Symptoms of Anxiety, Burnout, and PTSD and the Mitigation Effect of Serologic Testing in Emergency Department Personnel During the COVID-19 Pandemic - 21/06/21
, Juan Carlos C. Montoy, MD, PhD a, Karin F. Hoth, PhD b, David A. Talan, MD d, e, Karisa K. Harland, PhD c, Patrick Ten Eyck, PhD c, William Mower, MD, PhD e, Anusha Krishnadasan, PhD d, Scott Santibanez, MD, DMin f, Nicholas Mohr, MD, MS cfor the
Project COVERED Emergency Department Network
Bienvenue sur EM-consulte, la référence des professionnels de santé.
Article gratuit.
Connectez-vous pour en bénéficier!
Abstract |
Study Objective |
Among a comprehensive range of frontline emergency department health care personnel, we assessed symptoms of anxiety and burnout, specific coronavirus disease 2019 (COVID-19) work-related stressors, and risk for post-traumatic stress disorder (PTSD). We also determined whether COVID-19 serologic testing of HCP decreased their self-reported anxiety.
Methods |
In a prospective cohort study from May 13, 2020, to July 8, 2020, we used electronic surveys to capture participant self-reported symptoms before and after serologic testing for anti-SARS-CoV-2 immunoglobulin G antibodies. Participants were physicians, nurses, advanced practice providers, and nonclinical ED personnel at 20 geographically diverse United States EDs. We evaluated these domains: 1) the effects of the COVID-19 pandemic on overall stress and anxiety; 2) COVID-19-related work stressors; 3) burnout; and 4) PTSD risk (measured using the Primary Care-PTSD Screen for DSM-5, a 5-item screening instrument in which a score of ≥3 signifies high risk for PTSD). We also assessed perceptions of whether results of COVID-19 antibody testing decreased participants’ self-reported anxiety.
Results |
Of 1,606 participants, 100% and 88% responded to the baseline and follow-up surveys, respectively. At baseline, approximately half (46%) reported symptoms of emotional exhaustion and burnout from their work, and 308 (19.2%, 95% confidence interval [CI] 17.3% to 21.1%) respondents screened positive for increased PTSD risk. Female respondents were more likely than males to screen positive (odds ratio [OR] 2.03, 95% CI 1.49 to 2.78). Common concerns included exposing their family and the health of coworkers diagnosed with COVID-19. After receiving antibody test results, 54% (95% CI 51.8 to 56.7) somewhat agreed, agreed, or strongly agreed that knowledge of their immune status had decreased their anxiety. A positive serology result indicating prior SARS-CoV-2 infection was associated with a higher likelihood of reporting decreased anxiety (2.83, 95% CI 1.37 to 5.83).
Conclusion |
Symptoms of anxiety and burnout were prevalent across the spectrum of ED staff during the COVID-19 pandemic. One-fifth of ED personnel appeared to be at risk for PTSD. Increased provision of serologic testing may help to mitigate anxiety.
Le texte complet de cet article est disponible en PDF.Plan
| Please see page 36 for the Editor’s Capsule Summary of this article. |
|
| Supervising editor: Donald M. Yealy, MD. Specific detailed information about possible conflict of interest for individual editors is available at editors. |
|
| Author contributions: All authors conceived and designed the study and critically reviewed the manuscript for important intellectual content. MF, ZT, RR, RW, JCM, NA, and SS acquired, analyzed, and interpreted the data. RR, JCM, KH, NM, and SS drafted the manuscript. JCM, RR, and NM performed the statistical analysis. RR takes responsibility for the paper as a whole. |
|
| All authors attest to meeting the four ICMJE.org authorship criteria: (1) Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND (2) Drafting the work or revising it critically for important intellectual content; AND (3) Final approval of the version to be published; AND (4) Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. |
|
| Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org/). This project was funded by a cooperative agreement from the Centers for Disease Control and Prevention (CDC) (U01CK000480) and the Institute for Clinical and Translational Science at the University of Iowa through a grant from the National Center for Advancing Translational Sciences at the National Institutes of Health (UL1TR002537). |
|
| The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention. |
|
| The Project COVERED Emergency Department Network includes the following: Monica Bahamon, MPH, Jestin N. Carlson MD, MSc, Makini Chisolm-Straker, MD, MPH, Brian Driver, MD, Brett Faine, Pharm D, MS, James Galbraith, MD, Philip A. Giordano, MD, John P. Haran, MD, PhD, Amanda Higgins, MS, Jeremiah Hinson, MD, Stacey House, MD, PhD, Ahamed H. Idris, MD, Efrat Kean, MD, Elizabeth Krebs, MD, MSc, Michael C. Kurz, MD, MS, Lilly Lee SM, MD, Stephen Y. Liang, MD, MPHS, Stephen C. Lim, MD, Gregory Moran, MD, Utsav Nandi, MD, MSCI, Kavitha Pathmarajah, MPH, James H. Paxton, MD, MBA, Yesenia Perez, BS, Richard Rothman, MD, PhD, Walter A. Schrading, MD, Jessica Shuck, BA, Patricia Slev, MD, Howard A. Smithline, MD, Kimberly Souffront, PhD, FNP-BC, RN, Mark Steele, MD, Michelle St. Romain, MD, Amy Stubbs, MD, Morgan Swanson, BS, Josh Tiao, MD, Jesus R. Torres, MD, MPH, Stacy Trent, MD, MPH, Lisandra Uribe, BS, Arvind Venkat, MD, Gregory Volturo, MD, Kelli Wallace, MS, Kurt D. Weber, MD. |
|
| A podcast for this article is available at www.annemergmed.com. |
Vol 78 - N° 1
P. 35 - juillet 2021 Retour au numéro
Article précédent
- Diagnosed and Undiagnosed COVID-19 in US Emergency Department Health Care Personnel: A Cross-sectional Analysis
- Nicholas M. Mohr, Karisa K. Harland, Anusha Krishnadasan, Patrick Ten Eyck, William R. Mower, James Willey, Makini Chisolm-Straker, Stephen C. Lim, L. Clifford McDonald, Preeta K. Kutty, Elisabeth Hesse, Scott Santibanez, David A. Talan, Project COVERED Emergency Department Network, Monica Bahamon, Jestin N. Carlson, Brian Driver, Brett Faine, James Galbraith, Philip A. Giordano, John P. Haran, Amanda Higgins, Jeremiah Hinson, Stacey House, Ahamed H. Idris, Efrat Kean, Elizabeth Krebs, Michael C. Kurz, Lilly Lee, Stephen Y. Liang, Juan Carlos C. Montoy, Gregory Moran, Utsav Nandi, Kavitha Pathmarajah, James H. Paxton, Yesenia Perez, Lynne D. Richardson, Robert M. Rodriguez, Richard Rothman, Walter A. Schrading, Jessica Shuck, Patricia Slev, Howard A. Smithline, Kimberly Souffront, Mark Steele, Amy Stubbs, Morgan Swanson, Josh Tiao, Jesus R. Torres, Stacy Trent, Lisandra Uribe, Arvind Venkat, Gregory Volturo, Kelli Wallace, Kurt D. Weber
- Managing a Cutaneous Abscess in the Emergency Department
- Gillian R. Schmitz, Michael Gottlieb
Bienvenue sur EM-consulte, la référence des professionnels de santé.