How well did radiographers manage during the COVID-19 outbreak?

In Singapore, diagnostic radiographers were able to cope with the high demands of the COVID-19 pandemic in terms of provision of information, supplies, and physical equipment, a survey shows. However, they were less prepared to manage human factors, such as mental health and staff morale.

Data from imaging facilities in Singapore were collected between July and September 2020. A total of 123 radiographers responded (mean age 34.8 years, 62 percent female). Nearly 80 percent were working in tertiary hospitals, with an average working experience of 9.9 years. [J Med Imaging Radiat Sci 2023;S1939-8654(23)00010-3]

Eighty-nine percent of the respondents had been involved in the imaging of suspected or confirmed COVID-19 patients. The mean number of suspected or confirmed COVID-19 cases in a month was 19.6. Those performing general radiography had the highest number of cases at 300 per month.

Communication, preparedness

Ninety-four percent of respondents felt that information dissemination (including workflow changes, safety briefs) was timely. “Many were comforted by the frequent instructions and found these to be helpful, [but] others found these to be confusing,” the researchers said. The confusion stemmed from ‘unclear and rapidly changing instructions’, ‘largely inaccurate information’, or ‘poor communication between departments’.

Eighty-six percent felt that their institution had adequately prepared them for their tasks, while 94 percent believed their institution had sufficient personal protective gear. “[More than 90] percent commented that they had received some form of training to prepare for the pandemic, [and] most felt that there were enough preventive measures in the department workflow to minimize the community spread of COVID-19,” the researchers shared.

Support, stress, mental health

Despite others professing discontent, 87 percent shared that they had a ‘strong’ support system at work. “The support [was] in terms of collegial support, adequate resources, and welfare,” said the researchers. The dissatisfaction was driven by reasons such as ‘threat[s] to take punitive punishment against simple thing[s]’ or being ostracized as a ’secondary contact’ if they had worked with another staff who has contracted COVID-19.

During the SARS* outbreak in 2007, stress and poor mental health amongst healthcare workers were reported. [Br J Psychiatry 2004;185:127-133; Emerg Infect Dis 2005;11:404-410; Can J Psychiatry 2007;52:241-247; J Psychosom Res 2008;64:177-183] In the current survey, the two main sources of stress were fear of transmitting COVID-19 to family members (77 percent) and lack of manpower at work (73 percent).

Nonetheless, about two-thirds reported that they had no difficulty managing stress during the pandemic. No correlation was found between stress management and the respondents’ experience (r(121)=−0.02; p=0.83).

“[T]he perceived stress level for our radiography community was relatively low, [possibly] due to excellent internal institutional support for staff, such as care packs and increased eating spaces. Most staff may be able to work insouciantly,” the researchers said.

Adapting to new changes

The COVID-19 pandemic entailed frequent practice and workflow changes in healthcare facilities. Apart from their usual routines in their institutions, radiographers were also expected to provide services in the additional facilities set up to address the upsurge in cases. [J Med Radiat Sci 2022;69:147-155]

To prevent the development of mental illness and burnout in the radiography community, institutions must be able to support the transition as their staff adapts to new changes. “The safety and well-being of staff should not be compromised to reduce staff anxiety while performing their duties. Strategies to improve their ability to adapt to changes and provision of quality support are necessary measures in future pandemic situations,” said the researchers.

“Mental health programmes can provide some catharsis to empower staff to improve their psychological well-being in the long term,” they continued.

“The survey allowed us to recognize the variable experiences brought on by the COVID-19 pandemic in the radiography community. This may allow potential new strategies to ensure the psychological well-being of radiographers in future pandemic situations,” they concluded.