Multidimensional Stressors and Protective Factors Shaping Physicians’ Work Environments and Work-Related Well-Being in Two Large US Cities During COVID-19

Details

• Personal Author:
  Berlinger N ; Buchbinder L ; Buchbinder M ; Goldberg L ; Jenkins T ; Staley J
• Description:
  Introduction: Clinician burnout and poor work-related well-being reached a critical inflection point during the COVID-19 pandemic. This article applies a novel conceptual model informed by the Total Worker Health® approach to identify and describe multilevel stressors and protective factors that affected frontline physicians' work environments and work-related well-being. Methods: We conducted a qualitative study of hospital-based physicians from multiple hospital types in Los Angeles and Miami who cared for COVID-19 patients. Semistructured interviews lasting 60-90 min were conducted over Zoom. Interview transcripts were thematically coded using Dedoose qualitative software. Results: The final sample of 66 physicians worked in 20 hospitals. Stressors in the social, political, and economic environment included dealing with the politicization of COVID-19, including vaccine hesitancy; state and federal governmental COVID-19 policies and messaging; and shifting CDC guidance. Employment and labor pattern stressors included the national nursing shortage, different policies for paid time off, furloughs, reduced pay, and layoffs. Organizational-level stressors included institutional policies, staffing constraints and high patient volume (i.e., increased number of cases and longer lengths of stay), and perceived poor leadership. At the individual worker level, stressors included concerns about viral transmission to family, strained personal relationships, and work-life fit, particularly for those with young children. Respondents identified promising protective factors at multiple levels, including responsive state leadership, job security, concrete opportunities to provide input into institutional policy, strong leadership and communication, and feeling cared for by one's institution. Conclusion: Findings support a multi-level strategy that acknowledges internal organizational and external factors shaping clinicians' work-related well-being, consistent with the Total Worker Health® approach. [Description provided by NIOSH]
• Subjects:
  Communicable Diseases Health Personnel Mental Health Nervous System Occupational Health Safety Stress, Psychological Workplace
• Keywords:
  Author Keywords: COVID-19 Burnout COVID-19 Health Care Personnel Job Stress Mental Health Physicians Qualitative Qualitative Analysis Total Worker Health TWH United States Work-related Well-being Work Environment

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• ISSN:
  0271-3586
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  California ; New York ; North Carolina ; OSHA Region 2 ; OSHA Region 4 ; OSHA Region 9
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  66
• Issue:
  10
• NIOSHTIC Number:
  nn:20068087
• Citation:
  Am J Ind Med 2023 Oct; 66(10):854-865
• Contact Point Address:
  Mara Buchbinder, PhD, Department of Social Medicine and Center for Bioethics, School of Medicine, University of North Carolina at Chapel Hill, 333 S. Columbia St, 341A MacNider CB 7240, Chapel Hill, NC 27599, USA
• Email:
  mara_buchbinder@med.unc.edu
• Federal Fiscal Year:
  2024
• Performing Organization:
  University of North Carolina Chapel Hill
• Peer Reviewed:
  True
• Start Date:
  20210901
• Source Full Name:
  American Journal of Industrial Medicine
• End Date:
  20230831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:49f6c56e4dfdb45eea58af501c0292f77d2b263845d0deb06933319e4f43b5f173f2e055aa918adec19ac84f3a76e26cd77c8439de401db92e060b086011c654
• Download URL:
  https://stacks.cdc.gov/view/cdc/230305/cdc_230305_DS1.pdf
• File Type:
  [PDF - 842.29 KB ]