Global well-being, anxiety, social isolation, and emotional support among hospitalists during COVID-19 and Mpox outbreaks

ABSTRACT

Objective

The Coronavirus Disease-19 (COVID-19) pandemic caused a decline in hospitalist wellness. The COVID-19 pandemic has evolved, and new outbreaks (i.e. Mpox) have challenged healthcare systems. The objective of the study was to assess changes in hospitalist wellness and guide interventions.

Methods

We surveyed hospitalists (physicians and advanced practice providers [APPs]), in May 2021 and September 2022, at a healthcare system’s 16 hospitals in four US states using PROMIS® measures for global well-being, anxiety, social isolation, and emotional support. We compared wellness score between survey periods; in the September 2022 survey, we compared wellness scores between APPs and physicians and evaluated the associations of demographic and hospital characteristics with wellness using logistic (global well-being) and linear (anxiety, social isolation, emotional support) regression models.

Results

In May 2021 vs. September 2022, respondents showed no statistical difference in top global well-being for mental health (68.4% vs. 57.4%) and social activities and relationships (43.8% vs. 44.3%), anxiety (mean difference: +0.8), social isolation (mean difference: +0.5), and emotional support (mean difference: −1.0) (all, p ≥ 0.05). In September 2022, in logistic regression models, APPs, compared with physicians, had lower odds for top (excellent or very good) global well-being mental health (odds ratio [95% CI], 0.31 [0.13–0.76]; p < 0.05). In linear regression models, age <40 vs. ≥40 years was associated with higher anxiety (estimate ± standard error, 2.43 ± 1.05; p < 0.05), and concern about contracting COVID-19 at work was associated with higher anxiety (3.74 ± 1.10; p < 0.01) and social isolation (3.82 ± 1.21; p < 0.01). None of the characteristics showed association with change in emotional support. In September 2022, there was low concern for contracting Mpox in the community (4.6%) or at work (10.0%).

Conclusion

In hospitalists, concern about contracting COVID-19 at work was associated with higher anxiety and social isolation. The unchanged wellness scores between survey periods identified opportunities for intervention. Mpox had apparently minor impact on wellness.

KEYWORDS:

• hospitalists
• advanced practice providers
• COVID-19
• wellness
• Mpox

Declaration of financial/other relationships

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

All authors made substantial contribution as outlined: survey concept and design (all authors), survey questions (all authors), preparation of participant list (SBD, HLG, MJM, MP), data analysis (SBD, KMF, DRS, ITC), data review and interpretation (all authors), first draft of manuscript (SBD), critical revision of manuscript (all authors), administrative support (ITC, MCB), and funding (SBD).

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/21548331.2023.2241342

Additional information

Funding

S.B.D. was supported by the National Institutes of Health/National Institute on Minority Health and Health Disparities (NIH K23 MD016230) and the Robert and Elizabeth Strickland Career Development Award, Mayo Clinic, Rochester, MN, USA. The study was made possible by the Mayo Clinic CTSA through grant number UL1 TR000135 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health. The study was supported by the Mayo Clinic Department of Medicine Research Hub and Division of Hospital Internal Medicine. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health. The funders had no role in study design, data analysis and interpretation; in writing of the report; and in the decision to submit the manuscript for publication. The findings do not necessarily represent the views of the funders.