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Research ArticleOriginal Research

Hospital-Based Healthcare Worker Perceptions of Personal Risk Related to COVID-19: One Year Follow-Up

David Yamane, Kimia Zarabian, Kyle Devine, Ivy Benjenk, Katherine Farrar, Owen Lee Park, Justin Kim, Danielle Davison and Eric Heinz
The Journal of the American Board of Family Medicine March 2022, 35 (2) 284-294; DOI: https://doi.org/10.3122/jabfm.2022.02.210272
David Yamane
From the George Washington University Hospital (JK), Department of Anesthesiology and Critical Care (DY, IB, DD, EH), Department of Emergency Medicine (DY, OWP); The George Washington University School of Medicine and Health Sciences (KZ), School of Engineering and Applies Sciences (KD).
MD
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Kimia Zarabian
From the George Washington University Hospital (JK), Department of Anesthesiology and Critical Care (DY, IB, DD, EH), Department of Emergency Medicine (DY, OWP); The George Washington University School of Medicine and Health Sciences (KZ), School of Engineering and Applies Sciences (KD).
BS
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Kyle Devine
From the George Washington University Hospital (JK), Department of Anesthesiology and Critical Care (DY, IB, DD, EH), Department of Emergency Medicine (DY, OWP); The George Washington University School of Medicine and Health Sciences (KZ), School of Engineering and Applies Sciences (KD).
MS
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Ivy Benjenk
From the George Washington University Hospital (JK), Department of Anesthesiology and Critical Care (DY, IB, DD, EH), Department of Emergency Medicine (DY, OWP); The George Washington University School of Medicine and Health Sciences (KZ), School of Engineering and Applies Sciences (KD).
RN, PhD
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Katherine Farrar
From the George Washington University Hospital (JK), Department of Anesthesiology and Critical Care (DY, IB, DD, EH), Department of Emergency Medicine (DY, OWP); The George Washington University School of Medicine and Health Sciences (KZ), School of Engineering and Applies Sciences (KD).
PA
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Owen Lee Park
From the George Washington University Hospital (JK), Department of Anesthesiology and Critical Care (DY, IB, DD, EH), Department of Emergency Medicine (DY, OWP); The George Washington University School of Medicine and Health Sciences (KZ), School of Engineering and Applies Sciences (KD).
MD
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Justin Kim
From the George Washington University Hospital (JK), Department of Anesthesiology and Critical Care (DY, IB, DD, EH), Department of Emergency Medicine (DY, OWP); The George Washington University School of Medicine and Health Sciences (KZ), School of Engineering and Applies Sciences (KD).
MSN, APRN
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Danielle Davison
From the George Washington University Hospital (JK), Department of Anesthesiology and Critical Care (DY, IB, DD, EH), Department of Emergency Medicine (DY, OWP); The George Washington University School of Medicine and Health Sciences (KZ), School of Engineering and Applies Sciences (KD).
MD
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Eric Heinz
From the George Washington University Hospital (JK), Department of Anesthesiology and Critical Care (DY, IB, DD, EH), Department of Emergency Medicine (DY, OWP); The George Washington University School of Medicine and Health Sciences (KZ), School of Engineering and Applies Sciences (KD).
MD, PhD
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Article Figures & Data

Figures

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    Figure 1.

    Comparison of risk perception and work-related stress: Spring 2020 versus Spring 2021 (n = 1150).

  • Figure 2.
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    Figure 2.

    Traumatic stress, burnout, and compassion satisfaction by COVID-19 case intensity (n = 356).

Tables

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    • View popup
    Table 1.

    Demographic and Professional Characteristics of Study Participants

    VariableCategory2020 Distribution (n = 791)2021 Distribution (n = 359)p-Value
    Age<30 years25.16%31.09%0.035*
    30 to 39 years37.87%35.85%
    40 to 59 years26.43%26.89%
    60 + years10.55%6.16%
    GenderFemale78.20%71.99%0.022*
    Race/EthnicityWhite55.63%64.53%0.004**
    Black20.72%12.85%
    Hispanic3.20%3.35%
    Asian12.53%9.22%
    Other7.93%10.06%
    PositionAttending5.44%15.88%<0.001***
    Resident/Fellow14.29%14.48%
    APP6.19%11.98%
    Nurse/Tech/RT38.18%38.16%
    Rehab9.86%6.41%
    Other26.04%13.09%
    SpecialtyEmergency7.96%21.73%<0.001***
    Critical Care10.49%18.94%
    Surgery13.53%17.83%
    Medicine12.90%15.04%
    Other55.12%26.46%
    COVID-19 quarantineYes12.23%28.01%<0.001***
    COVID-19 vaccineReceivedN/A92.98%N/A
    COVID-19 care intensityNo deathsN/A35.67%N/A
    1 to 10 deathsN/A39.61%
    >10 deathsN/A24.72%
    • View popup
    Table 2.

    Risk Perception and Work Stress by COVID-19 Care Intensity

    No Deaths (n = 127)1-10 Deaths (n = 140)>10 Deaths (n = 88)p-Value
    Risk Perception
        Feels job is imposing great risk42.9%49.7%63.6%0.011*
        Afraid of falling ill with COVID-1940.8%44.3%33.0%0.233
        Feels little control over contracting COVID-1919.2%23.4%27.3%0.378
        Feels unlikely to survive if contracts COVID-194.8%2.1%4.6%0.457
        Afraid of passing COVID-19 on to others69.1%70.9%66.7%0.795
        Family/friends are worried about transmission48.4%58.2%55.7%0.264
        People avoid family26.2%33.6%40.2%0.094
        Willing to accept the risks57.9%70.2%76.1%0.013*
    Work Stress
        Feels extra stress at work72.4%72.9%79.6%0.438
        Thinking about resigning10.3%14.2%15.9%0.451
        Would keep practicing if another year ofCOVID-1957.1%51.4%55.7%0.626
        Feels perceived as a hero for work21.6%27.0%32.2%0.223
    • ↵* P < .05, **P < .01, ***P < .001.

    • View popup
    Table 3.

    Multivariable Linear Regression Exploring the Association between COVID-19 Care Intensity and Traumatic Stress, Burnout, and Compassion Satisfaction (n = 352)

    Traumatic StressBurnoutCompassion Satisfaction
    AOR (SE)p-valueAOR (SE)p-valueAOR (SE)p-value
    COVID-19 care intensity
        No deathsReferenceReferenceReference
        1 to 10 deaths2.70 (1.00)0.007*2.72 (0.93)0.004*−0.93 (0.93)0.320
        >10 deaths6.68 (1.30)<0.001*2.56 (1.22)0.036*1.13 (1.22)0.354
    Age
        <30 yearsReferenceReferenceReference
        30 to 39 years−1.19 (0.98)0.222−1.09 (0.91)0.234−0.39 (0.91)0.668
        40 to 59 years−1.44 (1.22)0.239−1.88 (1.14)0.1021.58 (1.14)0.168
        60 + years−3.74 (1.92)0.052−3.08 (1.80)0.0883.33 (1.80)0.065
    Sex
        Female1.13 (0.94)0.2301.08 (0.88)0.221−1.59 (0.89)0.073
    Race/Ethnicity
        WhiteReferenceReferenceReference
        Black1.23 (1.25)0.3250.22 (1.17)0.8510.54 (1.17)0.645
        Hispanic3.54 (2.27)0.1200.08 (2.13)0.970−1.10 (2.13)0.605
        Asian1.69 (1.39)0.224−1.23 (1.30)0.3463.03 (1.30)0.020*
        Other2.51 (1.35)0.0641.40 (1.26)0.270−3.02 (1.26)0.017*
    Position
        AttendingReferenceReferenceReference
        Resident/Fellow0.41 (1.61)0.8000.90 (1.51)0.554−1.01 (1.51)0.503
        APP4.98 (1.59)0.002*4.18 (1.49)0.005*−2.31 (1.49)0.122
        Nurse/Tech/RT4.30 (1.40)0.002*2.52 (1.32)0.056−1.06 (1.32)0.422
        Rehab4.17 (2.07)0.044*4.81 (1.94)0.013*−0.28 (1.94)0.884
        Other3.31 (1.80)0.0673.20 (1.69)0.058−2.10 (1.69)0.214
    Specialty
        EmergencyReferenceReferenceReference
        Critical Care−1.31 (1.37)0.341−1.97 (1.28)0.125−0.70 (1.28)0.583
        Surgery−0.42 (1.33)0.752−1.35 (1.25)0.282−0.37 (1.25)0.766
        Medicine1.09 (1.35)0.422−0.27 (1.27)0.8300.23 (1.27)0.857
        Other−1.73 (1.44)0.230−2.42 (1.35)0.0730.59 (1.35)0.660
    Quarantined for COVID-192.40 (0.92)0.009*1.89 (0.86)0.029*−1.51 (0.86)0.080
    Vaccinated against COVID-193.49 (1.61)0.031*3.41 (1.51)0.025*−1.71 (1.51)0.257
    Constant15.02 (2.42)<0.001*21.46 (2.27)<0.001*37.1 (2.27)<0.001*
    R20.23770.13940.1106
    Variance Inflation Factor?1.701.701.70
    • Abbreviations: AOR, adjusted odds ratio; SE, standard error; RT, respiratory therapist.

    • View popup
    Appendix Table 1.

    Survey Questions*

    Category20202021
    My job is putting me at great risk.XX
    I feel extra stress at work.XX
    I am afraid of falling ill with COVID-19.XX
    I have little control over whether I get infected or not.XX
    I am unlikely to survive if I were to get COVID-19.XX
    I think about resigning because of COVID-19.XX
    I am afraid I will pass COVID-19 on to others.XX
    My family and friends are worried they might get infected through me.XX
    People avoid my family because of my workXX
    Because I want to help the COVID-19 patients, I am willing to accept the risks involved.XX
    I feel that I am perceived as a hero for my work.X
    If COVID-19 were to continue for another year, I believe that I could continue practicing.X
    • ↵* Does not include Professional Quality of Life Scale (PROQOL) questions.

    • View popup
    Appendix Table 2.

    Care Intensity Analysis

    Overall (n = 355)No Deaths (n = 127)1-10 Deaths (n = 140)>10 Deaths (n = 88)p-Value
    Age
        <30 years31.27%31.5%28.57%35.23%0.362
        30 to 39 years36.06%31.5%36.43%42.05%
        40 to 59 years26.76%29.13%29.29%19.32%
        60 + years5.92%7.87%5.71%3.41%
    Gender
        Female71.83%85.04%62.14%68.18%<0.001***
    Race/ Ethnicity
        White65.07%63.78%63.57%69.32%0.680
        Black12.68%15.75%10.71%11.36%
        Hispanic3.1%1.57%3.57%4.55%
        Asian9.3%10.24%10.71%5.68%
        Other9.86%8.66%11.43%9.09%
    Position
        Attending16.01%7.09%23.4%17.05%<0.001***
        Resident/Fellow14.61%4.72%18.44%22.73%
        APP12.08%11.81%9.93%15.91%
        Nurse/Tech/RT37.92%42.52%33.33%38.64%
        Rehab6.46%10.24%4.26%4.55%
        Other12.92%23.62%10.64%1.14%
    Specialty
        Emergency21.91%11.02%29.08%26.14%<0.001***
        Critical Care19.1%3.94%12.77%51.14%
        Surgery17.7%22.05%21.99%4.55%
        Medicine14.89%12.6%17.02%14.77%
        Other26.4%50.39%19.15%3.41%
    COVID-19 quarantine
        Quarantined28.17%26.19%25.53%35.23%0.235
    COVID-19 vaccine
        Received93.22%87.3%95.04%98.85%0.002
    • Abbreviation: RT, respiratory therapist.

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The Journal of the American Board of Family     Medicine: 35 (2)
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Vol. 35, Issue 2
March/April 2022
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Hospital-Based Healthcare Worker Perceptions of Personal Risk Related to COVID-19: One Year Follow-Up
David Yamane, Kimia Zarabian, Kyle Devine, Ivy Benjenk, Katherine Farrar, Owen Lee Park, Justin Kim, Danielle Davison, Eric Heinz
The Journal of the American Board of Family Medicine Mar 2022, 35 (2) 284-294; DOI: 10.3122/jabfm.2022.02.210272

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Hospital-Based Healthcare Worker Perceptions of Personal Risk Related to COVID-19: One Year Follow-Up
David Yamane, Kimia Zarabian, Kyle Devine, Ivy Benjenk, Katherine Farrar, Owen Lee Park, Justin Kim, Danielle Davison, Eric Heinz
The Journal of the American Board of Family Medicine Mar 2022, 35 (2) 284-294; DOI: 10.3122/jabfm.2022.02.210272
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