Does COVID-19 compromise SGO member well-being?

OBJECTIVES: To assess the well-being of members of the gynecologic oncology healthcare team during the coronavirus disease-19 (COVID-19) pandemic using validated survey assessments of professional fulfillment, burnout, anxiety, and depression among Society of Gynecologic Oncology (SGO) members. METHODS: From June 15th-July 1st 2020, SGO members received a web-based survey consisting of the following validated measures: Professional Fulfillment Index (PFI); Generalized Anxiety Disorder (GAD-2 screener and PHQ-7); Patient Health Questionnaire (PHQ-2 screener and PHQ-9) and Impact of Event Scale-Revised (IES-6). Univariate and multivariate regression analyses were performed to identify factors associated with professional fulfillment, burnout, anxiety, and depression. RESULTS: Among the 254 SGO member respondents (approximately 12%), 58% (147) were ≤45 years, 73% (183) identified as female, and 76% (192) were gynecologic, medical, or radiation oncologists. COVID-19 institutional burden was reported as high/very high (23%, 59), moderate (44%, 110), or low (31%79). Most respondents provided direct patient care (96%, 242), including 22% (52) reported caring for COVID-19 patients. Personal history of COVID-19 infection was reported in 16% (41) of repondents. Among 232 PFI respondents, 58% (134) and 41% (95), respectively, met cutoff values for decreased professional fulfillment and burnout. Of those who completed the GAD (246) and PHQ (251) ultrascreeners, 25% (62) and 17% (42) screened positive for anxiety and depression, respectively. Among these, 41% (21/51) and 27% (10/37) reported potentially clinically significant anxiety and depression, while 18% (9/51) and 32% (12/37) of participant scores correlated with potentially severe depression. A total of 37% (97) reported significant trauma-related stress based on IES-6 scores predictive for post-traumatic stress disorder (PTSD). After multivariate adjustment, decreased professional fulfillment and burnout were significantly associated with screening positive for depression (p=0.005, p=<0.001) and anxiety (p=<0.0001, p=<0.001). Positive depression screening was significantly associated with male gender (p=.027), while positive anxiety screening was associated with female gender (p=0.007). Nurses, physician assistants and other non-physician health care professionals were more likely to screen positive for depression in comparison to physician oncologists (p=.022). When adjusted by demographic variables such as age, race, gender, burden of COVID infection, caring for COVID-19 patients, profession, history of anxiety or depression), no association was found with respect to levels of professional fulfillment or burnout. CONCLUSIONS: Our preliminary findings suggest that the majority of SGO members are not professionally fulfilled during the first wave of the COVID-19 pandemic, which represents data that differs from pre-COVID era findings, and indicates a significant impact on professional well-being. Though we observed no association between burden of COVID-19 infection or caring for COVID-19 patients with anxiety, depression, professional fulfillment, or burnout, respondents scores indicated moderate to severe anxiety and depression, and over one-third met IES-6 criteria shown to be correlative to the diagnosis of PTSD. The longevity of these effects is of particular concern. The next phase of our study will re-survey SGO members during the second wave of the pandemic. Findings from this work can target interventions to improve SGO member well-being during current and future threats to psychological resilience. [Figure: see text]