Ignite Creation Date:
2024-05-06 @ 2:38 PM
Last Modification Date:
2024-10-26 @ 1:34 PM
Study NCT ID:
NCT04379063
Status:
COMPLETED
Last Update Posted:
2022-12-20
First Post:
2020-05-05
Brief Title:
COVID-19 Pandemic Short Interval National Survey Gauging Psychological Distress
Sponsor:
Jon Bailey
Organization:
Nova Scotia Health Authority
Study Overview
Official Title:
COVID-19 Pandemic Short Interval National Survey Gauging Psychological Distress Among Physicians COPING Survey A Longitudinal Survey
Status:
COMPLETED
Status Verified Date:
2022-12
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
COPING
Brief Summary:
The Coronavirus Disease COVID-19 pandemic is unprecedented in its scale of infection and the response required to decrease the mortality rates Disturbingly the European and United States experience demonstrates that health care systems in industrialized countries are at risk of becoming overwhelmed Physicians are already at risk of burnout under normal working conditions and in particular when responding to crisis situations During the 2003 severe acute respiratory syndrome SARS outbreak healthcare workers experienced high rates of psychological distress that lasted years However there may be protective factors that may decrease the rate or severity of psychological distress and burnout This study seeks to investigate the rates of physician burnout assessed at multiple time points during the COVID-19 pandemic Further this study seeks to determine the factors that may increase or decrease burnout and psychological distress in such a setting
This study will be a national longitudinal survey of physicians in Canada It will include all physicians that currently hold a license to practice in Canada whether in training or a full license Consenting participants will complete an initial survey gathering information about their type of practice health conditions preparations the COVID-19 pandemic burnout and psychological distress Every month participants will be asked to complete a follow-up survey describing their stressors coping strategies burnout and psychological distress
The investigators will analyze and report the initial results to help provincial and national organizations support our physicians and mitigate burnout during this pandemic The results of the follow up surveys will be analyzed and reported following the pandemic These findings will help keep our physician workforce healthy under normal working conditions and during future crises
This study will be a national longitudinal survey of physicians in Canada It will include all physicians that currently hold a license to practice in Canada whether in training or a full license Consenting participants will complete an initial survey gathering information about their type of practice health conditions preparations the COVID-19 pandemic burnout and psychological distress Every month participants will be asked to complete a follow-up survey describing their stressors coping strategies burnout and psychological distress
The investigators will analyze and report the initial results to help provincial and national organizations support our physicians and mitigate burnout during this pandemic The results of the follow up surveys will be analyzed and reported following the pandemic These findings will help keep our physician workforce healthy under normal working conditions and during future crises
Detailed Description:
Background It has become ubiquitous to describe the severe acute respiratory syndrome coronavirus 2 SARS-CoV-2 pandemic and the global measures to decrease mortality rates of Coronavirus Disease COVID-19 as unprecedented The Public Health Agency of Canada PHAC models released on April 8th predict that even with strict epidemiologic controls 934000-1879000 people will be infected in Canada and 11000- 22000 will die Disturbingly the European and United States experience demonstrates that health care systems in industrialized countries are at risk of becoming overwhelmed It has long been recognized that physicians are at risk for burnout which can negatively affect their ability to care for patients their colleagues and themselves Infectious disease pandemics present many of the same challenges for physicians as natural disasters and mass casualty events with the addition of a prolonged time frame potential need for isolation away from family and concern of becoming infected or infecting loved ones During the 2003 severe acute respiratory syndrome SARS outbreak 18-57 of health care workers HCWs experienced measurable psychological distress Even 1-2 years following the SARS pandemic HCWs in Ontario experienced high levels of burnout 19-30 psychological distress 30-45 and PTSD symptoms 8-13 Despite the overall high rates there are several mitigating factors that may decrease the rate or severity of psychological distress and burnout
Given that these studies generally measure burnout and psychological distress at one or two cross-sectional time points it is difficult to tell how burnout develops over time Additionally the bulk of the studies assessed HCWs following natural disasters which tend to present as a single time point with one large wave of patients The current crisis is distinct in its sustained level of demand on HCWs with potential for multiple waves of patients or a sustained high number of patients outstripping the health care system resources for months at a time This study seeks to investigate the rates of burnout assessed at multiple time points during the COVID-19 pandemic Further this study seeks to determine the relationship between patient numbers mitigating factors and exacerbating factors and the rates of burnout at various time points
Objectives
1 What are the rates of psychological distress and burnout among physicians and residents throughout the COVID-19 pandemic
2 What baseline factors are associated with reductions and increases in psychological distress and burnout over time trajectories
Methods This study will be a national longitudinal survey of physicians in Canada The sampling frame will be all physicians currently practicing in Canada whether they hold a full provisional or post-graduate in-training license The survey will be distributed by 1 Advertisements on Twitter 2 Provincial physician associations and 3 National specialty groups for higher risk specialties anesthesia critical care emergency medicine Recipients will be directed to the survey site hosted by Redcap Cross-sectional results of the initial survey to give immediate feedback to provincial and national organizations about the threat of physician burnout and psychological distress Longitudinal results will analyze how burnout and distress change over time and will analyze the relationship to mitigating and exacerbating factors
Consenting participants will complete an initial survey gathering demographic information age gender trainee years in practice specialty chronic health conditions practice type academic community rural preparatory information prior to first COVID-19 suspected case COVID-19 pathwaysprocedures simulation designated areas scheduling changes and baseline measures Maslach Burnout Inventory - General Survey MBI-GS short form Pandemic Experience Perceptions Scale PEPS Hospital Anxiety and Depression Scale HADS stressors resources coping strategies Participants will then receive follow up questionnaires every month until there is a sustained period of no new cases in their province 1 month without a new case up to a maximum of one-year involvement These follow up questionnaires will measure burnout MBI-GS psychological distress HADS pandemic specific stressors PEPS workplace stressors and resourcescoping strategies A final follow-up survey will be sought one year after the end of the short- interval surveys to assess the long-term effects of responding to the COVID pandemic
Statistical Analysis Objective 1 Variables will be described using mean and standard deviation when normally distributed or median and interquartile range when skewed as measured by the Shapiro-Wilk test
Objective 2 The cross-sectional results of the initial survey will be analyzed using linear regression to quantify the strength of relationship between factors and burnout In the longitudinal analysis trajectory analysis using latent growth mixed modelling LGMM will be used to identify trajectories of burnout and psychological distress amongst physicians over time LGMM is ideally suited to longitudinal data as it is robust to the effects of missing data Furthermore LGMM may prove very useful in an unprecedented situation such as this in which there is scant data on which to base hypotheses as LGMM allows trajectories to be identified more empirically based on the data rather than through a priori conceptual models
Anticipated Outcomes The investigators will discover whether the characteristics of burnout during this pandemic are comparable to the current body of knowledge about physician burnout at baseline or during more limited periods of crisis This will inform whether current interventions for physician burnout are appropriate during widespread pandemic events both as physicians continue to deal with COVID-19 and in the future Improved understanding of stressors and protective factors will be essential not only for planning therapeutic studies at an individual level but will also allow institutions to mobilize high yield supports for physicians at risk
Given that these studies generally measure burnout and psychological distress at one or two cross-sectional time points it is difficult to tell how burnout develops over time Additionally the bulk of the studies assessed HCWs following natural disasters which tend to present as a single time point with one large wave of patients The current crisis is distinct in its sustained level of demand on HCWs with potential for multiple waves of patients or a sustained high number of patients outstripping the health care system resources for months at a time This study seeks to investigate the rates of burnout assessed at multiple time points during the COVID-19 pandemic Further this study seeks to determine the relationship between patient numbers mitigating factors and exacerbating factors and the rates of burnout at various time points
Objectives
1 What are the rates of psychological distress and burnout among physicians and residents throughout the COVID-19 pandemic
2 What baseline factors are associated with reductions and increases in psychological distress and burnout over time trajectories
Methods This study will be a national longitudinal survey of physicians in Canada The sampling frame will be all physicians currently practicing in Canada whether they hold a full provisional or post-graduate in-training license The survey will be distributed by 1 Advertisements on Twitter 2 Provincial physician associations and 3 National specialty groups for higher risk specialties anesthesia critical care emergency medicine Recipients will be directed to the survey site hosted by Redcap Cross-sectional results of the initial survey to give immediate feedback to provincial and national organizations about the threat of physician burnout and psychological distress Longitudinal results will analyze how burnout and distress change over time and will analyze the relationship to mitigating and exacerbating factors
Consenting participants will complete an initial survey gathering demographic information age gender trainee years in practice specialty chronic health conditions practice type academic community rural preparatory information prior to first COVID-19 suspected case COVID-19 pathwaysprocedures simulation designated areas scheduling changes and baseline measures Maslach Burnout Inventory - General Survey MBI-GS short form Pandemic Experience Perceptions Scale PEPS Hospital Anxiety and Depression Scale HADS stressors resources coping strategies Participants will then receive follow up questionnaires every month until there is a sustained period of no new cases in their province 1 month without a new case up to a maximum of one-year involvement These follow up questionnaires will measure burnout MBI-GS psychological distress HADS pandemic specific stressors PEPS workplace stressors and resourcescoping strategies A final follow-up survey will be sought one year after the end of the short- interval surveys to assess the long-term effects of responding to the COVID pandemic
Statistical Analysis Objective 1 Variables will be described using mean and standard deviation when normally distributed or median and interquartile range when skewed as measured by the Shapiro-Wilk test
Objective 2 The cross-sectional results of the initial survey will be analyzed using linear regression to quantify the strength of relationship between factors and burnout In the longitudinal analysis trajectory analysis using latent growth mixed modelling LGMM will be used to identify trajectories of burnout and psychological distress amongst physicians over time LGMM is ideally suited to longitudinal data as it is robust to the effects of missing data Furthermore LGMM may prove very useful in an unprecedented situation such as this in which there is scant data on which to base hypotheses as LGMM allows trajectories to be identified more empirically based on the data rather than through a priori conceptual models
Anticipated Outcomes The investigators will discover whether the characteristics of burnout during this pandemic are comparable to the current body of knowledge about physician burnout at baseline or during more limited periods of crisis This will inform whether current interventions for physician burnout are appropriate during widespread pandemic events both as physicians continue to deal with COVID-19 and in the future Improved understanding of stressors and protective factors will be essential not only for planning therapeutic studies at an individual level but will also allow institutions to mobilize high yield supports for physicians at risk
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None