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Emergency medicine physicians, nurses, residents, nurse practitioners, and physician assistants showed signs of mental and physical stress after frontline pandemic experience, a prospective study of 50 healthcare personnel in the New York City area found.
Previous studies have shown the physical and emotional impact of disasters on frontline healthcare workers, including emergency physicians and nurses, but changes in specific psychological and physiologic factors have not been well studied, according to Bernard P. Chang, MD, of Columbia University, New York City, and colleagues.
Frontline workers in disaster situations are prone to the development of “adverse behavioral, psychological, and physical sequelae, which may persist long after the disaster,” they said in an abstract presented at the American College of Emergency Physicians (ACEP) 2021 Scientific Assembly.
To examine the prevalence and predictors of mental and physical distress, the researchers identified 50 clinicians who were frontline workers in four emergency departments in a range of hospital settings (academic, community, urban, and suburban) in the New York metropolitan area from July 2020 to September 2020. They conducted baseline psychological testing that included assessment of stress related to COVID-19, as well as posttraumatic stress disorder, anxiety, depression, and burnout. The median age of the study participants was 42 years, 62% of the participants were women, and 67% were White. The study population included physicians/advanced practictitioners (45%), nurses (43%), and residents (12%).
On the physiologic side, the researchers collected data on home blood pressure at waking and sleeping, resting heart rate, and sleep duration using wristwatch devices. The average home blood pressure was 128/76 mm Hg, the average resting heart rate was 86 bpm, and the average sleep duration was 6.2 hours.
Overall, increased emotional exhaustion was associated with higher blood pressure and higher resting heart rate (Pearson correlation coefficients, 0.32 and 0.38, respectively). Increased emotional exhaustion was also negatively associated with sleep duration (Pearson correlation coefficient, 0.23).
At baseline, 48% of the participants screened positive for acute stress, 37% were positive for depressive symptoms, and 30% were positive for anxiety symptoms. Rates for acute stress and depression were not significantly different among house staff, attendings, or nurses.
The study findings were limited by several factors, including the small sample size and focus on New York City, the researchers noted. Additional research is needed to determine whether the elevated distress symptoms seen in this study persist as the COVID-19 pandemic evolves, they added.
The results reflect previous studies that show significant levels of both physical and mental distress among healthcare workers related to COVID-19 and highlight the need for ongoing mental health support for these individuals during and after the pandemic, the researchers concluded.
The study received no outside funding. The researchers have disclosed no relevant financial relationships.
Ann Emerg Med. 2021;78:S22. Abstract
American College of Emergency Physicians (ACEP) 2021 Scientific Assembly: Abstract 52. Presented October 2021.
Heidi Splete is a freelance medical journalist with 20 years of experience.
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