Title

The perceived work environment and well-being: A survey of emergency health care workers during the COVID-19 pandemic

Authors

Janice Blanchard, Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.
Yixuan Li, Department of Health Policy, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA.
Suzanne K. Bentley, Departments of Emergency Medicine & Medical Education, Icahn School of Medicine at Mount Sinai, New York City Health+Hospitals/Elmhurst, New York, New York, USA.
Michelle D. Lall, Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Anne M. Messman, Department of Emergency Medicine, Wayne State University School of Medicine, University Health Center-6G, Detroit, Michigan, USA.
Yiju Teresa Liu, Department of Emergency Medicine, David Geffen School of Medicine at UCLA, Harbor-UCLA Medical Center, Torrance, California, USA.
Deborah B. Diercks, Department of Emergency Medicine, University of Texas, Dallas, Texas, USA.
Rory Merritt-Recchia, Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Randy Sorge, Department of Emergency Medicine, Louisiana State University Spirit of Charity Emergency Medicine Residency Program, New Orleans, Louisiana, USA.
Jordan M. Warchol, Department of Emergency Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Christopher Greene, Department of Emergency Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
James Griffith, Department of Psychiatry, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.
Rita A. Manfredi, Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.
Melissa McCarthy, Departments of Health Policy and Emergency Medicine, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA.

Document Type

Journal Article

Publication Date

5-9-2022

Journal

Academic emergency medicine : official journal of the Society for Academic Emergency Medicine

DOI

10.1111/acem.14519

Abstract

BACKGROUND: During the COVID-19 pandemic, health care provider well-being was affected by various challenges in the work environment. The purpose of this study was to evaluate the relationship between the perceived work environment and mental well-being of a sample of emergency physicians (EPs), emergency medicine (EM) nurses, and emergency medical services (EMS) providers during the pandemic. METHODS: We surveyed attending EPs, resident EPs, EM nurses, and EMS providers from 10 academic sites across the United States. We used latent class analysis (LCA) to estimate the effect of the perceived work environment on screening positive for depression/anxiety and burnout controlling for respondent characteristics. We tested possible predictors in the multivariate regression models and included the predictors that were significant in the final model. RESULTS: Our final sample included 701 emergency health care workers. Almost 23% of respondents screened positive for depression/anxiety and 39.7% for burnout. Nurses were significantly more likely to screen positive for depression/anxiety (adjusted odds ratio [aOR] 2.04, 95% confidence interval [CI] 1.11-3.86) and burnout (aOR 2.05, 95% CI 1.22-3.49) compared to attendings. The LCA analysis identified four subgroups of our respondents that differed in their responses to the work environment questions. These groups were identified as Work Environment Risk Group 1, an overall good work environment; Risk Group 2, inadequate resources; Risk Group 3, lack of perceived organizational support; and Risk Group 4, an overall poor work environment. Participants in the two groups who perceived their work conditions as most adverse were significantly more likely to screen positive for depression/anxiety (aOR 1.89, 95% CI 1.05-3.42; and aOR 2.04, 95% CI 1.14-3.66) compared to participants working in environments perceived as less adverse. CONCLUSIONS: We found a strong association between a perceived adverse working environment and poor mental health, particularly when organizational support was deemed inadequate. Targeted strategies to promote better perceptions of the workplace are needed.

Department

Emergency Medicine

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