Physicians? Occupational Health During Covid-19: A Qualitative Analysis of Systems Factors

医生？

• 批准号: 10194989
• 负责人: Mara Helene Buchbinder
• 金额: $ 20.14万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10194989
• 关键词: Physicians; Occupational; Health; During; Covid

PROJECT ABSTRACT US physicians are at high risk for depression, substance abuse, suicide, overwork, exhaustion, and burnout. New working conditions imposed by the COVID-19 pandemic have exacerbated these occupational health burdens for physicians at a time when baseline levels of stress, burnout, and poor mental health were already overwhelmingly high. Research on physician burnout has expanded, yet much of it focuses on individual-level causes and solutions that do little to identify and respond to the broader structural factors shaping physicians' wellbeing. This study will apply an occupational health lens to examine the experiences of hospital physicians in New York City (NYC) and Seattle, the two epicenters of the US COVID-19 outbreak. Our socio- ecological model acknowledges the synergistic relationships between health systems, work environments, and individual wellbeing, and accounts for the complex interplay between the multi-level factors shaping physicians' occupational health. We will conduct qualitative interviews with physicians in NYC (n=40) and Seattle (n=40) who work at the front lines of COVID-19 care (i.e. hospital-based attending physicians or fellows practicing in internal medicine, family medicine, emergency medicine, infectious diseases, and pulmonary/critical care). By sampling physicians from diverse hospitals in each city, we will assess how differences in state and local public health responses and institutional factors mediate the way physicians respond to the crisis. Our specific aims are to: Aim 1: Describe the relationships among the systems-, professional-, and institutional-level factors shaping workplace conditions during the COVID-19 pandemic and physicians' perceptions of occupational health and wellbeing; Aim 2: Identify systems-, professional-, institutional-, and individual-level characteristics that protect physicians' occupational health and wellbeing during the COVID-19 pandemic; Aim 3. Develop and disseminate evidence-based recommendations to protect physicians' occupational health and wellbeing during normal and crisis conditions, with expert panel input. The study addresses a well-documented occupational health problem that has taken on new urgency due to the pandemic, and does so through novel attention to structural factors that shape occupational wellbeing during a unique historical moment. The outputs of this study include evidence-based recommendation to improve physicians' occupational health and wellbeing and organizational responses to pandemic conditions. Therefore, the study responds to NIOSH's Total Worker Health™ Initiative and meets NIOSH Research to Practice standards.

项目摘要 美国医生面临着抑郁、药物滥用、自杀、过度劳累、疲惫、 和倦怠。 COVID-19 大流行带来的新工作条件更加恶化 当压力达到基线水平时，这些职业健康负担对医生来说， 倦怠和心理健康状况不佳的比例已经非常高。医师研究 职业倦怠已经扩大，但其中大部分集中在个人层面的原因和解决方案上 几乎无法识别和应对影响医生健康的更广泛的结构性因素。这 研究将应用职业健康视角来检查医院医生的经验 纽约市 (NYC) 和西雅图是美国 COVID-19 疫情的两个震中。我们的社会—— 生态模型承认卫生系统、工作之间的协同关系 环境和个人福祉，并解释了两者之间复杂的相互作用 影响医生职业健康的多层次因素。我们将进行定性 采访纽约市 (n=40) 和西雅图 (n=40) 在一线工作的医生 COVID-19 护理（即医院的主治医生或在内部执业的研究员） 医学、家庭医学、急诊医学、传染病和肺/危重病 关心）。通过对每个城市不同医院的医生进行抽样，我们将评估如何 州和地方公共卫生反应和制度因素的差异调节了这种方式 医生应对危机。我们的具体目标是： 目标 1：描述关系 影响工作场所条件的系统、专业和机构层面的因素 COVID-19 大流行期间以及医生对职业健康和 福利;目标 2：确定系统、专业、机构和个人层面 在 COVID-19 期间保护医生职业健康和福祉的特征 大流行;目标 3. 制定并传播基于证据的建议以保护 正常和危机条件下医生的职业健康和福祉，由专家 面板输入。该研究解决了一个有据可查的职业健康问题 由于大流行，我们采取了新的紧迫性，并通过对结构性问题的新关注来实现这一点 在独特的历史时刻塑造职业福祉的因素。这个的输出 研究包括以证据为基础的建议，以改善医生的职业健康和 福祉和对大流行病的组织反应。因此，研究回应 符合 NIOSH 的 Total Worker Health™ Initiative 并符合 NIOSH Research to Practice 标准。