Impacts of the Coronavirus Disease 2019 (COVID-19) pandemic on healthcare workers: A nationwide survey of United States radiologists

Abstract

Background Efforts to reduce nosocomial spread of COVID-19 have resulted in unprecedented disruptions in clinical workflows and numerous unexpected stressors for imaging departments across the country. Our purpose was to more precisely evaluate these impacts on radiologists through a nationwide survey. Methods A 43-item anonymous questionnaire was adapted from the AO Spine Foundation's survey and distributed to 1521 unique email addresses using REDCap™ (Research Electronic Data Capture). Additional invitations were sent out to American Society of Emergency Radiology (ASER) and Association of University Radiologists (AUR) members. Responses were collected over a period of 8 days. Descriptive analyses and multivariate modeling were performed using SAS v9.4 software. Results A total of 689 responses from radiologists across 44 different states met the criteria for inclusion in the analysis. As many as 61% of respondents rated their level of anxiety with regard to COVID-19 to be a 7 out of 10 or greater, and higher scores were positively correlated the standardized number of COVID-19 cases in a respondent's state (RR = 1.11, 95% CI: 1.02–1.21, p = 0.01). Citing the stressor of “personal health” was a strong predictor of higher anxiety scores (RR 1.23; 95% CI: 1.13–1.34, p < 0.01). By contrast, participants who reported needing no coping methods were more likely to self-report lower anxiety scores (RR 0.4; 95% CI: 0.3–0.53, p < 0.01). Conclusion COVID-19 has had a significant impact on radiologists across the nation. As these unique stressors continue to evolve, further attention must be paid to the ways in which we may continue to support radiologists working in drastically altered practice environments and in remote settings.

Factors Associated With Psychological Distress in Health-Care Workers During an Infectious Disease Outbreak: A Rapid Systematic Review of the Evidence

“…Similarly, medical staff receiving inadequate training related to managing H7N9 had higher PTSD symptoms than those who received appropriate training ( 81 ). During COVID-19, HCW who felt HCW who felt that they did not have adequate information, training, personal protective equipment (PPE), felt unsafe, and perceived lower logistic support, reported higher levels of depression, anxiety, and acute stress symptoms ( 51 , 54 , 60 , 65 , 72 , 74 , 99 , 100 , 102 , 106 , 120 , 142 ).…”

Experiences and management of physician psychological symptoms during infectious disease outbreaks: a rapid review

“…Ninety-seven (97/172, 56.4%) studies from 43 countries (most from China [ n = 17], USA, [ n = 11], Turkey [ n = 9], India [ n = 8], Pakistan [ n = 7], or Italy [ n = 6]) reported physician anxiety during the COVID-19 pandemic. Most studies used the Generalized Anxiety Disorder (GAD-2/GAD-7)( n = 33), survey/interview ( n = 26, e.g., “Do you feel anxious when you case for COVID-19 patients” [ 35 ] or “Rate your level of anxiety regarding the COVID-19 outbreak on a scale of 1 to 10 [ 91 ]), Depression, Anxiety and Stress Scale-21 Items (DASS-21)( n = 9), Hospital Anxiety and Depression Scale (HADS)( n = 9), State Trait Anxiety Inventory (STAI) (each n = 4), along with other measurements (Additional File 3 ). The proportion of physicians who experienced symptoms of anxiety (i.e., any symptoms of anxiety measured on a validated scale [i.e., mild, moderate, and severe]) was reported in 34 studies, and ranged from 14.3% (Iran) to 92.3% (Saudi Arabia and Egypt) (Fig.…”

“…Physicians reported the importance of having social support from friends, family, colleagues, and professionals (e.g., counsellors) in 29 studies [ 28 , 30 , 39 , 43 , 44 , 48 , 56 , 58 , 67 , 72 , 78 , 83 , 91 , 99 , 102 , 106 , 115 , 119 , 131 , 150 , 155 , 163 , 172 , 192 , 202 – 205 ]. Several studies ( n = 29) described positive personal coping strategies such as maintaining a positive attitude and resilience [ 37 , 46 , 83 , 100 , 106 , 108 , 136 , 202 , 205 , 206 ], practicing self-care (e.g., physical activity, eating well, resting, engaging in activities they enjoy) [ 30 , 35 , 56 , 65 , 70 , 91 , 102 , 103 , 117 , 119 , 129 , 131 , 150 , 151 , 207 ], and engaging with religious practices [ 39 , 46 , 131 , 205 ] as a way to mitigate negative psychological outcomes. In contrast, two studies reported that physicians engaged in avoidance coping strategies (e.g., screaming, crying, denial, self-blame, disengaging, substance abuse, etc.)…”

Imaging of COVID-19: CT, MRI, and PET

“…The utility of radiologic imaging in screening and diagnosis of suspected COVID-19 cases has been hotly debated since the start of the pandemic, with many professional societies and expert panels having previously issued recommendations against first-line chest imaging as a primary screening modality. 15 , 18 , 19 , 20 , 21 , 22 Joint guidelines from the European Society of Radiology and the European Society of Thoracic Imaging as well as those issued by the Fleischner Society do recognize a limited role specifically for chest CT in resource-limited triage situations, 23 , 24 , 25 though discussion of the merits of these approaches lies beyond the scope of this article. Nevertheless, chest imaging remains an integral component of the workup and staging of COVID-19, especially when assessing for complications or disease progression.…”