Differences in the Long-term Impact of the COVID-19 Pandemic on the Mental Health and Professional Quality of Life of Resident and Specialist Physicians

Authors

  • Valentina Delle Donne Infectious Diseases Institute, Department of Safety and Bioethics, Catholic University of Sacred Heart, Rome, Italy
  • Valentina Massaroni Infectious Diseases Institute, Department of Safety and Bioethics, Catholic University of Sacred Heart, Rome, Italy
  • Nicoletta Ciccarelli Department of Psychology, Catholic University, Milan, Italy
  • Alberto Borghetti UOC Infectious Diseases, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
  • Arturo Ciccullo UOC Infectious Diseases, Ospedale San Salvatore, L’Aquila, Italy
  • Gianmaria Baldin Olbia Mater Hospital, Olbia, Italy
  • Gabriele Giuliano UOC Infectious Diseases, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
  • Alex Dusina UOC Infectious Diseases, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
  • Elena Visconti UOC Infectious Diseases, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
  • Enrica Tamburrini UOC Infectious Diseases, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
  • Simona Di Giambendetto Infectious Diseases Institute, Department of Safety and Bioethics, Catholic University of Sacred Heart, Rome, Italy

Keywords:

Covid-19, Healthcare workers, Mental health, Professional quality of life, Burnout

Abstract

Background: The COVID-19 pandemic created an extremely difficult situation for healthcare workers (HCWs) worldwide. We aimed to compare the mental health and professional quality of life of residents and specialist physicians in a cohort of Italian HCWs caring for patients with COVID-19 about two years after the start of the COVID-19 pandemic. Methods: In November 2021, an online survey investigating the emotional states of depression, anxiety, stress, compassion satisfaction and compassion fatigue was administered to HCWs (N= 78) at the Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome. Results: Our findings suggest that from 5 to 20% of our cohort of HCWs still showed the effects of the adverse psychological impact of the pandemic and more than half of them experienced medium levels of compassion fatigue as well as a medium level of compassion satisfaction. Our results also show that those with fewer years of clinical practice might be at greater risk of burnout (p= 0.021), anxiety and stress symptoms (both ps= 0.027) and might develop a lower level of compassion satisfaction (p=0.018). Moreover, the factors that potentially contribute to poor mental health, compassion fatigue and compassion satisfaction seem to differ between residents and specialist physicians. Conclusions: This overview presents one of the first pictures of the long-term effects of the pandemic on the mental health and professional quality of life of an Italian sample of HCWs. Moreover, it also helps identify professionals who are most in need of support and emphasises the importance of improving the psychological and professional wellbeing of these individuals especially during a pandemic-like crisis with long lasting effects.

 

References

REFERENCES

De Sio S, Buomprisco G, La Torre G, et al. The impact of COVID-19 on doctors’ well-being: results of a web survey during the lockdown in Italy. Eur Rev Med Pharmacol. 2020;24(14):7869-7879. Doi: https://doi.org/10.26355/eurrev_202007_22292

Pérez-Chacón M, Chacón A, Borda-Mas M, & Avargues-Navarro ML. Sensory Processing Sensitivity and Compassion Satisfaction as Risk/Protective Factors from Burnout and Compassion Fatigue in Healthcare and Education Professionals. Int J Env Res Pub Health. 2021;18(2),611. Doi: https://doi.org/10.3390/ijerph18020611.

Nathiya D, Suman S, Singh P, Raj P, Tomar BS. Mental Health outcome and Professional quality of Life among Healthcare Worker during COVID-19 pandemic: A (FRONTLINE-COVID) survey. Ann Med Psy-chol (Paris). 2021. Doi: 10.1016/j.amp.2020.12.017

Buselli R, Corsi M, Baldanzi S, et al. Professional Quality of Life and Mental Health Outcomes among Health Care Workers Exposed to Sars-Cov-2 (COVID-19). Int J Env Res Pub Health. 2020;17(17):6180. Doi: https://doi.org/10.3390/ijerph17176180

Cabarkapa S, Nadjidai SE, Murgier J, Ng CH. The psychological impact of COVID-19 and other viral epi-demics on frontline healthcare workers and ways to address it: A rapid systematic review. BBI-Health. 2020;8:100144. Doi: https://doi.org/10.1016/j.bbih.2020.100144

Pappa S, Ntella V, Giannakas T, Giannakoulis VG, Papoutsi E, Katsaounou P. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. BBI-Health. 2020;88:901-907. Doi: https://doi.org/10.1016/j.bbi.2020.05.026

World Health Organization. Mental health and psychosocial considerations during the COVID-19 out-break. 2020. Available at: https://www.who.int/docs/default-source/coronaviruse/mental-health-considerations.pdf

Xiang YT, Yang Y, Li W, et al. Timely mental health care for the 2019 novel coronavirus outbreak is ur-gently needed. Lancet Psychiat. 2020;7(3):228-229. Doi: https://doi.org/10.1016/S2215-0366(20)30046-8

Elbay RY, Kurtulmuş A, Arpacıoğlu S, Karadere E. Depression, anxiety, stress levels of physicians and as-sociated factors in Covid-19 pandemics. Psychiatry Res. 2020;290:113130. Doi: https://doi.org/10.1016/j.psychres.2020.113130

British Medical Association. The mental health and wellbeing of the medical workforce – now and beyond COVID-19. 2020. Available at https://www.bma.org.uk/media/2475/bma-covid-19-and-nhs-staff-mental-healthwellbeing-report-may-2020.pdf

Salazar de Pablo G, Vaquerizo-Serrano J, Catalan A, et al. Impact of coronavirus syndromes on physical and mental health of health care workers: Systematic review and meta-analysis. J Affect Disord. 2020;275:48–57. Doi: https://doi.org/10.1016/j.jad.2020.06.022

Maslach C. Comprendiendo el burnout. Cienc Trab. 2009;11:37-43.

Figley CR. Compassion fatigue: psychotherapists’ chronic lack of self care. J Clin Psychol. 2002;58(11):1433-1441. Doi: https://doi.org/10.1002/jclp.10090

Cocker F, Joss N. Compassion Fatigue among Healthcare, Emergency and Community Service Work-ers: A Systematic Review. Int J Env Res Pub Health. 2016;13(6):618. Doi: https://doi.org/10.3390/ijerph13060618

Brooks SK, Dunn R, Amlôt R, Rubin GJ, Greenberg N. A Systematic, Thematic Review of Social and Oc-cupational Factors Associated with Psychological Outcomes in Healthcare Employees During an Infec-tious Disease Outbreak. J Occup Environ Med. 2018;60(3):248-257. Doi: https://doi.org/10.1097/JOM.0000000000001235

Wallace CL, Wladkowski SP, Gibson A, White P. Grief During the COVID-19 Pandemic: Considerations for Palliative Care Providers. J Pain Symptom Manag. 2020;60(1):e70–e76. Doi: https://doi.org/10.1016/j.jpainsymman.2020.04.012

Dosil M, Ozamiz-Etxebarria N, Redondo I, Picaza M, Jaureguizar J. Psychological Symptoms in Health Professionals in Spain After the First Wave of the COVID-19 Pandemic. Front Psychol. 2020;11:606121. Doi: https://doi.org/10.3389/fpsyg.2020.606121

Salimi R, Gomar R, Heshmati B. The COVID-19 outbreak in Iran. J Global Health. 2020;10(1):010365. Doi: https://doi.org/10.7189/jogh.10.010365

Wu Y, Wang J, Luo C, et al. A Comparison of Burnout Frequency Among Oncology Physicians and Nurses Working on the Frontline and Usual Wards During the COVID-19 Epidemic in Wuhan, China. J Pain Symptom Manag. 2020;60(1):e60–e65. Doi: https://doi.org/10.1016/j.jpainsymman.2020.04.008

Ruiz-Fernández MD, Pérez-García E, Ortega-Galán ÁM. Quality of Life in Nursing Professionals: Burn-out, Fatigue, and Compassion Satisfaction. Int J Env Res Pub Health. 2020;17(4):1253. Doi: https://doi.org/10.3390/ijerph17041253

Bettinsoli ML, Di Riso D, Napier JL, et al. Mental Health Conditions of Italian Healthcare Professionals during the COVID-19 Disease Outbreak. Appl Psychol Health Well Being. 2020;12(4):1054-1073. Doi: https://doi.org/10.1111/aphw.12239

Di Mattei VE, Perego G, Milano F, et al. The "Healthcare Workers’ Wellbeing (Benessere Operatori)" Project: A Picture of the Mental Health Conditions of Italian Healthcare Workers during the First Wave of the COVID-19 Pandemic. Int J Env Res Pub Health. 2021;18(10):5267. Doi: https://doi.org/10.3390/ijerph18105267

Farì G, de Sire A, Giorgio V, et al. Impact of COVID-19 on the mental health in a cohort of Italian reha-bilitation healthcare workers. J Med Virol. 2022;94(1):110-118. Doi: https://doi.org/10.1002/jmv.27272

Corradini E, Ventura P, Ageno W, et al. Clinical factors associated with death in 3044 COVID-19 pa-tients managed in internal medicine wards in Italy: results from the SIMICOVID-19 study of the Italian society of internal medicine (SIMI). Intern Emerg Med. 2021;16(4):1005-1015. Doi: https:// doi. org/ 10. 1007/ s11739- 021- 02742-8

Cicco S, Guerra R, Leaci A, et al. Coronavirus disease 19 (CoViD-19) impact on cardiovascular disease in a non-CoViD-19 emergency setting. Intern Emerg Med. 2021;16(5):1377-1379. Doi: https://doi.org/10. 1007/s11739-020-02573-z.

Li W, Frank E, Zhao Z, et al. Mental health of young physicians in china during the novel coronavirus disease 2019 outbreak. JAMA Netw Open. 2020;3(6):e2010705. Doi: https://doi.org/10. 1001/jamanetworkopen.2020.10705

Farr S, Berry JA, Berry DK, et al. The impact of the COVID-19 pandemic on resident physicians well-being in the surgical and primary care specialties in the United States and Canada. Cureus. 2021;13(11):e19677. Doi: https://doi.org/10.7759/cureus.19677

Barac A, Krnjaic P, Vujnovic N, et al. The impact of the COVID-19 pandemic on resident physicians: a cross-sectional study. Work. 2021;69(3):751-758. Doi: https://doi. org/10.3233/WOR- 205253

Cravero AL, Kim NJ, Feld LD, et al. Impact of exposure to patients with COVID-19 on residents and fel-lows: an international survey of 1420 trainees. Postgrad Med J. 2021;97(1153):706-715. Doi: https://doi. org/10.1136/postg radme dj-2020-138789

Thomas NK. Resident burnout. JAMA, 2004;292:2880-2889.

Eckleberry-Hunt J, Lick D, Boura J, et al. An exploratory study of resident burnout and wellness. Acad. Med. 2009,84:269-277.

Romiti GF, Bencivenga L, Villani R, et al. The impact of COVID-19 pandemic on well-being of Italian physicians: a report from the Italian Society of Internal Medicine (SIMI) national survey. Intern Emerg Med. 2023;18:53-65. Advance online publication. Doi: https://doi.org/10.1007/s11739-022-03108-4

Zoorob D, Shah S, La Saevig D, et al. Insight into resident burnout, mental wellness, and coping mecha-nisms early in the COVID-19 pandemic. PLoS ONE. 2021;16:e0250104.

Mion G, Hamann P, Saleten M, et al. Psychological impact of the COVID-19 pandemic and burnout se-verity in French residents: A national study. Eur J Psychiatry. 2021;35:173-180.

Holmes EA, O'Connor RC, Perry VH, et al. Multidisciplinary research priorities for the COVID-19 pan-demic: a call for action for mental health science. Lancet Psychiat. 2020;7(6):547-560. Doi: https://doi.org/10.1016/S2215-0366(20)30168-1

Wu P, Fang Y, Guan Z, et al. The psychological impact of the SARS epidemic on hospital employees in China: exposure, risk perception, and altruistic acceptance of risk. Can J Psuchiatry. 2009;54(5):302-311. Doi: https://doi.org/10.1177/070674370905400504

Stamm B. The Concise ProQOL Manual: The concise manual for the Professional Quality of Life Scale, 2 nd Edition. Pocatello; 2010.

Palestini L, Prati G, Pietrantoni L, Cicognani E. The professional quality of life in accident and emer-gency work: A contribution to the Italian validation of the Professional Quality of Life Scale (ProQOL). Psicoter Cogn e Comportamentale. 2009;15:2.

Henry JD, Crawford JR. The short-form version of the Depression Anxiety Stress Scales (DASS-21): construct validity and normative data in a large non-clinical sample. Br J Clin Psychol. 2005;44(Pt2):227-239. Doi: https://doi.org/10.1348/014466505X29657

Bottesi G, Ghisi M, Altoè G, Conforti E, Melli G, Sica C. The Italian version of the Depression Anxiety Stress Scales-21: Factor structure and psychometric properties on community and clinical samples. Compr Psychiatry. 2015;60:170-181. Doi: https://doi.org/10.1016/j.comppsych.2015.04.005

Restauri N, Sheridan AD. Burnout and Posttraumatic Stress Disorder in the Coronavirus Disease 2019 (COVID-19) Pandemic: Intersection, Impact, and Interventions. J Am Coll Radiol. 2020;17(7):921-926. Doi: https://doi.org/10.1016/j.jacr.2020.05.021

De Kock JH, Latham HA, Leslie SJ, et al. A rapid review of the impact of COVID-19 on the mental health of healthcare workers: implications for supporting psychological well-being. BMC Public Health. 2021;21(1):104. Doi: https://doi.org/10.1186/s12889-020-10070-3

Della Monica A, Ferrara P, Dal Mas F, Cobianchi L, Scannapieco F, Ruta F. The impact of Covid-19 healthcare emergency on the psychological well-being of health professionals: a review of literature. Ann Ig. 2022;34(1):27-44. Doi: https://doi.org/10.7416/ai.2021.2445

Magnavita N, Tripepi G, Di Prinzio RR. Symptoms in Health Care Workers during the COVID-19 Epi-demic. A Cross-Sectional Survey. Int J Env Res Pub Health. 2020;17(14):5218. Doi: https://doi.org/10.3390/ijerph17145218

Xu J, Xu QH, Wang CM, Wang J. Psychological status of surgical staff during the COVID-19 outbreak. Psychiatry Res. 2020;288:112955. Doi: https://doi.org/10.1016/j.psychres.2020.112955

Huang Z, Zhuang D, Xiong B, Deng DX, Li H, Lai W. Occupational exposure to SARS-CoV-2 in burns treatment during the COVID-19 epidemic: Specific diagnosis and treatment protocol. Biomed Pharma-cother. 2020;127:110176. Doi: https://doi.org/10.1016/j.biopha.2020.110176

Cai H, Tu B, Ma J, et al. Psychological Impact and Coping Strategies of Frontline Medical Staff in Hunan Between January and March 2020 During the Outbreak of Coronavirus Disease 2019 (COVID 19) in Hu-bei, China. Med Sci Monit. 2020;26:e924171. Doi: https://doi.org/10.12659/MSM.924171

Bozdağ F, Ergün N. Psychological Resilience of Healthcare Professionals During COVID-19 Pandemic. Psychol Rep. 2021,124(6):2567-2586. Doi: https://doi.org/10.1177/0033294120965477

Shacham M, Hamama-Raz Y, Kolerman R, Mijiritsky O, Ben-Ezra M, Mijiritsky E. COVID-19 Factors and Psychological Factors Associated with Elevated Psychological Distress among Dentists and Dental Hy-gienists in Israel. Int J Env Res Pub Health. 2020;17(8):2900. Doi: https://doi.org/10.3390/ijerph17082900

Pietromonaco PR, Overall NC. Implications of social isolation, separation, and loss during the COVID-19 pandemic for couples’ relationships. Current Opin Psychol. 2022;43:189-194. Doi: https://doi.org/10.1016/j.copsyc.2021.07.014

Lee SJ, Ward KP, Rodriguez CM. Longitudinal Analysis of Short-term Changes in Relationship Conflict During COVID-19: A Risk and Resilience Perspective. J Interpers Violence. 2021;37:15-16. Advance online publication. Doi: https://doi.org/10.1177/08862605211006359

Sun N, Wei L, Shi S, et al. A qualitative study on the psychological experience of caregivers of COVID-19 patients. Am J Infect Control. 2020;48(6):592-8. Doi: https://doi.org/10.1016/j.ajic.2020.03.018

Lai J, Ma S, Wang Y, et al. Factors Associated with Mental Health Outcomes Among Health Care Work-ers Exposed to Coronavirus Disease 2019. JAMA Netw Open. 2020;3(3):e203976. Doi: https://doi.org/10.1001/jamanetworkopen.2020.3976

Eid RS, Gobinath AR, Galea L. Sex differences in depression: Insights from clinical and preclinical stud-ies. Prog Neurobiol .2019;176:86-102. Doi: https://doi.org/10.1016/j.pneurobio.2019.01.006

Brera AS, Arrigoni C, Dellafiore F, et al. Burnout syndrome and its determinants among healthcare workers during the first wave of the Covid-19 outbreak in Italy: a cross-sectional study to identify sex-related differences. Med Lav. 2021;112(4):306-319. Published 2021 Aug 26. Doi:10.23749/mdl.v112i4.11316

Di Tella M, Romeo A, Benfante A, Castelli L. Mental health of healthcare workers during the COVID-19 pandemic in Italy. J Eval Clin Pract. 2020;26(6):1583-1587. Doi:10.1111/jep.13444

Azzolina D, Lorenzoni G, Silvestri L, Prosepe I, Berchialla P, Gregori D. Regional Differences in Mortality Rates During the COVID-19 Epidemic in Italy. Disaster Med Public Health Prep. 2022;16(4):1355-1361. Doi: 10.1017/dmp.2020.486

Buselli R, Corsi M, Veltri A, et al. Mental health of Health Care Workers (HCWs): a review of organiza-tional interventions put in place by local institutions to cope with new psychosocial challenges resulting from COVID-19. Psychiatry Res. 2021;299:113847. Doi: https://doi.org/10.1016/j.psychres.2021.113847

Halms T, Strasser M, Kunz M, Hasan A. How to Reduce Mental Health Burden in Health Care Workers During COVID-19? – A Scoping Review of Guideline Recommendations. Front Psychiatry. 2022;12,770193. Doi: https://doi.org/10.3389/fpsyt.2021.770193

De Vera MIV, Gabari MI. Associated factors with resilience and burnout: A cross-sectional study in a teaching group in Spain. Aula Abierta. 2020;49,177-184.

Galindo-Domínguez H, Pegalajar M, Uriartec JD. Mediator and moderator effect of resilience between self-efficacy and burnout amongst social and legal sciences faculty members. Rev Psicodidáctica. 2020;25:127-135.

Soons I, Brouwers A, Tomic W. An experimental study of the psychological impact of a Mindful-ness-Based Stress Reduction Program on highly sensitive persons. Eur J Psycol. 2010;4:148-169. Doi: 10.5964/ejop.v6i4.228

Albott CS, Wozniak JR, McGlinch BP, Wall MH, Gold BS, Vinogradov S. Battle Buddies: Rapid Deployment of a Psychological Resilience Intervention for Health Care Workers During the COVID-19 Pandemic. Anesth Analg. 2020;131(1):43-54. Doi: https://doi.org/10.1213/ANE.0000000000004912

Giorgi G, Lecca LI, Alessio F, et al. COVID-19-Related Mental Health Effects in the Workplace: A Narrative Review. Int J Environ Res Public Health. 2020;17(21):7857. Doi. https://doi.org/10.3390/ijerph17217857

Morina N, Weilenmann S, Dawson K, et al. RECHARGE – A Brief Psychological Intervention to Build Re-silience in Health Care Workers During the COVID-19 Pandemic: Study Protocol for a Randomized Con-trolled Trial. 15 March 2021, PREPRINT (Version 1) available at Research Square [https://doi.org/10.21203/rs.3.rs-212942/v1] .

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13-04-2023

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Differences in the Long-term Impact of the COVID-19 Pandemic on the Mental Health and Professional Quality of Life of Resident and Specialist Physicians. Med Lav [Internet]. 2023 Apr. 13 [cited 2024 May 21];114(2):e2023012. Available from: https://mattioli1885journals.com/index.php/lamedicinadellavoro/article/view/13829