Supplementary Material for: Psychological State Experienced by Gastroenterologists Following Endoscopic Adverse Events: Insights from a Nationwide Cross-Sectional Study

Background: Adverse events (AEs) are unintentional patient outcomes expected in medicine, but their impact on physicians remains underexplored. Objectives: This study assessed the psychological state experienced by gastroenterologists following endoscopic AEs. Methods: A nationwide online survey was sent to all registered gastroenterologists (n=709). Psychological state was assessed using validated scales assessing psychological distress (DASS-21), professional quality of life (ProQOL-5), self-compassion (SCS-12), and shame feelings (OAS2). Results are presented as mean and 95% confidence interval (CI). Results: Seventy responded (9.87% response rate; median age 41; 41% female). Nearly all (99%) experienced AEs, most during polypectomy/mucosectomy (66%). None consulted psychological support. Stress (9.4 [7.3-11.5]), anxiety (5.1 [3.5-6.7]), and depression (5.2 [3.7-6.8]) were normal; while burnout (25.9 [24.5-27.2]) and traumatic stress (24.3 [23.0-25.5]) were moderate. Higher compassion satisfaction was associated with consultant status (41.5 vs. 37.7, p=0.039), >10 years’ experience (44.3 vs 40.2, p=0.032), age >50 years (41.9 vs 39.3, p=0.008) and those involved in legal actions (45.5 vs 40.6; p=0.023). Age >50 was also associated with higher stress (15.2 vs 8.7, p=0.023) and traumatic stress (26.3 vs 23.8, p=0.035. Stopping procedures after AEs was associated with higher anxiety (12.0 vs 4.8, p=0.026). Conclusions: This is among the first studies to assess the psychological state of AEs on gastroenterologists. Participants showed moderate burnout and traumatic stress, but none consulted psychological support. Findings highlight the need for targeted healthcare support and further research on the emotional burden of AEs among endoscopists.