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“To be stressed or not TOO stressed?” – Resident Stress and Anxiety Scores before and after Obstetric Anesthesia Rotation
Abstract Number: T5D-4
Abstract Type: Original Research
Acute clinical care environments such as obstetric anesthesia (ObA) possess a unique set of stressors and high intensity situations that can lead to high rates of burnout in anesthesiologists (1). We assessed residents’ wellbeing related to ObA by comparing their anxiety and stress levels immediately before and after their ObA rotation.
Between 11/2016 - 07/2017, all residents were sent surveys to assess their anxiety and stress levels before and after a 4-week ObA rotation (N=54). Anxiety was measured using the Spielberger State Anxiety Inventory for Adults (SAI-AD) with a cut-off score of 39 suggesting clinically significant symptoms of anxiety (2). Stress level was quantified using Cohen Perceived Stress Scale (PSS-14) with normative mean of 17.4 ± 6.4 (3). Pre and post-rotation SAI-AD and PSS scores were compared using paired T tests.
Demographic data is not available since the surveys were anonymous. The response rate was 57.4% (N=31) for the ‘before’ survey and 29.6% (N=16) for both ‘before’ and ‘after’ ObA rotation surveys. SAI-AD scores were 47.8 ± 6.4 before versus 47.8 ± 7.6 after (mean difference 0.06 ± 7.99; p value = 0.98). The PSS scores were 21.6 ± 8.8 before versus 19.8 ± 6.8 after (mean difference -1.86 ±, SD 7.15; p=0.53). There was no difference in anxiety and stress scores before and after the ObA rotation
Despite our predictions that the 4-week ObA experience would trigger anxiety and stress, scores were not significantly different before and after the rotation. While dedicated faculty supervision and guidance, peer-support, and a positive emotional work environment are possible explanations for the stability of residents’ stress and anxiety levels, compared to published normative scores, our residents exhibited high anxiety (by 12 points on average) and stress (by 4 points on average) levels at baseline. These findings may be due a tendency of high stress and anxiety personality types choosing Anesthesiology or may be a result of anesthesia as a field causing persistently increased stress and anxiety in otherwise calm individuals. Future studies focusing on the causes and effects of anxiety and stress as a way of assessing physician burnout in anesthesiology need to be performed.
1. Anesth Analg. 2018 Jan 5. doi: 10.1213.
2. Spielberger CDS-TAIBnePA, CA: Consulting Psychologists Press.
3. J Health Soc Behav. 1983;24(4):385-96.