Association of US Nurse and Physician Occupation With Risk of Suicide

Davis, Matthew; Cher, Benjamin A Y; Friese, Christopher R.; Bynum, Julie

doi:10.1001/jamapsychiatry.2021.0154

Cited by 92 publications

(129 citation statements)

References 26 publications

(54 reference statements)

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“…Given prior work demonstrating high trauma exposure and psychiatric symptoms in FR 38 , including high rates of both suicidal thoughts and behaviors, particularly in EMS 39 , results highlight the importance of addressing the impact of working during a pandemic on FR. Similarly, findings underscored the higher CROS exposure and psychiatric distress in nurses as compared with physicians, building on prior work finding increased distress, suicidal ideation, and suicidal behavior specifically in nurses 40 .…”

Section: Discussionsupporting

confidence: 54%

The Impact of the COVID-19 Pandemic on Mental Health, Occupational Functioning, and Professional Retention Among Health Care Workers and First Responders

et al. 2021

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Background The COVID-19 pandemic has greatly affected front-line health care workers (HCW) and first responders (FR). The specific components of COVID-19 related occupational stressors (CROS) associated with psychiatric symptoms and reduced occupational functioning or retention remain poorly understood. Objectives Examine the relationships between total and factored CROS, psychiatric symptoms, and occupational outcomes. Design Observational, self-report, single time-point online assessment. Participants A total of 510 US HCW (N = 301) and FR (N = 200) with occupational duties affected by the COVID-19 pandemic. Main Outcomes and Measures CROS were assessed using a custom 17-item questionnaire. Post-traumatic stress disorder (PTSD), depression, insomnia, and generalized anxiety symptoms were assessed using the PTSD Checklist-5 (PCL5), Patient Health Questionnaire-9 (PHQ9), Insomnia Severity Index (ISI), and General Anxiety Disorder-7 (GAD7). Respondents’ likelihood of leaving current field and occupational functioning were assessed with 2-item PROMIS subscales. Relationships were modeled using multivariable regression. Open-ended responses were coded using rapid template analysis. Results CROS total scores correlated significantly with all four psychiatric symptom domains (R’s = .42–.53), likelihood of leaving one’s current occupation (R = .18), and trouble doing usual work (R = .28), all p’s < .001. Half of HCW indicated a decreased likelihood of staying in their current occupation as a result of the pandemic. CROS were fit to a 3-factor model consisting of risk, demoralization, and volume factors. All CROS factors were associated with psychiatric symptom burden, but demoralization was most prominently associated with psychiatric symptoms and negative occupational outcomes. Among psychiatric symptoms, PTSD symptoms were most strongly associated with negative occupational outcomes. Open-ended statements emphasized lack of protection and support, increased occupational demands, and emotional impact of work duties. Conclusions and Relevance These results demonstrate potentially treatable psychiatric symptoms in HCW and FR experiencing CROS, impacting both wellbeing and the health care system. Mitigating CROS, particularly by addressing factors driving demoralization, may improve HCW and FR mental health, occupational functioning, and retention.

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Section: Discussionsupporting

confidence: 54%

The Impact of the COVID-19 Pandemic on Mental Health, Occupational Functioning, and Professional Retention Among Health Care Workers and First Responders

et al. 2021

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“…It is anticipated that nurse's psychological burden will potentially increase in the context of the COVID‐19 global pandemic (Davis et al . 2021 ). Consequently, there has been a number of international studies exploring the psychological burden of healthcare workers during the COVID‐19 pandemic.…”

Section: Introductionmentioning

confidence: 99%

“…Psychological burden has impacted between 12% and 67% of nurses during the COVID-19 pandemic (Vizheh et al 2020). Consequently, suicide rates among nurses are predicted to increase during the COVID-19 pandemic as a result of work-related stressors and mental health problems (Davis et al 2021). The monitoring and surveillance of clinician's mental health and associated workplace characteristics are critical (Jackson et al 2020).…”

Section: Introductionmentioning

confidence: 99%

The impact of COVID‐19 pandemic‐related stress experienced by Australian nurses

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Samios

Penman

et al. 2021

Int J Mental Health Nurs

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Globally, the impact of COVID‐19 on healthcare workers' mental health has been a major focus of recent research. However, Australian research involving nurses, particularly across the acute care sector, is limited. This cross‐sectional research aimed to explore the impact of pandemic‐related stress on psychological adjustment outcomes and potential protective factors for nurses ( n = 767) working in the Australian acute care sector during the COVID‐19 pandemic. Nurses completed an online questionnaire with psychometrically validated measures of pandemic‐related stress, psychological adjustment outcomes (depression, anxiety, and subjective well‐being), and protective factors (posttraumatic growth and self‐compassion). Descriptive analyses revealed that pandemic‐related stress was reported by 17.7% of the participants. Psychological adjustment outcome scores above normal for depression (27.5%) and anxiety (22.0%) were found, and 36.4% of the participants reported poor subjective well‐being. Regression analyses suggest that pandemic‐related stress predicted greater depression ( B = 0.32, SE = 0.02, 95% confidence interval [0.28, 0.35]) and anxiety ( B = 0.26, SE = 0.01, 95% confidence interval [0.24, 0.29]) and less subjective well‐being ( B = −0.14, SE = 0.01, 95% confidence interval [−0.16, −0.12]). Self‐compassion weakened the relationship between pandemic‐related stress and greater depression, however, exacerbated the relationship between pandemic‐related stress and less subjective well‐being. Posttraumatic growth reduced the negative relationship between pandemic‐related stress and psychological adjustment outcomes. These findings will inform strategies to facilitate psychological resources that support nurses' psychological adjustment, enabling better pandemic preparedness at both an individual and organizational level.

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“…Using the latest available data from the Centers for Disease Control and Prevention National Violent Death Reporting System, Davis et al (2021) found that between 2007 and 2018, nurses were 18% more likely to die from suicide than the general population. Among female nurses, the risk of death by suicide was approximately twice the risk observed in the general population, and 70% more likely than female physicians.…”

Section: The Alarming Evidencementioning

confidence: 99%

“…Rates of death by suicide among physicians did not differ signifi cantly from the general population. Davis et al (2021) also reported that from 2017 to 2018, an estimated 729 American nurses died by suicide, the highest reported number on record. But we fear the worst is yet to come.…”

Section: The Alarming Evidencementioning

confidence: 99%