Global vascular surgeons experience, stressors, and coping during the COVID-19 pandemic

Shalhub, Sherene; Mouawad, Nicolas J.; Malgor, Rafael D.; Johnson, Adam P.; Wohlauer, Max V.; Coogan, Sheila M.; Loveland, Katherine A.; Cuff, Robert. F.; Leonardi, Claudia; Coleman, Dawn M.; Sheahan, Malachi G.; Woo, Karen

INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic has led to unprecedented challenges for health care systems globally. We designed and administered a global survey to examine the impact of COVID-19 on vascular surgeons and explore the COVID-19 related stressors faced, coping strategies employed, and support structures available METHODS: The Pandemic Practice, Anxiety, Coping, and Support Survey for Vascular Surgeons is an anonymous cross-sectional survey sponsored by the Society for Vascular Surgery Wellness Committee. The survey analysis evaluates the impact of COVID-19 related stressors on vascular surgeons as measured by the Generalized Anxiety Disorder 7-item (GAD-7) scale. The 28-item Brief Coping Orientation to Problems Experienced (Brief-COPE) inventory was used to assess the active and avoidant coping strategies. Survey data were collected using REDCap between 4/14/2020 and 4/24/2020 inclusive. Additional qualitative data were collected using open-ended questions. Univariable and multivariable analysis of factors associated with anxiety levels and qualitative analysis were performed. RESULTS: A total of 1,609 survey responses (70.5% male, 82.5% Vascular Surgeons in Practice) from 58 countries (43.4% United States, 43.4% Brazil) were eligible for analysis. Some degree of anxiety was reported by 54.5% of the respondents and 23.3% reported moderate or severe anxiety. Most respondents (∼60%) used active coping strategies and the avoidant coping strategy “self-distraction and 20% used other avoidant coping strategies. Multivariable analysis identified the following factors as significantly associated with increased self-reported anxiety levels: staying in a separate room at home or staying at the hospital/hotel after work (OR 1.39 (95%CI 1.08-1.79), donning/doffing personal protective equipment (OR 1.81, 95%CI 1.41-2.33), worry about potential adverse patient outcomes due to care delay (OR 1.47, 95%CI 1.16-1.87), and financial Concerns (OR 1.90, 95%CI 1.49-2.42). Factors significantly associated with decreased self-reported anxiety levels were hospital support (OR 0.83, 95%CI 0.76-0.91) and use of positive reframing as an active coping strategy (OR 0.88, 95%CI 0.81-0.95). CONCLUSIONS: Vascular surgeons globally are experiencing multiple COVID-19 related stressors during this devastating crisis. These findings highlight the continued need for hospital systems to support their vascular surgeons and the importance of national societies to continue to invest in peer support programs as paramount to promoting the well-being of vascular surgeons during and after the COVID-19 pandemic.