S.E. Munter1, L. Perkins1, L. Adams1, B. Harris1, T. Constantini1, J. Doucet1, J. Santorelli1 1University Of California – San Diego, San Diego, CA, USA
Introduction: During the COVID pandemic, mask-wearing by providers became an essential component of pandemic response. Prior research done in local outpatient clinics has suggested that masks have a negative impact on establishing an effective provider-patient relationship. However, the impact on hospitalized patients is not yet well understood. We sought to capture a wider perspective on this issue through utilization of social media. We hypothesized that mask-wearing had a negative impact on trust and communication between patients and inpatient providers, particularly for surgical patients.
Methods: A cross-sectional study was performed by releasing an English online survey to Facebook users in the United States 7/2023 to 1/2024. The survey screened participants for any hospitalization during or after the COVID pandemic (March 2020-present). Demographic data and eight questions about patient perceptions of provider inpatient mask-wearing was collected using a 5-point Likert scale.
Results: There were 288 respondents who were hospitalized during or after the COVID pandemic. The respondents were 59% female, and 71% white, with a median age group of 25-44 years (IQR 35-64). Most patients were admitted for a medical (43%) or surgical (34%) issue and 22% were emergent admissions. 60% of respondents receiving surgery during admission. Out of all respondents, 20-30% agreed that masks negatively impacted their ability to recognize, communicate with, perceive empathy from, and trust their provider. 25% of surgical patients agreed that masks made them feel less comfortable in providing informed consent. On multivariable regression, older age was associated with a more negative perception of masks and female gender was associated with a more positive perception. Increasing age was associated with lower levels of trust (OR 1.60, CI 1.24-2.12, p<0.001) and comfort in providing consent (OR 1.69, CI 1.03-2.99, p=0.049). Female surgical respondents were less impacted by masks and reported feeling safer with mask use.
Conclusion: Mask-wearing is a critical component of patient safety during pandemics, but providers must be aware that it can act as a barrier to establishing effective communication and trust with patient. Patient attitudes towards masks are mixed, and correlated with age and gender. The positive response to masks from female respondents suggests that with effective communication, masks could become a tool for improving the patient-provider relationship. Surgeons should be cognizant of this when obtaining consent for surgical procedures, particularly with older patients.