subspecialisation leading to minimal levels of anxiety remains to be proven, as in our study we did not observe any such significant association.…”

“…The number of participants was based on the sample size calculation for cross-sectional studies 13 and past studies from the literature. [11][12][13][14] This method drew on Facebook's inherent peer network structures to encourage users to recruit other orthopaedic surgeons who may or may not be on Facebook. 15 Participants were invited through three online venues: public ('wall') posts advertising our research survey on some orthopaedic groups; peer referral on Facebook and What-sApp group messages from 2 May to 16 May 2020.…”

“…5 Past research studies provide evidence to support the high anxiety levels among HCWs 6 –9 including orthopaedic surgeons in India 10 and UK. 11 In order to assess the burden of anxiety among orthopaedic surgeons in India during this outbreak, a web-based cross-sectional survey using a seven-item Generalised Anxiety Disorder Scale (GAD-7) 12 was conducted. This is a novel study from India which assessed the burden of anxiety using a previously validated standardised questionnaire (GAD-7), sleep outcomes and the impact of unavailability of adequate PPE among orthopaedic surgeons during the COVID-19 pandemic.…”

The value of routine radiographic follow up in the postoperative management of canine medial patellar luxation

“…Increased working hours and/or a stressful working environment have been reported to be important risk factors affecting human orthopedic surgeons' mental health. [30][31][32] Depression, anxiety and burn out have been reported to affect up to 22.8%, 23.2% and an average of 40% of orthopedic surgeons respectively. 33 This is directly transferable to veterinarians; veterinary surgeons' mental health should not be overlooked, as our professions' suicide rate is a least 3 times that of the general population.…”

“…The impact of unnecessary or unjustified interventions on personnel strain and workload should also not be taken lightly. Increased working hours and/or a stressful working environment have been reported to be important risk factors affecting human orthopedic surgeons' mental health 30–32 . Depression, anxiety and burn out have been reported to affect up to 22.8%, 23.2% and an average of 40% of orthopedic surgeons respectively 33 .…”