Table 4.
Univariate and Multivariate Predictors of Emotional Distress and Burnout
| Emotional Distress and Burnout Predictor Characteristic | RR (95% CI) | P Value | ARR (95% CI) | P Value |
|---|---|---|---|---|
| Sex | ||||
| Male | Ref | Ref | ||
| Female | 1.36 (1.21-1.53) | <.001 | 1.16 (1.01-1.33) | .03 |
| Region | ||||
| North America | Ref | Ref | ||
| East Asia and Pacific | 0.52 (0.41-0.66) | < .001 | 0.85 (0.52-1.37) | .5 |
| Europe and Central Asia | 0.84 (0.74-0.96) | .01 | 0.86 (0.75-1.00) | .04 |
| Latin America and the Caribbean | 0.71 (0.45-1.13) | .15 | 1.07 (0.63-1.80) | .8 |
| Middle East and North Africa | 0.78 (0.51-1.19) | .25 | 1.15 (0.63-2.09) | .65 |
| South Asia | 0.56 (0.28-1.11) | .1 | 0.84 (0.37-1.90) | .68 |
| Sub-Saharan Africa | 0.58 (0.19-1.80) | .34 | 0.89 (0.26-2.98) | .85 |
| Provider type | ||||
| Attending physicians | Ref | Ref | ||
| Physicians in training | 0.97 (0.77-1.23) | .82 | 0.90 (0.71-1.15) | .41 |
| Nurses | 1.45 (1.28-1.65) | < .001 | 1.31 (1.13-1.53) | .01 |
| APPs | 1.30 (1.06-1.60) | .01 | 1.11 (0.89-1.39) | .35 |
| RTs | 1.29 (1.07-1.55) | .01 | 1.14 (0.93-1.40) | .2 |
| Poor communication from my supervisors | 1.85 (1.66-2.07) | < .001 | 1.30 (1.16-1.46) | < .001 |
| Reported lack of stuff, staff, and space | ||||
| Limited availability of PAPRs | 1.36 (1.15-1.62) | < .001 | 1.30 (1.09-1.55) | < .001 |
| Limited ventilator availability | 1.16 (1.00-1.35) | .04 | 1.03 (0.88-1.20) | .71 |
| Lack of intensivists | 1.14 (0.99-1.31) | .06 | … | … |
| Lack of nurses | 1.34 (1.21-1.50) | < .001 | 1.18 (1.05-1.33) | .01 |
| Lack of ICU beds | 1.19 (1.02-1.37) | .02 | … | … |
| No. of patients with COVID-19 cared for | ||||
| < 10 | Ref | Ref | ||
| 10-50 | 1.33 (1.18-1.49) | < .001 | 1.17 (1.04-1.33) | .01 |
| > 50 | 1.41 (1.19-1.68) | < .001 | 1.28 (1.06-1.53) | .01 |
| COVID-19 severity indexa | ||||
| Less severe | Ref | Ref | ||
| Most severe | 1.73 (1.45-2.07) | < .001 | 1.22 (0.80-1.85) | .35 |
The severity index indicates daily deaths by population during the time of survey administration. Physicians in training include residents and fellows. Time from peak (mortality) was not associated with outcomes in univariate or multivariate regressions (data not shown). Variables not statistically associated with the outcomes in univariate regression or whose inclusion did not improve model fit were not included in the multivariate regression. No. of observations for multivariate regressions: mechanical ventilation limited (n = 2,231), CPR and DNR policies and practices changed since COVID-19 (n = 2,230), emotional distress and burnout (n = 2,477). See Tables 1 and 3 legends for expansion of abbreviations.