Asistan hekimlerde korona virüs salgını nedeniyle yaşanılan zorluklar, kaygı düzeyi ve tükenmişlik sendromunun incelenmesi

Yıl 2022, Cilt: 27 Sayı: 2, 103 - 114, 24.05.2022

Seda Türkili Eda Aslan Şenel Tot Semra Erdoğan Gamze Güleryüz Beyza Erdoğan Aktürk Emre Özaslan

https://doi.org/10.21673/anadoluklin.1005533

Cited By: 3

Öz

Amaç: Yeni tip koronavirüs (COVID-19) pandemisi dünya çapında sağlık çalışanlarını gerek fiziksel gerekse ruhsal açıdan etkileyecek birçok zorluğu beraberinde getirmiştir. Bu çalışmada amaç, COVID-19 pandemisi sürecinde görev alan asistan hekimlerin karşılaştıkları zorlukların, kaygı yaratan durumların belirlenmesi ve tükenmişlik sendromu ve ilişkili faktörlerin değerlendirilmesi ve risk faktörleri için bir çerçeve sunulmasıdır.

Yöntemler: Çalışmamız internet üzerinden uygulanan bir anket çalışması olup, hastanemizin asistan hekimlerine sosyal platformlar üzerinden uygulanmıştır. 82 kadın, 73 erkek toplam 155 katılımcı anketi tamamlamıştır. Ankette sosyodemografik veriler ve COVID-19 pandemisi deneyimleri soru formu, Hasta Sağlık Anketi-4 ve Maslach Tükenmişlik Ölçeği kullanılmıştır.

Bulgular: Çalışmamızda katılımcıların % 61,3’ünün (n=95) anksiyete, % 58,1’inin (n=90) depresyon yaşadığı saptanmıştır. Tükenmişlik alt ölçeklerinde ortalama puanlar “duygusal tükenme” için 21,4 (±8,4), “duyarsızlaşma” için 8,65 (±5,10) ve “kişisel başarı” için 12,6 (±5,8) olarak bulunmuştur. COVID-19 hastaları ile artmış temas sıklığı, algılanan bulaş riski, idareciler tarafından algılanan destek eksikliği, sosyal destek eksikliği, damgalanma ve aşırı sosyal medya kullanımı ile depresyon artışı, anksiyete ve tükenmişlik seviyeleri arasında ilişki olduğu saptanmıştır.

Sonuç: Pandemi sürecinde sağlık hizmetlerinin etkin ve kaliteli bir şekilde sürdürülmesi, bu süreçte kilit rol oynayan asistan hekimlerin gerek fiziksel gerekse ruhsal açıdan iyi oluş hali ile doğrudan ilişkilidir. Bu süreçte görev alan sağlık çalışanlarının pandemi hakkında doğru bilgiye zamanında erişimlerinin sağlanması, kişisel koruyucu ekipmanlara yeterli erişim, çalışılan kurum idarecilerinin yanı sıra aile ve sosyal çevrenin desteği ile dışlanma damgalanma deneyimlerinin en aza indirgenmesi ve sosyal medya, TV gibi mecralar kanalıyla yoğun bir biçimde pandemi haberlerine ve yanlış bilgilere maruz kalmanın engellenmesi ruhsal açıdan koruyucu olacaktır. Yine mesai düzenlemelerinin enfekte hastalar ile temas sıklığını en alt düzeyde tutacak şekilde planlanması algılanan tehdit ve buna bağlı ruhsal etkilenmeleri azaltmada etkili olacaktır.

Anahtar Kelimeler

anksiyete, asistan hekim, depresyon, pandemi, tükenmişlik

Destekleyen Kurum

YOK

Proje Numarası

YOK

Examination of challenges, anxiety and burnout among assistant physicians due to corona virus outbreak

Öz

Aim: The novel coronavirus (COVID-19) pandemic has brought many difficulties that could affect healthcare workers physically and mentally together. The aim of the present study is to determine the challenges, and conditions that lead to anxiety in residents who work during the COVID-19 pandemic, evaluate burnout syndrome along with the related factors to it, and frame the risk factors.

Methods: Our study is a questionnaire study applied through the internet and conducted on residents on social platforms. A total of 155 participants (82 females and 73 males) completed the questionnaire. Socio-demographic data form, COVID-19 pandemic experiences form, Patient Health Questionnaire-4, and Maslach Burnout Scale were used in the study.

Results: Of the participants, 61.3% (n=95) were detected to have anxiety and 58.1% (n=90) were detected to have depression. In burnout subscales, the mean score was found to be 21,4 (±8,4) for “emotional burnout”, 8,65 (±5,10) for “desensitization” and 12,6 (±5,8) for “personal success”. Increased frequency of contact with COVID-19 patients, perceived transmission risk, lack of support from the management, lack of social support, stigmatization, and excess social media use were detected to be related to increased depression, anxiety, and burnout levels.

Conclusion: Maintenance of health services effectively and qualified during the pandemic is suggested to be related to both the physical and mental well-being of residents who play a key role during this process. Ensuring timely access to accurate information about the pandemic of the healthcare professionals involved in this process, adequate access to personal protective equipment, minimizing the experience of exclusion and stigmatization with the support of the family and social environment as well as preventing exposure to news and false information through ways such as social media and TV will be psychologically protective. Again, planning the working arrangements in a way to keep the frequency of contact with infected patients at the lowest level will be effective in reducing the perceived threat and related psychological effects.

Anahtar Kelimeler

anxiety, assistant physicians, burnout, depression, pandemic

Proje Numarası

YOK

Kaynakça

• T.C. Sağlık Bakanlığı COVID-19 Bilgilendirme Platformu. https://covid19.saglik.gov.tr/TR-66494/pandemi. html. Erişim Tarihi: 14.04.2021
• Maunder RG, Lancee WJ, Balderson KE, Bennett JP, Borgundvaag B, Evans S, et al. Long-term psychological and occupational effects of providing hospital healthcare during SARS outbreak. Emerg Infect Dis. 2006;12(12):1924-32.
• Nickell LA, Crighton EJ, Tracy CS, Al-Enazy H, Bolaji Y, Hanjrah S, et al. Psychosocial effects of SARS on hospital staff: survey of a large tertiary care institution. CMAJ. 2004;170(5):793-8.
• Jalili M, Niroomand M, Hadavand F. et al. Burnout among healthcare professionals during COVID-19 pandemic: a cross-sectional study. Int Arch Occup Environ Health 94, 1345–1352 (2021). https://doi.org/10.1007/ s00420-021-01695-x
• Poon E, Liu KS, Cheong DL, Lee CK, Yam LY, Tang WN. Impact of severe respiratory syndrome on anxiety levels of front-line health care workers. Hong Kong Med J. 2004;10(5):325-30.
• Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open. 2020;3(3);e203976;1-12.
• Xiao X, Zhu X, Fu S, Hu Y, Li X, Xiao J. Psychological impact of healthcare workers in China during COVID-19 pneumonia epidemic: A multi-center cross-sectional survey investigation. J Affect Disord. 2020;274:405-10.
• Barello S, Palamenghi L, Graffigna G. Burnout and somatic symptoms among frontline healthcare professionals at the peak of the Italian COVID-19 pandemic. Psychiatry Res. 2020;290:113129.
• Morgantini LA, Naha U, Wang H, Francavilla S, Acar Ö, Flores JM, et al. Factors Contributing to Healthcare Professional Burnout During the COVID-19 Pandemic: A Rapid Turnaround Global Survey. PLoS One. 2020;15(9):e0238217.
• Austria-Corrales F, Cruz-Valdés B, Herrera-Kiengelher L, Vázquez-García JC, Salas-Hernández J. Burnout syndrome among medical residents during the influenza A H1N1 sanitary contigency in Mexico. Gac Med Mex. 2011;147:97-103.
• Tam CWC, Pang EPF, Lam LCW, Chiu HF. Severe acu- te respiratory syndrome (SARS) in Hong Kong in 2003: stress and psychological impact among frontline healthcare workers. Psychol Med. 2004;34:1197-204.
• Wu P, Fang Y, Guan Z, Fan B, Kong J, Yao Z, et al. The psychological impact of the SARS epidemic on hospital employees in China: exposure, risk perception, and altruistic acceptance of risk. Can J Psychiatry. 2009;54:302-11.
• Rambaldini G, Wilson K, Rath D, Lin Y, Gold WL, Kapral MK, et al. The impact of severe acute respiratory syndrome on medical house staff: a qualitative study. J Gen Intern Med. 2005;20:381–5.
• Sim K, Chong PN, Chan YH, Soon WS. Severe acute respiratory syndrome-related psychiatric and posttraumatic morbidities and coping responses in medical staff within a primary health care setting in Singapore. J Clin Psychiatry. 2004;65(8):1120-7.
• Khee KS, Lee LB, Chai OT, et al. The psychological impact of SARS on health care providers. Crit Care & Shock. 2004;7:99-106.
• Koh D, Lim MK, Chia SE, Ko SM, Qian F, Ng, V, et al. Risk perception and impact of severe acute respiratory syndrome (SARS) on work and personal lives of healthcare workers in Singapore: What can we learn? Med Care. 2005;43(7):676-82.
• Kroenke K, Spitzer RL, Williams, JB, Löwe B. An ultra-brief screening scale for anxiety and depression: the PHQ–4. Psychosomatics. 2009;50(6):613-21.
• Demirci İ, Ekşi H. ERPA 2018 International Congresses on Education, Book of Proceedings. Don’t bother your pretty little head otherwise you can’t enjoy life. 28 June-1 July 2018; Turkey. Istanbul: Edugarden; 2018. p.287-92.
• Ergin C. Doktor ve Hemşirelerde Tükenmişlik ve Maslach Tükenmişlik Ölçeğin Uyarlanması. VII. Ulusal Psikoloji Kongresi Bilimsel Çalışmaları El Kitabı. 1992, Ankara: Türk Psikologlar Derneği Yayınları;1992: p.143-54.
• Sever A. Hemşirelerin İş Stresi İle Başa Çıkma Yolları ve Bunun Sonuçlarının Araştırılması (Doktora Tezi), İstanbul, ÇÜ Sağlık Bilimleri Enstitüsü, 2007.
• Çapri B. Tükenmişlik ölçeğinin Türkçe uyarlaması. Mersin Üniversitesi Eğitim Fakültesi Dergisi 2006;12:62-77.
• Imran N, Masood HMU, Ayub M, Gondal KM. Psychological impact of COVID-19 pandemic on postgraduate trainees: a cross-sectional survey. Postgrad Med J. 2020; 2021;97(1152):632–7
• Elhadi M, Msherghi A, Elgzairi M, Alhashimi A, Bouhuwaish A, Biala M, et al. Psychological status of healthcare workers during the civil war and COVID-19 pandemic: A cross-sectional study. J Psychosom Res. 2020;137:110221.
• Karaoğlu N, Demirbaş N. COVID-19 Pandemisinin İntörn Hekim ve Hekimlerin Yalnızlık, Umutsuzluk ve Anksiyete Belirti Düzeylerine Etkisi. TJFMPC, 2021;15(2): 251-60.
• Kisely S, Warren N, McMahon L, Dalais C, Henry I, Siskind D et al. Occurrence, prevention, and management of the psychological effects of emerging virus outbreaks on healthcare workers: rapid review and meta-analysis. BMJ. 2020;369:m1642.
• West CP, Tan AD, Habermann TM, Sloan JA, Shanafelt TD. Association of resident fatigue and distress with perceived medical errors. JAMA. 2009;302:1294–300.
• Van der Heijden F, Dillingh G, Bakker A, Prins J. Suicidal thoughts among medical residents with burnout. Arch Suicide Res. 2008;12:344–6.
• Van Gerven E, Vander Elst T, Vandenbroeck S, Diericx S, Euwema M, Sermeus W et al. Increased Risk of Burnout for Physicians and Nurses Involved in a Patient Safety Incident. Med Care. 2016;54(10):937-43.
• Garcia CL, Abreu LC, Ramos JLS, Castro CFD, Smiderle FRN, Santos JA et al. Influence of burnout on patient safety: systematic review and meta-analysis. Medicina. 2019; 55(9):553.
• Arpacıoğlu MS, Baltacı Z, Ünübol B. COVID-19 pandemisinde sağlık çalışanlarında tükenmişlik, Covid korkusu, depresyon, mesleki doyum düzeyleri ve ilişkili faktörler. Cukurova Med J. 2021;46(1):88-100.
• Elbay RY, Kurtulmuş A, Arpacıoğlu S, Karadere E. Depression, anxiety, stress levels of physicians and associated factors in Covid-19 pandemics. Psychiatry Research. 2020;290:113130.
• Tang L, Pan L, Yuan L, Zha L. Prevalence and related factors of posttraumatic stress disorder among medical staff members exposed to H7N9 patients. Int J Nurs Sci.2016;4:63-7.
• Dai Y, Hu G, Xiong H, Qiu H, Yuan X. Psychological impact of the coronavirus disease 2019 (COVID- 19) outbreak on healthcare workers in China. medRxiv. 2020.03.03.20030874.
• Damery S, Draper H, Wilson S, Greenfield S, Ives J, Parry J, et al. Healthcare workers’ perceptions of the duty to work during an influenza pandemic. J Med Ethics. 2010;36:12–8.
• Imai H, Matsuishi K, Ito A, Mouri K, Kitamura N, Akimoto K, et al. Factors associated with motivation and hesitation to work among health professionals during a public crisis: a cross sectional study of hospital workers in Japan during the pandemic (H1N1) 2009. BMC Public Health. 2010;10:672.
• Shanafelt T, Ripp J, Trockel M. Understanding and Addressing Sources of Anxiety Among Health Care Professionals During the COVID-19 Pandemic. JAMA. 2020;323(21):2133-4.
• Depoux A, Martin S, Karafillakis E, Preet R, Wilder-Smith A, Larson H. The Pandemic of Social Media Panic Travels Faster Than the COVID-19 Outbreak. J Travel Med. 2020;27(3):taaa031.
• Song J, Song TM, Seo DC, Jin DL, Kim JS. Social big data analysis of information spread and perceived infection risk during the 2015 Middle East Respiratory Syndrome outbreak in South Korea. Cyberpsychol Behav Soc Netw. 2017;20(1):22–9.
• Kavaklı M, Ak M, Uğuz F, Türkmen OO. The mediating role of self-compassion in the relationship between perceived COVID-19 threat and death anxiety. J Clin Psy. 2020;23(1):15-23.
• Huremović D. Social distancing, quarantine, and isolation. In Psychiatry of Pandemics: A Mental Health Response to Infection Outbreak (ed D Huremović): Springer, 2019, p.85–94.
• Huang JZ, Han MF, Luo TD, Ren AK, Zhou XP. Mental health survey of 230 medical staff in a tertiary infectious disease hospital for COVID-19. Chinese Journal of Industrial Hygiene and Occupational Diseases. 2020;38(3):192-5.
• Taylor S, Landry CA, Rachor GS, Paluszek MM, Asmundson GJG. Fear and avoidance of healthcare workers: An important, under-recognized form of stigmatization during the COVID-19 pandemic. J Anxiety Disord. 2020;75:102289.
• Bagcchi S. Stigma during the COVID-19 pandemic. Lancet. 2020;20:782
• Taylor S. The psychology of pandemics: Preparing for the next global outbreak of infectious disease. Newcastle upon Tyne: Cambridge Scholars Publishing 2019.
• Bai Y, Lin CC, Lin CY, Chen J.Y, Chue CM, Chou P. Survey of stress reactions among health care workers involved with the SARS outbreak. Psychiatr Serv. 2004;55(9):1055-7.
• Eren-Bana P. Evaluation of the social implication perception of healthcare employees In the COVID-19 outbreak process. PressAcademia Procedia (PAP). 2020;11:115-9
• Taylor S, Landry C, Paluszek M, Fergus TA, McKay D, Asmundson GJG. Development and initial validation of the COVID stress scales. J Anxiety Disord. 2020;72:102232.
• Taylor S, Landry CA, Paluszek MM, Fergus TA, McKay D, Asmundson GJG. COVID stress syndrome: Concept, structure, and correlates. Depress Anxiety 2020;37(8):706-14.
• Ramaci T, Barattucci M, Ledda C, Rapisarda V. Social stigma during COVID-19 and its impact on HCWs outcomes. Sustainability. 2020;12:3834.
• Taylor S, Asmundson GJG. Treating health anxiety. New York: Guilford 2020.