Health-care Professionals' Perceptions of Critical Care Resource Availability and Factors Associated With Mental Well-being During Coronavirus Disease 2019 (COVID-19): Results from a US Survey. (2nd September 2020)

• Record Type: Journal Article
• Authors: Sharma, Monisha; Creutzfeldt, Claire J; Lewis, Ariane; Patel, Pratik V; Hartog, Christiane; Jannotta, Gemi E; Blissitt, Patricia; Kross, Erin K; Kassebaum, Nicholas; Greer, David M; Curtis, J Randall; Wahlster, Sarah
• Is Part Of: Clinical infectious diseases. Volume 72:Number 10(2021)
• Page Start: e566
• Page End: e576
• Publication Date: 2020-09-02
• Subjects: COVID-19 -- critical care resources -- health-care provider -- mental health -- burnout -- personal protective equipment; Communicable diseases -- Periodicals; 616.905
• DOI: 10.1093/cid/ciaa1311
• Languages: English
• ISSNs: 1058-4838

Abstract

Abstract: Background: Assessing the impact of coronavirus disease 2019 (COVID-19) on intensive care unit (ICU) providers' perceptions of resource availability and evaluating the factors associated with emotional distress/burnout can inform interventions to promote provider well-being. Methods: Between 23 April and 7 May 2020, we electronically administered a survey to physicians, nurses, respiratory therapists (RTs), and advanced practice providers (APPs) caring for COVID-19 patients in the United States. We conducted a multivariate regression to assess associations between concerns, a reported lack of resources, and 3 outcomes: a primary outcome of emotional distress/burnout and 2 secondary outcomes of (1) fear that the hospital is unable to keep providers safe; and (2) concern about transmitting COVID-19 to their families/communities. Results: We included 1651 respondents from all 50 states: 47% were nurses, 25% physicians, 17% RTs, and 11% APPs. Shortages of intensivists and ICU nurses were reported by 12% and 28% of providers, respectively. The largest supply restrictions reported were for powered air purifying respirators (56% reporting restricted availability). Provider concerns included worries about transmitting COVID-19 to their families/communities (66%), emotional distress/burnout (58%), and insufficient personal protective equipment (PPE; 40%). After adjustment, emotional distress/burnout was significantly associated with insufficient PPE access (adjusted relative risk [aRR], 1.43; 95% confidence interval [CI], 1.32–1.55), stigma from community (aRR, 1.32; 95% CI, 1.24–1.41), and poor communication with supervisors (aRR, 1.13; 95% CI, 1.06–1.21). Insufficient PPE access was the strongest predictor of feeling that the hospital is unable to keep providers safe and worries about transmitting infection to their families/communities. Conclusions: Addressing insufficient PPE access, poor communication from supervisors, and community stigma may improve provider mental well-being during the COVID-19 pandemic. Abstract : Health-care providers report high rates of emotional distress/burnout and concerns about insufficient personal protective equipment, which was the strongest predictor of provider well-being. Other risk factors include poor communication from supervisors, shortage of intensive care unit nurses, and social stigma.