key: cord-1040933-jhsnesgk
authors: Vittori, Alessandro; Marchetti, Giuliano; Pedone, Roberto; Francia, Elisa; Mascilini, Ilaria; Marinangeli, Franco; Picardo, Sergio Giuseppe
title: COVID-19 pandemic mental health risks among anesthesiologists: it is not only burnout
date: 2021-02-19
journal: Braz J Anesthesiol
DOI: 10.1016/j.bjane.2021.01.002
sha: 56fd11f2924854d5a96990906c8fb80d64d4f739
doc_id: 1040933
cord_uid: jhsnesgk

nan

Physical fatigue due to the heavy workload is considerable and could affect the person's own health and the care provided to the patients. The lack of staff and unfavorable conditions in which anesthesiologists are forced to work, and the quarantine could be threatening to the mental health.

In addition, the risk of burnout is concrete and tangible. In fact, even if the challenge is high, and stimulating from an intellectual point of view, the risk factors for burnout are all there. [1] Emotional exhaustion, depersonalization, and reduced personal accomplishment are situations experienced during the pandemic that increased the risk to develop burnout.

First of all, the Emotional Exhaustion is due to the massive influx of patients into the wards, the high number of deaths, and the enormous difficulty of caring for infected patients. [2] Secondly, the Depersonalization, due to the inevitable repetitiveness of standardized protocols, the use of individual protection devices that make people anonymous, and the reduction of moments of workplace debriefing.

Finally, the Reduced Personal Accomplishment is due to the forced transfer of the department, the provision, albeit temporary, of expertise acquired, to the reduction of the possibilities of practicing hobbies, and interests by the quarantine.

Burnout, however, is not the only mental risk for anesthesiologists, especially in the long term. There are grounds for this unique experience to result in post-traumatic stress disorder (PTSD), which can also occur six months after the end of the pandemic. Commander Sullemberger, exposed to risks of PTSD and criticism for their work are at higher risk of developing mental disorders even months after the emergency. On the other hand, the situation for the anesthesiologists who are not at the frontline in the most affected areas may not be easier, either. For these anesthesiologists, COVID-19 could be a factor as frustrating as for the rest of the population. Anesthesiologists who are not on the frontlines feel privileged because they are not exposed to the same risks and the same emotional pain, and they are overwhelmed with guilt. In fact, anesthesiologists are In the short term, besides burnout and PTSD, it is also necessary to test for anxiety, depression, and guilt of healthcare professionals to obtain a starting baseline. In this way we can have a picture of the current situation and monitor the trends. In the medium to long term, psychological support tools must be offered to the anesthesiologists involved in the most affected areas, for those who have continued to ensure their work with professionalism and diligence.

[4] Further research is necessary to identify which programs will best suit the needs of anesthesiologists and to measure their effects on patient care and health care system quality.

It is possible that cognitive behavioral therapy (CBT), which is a short and simple approach to problem solving, is the more suitable item for anesthesiologists who are affected. This therapy aimed to help making decisions and to solve problems without finery. Additionally, CBT is validated for PTSD, guilt, shame and anxiety treatment, with short therapies that can be compatible with a work life.

[5]

These measures should not remain exceptional but should lay the foundations for a support protocol by National Healthcare systems. In this way, the experience of the COVID-19 pandemic will be able to bear good results of resilience.

Understanding the burnout experience: recent research and its implications for psychiatry

SIAARTI recommendations for the

The authors declare no conflicts of interest