A survey study of healthcare workers found an association between childcare stress (CCS) and burnout, anxiety and depression, and intent to reduce hours or leave the job during the COVID-19 pandemic.
The study, published in JAMA Network Open, surveyed healthcare workers (HCWs), asking “due to…COVID-19, I am experiencing concerns about childcare,” and the presence of CCS was considered as a score of 3 or 4 on a scale from 1, not at all, to 4, a great extent.
Respondents were from 208 organizations and included 58,408 health care workers; 19.5% were nurses and 67.1% were women.
“CCS findings have practical and financial implications, ranging from the increased risk of self-reported medical error to turnover and other costs associated with burnout,” the researchers wrote. “HCWs’ occupational stress (ie, burnout) and mental health are of major national concern, and physician turnover and reduced clinical effort due to burnout are estimated to cost $4.6 billion annually, with nursing burnout-related turnover adding $14 billion annually.”
CCS was more frequently reported among racial and ethnic minority individuals and those not identifying race or ethnicity compared with White respondents (25.2% vs. 18.8%; P<.001). CCS was also more frequently reported by women respondents as compared with men (21.1% vs. 17.9%; odds ratio [OR]=1.22; 95% CI, 1.17-1.29.)
Respondents with CCS had 115% greater odds of anxiety or depression (OR=2.15; 95% CI, 2.04-2.26;P<.001) and 80% increased risk of burnout (OR=1.80; 95% CI, 1.70-1.90; P<.001) compared with respondents without CCS.
High CCS was associated with increased odds of intent to reduce hours and intent to leave. Controlling for years in practice, specialty and role, women had greater odds of reporting intent to reduce hours as compared with men. However, when the model was constructed for physicians, there was no significant difference in intent to reduce hours by gender.
“We propose a more intentional approach in the healthcare workplace to assessing and addressing childcare concerns when worker assignments are made. Workplaces that can accommodate change on short notice, provide on-site care for ill children or on-site schools, and are aware of worker concerns about their children will be better positioned to show workers they are a caring environment, one that, we hope, workers would be more likely to remain with rather than leaving for shift work in other settings, a scenario that is currently occurring in large numbers.”