Covid-19 pandemic induced traumatizing medical job contents and mental health distortions of physicians working in private practices and in hospitals

Abstract Background:The traumatic burden of the Covid-19 pandemic during its early phases posed significant psychological threats particularly for medical frontline personal. It is unclear whether the medical workforce with the passage of time has adapted to these threats or whether emotional perturbations have generalized to wider medical settings.Participants and Methods: An online survey was conducted among 1,476 physicians. Valid data were achieved from 1,327 participants. A pandemic induced job context score was built by nine items. Depression and anxiety were screened with the PHQ-2 and the GAD-2.Results:Among a subtotal of 1,139 (86.6%) physicians with personal treatment experiences with Covid-19 patients, 553 (84.8%) worked in a private practice (PP) and 586 (88.3%) in a hospital (HP). Covid-19 provoked profound conflicts between professional and ethical values: more physicians in PPs than HPs reported external constraints on their medical care being in conflict with the code of medical ethics (39.1% vs. 34.4%, p<0.002). However, significantly more HPs failed to maintain the dignity of their patients during the pandemic (48% vs. 27%, p< 0.0001). Prevalence of depression was 23.0% and 24.16% for anxiety. Comparison with mean PHQ-2 and GAD-2 data from reference groups among physicians with comparable size and settings during the first wave of Covid-19 revealed a significant increase in mental health distortions. A total of 63.3% HPs and 53.4% PPs reported feelings of helplessness associated with female sex, minor years of medical experience, being weakened by sleeping problems (OR= 2.5) and being encountered to unsettling events (OR=3.4). The association between exposure to unsettling events and helplessness was significantly mediated by sleep disturbances (Indirect path: ß= 0.29, S E= 0.03, p<0.0001).Conclusions:Major Covid-19 induced stress job content issues have broadened to more medical disciplines beyond frontline workers. Mental health deteriorations and feelings of helplessness among physicians have become frequent. (248)