Fear among Resident Doctors as Frontliners during Corona Virus Disease 2019 Pandemic: An Online Survey

Abstract

Background: Fear is an adaptive emotion that serves to mobilize energy to deal with potential threat. A threat stimulus, such as site of a predator, triggers a fear response in the amygdala, which activates areas involved in preparation for motor function in fight or flight. Considering the outbreak of coronavirus disease 2019 (COVID-19), fighting against this specific infectious disease was a serious challenge to the residents who were at a risk of themselves contacting the disease. This leads to exhaustion, isolation, and persistent emotional trauma during the COVID-19 pandemic period. Objectives: The objective of the study was to assess the level of perceived fear of residents doctors as front-liners and to find coping strategies used by resident doctors as front-liners to overcome fear. Study Design: An online survey was conducted. Methods: An online questionnaire-based survey was conducted to understand fear level in resident doctors as front-liners and various strategies used by them to overcome fear. The survey questionnaire consisted 21 items. This questionnaire was validated by three faculties. The final questionnaire consisted of 20 questions pertaining to the level of fear. Out of 150 e-mails sent to resident doctors in March 2020, received responses were from 86 resident doctors. Google Form link with the same questionnaire was resent to these 86 resident doctors, in November 2020. Out of these 86 e-mails, responses from 50 resident doctors of only COVID tertiary hospital were quantitatively analyzed. Results: The initial total minimum score was 134 and the maximum score was 200, and the average score was 156.16. Out of 50 residents, 28 (56%) were in the range less than or equal to average and 22 (44%) residents were in range greater than average. The total minimum score after 8 months was 69 and the maximum score was 179, and the average score was 128. Out of 50 residents, 20 (40%) were in the range less than or equal to average and 30 (60%) residents were in range greater than average. Out of 50 residents, 44 (88%) residents had severe fear and 6 (12%) had moderate fear at the initial stage of pandemic, whereas after 8 months of pandemic, only 11 (22%) residents had severe fear and 37 (74%) residents had moderate fear with 2 (4%) residents having only mild fear. Conclusion: Resident doctors who worked for more than 6 h per day in the COVID wards experienced moderate-to-severe levels of fear, which decreased with continued exposure to similar situation. The coping strategies used by residents also helped them to overcome this fear.