Impact of COVID-19 pandemic on orthopaedic surgeons in terms of anxiety, sleep outcomes and change in management practices: A cross-sectional study from India

Abstract

Purpose: The aim of this study was to assess the effects of the COVID-19 pandemic on anxiety, sleep outcomes and change in clinical management practices among orthopaedic surgeons following a nation-wide lockdown. Methods: We conducted an online cross-sectional study using piloted structured questionnaires with self-reported responses from Indian orthopaedic surgeons. Study participants were identified through social networking sites: Facebook and WhatsApp. The extent of anxiety and sleep quality was assessed by the standardised seven-item Generalised Anxiety Disorder (GAD-7) scale, single-item sleep quality scale, questions on unavailability of personal protective equipment, training module on COVID-19 and change in orthopaedic patient management. Results: One hundred male orthopaedic surgeons responded to the survey with majority (79%) in 30–44 years age group. Severe anxiety scores were observed in 8%; moderate, mild and minimal anxiety was observed in 12%, 27% and 53% surgeons respectively. Changes in management practice due to the pandemic was admitted by 65% respondents. We also observed an association between higher anxiety among surgeons and primary or secondary level of healthcare facility: (p = 0.04). Sleep disturbance was significantly associated with change in management practice to non-operative procedures (p = 0.03). Conclusion: Anxiety among orthopaedic surgeons during the COVID-19 pandemic is related to factors like younger age group, working in a primary or secondary healthcare facility. Early recognition of anxiety is essential to prevent serious psychological sequelae.

Sleep disturbances during the COVID-19 pandemic: A systematic review, meta-analysis, and meta-regression

“… SD 5 179 Sharma et al, 2020 [ 221 ] India No Healthcare workers [Frontline = 60.9%, Nurses = 41.8%] Cross-sectional design, N = 184, Female = 58.7%, Age = 20-50 years. ISI 7 180 Sharma et al, 2021 [ 222 ] India Yes Healthcare workers [Frontline = 0%, Nurses = 0%] Cross-sectional design, N = 100, Female = 0%, Age = 30-60 years. SQS 4 181 Shi et al, 2020 [ 223 ] China No General Population Cross-sectional design, N = 56679, Female = 52.1%, Age = 36 years.…”

Burnout in Surgical Trainees: a Narrative Review of Trends, Contributors, Consequences and Possible Interventions

“…In the Netherlands, surgeons assigned to a COVID ward reported high burnout symptoms [ 61 ]. In India, 1 in every 2 orthopaedic surgeons reported experiencing either mild, moderate or severe anxiety in May 2020 [ 62 ]. However, further research is needed which focuses on surgical trainees; this group may be particularly vulnerable to burnout given the pandemic’s impact on their training and education [ 11 ].…”

Stress, anxiety, and burnout of orthopaedic surgeons in COVID-19 pandemic

“…Stress and anxiety among surgeons is not a new phenomenon resulting in burnout, as well as in suicide in extreme situations [ 11 , 23 , 24 ]. There is a consensus that healthcare professionals are at an increased risk of high levels of stress, anxiety, depression, burnout, addiction, and post-traumatic stress disorders that could have long-term psychological implications [ 25 ].…”

“…Early recognition of anxiety among orthopaedic surgeons is essential. The present pandemic has impacted orthopaedic surgeons psychologically in the form of definite or mild anxiety that is related to factors such as younger age group, working in a primary or secondary healthcare facility, unavailability of adequate personal protective equipment, disruption of life-work balance, and uncertainties regarding return to work [ 11 , 27 ]. COVID-19 has had a significant impact on all adult reconstruction surgeons including residents, fellows, and early career surgeons, with different impacts on each subgroup.…”