{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T06:48:38Z","timestamp":1762325318295,"version":"3.43.0"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"SUMMARY<\/jats:title>\n \n Goal:<\/jats:title>\n Perceived organizational support (POS) may promote healthcare worker mental health, but organizational factors that foster POS during the COVID-19 pandemic are unknown. The goals of this study were to identify actions and policies regarding COVID-19 that healthcare organizations can implement to promote POS and to evaluate the impact of POS on physicians\u2019 mental health, burnout, and intention to leave patient care.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n We conducted a cross-sectional national survey with an online panel of internal medicine physicians from the American College of Physicians in September and October of 2020. POS was measured with a 4-item scale, based on items from Eisenberger\u2019s Perceived Organizational Support Scale that were adapted for the pandemic. Mental health outcomes and burnout were measured with short screening scales.<\/jats:p>\n <\/jats:sec>\n \n Principal Findings:<\/jats:title>\n The response rate was 37.8% (N<\/jats:italic> = 810). Three healthcare organization actions and policies were independently associated with higher levels of POS in a multiple linear regression model that included all actions and policies as well as potential confounding factors: opportunities to discuss ethical issues related to COVID-19 (\u03b2<\/jats:italic> (regression coefficient) = 0.74, p<\/jats:italic> = .001), adequate access to personal protective equipment (\u03b2<\/jats:italic> = 1.00, p<\/jats:italic> = .005), and leadership that listens to healthcare worker concerns regarding COVID-19 (\u03b2<\/jats:italic> = 3.58, p<\/jats:italic> < .001). Sanctioning workers who speak out on COVID-19 safety issues or refuse pandemic deployment was associated with lower POS (\u03b2<\/jats:italic> = \u20132.06, p<\/jats:italic> < .001). In multivariable logistic regression models, high POS was associated with approximately half the odds of screening positive for generalized anxiety, depression, post-traumatic stress disorder, burnout, and intention to leave patient care within 5 years.<\/jats:p>\n <\/jats:sec>\n \n Applications to Practice:<\/jats:title>\n Our results suggest that healthcare organizations may be able to increase POS among physicians during the COVID-19 pandemic by guaranteeing adequate personal protective equipment, making sure that leaders listen to concerns about COVID-19, and offering opportunities to discuss ethical concerns related to caring for patients with COVID-19. Other policies and actions such as rapid COVID-19 tests may be implemented for the safety of staff and patients, but the policies and actions associated with POS in multivariable models in this study are likely to have the largest positive impact on POS. Warning or sanctioning workers who refuse pandemic deployment or speak up about worker and patient safety is associated with lower POS and should be avoided. We also found that high degrees of POS are associated with lower rates of adverse outcomes. So, by implementing the tangible support policies positively associated with POS and avoiding punitive ones, healthcare organizations may be able to reduce adverse mental health outcomes and attrition among their physicians.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/jhm-d-21-00208","type":"journal-article","created":{"date-parts":[[2022,5,11]],"date-time":"2022-05-11T17:00:16Z","timestamp":1652288416000},"page":"192-205","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Effects of Healthcare Organization Actions and Policies Related to COVID-19 on Perceived Organizational Support Among U.S. Internists: A National Study"],"prefix":"10.1097","volume":"67","author":[{"given":"Jeffrey","family":"Sonis","sequence":"first","affiliation":[{"name":"Department of Social Medicine and Department of Family Medicine, University of North Carolina at Chapel Hill"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donald E.","family":"Pathman","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Read","sequence":"additional","affiliation":[{"name":"Research Center, American College of Physicians, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bradley N.","family":"Gaynes","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Department of Epidemiology, University of North Carolina at Chapel Hill"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Courtney","family":"Canter","sequence":"additional","affiliation":[{"name":"School of Medicine and Department of Anthropology, University of North Carolina at Chapel Hill"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Curran","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of North Carolina at Chapel Hill"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheryl B.","family":"Jones","sequence":"additional","affiliation":[{"name":"Cecil G. Sheps Center for Health Services Research and School of Nursing, University of North Carolina at Chapel Hill"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of North Carolina at Chapel Hill"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2022,5]]},"reference":[{"key":"R2-20250803","doi-asserted-by":"crossref","DOI":"10.1016\/j.psychres.2021.113847","article-title":"Mental health of health care workers (HCWs): A review of organizational interventions put in place by local institutions to cope with new psychosocial challenges resulting from COVID-19","volume":"299","author":"Buselli","year":"2021","journal-title":"Psychiatry Research"},{"key":"R3-20250803","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1037\/1082-989X.6.4.330","article-title":"A comparison of inclusive and restrictive strategies in modern missing-data procedures","volume":"6","author":"Collins","year":"2001","journal-title":"Psychological Methods"},{"issue":"(6)","key":"R4-20250803","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1093\/aje\/kwv080","article-title":"Health estimates using survey raked-weighting techniques in an Australian Population Health Surveillance System","volume":"182","author":"Dal Grande","year":"2015","journal-title":"American Journal of Epidemiology"},{"issue":"(3)","key":"R6-20250803","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1037\/0021-9010.71.3.500","article-title":"Perceived organizational support","volume":"71","author":"Eisenberger","year":"1986","journal-title":"Journal of Applied Psychology"},{"key":"R7-20250803","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1146\/annurev-orgpsych-012119-044917","article-title":"Perceived organizational support: Why caring about employees counts. In F. Morgeson (Ed.)","volume":"7","author":"Eisenberger","year":"2020","journal-title":"Annual Review of Organizational Psychology and Organizational Behavior"},{"key":"R8-20250803","article-title":"Poststratification and weighting adjustments","author":"Gelman","year":"2002","journal-title":"Survey nonresponse"},{"issue":"(21)","key":"R9-20250803","article-title":"COVID-19-related mental health effects in the workplace: A narrative review","volume":"17","author":"Giorgi","year":"2020","journal-title":"International Journal of Environmental Research and Public Health"},{"issue":"(27)","key":"R10-20250803","doi-asserted-by":"crossref","first-page":"853","DOI":"10.15585\/mmwr.mm6927a1","article-title":"Increases in health-elated workplace absenteeism among workers in essential critical infrastructure occupations during the COVID-19 pandemic\u2014United States, March-April 2020","volume":"69","author":"Groenewold","year":"2020","journal-title":"MMWR Morbidity and Mortality Weekly Report"},{"issue":"(1)","key":"R12-20250803","first-page":"11","article-title":"Workplace factors associated with mental health of healthcare workers during the COVID-19 pandemic: an international cross-sectional study","volume":"21","author":"Khajuria","year":"2021","journal-title":"BMC Health Services Research"},{"key":"R13-20250803","doi-asserted-by":"crossref","first-page":"m1642","DOI":"10.1136\/bmj.m1642","article-title":"Occurrence, prevention, and management of the psychological effects of emerging virus outbreaks on healthcare workers: rapid review and meta-analysis","volume":"369","author":"Kisely","year":"2020","journal-title":"BMJ"},{"issue":"(11)","key":"R14-20250803","doi-asserted-by":"crossref","first-page":"1284","DOI":"10.1097\/01.MLR.0000093487.78664.3C","article-title":"The patient health questionnaire-2: Validity of a two-item depression screener","volume":"41","author":"Kroenke","year":"2003","journal-title":"Medical Care"},{"issue":"(5)","key":"R15-20250803","doi-asserted-by":"crossref","first-page":"317","DOI":"10.7326\/0003-4819-146-5-200703060-00004","article-title":"Anxiety disorders in primary care: Prevalence, impairment, comorbidity, and detection","volume":"146","author":"Kroenke","year":"2007","journal-title":"Annals of Internal Medicine"},{"issue":"(6)","key":"R16-20250803","doi-asserted-by":"crossref","first-page":"1854","DOI":"10.1177\/0149206315575554","article-title":"Perceived organizational support: A meta-analytic evaluation of organizational support theory","volume":"43","author":"Kurtessis","year":"2017","journal-title":"Journal of Management"},{"issue":"(7)","key":"R17-20250803","doi-asserted-by":"crossref","first-page":"1653","DOI":"10.1111\/jonm.13121","article-title":"COVID-19 anxiety among front-line nurses: Predictive role of organisational support, personal resilience and social support","volume":"28","author":"Labrague","year":"2020","journal-title":"Journal of Nursing Management"},{"issue":"(3)","key":"R18-20250803","doi-asserted-by":"crossref","first-page":"e0246454","DOI":"10.1371\/journal.pone.0246454","article-title":"Prevalence of depression, anxiety and post-traumatic stress disorder in health care workers during the COVID-19 pandemic: A systematic review and meta-analysis","volume":"16","author":"Li","year":"2021","journal-title":"PLoS ONE"},{"issue":"(1447)","key":"R19-20250803","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1098\/rstb.2004.1483","article-title":"The experience of the 2003 SARS outbreak as a traumatic stress among frontline healthcare workers in Toronto: Lessons learned","volume":"359","author":"Maunder","year":"2004","journal-title":"Philosophical Transactions of the Royal Society B Biological Sciences"},{"issue":"(4)","key":"R20-20250803","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1097\/JHM-D-20-00288","article-title":"Healthcare is a team sport: Stress, resilience, and correlates of well-being among health system employees in a crisis","volume":"66","author":"Meese","year":"2021","journal-title":"Journal of Healthcare Management"},{"key":"R21-20250803","doi-asserted-by":"crossref","first-page":"113441","DOI":"10.1016\/j.psychres.2020.113441","article-title":"The mental health impact of the COVID-19 pandemic on healthcare workers, and interventions to help them: A rapid systematic review","volume":"293","author":"Muller","year":"2020","journal-title":"Psychiatry Research"},{"issue":"(2)","key":"R23-20250803","doi-asserted-by":"crossref","first-page":"e0245885","DOI":"10.1371\/journal.pone.0245885","article-title":"Willingness to work during initial lockdown due to COVID-19 pandemic: Study based on an online survey among physicians of Bangladesh","volume":"16","author":"Rafi","year":"2021","journal-title":"PLOS ONE"},{"issue":"(12)","key":"R24-20250803","doi-asserted-by":"crossref","first-page":"4267","DOI":"10.3390\/ijerph17124267","article-title":"Preserving organizational resilience, patient safety, and staff retention during COVID-19 requires a holistic consideration of the psychological safety of healthcare workers","volume":"17","author":"Rangachari","year":"2020","journal-title":"International Journal of Environmental Research and Public Health"},{"issue":"(21)","key":"R26-20250803","doi-asserted-by":"crossref","first-page":"2133","DOI":"10.1001\/jama.2020.5893","article-title":"Understanding and addressing sources of anxiety among health care professionals during the COVID-19 pandemic","volume":"323","author":"Shanafelt","year":"2020","journal-title":"JAMA"},{"issue":"(3\u20134)","key":"R27-20250803","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1037\/mgr0000088","article-title":"Treating employees well: The value of organizational support theory in human resource management","volume":"22","author":"Shanock","year":"2019","journal-title":"Psychologist-Manager Journal"},{"key":"R28-20250803","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/j.genhosppsych.2021.05.004","article-title":"Generalized anxiety, depression and posttraumatic stress disorder in a national sample of U.S. internal medicine physicians during the COVID-19 pandemic","volume":"71","author":"Sonis","year":"2021","journal-title":"General Hospital Psychiatry"},{"issue":"(3\u20134)","key":"R30-20250803","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1111\/jocn.15548","article-title":"Correlation between emotional intelligence and negative emotions of front-line nurses during the COVID-19 epidemic: A cross-sectional study","volume":"30","author":"Sun","year":"2021","journal-title":"Journal of Clinical Nursing"},{"issue":"(11)","key":"R31-20250803","doi-asserted-by":"crossref","first-page":"1445","DOI":"10.1007\/s11606-012-2015-7","article-title":"Concurrent validity of single-item measures of emotional exhaustion and depersonalization in burnout assessment","volume":"27","author":"West","year":"2012","journal-title":"Journal of General Internal Medicine"},{"issue":"(1)","key":"R32-20250803","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1097\/00004010-200101000-00002","article-title":"Understanding physicians\u2019 intentions to withdraw from practice: The role of job satisfaction, job stress, mental and physical health","volume":"26","author":"Williams","year":"2001","journal-title":"Health Care Management Review"},{"issue":"(21)","key":"R33-20250803","article-title":"Supporting role of society and firms to COVID-19 management among medical practitioners","volume":"17","author":"Zandi","year":"2020","journal-title":"International Journal of Environmental Research and Public Health"},{"key":"R34-20250803","doi-asserted-by":"crossref","first-page":"113174","DOI":"10.1016\/j.psychres.2020.113174","article-title":"Developing and testing a measure of COVID-19 organizational support of healthcare workers\u2014Results from Peru, Ecuador, and Bolivia","volume":"291","author":"Zhang","year":"2020","journal-title":"Psychiatry Research"},{"issue":"(4)","key":"R35-20250803","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1111\/aphw.12267","article-title":"Perceived organizational support and PTSD symptoms of frontline healthcare workers in the outbreak of COVID-19 in Wuhan: The mediating effects of self-efficacy and coping strategies","volume":"13","author":"Zhou","year":"2021","journal-title":"Applied Psychology-Health and Well Being"},{"issue":"(9)","key":"R36-20250803","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1002\/da.22942","article-title":"Developing an optimal short-form of the PTSD checklist for DSM-5 (PCL-5)","volume":"36","author":"Zuromski","year":"2019","journal-title":"Depression and Anxiety"}],"container-title":["Journal of Healthcare Management"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/JHM-D-21-00208","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,3]],"date-time":"2025-08-03T21:01:28Z","timestamp":1754254888000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/JHM-D-21-00208"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5]]},"references-count":30,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.1097\/jhm-d-21-00208","relation":{},"ISSN":["1096-9012","1944-7396"],"issn-type":[{"type":"print","value":"1096-9012"},{"type":"electronic","value":"1944-7396"}],"subject":[],"published":{"date-parts":[[2022,5]]}}}