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Psychological Distress and Trauma in Doctors Providing Frontline Care During the COVID-19 Pandemic in the United Kingdom and Ireland: A Prospective Longitudinal Survey Cohort Study

30 Pages Posted: 11 Jan 2021

See all articles by Tom Roberts

Tom Roberts

Royal College of Emergency Medicine

Jo Daniels

University of Bath

William Hulme

Statistical Consultant

Robert Hirst

Department of Anaesthesia, North Bristol NHS Trust

Daniel Horner

Royal College of Emergency Medicine

Mark D. Lyttle

Emergency Department, Bristol Royal Hospital for Children

Katie Samuel

Department of Anaesthesia, North Bristol NHS Trust

Blair Graham

University Hospitals Plymouth NHS Trust

Charles Reynard

Department of Cardiovascular Sciences, University of Manchester

Michael J. Barrett

Department of Emergency Medicine, Children’s Health Ireland at Crumlin

James Foley

Emergency Department, University Hospital Waterford

John Cronin

Department of Emergency Medicine, St Vincent’s University Hospital

Etimbuk Umana

Emergency Department, Connolly Hospital Blanchardstown

Edward Carlton

Royal College of Emergency Medicine

Joao Vinagre

College of Anaesthesiologists of Ireland

Trainee Emergency Research Network (TERN) Group

Independent

Paediatric Emergency Research Network UK and Ireland (PERUKI) Group

Independent

Research and Audit Federation of Trainees (RAFT) Group

Independent

Irish Trainee Emergency Research Network (ITERN and Trainee Research in Intensive Care (TRIC) Group

Independent

More...

Abstract

Background: The psychological impact of the COVID-19 pandemic on doctors is a significant concern. Due to the emergence of a multiple pandemic waves, longitudinal data on the impact of COVID-19 is vital to ensure an adequate psychological response. The primary aim was to assess the prevalence and degree of psychological distress and trauma in Emergency Medicine (EM), Anaesthetics and Intensive Care Medicine (ICM) doctors during the acceleration, peak and deceleration of the COVID-19 first wave. Personal and professional factors associated with psychological distress are also reported.  

Methods: A prospective online three-part longitudinal survey of frontline doctors across the UK and Ireland, administered at the acceleration, peak and deceleration of the COVID-19 first wave. Primary outcome measures were psychological distress and trauma, measured using the General Health Questionnaire-12 and the Impact of Events-Revised. 

Findings: Acceleration survey response rate was 15.9% (n=5440), of an estimated 34,188 doctors. Peak and deceleration response rates were 71·6% (n=3896) and 56·6% (n=3079) respectively. Prevalence of psychological distress was 44·7% (n=1334) during the acceleration, 36·9% (n=1098) at peak and 31·5% (n=918) at the deceleration phase. The prevalence of trauma was 23·7% (n=647) at peak and 17·7% (n=484) at deceleration. The prevalence of probable post-traumatic stress disorder was 12·6% (n=343) at peak and 10·1% (n=276) at deceleration. Worry of family infection due to clinical work was most strongly associated with both distress (R2 = 0·06) and trauma (R2 =0·10). 

Interpretation:  Findings reflect a pattern of elevated distress at acceleration and peak, with some natural recovery. It is essential that policymakers seek to prevent future adverse effects through (a)provision of vital equipment to mitigate physical and psychological harm (b)increased awareness and recognition of signs of psychological distress and (c)the development of clear pathways to effective psychological care.  

Funding: Funding received from the Royal College of Emergency Medicine.

Declaration of Interests: Many of the authors have been working as frontline clinicians during the COVID-19 pandemic. They have no competing interests to declare.

Ethics Approval Statement: Ethical approval was obtained from the University of Bath (UK) and Children’s Health Ethics Committee (Ireland). Regulatory approval was obtained from the Health Regulation Authority (UK), Health and Care Research Wales. Participants provided electronic informed consent for each survey.

Suggested Citation

Roberts, Tom and Daniels, Jo and Hulme, William and Hirst, Robert and Horner, Daniel and Lyttle, Mark D. and Samuel, Katie and Graham, Blair and Reynard, Charles and Barrett, Michael J. and Foley, James and Cronin, John and Umana, Etimbuk and Carlton, Edward and Vinagre, Joao and Group, Trainee Emergency Research Network (TERN) and Group, Paediatric Emergency Research Network UK and Ireland (PERUKI) and Group, Research and Audit Federation of Trainees (RAFT) and Group, Irish Trainee Emergency Research Network (ITERN and Trainee Research in Intensive Care (TRIC), Psychological Distress and Trauma in Doctors Providing Frontline Care During the COVID-19 Pandemic in the United Kingdom and Ireland: A Prospective Longitudinal Survey Cohort Study. Available at SSRN: https://ssrn.com/abstract=3760472 or http://dx.doi.org/10.2139/ssrn.3760472

Tom Roberts (Contact Author)

Royal College of Emergency Medicine ( email )

London
United Kingdom

Jo Daniels

University of Bath

Claverton Down
Bath, BA2 7AY
United Kingdom

William Hulme

Statistical Consultant ( email )

Robert Hirst

Department of Anaesthesia, North Bristol NHS Trust ( email )

Daniel Horner

Royal College of Emergency Medicine ( email )

Mark D. Lyttle

Emergency Department, Bristol Royal Hospital for Children ( email )

Katie Samuel

Department of Anaesthesia, North Bristol NHS Trust ( email )

Blair Graham

University Hospitals Plymouth NHS Trust

Plymouth, PL6 8DH
United Kingdom

Charles Reynard

Department of Cardiovascular Sciences, University of Manchester ( email )

Oxford Rd
Manchester, M13 9PL
United Kingdom

Michael J. Barrett

Department of Emergency Medicine, Children’s Health Ireland at Crumlin ( email )

James Foley

Emergency Department, University Hospital Waterford ( email )

John Cronin

Department of Emergency Medicine, St Vincent’s University Hospital ( email )

Etimbuk Umana

Emergency Department, Connolly Hospital Blanchardstown ( email )

Edward Carlton

Royal College of Emergency Medicine ( email )

Joao Vinagre

College of Anaesthesiologists of Ireland ( email )

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