Emotional Impact of Patient Death and Associated Psychological Distress in Cardiac Physicians

Despite the frequent occurrence of patient death in cardiac practice, its emotional impact on cardiac physicians (CPs) remains poorly explored.

The objective of the study was to assess the Emotional Impact of Patient Death (EIPD) and examine its association with symptoms of psychological distress, including anxiety, depression, post-traumatic stress disorder, and burnout. A secondary objective was to identify risk factors of high emotional impact.

Cross-sectional survey of French CPs, using EIPD self-reported 10-point Likert scale, the Hospital Anxiety and Depression Scale, the Impact of Event Scale-Revised, and the Maslach Burnout Inventory.

Among 6,080 invited physicians, 747 CPs completed the survey (response rate 12.2%; mean age 44.5 ± 12.3 years; 43% women; 75% cardiologists, 12% anesthesiologists, 8% surgeons, and 5% pediatric cardiologists). CPs were divided into EIPD quartiles; Q4 (≥8/10) comprised 201 (26%) respondents. Higher EIPD was associated with a greater psychological distress: Q4 participants reported symptoms of anxiety (n = 104, 52%), depression (n = 85, 42%), post-traumatic stress disorder (n = 121, 60%), and severe burnout (n = 103, 51%). This group also reported more frequent conflicts with colleagues and higher use of psychotropic or addictive substances. In multivariable analysis, female sex, cardiothoracic surgical specialty, and a history of personal trauma were independently associated with high EIPD (Q3-Q4 vs Q1-Q2).

The emotional impact of patient death is significantly associated with symptoms of psychological distress among CPs, highlighting an under-recognized dimension of physician well-being that requires targeted institutional support and training.