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

项目摘要 美国医生患抑郁症、药物滥用、自杀、过度劳累、精疲力竭的风险很高， 和倦怠COVID-19疫情带来的新工作条件加剧 这些职业健康负担的医生在一个时间，当基线水平的压力， 倦怠和心理健康状况不佳的比例已经非常高。医师研究 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， 几乎没有识别和应对塑造医生健康的更广泛的结构性因素。这 研究将应用职业健康透镜来检查医院医生的经验， 纽约市（NYC）和西雅图，美国COVID-19疫情的两个震中。我们的社会- 生态模式承认卫生系统、工作和环境之间的协同关系， 环境和个人福祉，并解释了环境和个人之间的复杂相互作用。 影响医师职业健康的多层次因素。我们将进行定性分析 采访了纽约市（n=40）和西雅图（n=40）的医生，他们在一线工作， 2019冠状病毒病护理（即医院的主治医生或研究员在内部执业） 内科、家庭医学、急诊医学、传染病和肺/危重病 护理）。通过对每个城市不同医院的医生进行抽样调查，我们将评估 州和地方公共卫生反应的差异和制度因素介导了这种方式， 医生应对危机。我们的具体目标是：目标1：描述关系 在影响工作场所条件的系统、专业和机构层面的因素中， 在COVID-19大流行期间，医生对职业健康的看法， 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 大流行病;目标3.制定和传播循证建议， 医生在正常和危机条件下的职业健康和福祉， 面板输入。这项研究解决了一个有据可查的职业健康问题， 由于大流行病而采取了新的紧迫性，并通过对结构性的新关注来实现这一点。 在一个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建议，以改善医生的职业健康， 健康和组织对流行病状况的反应。因此，研究回应 符合NIOSH的Total Worker Health™ Initiative，并符合NIOSH的研究实践标准。

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.