Clinical trial NCT04791085: Investigation of Stress Levels and Lifestyle of a Sample of Greek General Surgeons in Covid-19
Official title: Investigation of Stress Levels and Lifestyle of a Sample of Greek General Surgeons in Covid-19 and Non-reference Hospitals
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Stress, Psychological
Stress, Emotional
Life Style Induced Illness
Anxiety Depression
Covid19
Lead sponsor: National and Kapodistrian University of Athens
Sponsor class: OTHER
Collaborators: name: Amalia Fleming General Hospital
First posted: 2021-03-10
Enrollment: 200
Sex: ALL
Minimum age (years): 23
Maximum age (years): 75
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: OTHER
Time perspective: CROSS_SECTIONAL
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Greek general surgeons and interns of general surgery working in private and general hospitals in the country.

Brief summary: A new pandemic appeared in early 2020, also known as the coronavirus (Covid-19), affecting all health systems worldwide. Medical and nursing staff make every effort to treat patients resulting in physical and psychological exhaustion, which is exacerbated by the lack of medical and nursing staff, the lack of protective equipment, the increased workload, and increased shifts.

In this context, the surgeons had to contribute in turn, in order to help as much as they could in dealing with this new health crisis, as a result of which they find themselves in positions that are not on their subject or in their proper training and to handle patients with a dangerous and highly aggressive respiratory infection. This brought more psychological and physical stress to the surgeons. The pandemic of Covid-19 is not known to be a purely surgical condition, but many patients with coronavirus require surgery due to an additional infection, condition, or complication.

The design of this research will be observational and quantitative. Quantitative design involves the provision of numerically coded and analytical measurements, such as self-report questionnaires.

The purpose of this cross-sectional research is primarily to record the levels of stress, anxiety, depressive symptoms of Greek surgeons, and their lifestyle. Secondary to correlate the stress levels with socio-demographic data and their lifestyle with other parameters of the study.

Detailed description: A new pandemic emerged in early 2020, also known as the coronavirus (Covid-19) pandemic, affecting all health systems worldwide. This disease, although it attacks the human respiratory system, has greatly affected all health personnel regardless of specialty and the reason is that these patients need a high level of care. Medical and nursing staff make every effort to treat patients resulting in physical and psychological exhaustion, which is exacerbated by the lack of medical and nursing staff, the lack of protective equipment, the increased workload. and increased shifts.

In this context, the surgeons had to contribute in turn, in order to help as much as they could in dealing with this new health crisis, as a result of which they find themselves in positions that are not on their subject or in their proper training and to handle patients with a dangerous and highly aggressive respiratory infection. This brought more psychological and physical stress to the surgeons.

Their presence in aerosol situations (surgeries - intubation, placement of central venous catheters) and frequent contact with patients increased the likelihood of disease spread. With the increased likelihood of the disease spreading as their exposure to patients was high, it began to cause concern to staff living with the elderly or other vulnerable groups.

The incidence of the Covid-19 pandemic is increasing rapidly, resulting in worldwide healthcare systems operating feverishly to adequately meet the demands of this new disease. Several countries around the world have converted general hospitals to host hospitals exclusively for this disease, as a safety measure and limitation of the spread of Covid-19.

Front-line health personnel is under stress due to increased workload, lack of protective equipment, lack of information, and social isolation from loved ones. This staff includes physicians, pulmonologists, intensivists, surgeons.

In the last decade, there has been a great deal of mobility in the health sciences with reference to stress as many studies have linked it to the occurrence of various physical and psychological disorders. Undoubtedly, stress is a multifactorial concept, which makes it difficult to define clearly.

Stress, in particular, is a response mechanism, a "fight or flight" reflex in order to protect the body from various dangers. It is always activated with the "perception" of danger or threat (real or imaginary), where the sympathetic fate of the autonomic nervous system is stimulated and aims to prepare the body either to escape from danger or to fight with it.

The stressors that affect surgeons are many and varied, such as minimal sleep and its disturbance with multiple shifts, workplace tension, heavy workload, poor diet, etc. Depending on the stressors, the stress axis is activated with the corresponding effects on their psychosomatic health (depression, burnout, obesity, cardiovascular and autoimmune diseases).

Based on the above, the present study has not so far looked more broadly at the psychological stress of surgeons in relation to their quality of life during the Covid-19 period.

The design of this research will be observational and quantitative. Quantitative design involves the provision of numerically coded and analytical measurements, such as self-report questionnaires (social-demographic data, DASS-21, Anxiety Covid-19, Pittsburgh, Healthy Lifestyle and Personal Control Questionnaire, Multidimensional Health Locus of Control).

The purpose of this cross-sectional research is primarily to record the levels of stress, anxiety, depressive symptoms of Greek surgeons, and their lifestyle. Secondary to correlate the stress levels with socio-demographic data and their lifestyle with other parameters of the study.

Eligibility criteria: Inclusion Criteria:

* participants will be surgeons or interns of general surgery in any hospital in Greece.

Exclusion Criteria:

* participants who will practice another medical specialty

Primary outcomes:
measure: Perceived Stress Scale (PSS)
timeFrame: day 1
measure: DASS-21
timeFrame: day 1
measure: PITTSBURGH (GR-PSQI)
timeFrame: day 1
measure: Healthy Lifestyle and Personal Control Questionnaire
timeFrame: day 1
measure: Multi dimensional Health Locus of Control (MHLC)
timeFrame: day 1
measure: COVID-19-Anxiety Questionnaire (C-19-A)
timeFrame: day 1
Secondary outcomes:
Other outcomes:
Locations:
city: Athens
country: Greece
facility: Sismanoglio-Amalia Fleming Hospital
state: Melissia
Study officials:
affiliation: Sismanoglio - Amalia Fleming General Hospital
name: Petros L Chalkias, MD
role: PRINCIPAL_INVESTIGATOR
References:
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citation: Balibrea JM, Badia JM, Rubio Perez I, Martin Antona E, Alvarez Pena E, Garcia Botella S, Alvarez Gallego M, Martin Perez E, Martinez Cortijo S, Pascual Miguelanez I, Perez Diaz L, Ramos Rodriguez JL, Espin Basany E, Sanchez Santos R, Soria Aledo V, Lopez Barrachina R, Morales-Conde S. Surgical Management of Patients With COVID-19 Infection. Recommendations of the Spanish Association of Surgeons. Cir Esp (Engl Ed). 2020 May;98(5):251-259. doi: 10.1016/j.ciresp.2020.03.001. Epub 2020 Apr 3.
citation: Brat GA, Hersey S, Chhabra K, Gupta A, Scott J. Protecting Surgical Teams During the COVID-19 Outbreak: A Narrative Review and Clinical Considerations. Ann Surg. 2023 Nov 1;278(5):e957-e959. doi: 10.1097/SLA.0000000000003926. Epub 2020 Apr 17. No abstract available.