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

BACKGROUND: Despite the frequent occurrence of patient death in cardiac practice, its emotional impact on cardiac physicians (CPs) remains poorly explored. OBJECTIVES: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.