From compassion to indifference: changes in physicians' emotional responses to treating Ukrainian refugees in Poland

Introduction The war in Ukraine and the resulting refugee crisis have created new emotional and organizational challenges for healthcare professionals across Europe. This study aimed to assess emotional responses among physicians in Poland related to providing medical care to Ukrainian refugees and to identify factors associated with occupational burden and support needs. Methods This cross-sectional, retrospective study included 215 physicians from multiple hospitals in Poland, recruited between June and July 2025 using snowball sampling. An author-developed questionnaire, informed by clinical observations and consultation with a psychologist, was pilot-tested prior to implementation. Physicians retrospectively recalled their emotions during initial contacts with Ukrainian refugee patients and reported their current emotions. Analyses included paired comparisons and additional multivariable models. Results Physicians recalled significantly more pleasant than unpleasant emotions during their initial contacts with Ukrainian refugee patients ( p < 0.001). Compared with recalled initial responses, fewer pleasant and more unpleasant emotions were reported at survey completion (both p < 0.001). Compassion was selected by 77.7% of physicians for initial contacts and by 41.9% currently ( p < 0.001), whereas reluctance increased from 7.4% to 26.0% ( p < 0.001) and anger from 6.0% to 12.6% ( p = 0.022). The proportion reporting none of the listed emotions increased from 7.4% to 19.1% ( p < 0.001). A higher number of reported unpleasant emotions was associated with more perceived work-related burdens (Spearman's Rs = 0.506, p < 0.001). After adjustment for age, specialty, and contact frequency, associations between sex and positive emotions or support needs were not statistically significant. The most commonly identified challenges were language barriers (56.7%), demanding patient attitudes (42.3%), and cultural differences (33.5%). Professional interpreter services were the most frequently expected form of support (53.0%). Conclusions Physicians reported different emotional responses for initial and current contacts with Ukrainian refugee patients. These retrospective findings cannot establish the causes of these differences or demonstrate compassion fatigue or burnout. Professional interpreter services and support for reconstructing medical records may address the main practical difficulties identified by respondents.