Psychological Morbidity among Emergency Department Doctors and Nurses after the SARS Outbreak
Abstract
Objective
To determine the psychological morbidity among emergency department (ED) doctors and nurses six months after the 2003 Severe Acute Respiratory Syndrome (SARS) outbreak.
Methods
During the SARS outbreak from 13 March to 31 May 2003, the study ED was designated as Singapore's only screening centre for SARS and was closed to all other patients. A self-administered questionnaire survey was conducted in November 2003. Doctors and nurses of the study ED who had patient contact during the outbreak were included. Data collected were demographics and responses to (a) Impact of Event Scale (IES) and (b) General Health Questionnaire 28 (GHQ 28). Scores were assigned to the responses whereby an IES score ≥26/75 or a GHQ 28 score ≥5/28 was indicative of post-event and psychiatric morbidity respectively.
Results
Thirty-eight out of 41 (92.7%) doctors and 58 out of 83 (69.9%) nurses responded. Fewer doctors reported post-event and psychiatric morbidity compared to nurses, with 5 (13.2%) doctors and 12 (20.7%) nurses scoring ≥26 on IES, 6 (15.8%) doctors and 12 (20.7%) nurses scoring ≥5 on GHQ 28. The doctors reported a median of 9.5 (range 0–47) on IES and 0 (range 0–11) on GHQ 28. The nurses reported a median of 15 (range 0–61) on IES and 1 (range 0–25) on GHQ 28.
Conclusions
Six months after SARS, the rates of post-event and psychiatric morbidity were relatively low among the study ED doctors and nurses. The results might have underestimated actual morbidity as the study was conducted six months after the outbreak.
References
1. World Health Organization. Update 70 - Singapore removed from list of areas with local SARS transmission [cited 2003 Jun 28]. Available from: http://www.who.int/csr/don/2003_05_30a/en/.
2. Ministry of Health, Singapore. Enhanced precautionary measures to break SARS transmission, March 22, 2003 - press release [cited 2003 Apr 4]. Available from: http://app.moh.gov.sg/new/new02.asp.
3. Maunder R., Hunter J., Vincent L., Bennett J., Peladeau N., Leszcz M. et al. The immediate psychological and occupational impact of the 2003 SARS outbreak in a teaching hospital. CMAJ 2003; 168(10): 1245–51.
4. Robertson E., Hershenfield K., Grace S.L., Stewart D.E. The psychosocial effects of being quarantined following exposure to SARS: a qualitative study of Toronto health care workers. Can J Psychiatry 2004; 49(6): 403–7.
5. Khee K.S., Lee L.B., Chai O.T., Loong C.K., Ming C.W., Kheng T.H. The psychological impact of SARS on health care providers. Crit Care Shock 2004; 7(2): 99–106.
6. Straus S.E., Wilson K., Rambaldini G., Rath D., Lin Y., Gold W.L. et al. Severe acute respiratory syndrome and its impact on professionalism: qualitative study of physicians' behaviour during an emerging healthcare crisis [cited 2004 Oct 24]. Available from: http://bmj.com/cgi/content/full/329/7457/83.
7. Nickell L.A., Crighton E.J., Tracy C.S., Al-Enazy H., Bolaji Y., Hanjrah S. et al. Psychosocial effects of SARS on hospital staff: survey of a large tertiary care institution. CMAJ 2004; 170(5): 793–8.
8. Maunder R. The experience of the 2003 SARS outbreak as a traumatic stress among frontline healthcare workers in Toronto: lessons learned. Philos Trans R Soc Lond B Biol Sci 2004; 359(1447): 1117–25.
9. Chua S.E., Cheung V., Cheung C., McAlonan G.M., Wong J.W., Cheung E.P. et al. Psychological effects of the SARS outbreak in Hong Kong on high-risk health care workers. Can J Psychiatry 2004; 49(6): 391–3.
10. Poon E., Liu K.S., Cheong D.L., Lee C.K., Yam L.Y., Tang W.N. Impact of severe respiratory syndrome on anxiety levels of front-line health care workers. Hong Kong Med J 2004; 10(5): 325–30.
11. Chong M.Y., Wang W.C., Hsieh W.C., Lee C.Y., Chiu N.M., Yeh W.C. et al. Psychological impact of severe acute respiratory syndrome on health workers in a tertiary hospital. Br J Psychiatry 2004; 185: 127–33.
12. Chan A.O., Huak C.Y. Psychological impact of the 2003 severe acute respiratory syndrome outbreak on health care workers in a medium size regional general hospital in Singapore. Occup Med (Lond) 2004; 54(3): 190–6.
13. Sim K., Chong P.N., Chan Y.H., Soon W.S. Severe acute respiratory syndrome-related psychiatric and posttraumatic morbidities and coping responses in medical staff within a primary health care setting in Singapore. J Clin Psychiatry 2004; 65(8): 1120–7.
14. Phua D.H., Tang H.K., Tham K.Y. Coping responses of emergency physicians and nurses to the 2003 severe acute respiratory syndrome outbreak. Acad Emerg Med 2005; 12(4): 322–8.
15. Tham K.Y. An emergency department response to severe acute respiratory syndrome: a prototype response to bioterrorism. Ann Emerg Med 2004; 43(1): 6–14.
16. Ng W.C. The Silent War: 1 March - 31 May 2003. Singapore: Tan Tock Seng Hospital; 2004: 223–5.
17. Horowitz M., Wilner N., Alvarez W. Impact of Event Scale: a measure of subjective stress. Psychosom Med 1979; 41(3): 209–18.
18. Goldberg D.P., Williams P. A user's guide to the General Health Questionnaire. Windsor: NFER-Nelson; 1988.
19. Horowitz M.J., Wilner N., Alvarez W. Impact of Event Scale. In: Task Force for the Handbook of Psychiatric Measures. Handbook of psychiatric measures, 1st ed. Washington DC: American Psychiatric Publishing Group; 2000: 579–81.
20. Neal L.A., Busuttil W., Rollins J., Herepath R., Strike P., Turnbull G. Convergent validity of measures of post-traumatic stress disorder in a mixed military and civilian population. J Trauma Stress 1994; 7(3): 447–55.
21. Corneil W., Beaton R., Murphy S., Johnson C., Pike K. Exposure to traumatic incidents and prevalence of posttraumatic stress symptomatology in urban firefighters in two countries. J Occup Health Psychol 1999; 4(2): 131–41.
22. Fones C.S., Kua E.H., Ng T.P., Ko S.M. Studying the mental health of a nation: a preliminary report on a population survey in Singapore. Singapore Med J 1998; 39(6): 251–5.
23. Boey K.W., Chan K.B., Ko Y.C., Goh L.G., Lim G.C. Work stress and psychological well-being among the nursing profession in Singapore. Singapore Med J 1997; 38(6): 256–60.
24. McPherson S., Hale R., Richardson P., Obholzer A. Stress and coping in accident and emergency senior house officers. Emerg Med J 2003; 20(3): 230–1.
25. Burbeck R., Coomber S., Robinson S.M., Todd C. Occupational stress in consultants in accident and emergency medicine: a national survey of levels of stress at work. Emerg Med J 2002; 19(3): 234–8.
26. Williams S., Dale J., Glucksman E., Wellesley A. Senior house officers' work related stressors, psychological distress, and confidence in performing clinical tasks in accident and emergency: a questionnaire study. BMJ 1997; 314(7082): 713–8.
27. Gallery M.E., Whitley T.W., Klonis L.K., Anzinger R.K., Revicki D.A. A study of occupational stress and depression among emergency physicians. Ann Emerg Med 1992; 21(1): 58–64.
28. Whitley T.W., Allison E.J. Jr, Gallery M.E., Cockington R.A., Gaudry P., Heyworth J. et al. Work-related stress and depression among practicing emergency physicians: an international study. Ann Emerg Med 1994; 23(5): 1068–71.
29. Whitley T.W., Allison E.J. Jr, Gallery M.E., Heyworth J., Cockington R.A., Gaudry P. et al. Work-related stress and depression among physicians pursuing postgraduate training in emergency medicine: an international study. Ann Emerg Med 1991; 20(9): 992–6.
30. Doan-Wiggins L., Zun L., Cooper M.A., Meyers D.L., Chen E.H. Practice satisfaction, occupational stress, and attrition of emergency physicians. Wellness Task Force, Illinois College of Emergency Physicians. Acad Emerg Med 1995; 2(6): 556–63.
31. Laposa J.M., Alden L.E., Fullerton L.M. Work stress and posttraumatic stress disorder in ED nurses/personnel. J Emerg Nurs 2003; 29(1): 23–8.
32. Helps S. Experiences of stress in accident and emergency nurses. Accid Emerg Nurs 1997; 5(1): 48–53.
33. Hawley M.P. Sources of stress for emergency nurses in four urban Canadian emergency departments. J Emerg Nurs 1992; 18(3): 211–6.
34. Keller K.L. The management of stress and prevention of burnout in emergency nurses. J Emerg Nurs 1990; 16(2): 90–5.
35. The Straits Times Interactive, Singapore. TTSH staff win accolade for their work [cited 2004 Jun 23]. Available from: http://straitstimes.asai1.com.sg/html/webspecial/sars/0105_13.html.
Cite article
Cite article
Cite article
OR
Download to reference manager
If you have citation software installed, you can download article citation data to the citation manager of your choice
Information, rights and permissions
Information
Published In
Article first published: October 2005
Issue published: October 2005
Keywords
Authors
Metrics and citations
Metrics
Journals metrics
This article was published in Hong Kong Journal of Emergency Medicine.
VIEW ALL JOURNAL METRICSArticle usage*
Total views and downloads: 926
*Article usage tracking started in December 2016
Articles citing this one
Receive email alerts when this article is cited
Web of Science: 0
Crossref: 0
-
Stress, anxiety, depression and sleep disturbance among healthcare pro...
-
Mental health issues and psychological risk factors among Paraguayan h...
-
Evaluation of the mental health status of community frontline medical ...
-
The prevalence and associated factors of depression, anxiety, and PTSD...
-
Mental Health Effects of Past and Current Pandemics on Health-Care Pro...
-
PREVALENCE AND PREDICTORS OF POSTTRAUMATIC STRESS DISORDER, DEPRESSION...
-
Post-traumatic Stress Disorder Symptoms and Its Predictors Among Healt...
-
Incorporating the Outcomes of COVID-19 with Other Recent Pandemic Outb...
-
Sexual Functioning and Its Association with Psychological Symptoms amo...
-
Experiences and management of physician psychological symptoms during ...
-
History for some or lesson for all? A systematic review and meta-analy...
-
Prevalence of post-traumatic stress disorder on health professionals i...
-
Impact of COVID-19 on the mental health of Singaporean GPs: a cross-se...
-
The Impact of Epidemics and Pandemics on the Mental Health of Healthca...
-
Mental Health Outcomes of Healthcare Providers During COVID-19 Pandemi...
-
Psychological effects of the COVID-19 outbreak on nurses working in te...
-
Prevalence and predictors of post-traumatic stress symptoms and depres...
-
The prevalence of post-traumatic stress disorder related symptoms in C...
-
Prevalence of stress, depression, anxiety and sleep disturbance among ...
-
Mental health of clinical staff working in high-risk epidemic and pand...
-
The impact of COVID-19 pandemic on mental health & wellbeing among hom...
-
A Systematic Review of the Impact of Viral Respiratory Epidemics on Me...
-
A Systematic Review and Provisional Metanalysis on Psychopathologic Bu...
-
PTSD symptoms in healthcare workers facing the three coronavirus outbr...
-
The psychosocial impact of flu influenza pandemics on healthcare worke...
-
The Psychological Impact of Epidemic and Pandemic Outbreaks on Healthc...
-
Love in the time of coronavirus: training and service during COVID-19
-
A Systematic Review of the Impact of Disaster on the Mental Health of ...
-
Nurses' perceptions of risk from emerging respiratory infectious disea...
Figures and tables
Figures & Media
Tables
View Options
View options
PDF/ePub
View PDF/ePubGet access
Access options
If you have access to journal content via a personal subscription, university, library, employer or society, select from the options below:
loading institutional access options
Alternatively, view purchase options below:
Purchase 24 hour online access to view and download content.
Access journal content via a DeepDyve subscription or find out more about this option.
