COVID-19: Which factors affect perceived stress of SG healthcare workers?

Regardless of the scope of work involved, all healthcare workers (HCWs) are similarly stressed by the novel coronavirus disease (COVID-19) pandemic as compared to the general population, according to a Singapore study.

“Improving the confidence of HCWs in their training, protection and the support of personal protective equipment, and retaining experienced HCWs who can provide advice and emotional support to younger colleagues are important,” the researchers said. “Adequate psychological support for HCWs in the pandemic can be transformed into reserves of psychological resilience for future disease outbreaks.”

An electronic self-administered questionnaire was used to carry out this cross-sectional study at the National Healthcare Group Polyclinics in March 2020. Data was collected anonymously, and analysis was performed using regression modelling.

Of the 1,492 eligible participants, 1,040 HCWs (69.7 percent) responded to the survey. Their mean perceived stress level in various departments ranged from 17.2 to 20.3. Muslim respondents, those who reported higher job stress, who made alternative living arrangements, and who were affected more by the pandemic had higher perceived stress. [Singapore Med J 2020;doi:10.11622/smedj.2020163]

On the other hand, HCWs who had been through the severe acute respiratory syndrome epidemic in 2003 and H1N1 pandemic in 2009 and those who had higher confidence in the organization’s training, protection, and support (TPS) reported lower perceived stress.

“The study results suggest that it is important to provide adequate infection control training for our HCWs, and to retain experienced HCWs who can provide helpful advice and be positive role models for their younger colleagues during such a trying time,” the researchers said.

“It also underpins the importance of providing adequate psychological support for the workforce so that the current stressful experience can be transformed into reserves of psychological resilience for future disease outbreaks,” they added.

Prior to the pandemic, the baseline Perceived Stress Scale level of the general Singapore population was between 16.0 and 17.0, which was lower than the perceived stress level of HCWs in the current study. [J Adv Nurs 2019;75:1922-1932]

The increase in stress level could have been driven by the demands on HCWs during the pandemic, according to the researchers. Other possible contributors to increased psychological stress for HCWs were the frequent changes in workflows in response to the growing spread of COVID-19 internationally and the requirements for rapid data submission locally.

Of note, the higher perceived stress reported by Muslim HCWs could be due to the cancellation of their overseas leave, as it is common practice for Singaporean Muslims to go on a pilgrimage during the March school holidays. Also, the Islamic Religious Council of Singapore reported that five Singaporeans who tested positive for COVID-19 had visited 10 different local mosques during their infectious period.

“As the COVID-19 pandemic is likely going to last for a while… the team will continue to study how the perceived stress level may change over time as the government implements further measures to curb the spread of COVID-19,” the researchers said. “The results of this and future studies could help to improve the current system to sustain a healthy and resilient work environment.”