Impact of COVID-19 pandemic on orthopaedic surgeons in terms of anxiety, sleep outcomes and change in management practices: A cross-sectional study from India.

Vyom Sharma,Bhawna Gupta,Narinder Kumar,Akanksha Mahajan

doi:10.1177/23094990211001621

Vyom Sharma, Bhawna Gupta + Show 2 more

Open Access

https://doi.org/10.1177/23094990211001621

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Abstract

The aim of this study was to assess the effects of the COVID-19 pandemic on anxiety, sleep outcomes and change in clinical management practices among orthopaedic surgeons following a nation-wide lockdown. We conducted an online cross-sectional study using piloted structured questionnaires with self-reported responses from Indian orthopaedic surgeons. Study participants were identified through social networking sites: Facebook and WhatsApp. The extent of anxiety and sleep quality was assessed by the standardised seven-item Generalised Anxiety Disorder (GAD-7) scale, single-item sleep quality scale, questions on unavailability of personal protective equipment, training module on COVID-19 and change in orthopaedic patient management. One hundred male orthopaedic surgeons responded to the survey with majority (79%) in 30-44 years age group. Severe anxiety scores were observed in 8%; moderate, mild and minimal anxiety was observed in 12%, 27% and 53% surgeons respectively. Changes in management practice due to the pandemic was admitted by 65% respondents. We also observed an association between higher anxiety among surgeons and primary or secondary level of healthcare facility: (p = 0.04). Sleep disturbance was significantly associated with change in management practice to non-operative procedures (p = 0.03). Anxiety among orthopaedic surgeons during the COVID-19 pandemic is related to factors like younger age group, working in a primary or secondary healthcare facility. Early recognition of anxiety is essential to prevent serious psychological sequelae.

Highlights

IntroductionIndian public health system is well known and dependence on it would be imprudent when some of the best health systems in the world have been found to be grossly inadequate.[2] Large disparities continue to exist in India between rural and urban across social classes with overdependence on private healthcare providers
The risk to own families, separation from families, strict isolation measures required, shortage of personal protective equipment (PPE), non-availability of essential equipment like ventilators as well as lack of clarity about pathogenesis, routes of transmission and treatment modalities for COVID-19 infection are potential risk factors leading to increased stress and disturbed sleep leading to a negative psychological impact on Healthcare workers (HCWs) including orthopaedic surgeons.[3]
There was no significant correlation of response to resuming elective surgery, change to non-operative management and subspecialisation with anxiety levels and sleep disturbance (Tables 5 and 6). This is the first online survey conducted on orthopaedic surgeons in India during the COVID-19 pandemic that highlights the potential burden of anxiety, sleep disturbance, inadequate availability of PPE, as well as the impact of any training module on management and preparation to face this pandemic

Summary

Introduction

Indian public health system is well known and dependence on it would be imprudent when some of the best health systems in the world have been found to be grossly inadequate.[2] Large disparities continue to exist in India between rural and urban across social classes with overdependence on private healthcare providers. Healthcare workers (HCWs), both from private and public sector, have been at the forefront of the effort to control the spread of COVID-19 infection. The risk to own families, separation from families, strict isolation measures required, shortage of personal protective equipment (PPE), non-availability of essential equipment like ventilators as well as lack of clarity about pathogenesis, routes of transmission and treatment modalities for COVID-19 infection are potential risk factors leading to increased stress and disturbed sleep leading to a negative psychological impact on HCWs including orthopaedic surgeons.[3]

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