Symptoms of burnout in intensive care unit specialists facing the COVID-19 outbreak
Symptoms of burnout in intensive care unit specialists facing the COVID-19 outbreak
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DOI：
10.1186/s13613-020-00722-3
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发表时间：
2020-08-08
影响因子：
8.1
通讯作者：
Cecconi, Maurizio
中科院分区：
文献类型：
--
作者：
Azoulay, Elie;De Waele, Jan;Cecconi, Maurizio
背景COVID-19大流行导致了前所未有的医疗保健危机，医疗保健提供者的心理困扰患病率很高。我们试图记录面临COVID-19爆发的重症监护医生中倦怠综合征的患病率。方法对欧洲重症监护医学会的重症监护医师进行横断面调查。收集严重倦怠、焦虑和抑郁的症状。采用考克斯模型分析与严重职业倦怠相关的独立因素。结果应答率为20%（1001份完整的问卷被收回，45岁[39-53]，34%女性，来自85个国家，12个地区，50%大学附属医院）。焦虑和抑郁症状或严重倦怠的患病率分别为46.5%、30.2%和51%，并且在不同地区之间存在显著差异。重症监护医生和其他ICU利益相关者之间的关系的评级显着不同，根据焦虑，抑郁或倦怠的存在。他们对道德氛围或决策质量的评级也报告了类似的数字。与焦虑独立相关的因素是女性（HR 1.85 [1.33-2.55]），在大学附属医院工作（HR 0.58 [0.42-0.80]），居住在人口超过100万的城市（HR 1.40 [1.01-1.94]），以及临床医生对伦理气候的评分（HR 0.83 [0.77-0.90]）。抑郁症的独立决定因素包括女性（HR 1.63 [1.15-2.31]）和临床医生对道德氛围的评分（HR 0.84 [0.78-0.92]）。与严重倦怠症状独立相关的因素包括年龄（HR 0.98/年[0.97-0.99]）和临床医生对道德氛围的评分（HR 0.76 [0.69-0.82]）。结论COVID-19大流行对重症监护医生产生了压倒性的心理影响。有必要进行随访和管理，以评估长期心理结果，减轻疫情对一线人员的心理负担。
Background The COVID-19 pandemic has resulted in an unprecedented healthcare crisis with a high prevalence of psychological distress in healthcare providers. We sought to document the prevalence of burnout syndrome amongst intensivists facing the COVID-19 outbreak. Methods Cross-sectional survey among intensivists part of the European Society of Intensive Care Medicine. Symptoms of severe burnout, anxiety and depression were collected. Factors independently associated with severe burnout were assessed using Cox model. Results Response rate was 20% (1001 completed questionnaires were returned, 45 years [39-53], 34% women, from 85 countries, 12 regions, 50% university-affiliated hospitals). The prevalence of symptoms of anxiety and depression or severe burnout was 46.5%, 30.2%, and 51%, respectively, and varied significantly across regions. Rating of the relationship between intensivists and other ICU stakeholders differed significantly according to the presence of anxiety, depression, or burnout. Similar figures were reported for their rating of the ethical climate or the quality of the decision-making. Factors independently associated with anxiety were female gender (HR 1.85 [1.33-2.55]), working in a university-affiliated hospital (HR 0.58 [0.42-0.80]), living in a city of > 1 million inhabitants (HR 1.40 [1.01-1.94]), and clinician's rating of the ethical climate (HR 0.83 [0.77-0.90]). Independent determinants of depression included female gender (HR 1.63 [1.15-2.31]) and clinician's rating of the ethical climate (HR 0.84 [0.78-0.92]). Factors independently associated with symptoms of severe burnout included age (HR 0.98/year [0.97-0.99]) and clinician's rating of the ethical climate (HR 0.76 [0.69-0.82]). Conclusions The COVID-19 pandemic has had an overwhelming psychological impact on intensivists. Follow-up, and management are warranted to assess long-term psychological outcomes and alleviate the psychological burden of the pandemic on frontline personnel.