Interventional Radiology in the Coronavirus Disease 2019 Pandemic: Impact on Practices and Wellbeing

Abstract

Purpose: To report the impact of the coronavirus disease 2019 (COVID-19) pandemic on interventional radiology (IR).

Materials and methods: A 78-question survey was distributed to practicing interventional radiologists and IR trainees. The survey consisted of demographic and practice environment queries. Anxiety symptoms were evaluated using the Generalized Anxiety Disorder-7 (GAD-7) screener, and coping strategies were assessed using the Brief-Coping Orientation to Problems Experienced (Brief-COPE) questionnaire.

Results: There were 422 respondents including 333 (78.9%) attending interventional radiologists and 89 (21.1%) interventional radiologists-in-training from 15 counties. Most respondents were from academic medical centers (n = 218; 51.7%). A large majority (n = 391; 92.7%) performed a procedure on a patient with confirmed COVID-19 infection. An N95 mask was the most common (n = 366; 93.6%) safety measure employed. Cancellation or limitation of elective procedures were reported by 276 (65.4%) respondents. Many respondents (n = 177; 41.9%) had self-reported anxiety (GAD-7 score >5) with an overall mean GAD-7 score of 4.64 ± 4.63 (range: 0-21). Factors associated with reporting anxiety included female gender (p = 0.045), increased call coverage (p = 0.048), lack of adequate departmental adjustments (p <0.0001), and lack of adjustments in a timely manner (p <0.0001). The most utilized coping strategy was acceptance (mean of 5.49 ± 1.88), while the most employed dysfunctional coping strategy was self-distraction (mean of 4.16 ± 1.67). The odds of reporting anxiety increased by >125% with adoption of dysfunctional strategies.

Conclusion: The COVID-19 pandemic induced practice alterations and high rates of self-reported anxiety in IR. Female gender, increased call coverage, and lack of adequate or timely departmental adjustments were associated with increased anxiety levels.

Keywords: Anxiety; Burnout; COVID-19; Coping strategies; Coronavirus disease 2019 pandemic; GAD-7, Brief-COPE; IR; Interventional radiology; Practices; Wellbeing.

Figure 1

Survey Respondent Demographic Data. (A) Pie chart demonstrating percentage of attending and practitioner versus trainee responses. Within the attending proportion is further description of time in practice. (B) Reported race and ethnicity of the survey respondents. (C) Reported types of practice amongst respondents. (D) Representative countries for survey respondents. (E) Reported gender of the survey respondents. (Color version of figure is available online.)

Figure 2

Location of Survey Respondents. (A) Heat map of the contiguous United States (US) demonstrates frequency of responses. (B) Global heat map demonstrates frequency of responses by country across five continents. (Color version of figure is available online.)

Figure 3

Patterns of COVID-19 Exposure Control and Preventative Screening. (A) Frequencies of various management strategies regarding post-COVID-19 exposure. (B) Frequencies of employed screening practices for individuals entering their clinical sites. (Color version of figure is available online.)

Figure 4

Program Data and Education Environment Changes for Interventional Radiologist Trainees. Four pie-charts demonstrating (A) respondent's training program, (B) year in training, (C) changes in time in outpatient clinics, and (D) change in time on inpatient clinical services. (Color version of figure is available online.)

Figure 5

GAD-7 Survey Results for All Respondents. Graph demonstrating the percentage of respondents with self-reported anxiety, including subcategorization into mild, moderate, and severe anxiety levels. (Color version of figure is available online.)

Figure 6

Breakdown of Responses to the Seven Questions Included on the GAD-7 Survey. Respondents were able to provide one response to the listed statements, responses to the given prompts included “not at all,” “several of the days,” “more than half of the days,” and “nearly every day.” (Color version of figure is available online.)

Figure 7

Summarized Data from the Brief-COPE Survey. The 14 assessed coping strategies are grouped into emotion-focused coping, problem-focused coping, or dysfunctional coping. Brief-COPE survey scores range from 2 (minimal utilization) to 8 (maximum utilization) on the y-axis. Scores are tallied for all responses, attendings and practitioners, and trainees. (Color version of figure is available online.)