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Published in: BMC Primary Care 1/2021

Open Access 01-12-2021 | Affective Disorder | Research

The impacts of the COVID-19 pandemic on the mental health and residency training of family medicine residents: findings from a nationwide cross-sectional survey in Turkey

Authors: Hüsna Çevik, Mehmet Ungan

Published in: BMC Primary Care | Issue 1/2021

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Abstract

Background

The COVID-19 pandemic has had a negative impact on resident training in different branches and affected the physical and mental health of frontline residents adversely. This nationwide cross-sectional survey aimed to investigate the effects of the COVID-19 pandemic on family medicine residents in Turkey, including the levels of depression and burnout.

Methods

An anonymous online survey was distributed to all family medicine residents via e-mail and a web link between 28.11.2020 and 12.12.2020. Information on sociodemographic data and the residency programme were evaluated, and factors associated with depression and burnout were examined using the Patient Health Questionnaire-9 (PHQ-9) and the Burnout Measure-Short Version (BMS) respectively.

Results

Although the weekly average working hours of the 477 respondents increased significantly during the pandemic (p < 0.05), the average weekly working time in the Family Medicine (FM) outpatient clinic decreased. The greatest concern of 58.3% of the residents was fear of transmitting COVID-19 to their family members. 90.2% of the residents stated that training programmes were negatively or very negatively affected. According to PHQ-9 scores, 15.7% of residents had moderately severe, and 14.9% severe depression. The BMS scores of the residents demonstrated that 24.1% had a very severe burnout problem, and 23.3% should seek professional help as soon as possible. Being single, having no children, female gender, lack of personal protective equipments and increased contact time with COVID-19 patients were associated with higher scores in the depression and burnout scales (p < 0.05).

Conclusions

The COVID-19 pandemic has had a negative impact on training programmes for FM residents, who are at the forefront of the pandemic in Turkey, and this situation is closely related to depression and burnout. Due to the unpredictability of the pandemic, long-term plans should be made for the training needs of residents in order to protect their physical and mental health.
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Literature
1.
Jebril N. World Health Organization declared a pandemic public health menace: A systematic review of the coronavirus disease 2019 “COVID-19”, up to 26th March 2020. Available at SSRN 3566298 2020.
2.
Genç K. COVID-19 in Turkey: a nation on edge. Lancet. 2021;397(10287):1794–6.CrossRef
3.
4.
5.
Şimşek AÇ, Kara A, Baran-Aksakal FN, Gülüm M, Ilter B, Ender L, Bulut YE, Gül H, Irmak H, Altunay K. Contact tracing management of the COVID-19 pandemic. Türk Hijyen Deneysel Biyoloji Dergisi. 2020;77(3):269–80.
6.
Panocchia N, D'Ambrosio V, Corti S, Lo Presti E, Bertelli M, Scattoni ML, Ghelma F. COVID-19 pandemic, the scarcity of medical resources, community-centred medicine and discrimination against persons with disabilities. J Med Ethics. 2021;47:362–6.
7.
Sahin B, Hanalioglu S. The Continuing Impact of Coronavirus Disease 2019 on Neurosurgical Training at the 1-Year Mark: Results of a Nationwide Survey of Neurosurgery Residents in Turkey. World Neurosurg. 2021;151:e857–e870.
8.
Caruana EJ, Patel A, Kendall S, Rathinam S. Impact of coronavirus 2019 (COVID-19) on training and well-being in subspecialty surgery: a national survey of cardiothoracic trainees in the United Kingdom. J Thorac Cardiovasc Surg. 2020;160(4):980–7.CrossRef
9.
World Health Organization: Role of primary care in the COVID-19 response. 2020.CrossRef
10.
Ardıç C. COVID-19 Pandemi Süreci. Türkiye Klinikleri 2020, 1. Baskı(Aile Hekimliği ve COVID-19 Pandemisi):5–7.
11.
Nasrallah MS, Tawfik HA, Aseel MT. Family medicine residency training program during COVID19: Qatari experience. Pan Afr Med J. 2020;35(Suppl 2):126.PubMedPubMedCentral
12.
Preti E, Di Mattei V, Perego G, Ferrari F, Mazzetti M, Taranto P, et al. The psychological impact of epidemic and pandemic outbreaks on healthcare workers: rapid review of the evidence. Curr Psychiatry Rep. 2020;22(8):1–22.CrossRef
13.
Sharif S, Amin F, Hafiz M, Benzel E, Peev N, Dahlan RH, et al. COVID 19–depression and neurosurgeons. World Neurosurg. 2020;140:e401–10.CrossRef
14.
Magnavita N, Chirico F, Garbarino S, Bragazzi NL, Santacroce E, Zaffina S. SARS/MERS/SARS-CoV-2 outbreaks and burnout syndrome among healthcare workers. An umbrella systematic review. Int J Environ Res Public Health. 2021;18(8):1–13.
15.
Rakowsky S, Flashner BM, Doolin J, Reese Z, Shpilsky J, Yang S, Smith CC, Graham K. Five questions for residency leadership in the time of COVID-19: reflections of chief medical residents from an internal medicine program. Acad Med. 2020;95(8):1152–4.
16.
Balhareth A, AlDuhileb MA, Aldulaijan FA, Aldossary MY. Impact of COVID-19 pandemic on residency and fellowship training programs in Saudi Arabia: a nationwide cross-sectional study. Ann Med Surg. 2020;57:127–32.CrossRef
17.
Dimitriu MCT, Pantea-Stoian A, Smaranda AC, Nica AA, Carap AC, Constantin VD, et al. Burnout syndrome in Romanian medical residents in time of the COVID-19 pandemic. Med Hypotheses. 2020;144:109972.CrossRef
18.
Sari YE, Kokoglu B, Balcioglu H, Bilge U, Colak E, Unluoglu I. Turkish reliability of the patient health questionnaire-9. Biomed Res India. 2016;27:460–2.
19.
Capri B. The Turkish adaptation of the burnout measure-short version (BMS) and couple burnout measure-short version (CBMS) and the relationship between career and couple burnout based on psychoanalytic-existential perspective. Educ Sci Theory Pract. 2013;13(3):1408–17.
20.
Chang DG, Park JB, Baek GH, Kim HJ, Bosco A, Hey HWD, Lee CK. The impact of COVID-19 pandemic on orthopaedic resident education: a nationwide survey study in South Korea. Int Orthop. 2020;44(11):2203–10.
21.
Coleman JR, Abdelsattar JM, Glocker RJ. COVID-19 Pandemic and the lived experience of surgical residents, fellows, and early-career surgeons in the American College of Surgeons. J Am Coll Surg. 2021;232(2):119–135.e120.
22.
Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–13.CrossRef
23.
Malach-Pines A. The burnout measure, short version. Int J Stress Manag. 2005;12(1):78.CrossRef
24.
World Health Organization: WHO COVID-19: Case definitions [WHO/2019-nCoV/Surveillance_Case_Definition/2020.1]. Geneva: World Health Organization; 2020.
25.
McCarthy C, Carayannopoulos K, Walton JM. COVID-19 and changes to postgraduate medical education in Canada. CMAJ. 2020;192(35):E1018–20.CrossRef
26.
Potts JR 3rd. Residency and fellowship program accreditation: effects of the novel coronavirus (COVID-19) pandemic. J Am Coll Surg. 2020;230(6):1094–7.CrossRef
27.
Pertile D, Gallo G, Barra F, Pasculli A, Batistotti P, Sparavigna M, et al. The impact of COVID-19 pandemic on surgical residency programmes in Italy: a nationwide analysis on behalf of the Italian Polyspecialistic young surgeons society (SPIGC). Updat Surg. 2020;72(2):269–80.CrossRef
28.
Ehrlich H, McKenney M, Elkbuli A. We asked the experts: virtual learning in surgical education during the COVID-19 pandemic-shaping the future of surgical education and training. World J Surg. 2020;44(7):2053–5.CrossRef
29.
Singh K, Srivastav S, Bhardwaj A, Dixit A, Misra S. Medical education during the COVID-19 pandemic: a single institution experience. Indian Pediatr. 2020;57(7):678–9.CrossRef
30.
Dedeilia A, Sotiropoulos MG, Hanrahan JG, Janga D, Dedeilias P, Sideris M. Medical and surgical education challenges and innovations in the COVID-19 era: a systematic review. In Vivo. 2020;34(3 suppl):1603–11.CrossRef
31.
Alrawashdeh HM, Al-Tammemi AB, Alzawahreh MK, Al-Tamimi A, Elkholy M, Al Sarireh F, et al. Occupational burnout and job satisfaction among physicians in times of COVID-19 crisis: a convergent parallel mixed-method study. BMC Public Health. 2021;21(1):811.CrossRef
32.
Amerio A, Bianchi D, Santi F, Costantini L, Odone A, Signorelli C, et al. Covid-19 pandemic impact on mental health: a web-based cross-sectional survey on a sample of Italian general practitioners. Acta Biomed Atenei Parmensis. 2020;91(2):83–8.
33.
Morgantini LA, Naha U, Wang H, Francavilla S, Acar Ö, Flores JM, Crivellaro S, Moreira D, Abern M. Eklund M, et al. Factors Contributing to Healthcare Professional Burnout During the COVID-19 Pandemic: A Rapid Turnaround Global Survey. PLOS ONE. 2020;15(9):e0238217.
34.
Magnavita N, Garbarino S. Social psychiatry in the waiting room: what a physician can learn about occupational stress from workers waiting to be examined. Psychiatry J. 2013;2013:701872.CrossRef
35.
Magnavita N, Fileni A. Association of work-related stress with depression and anxiety in radiologists. Radiol Med. 2014;119(5):359–66.CrossRef
36.
Ing EB, Xu QA, Salimi A, Torun N. Physician deaths from corona virus (COVID-19) disease. Occup Med (Lond). 2020;70(5):370–4.CrossRef
37.
Luo M, Guo L, Yu M, Jiang W, Wang H. The psychological and mental impact of coronavirus disease 2019 (COVID-19) on medical staff and general public - a systematic review and meta-analysis. Psychiatry Res. 2020;291:113190.CrossRef
38.
Pappa S, Ntella V, Giannakas T, Giannakoulis VG, Papoutsi E, Katsaounou P. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis. Brain Behav Immun. 2020;88:901–7.CrossRef
39.
Inaba A, Thoits PA, Ueno K, Gove WR, Evenson RJ, Sloan M. Depression in the United States and Japan: gender, marital status, and SES patterns. Soc Sci Med. 2005;61(11):2280–92.CrossRef
40.
Ruiz-Fernández MD, Ramos-Pichardo JD, Ibáñez-Masero O, Cabrera-Troya J, Carmona-Rega MI, Ortega-Galán ÁM. Compassion fatigue, burnout, compassion satisfaction and perceived stress in healthcare professionals during the COVID-19 health crisis in Spain. J Clin Nurs. 2020;29(21–22):4321–30.CrossRef
41.
Breazzano MP, Shen J, Abdelhakim AH, Glass LRD, Horowitz JD, Xie SX, de Moraes CG, Chen-Plotkin A, Chen RWS, on behalf of the New York City Residency Program Directors COVID-19 Research Group. New York City COVID-19 resident physician exposure during exponential phase of pandemic. J Clin Invest. 2020;130(9):4726–33.
42.
Anton M, Wright J, Braithwaite M, Sturgeon G, Locke B, Milne C, Crosby A. Creating a COVID-19 Action Plan for GME Programs. J Grad Med Educ. 2020;12(4):399–402.
43.
Leung K, Wu JT, Liu D, Leung GM. First-wave COVID-19 transmissibility and severity in China outside Hubei after control measures, and second-wave scenario planning: a modelling impact assessment. Lancet. 2020;395(10233):1382–93.
44.
Greenberg N, Docherty M, Gnanapragasam S, Wessely S. Managing mental health challenges faced by healthcare workers during covid-19 pandemic. Bmj. 2020;368:m1211.CrossRef
45.
Kannampallil TG, Goss CW, Evanoff BA, Strickland JR, McAlister RP, Duncan J. Exposure to COVID-19 patients increases physician trainee stress and burnout. PLoS One. 2020;15(8):e0237301.CrossRef
46.
Lima CKT, Carvalho PMM, Lima I, Nunes J, Saraiva JS, de Souza RI, da Silva CGL, Neto MLR. The emotional impact of Coronavirus 2019-nCoV (new Coronavirus disease). Psychiatry Res. 2020;287:112915.
47.
Xiang Y-T, Yang Y, Li W, Zhang L, Zhang Q, Cheung T, et al. Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. Lancet Psychiatry. 2020;7(3):228–9.CrossRef
48.
Alshdaifat E, Sindiani A, Khasawneh W, Abu-Azzam O, Qarqash A, Abushukair H, et al. The impact of COVID-19 pandemic on training and mental health of residents: a cross-sectional study. BMC Med Educ. 2021;21(1):208.CrossRef
49.
De Brier N, Stroobants S, Vandekerckhove P, De Buck E. Factors affecting mental health of health care workers during coronavirus disease outbreaks (SARS, MERS & COVID-19): a rapid systematic review. PLoS One. 2020;15(12):e0244052.CrossRef
50.
Lee TH, Zhang C, Wood R, Kothari D. C.O.V.I.D.: a survival guide for GI fellowship training during the COVID-19 pandemic. Clin Gastroenterol Hepatol. 2021;19(1):6–9.CrossRef
51.
Dzau VJ, Kirch D, Nasca T. Preventing a parallel pandemic - a National Strategy to protect Clinicians' well-being. N Engl J Med. 2020;383(6):513–5.CrossRef
52.
Anwar A, Seger C, Tollefson A, Diachun CAB, Tanaka P, Umar S. Medical education in the COVID-19 era: impact on anesthesiology trainees. J Clin Anesth. 2020;66:109949.CrossRef
Metadata
Title
The impacts of the COVID-19 pandemic on the mental health and residency training of family medicine residents: findings from a nationwide cross-sectional survey in Turkey
Authors
Hüsna Çevik
Mehmet Ungan
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2021
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-021-01576-9

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