COVID-19 survey: Support of hospitals and societies ‘paramount’ to promoting well-being of vascular surgeons

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Nicolas Mouawad presents during SVS ONLINE

Responses to the COVID-19 pandemic practice, anxiety, coping and support survey for vascular surgeons, recently presented in a Special Scientific Session on COVID-19 during SVS ONLINE on June 27, reveal higher anxiety and stress levels in vascular surgeons worried about the negative consequences of care delays to their patients, worries about family, friends, and colleagues being infected with COVID-19, adequacy of personal protective equipment (PPE), changes in home routine, and financial concerns.

The survey, sponsored by the Society for Vascular Surgery (SVS) Wellness Task Force, “identified several areas where vascular surgeons can be supported at institutional, regional, and national societal levels,” remark the authors, Sherene Shalhub, MD, associate professor of surgery in the division of vascular surgery, the department of surgery, at the University of Washington School of Medicine, Seattle, Nicolas Mouawad, MD, chief of vascular and endovascular surgery in the McLaren Health System-Bay Region in Bay City, Michigan, and colleagues.

They conclude: “Vascular surgeons globally are experiencing multiple COVID-19 related stressors during this devastating crisis. These findings highlight the continued need for hospital systems to support their vascular surgeons and the importance of national societies to continue to invest in peer support programs as paramount to promoting the well-being of vascular surgeons during and after the COVID-19 pandemic.”

Shalhub and Mouawad describe the survey as an “anonymous cross-sectional global survey.” Data were collected 14–24 April 2020 using REDCap. Survey results were then analyzed to evaluate the impact of COVID-19 related stressors on vascular surgeons as measured by the Generalized anxiety disorder 7-item (GAD-7) scale. The 28-item Brief coping orientation to problems experienced (Brief-COPE) inventory was used to assess the active and avoidant coping strategies and additional qualitative data were collected using open-ended questions.

Shalhub et al note that the COVID-19 pandemic has led to “unprecedented challenges for healthcare systems globally,” which led the investigators to design and administer a global survey to examine the impact of COVID-19 on vascular surgeons and explore the COVID-19 related stressors faced, coping strategies employed, and support structures available.

The investigators report that a total of 1,609 survey responses (70.5% male, 82.5% vascular surgeons in practice) from 58 countries (43.4% USA, 43.4% Brazil) were eligible for analysis. Some degree of anxiety was reported by 54.5% of the respondents. Most respondents (around 60%) used active coping strategies and the avoidant coping strategy “self-distraction” and 20% used other avoidant coping strategies.

Multivariable analysis identified the following factors as significantly associated with increased self-reported anxiety levels: staying in a separate room at home or staying at the hospital/hotel after work (odds ratio [OR] 1.39 [95% confidence interval [CI] 1.08–1.79]), donning/doffing PPE (OR 1.81, 95% CI 1.41–2.33), worry about potential adverse patient outcomes due to care delay (OR 1.47, 95% CI 1.16–1.87), and financial concerns (OR 1.90, 95% CI 1.49–2.42).

Finally, they state that hospital support (OR 0.83, 95% CI 0.76–0.91) and use of positive reframing as an active coping strategy (OR 0.88, 95% CI 0.81–0.95) were noted as factors significantly associated with decreased self-reported anxiety levels.

“This survey it is a first step in understanding the psychological impact of COVID-19 on vascular surgeons,” Mouawad told Vascular Specialist. “The findings of this survey identify multiple stressors experienced by vascular surgeons globally during this devastating crisis and highlight the continued need for hospital systems and national societies to invest in and promote the well-being of vascular surgeons through peer support programs during the COVID-19 pandemic. Further analysis is focused on the specific effects of this pandemic on vascular trainees around the world, on our largest international cohort in Brazil, and the impact on vascular surgery practice in the U.S.”

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