title: Psychological impact of the 2003 severe acute respiratory syndrome outbreak on health care workers in a medium size regional general hospital in Singapore.
abstract: OBJECTIVE
  To describe the psychological impact of severe acute respiratory syndrome (SARS) on health care workers in a regional general hospital 2 months post-outbreak.
  
  
  METHODS
  Doctors and nurses were encouraged to participate. The survey consisted of self-report measures: demographics, the General Health Questionnaire (GHQ) 28 and Impact of Events Scale (IES). A questionnaire enquiring about changes in life's priorities due to SARS and circumstances that helped with coping was used. Participation was strictly voluntary and responses anonymous.
  
  
  RESULTS
  In total 177 out of 661 (27%) participants [40 out of 113 (35%) doctors and 137 out of 544 (25%) nurses] had a GHQ 28 score >or=5. Doctors [P = 0.026, odds ratio (OR) = 1.6 and 95% confidence interval (CI) = 1.1-2.5] and single health care workers were at higher risk (P = 0.048, OR = 1.4 and 95% CI = 1.02-2.0) compared to nurses and those who were married. Approximately 20% of the participants had IES scores >or=30, indicating the presence of post-traumatic stress disorder (PTSD). Four areas were classified as more important using factor analysis: health and relationship with the family, relationship with friends/colleagues, work and spiritual. The areas for coping strategies were clear directives/precautionary measures, ability to give feedback to/obtain support from management, support from supervisors/colleagues, support from the family, ability to talk to someone and religious convictions. Support from supervisors/colleagues was a significant negative predictor for psychiatric symptoms and PTSD. Work and clear communication of directives/precautionary measures also helped reduce psychiatric symptoms.
  
  
  CONCLUSIONS
  Many health care workers were emotionally affected and traumatized during the SARS outbreak. Hence, it is important for health care institutions to provide psychosocial support and intervention for their health care workers.
authors.affiliation: Psychological Medicine, Changi General Hospital, 2 Simei Street 3, Singapore 529889. chanom@pacific.net.sg
authors.forename: Angelina O M
authors.initials: AO
authors.lastname: Chan
authors.forename: Chan Yiong
authors.initials: CY
authors.lastname: Huak
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D004196:Disease Outbreaks; D006769:Hospitals, General; D006801:Humans; D016015:Logistic Models; D008505:Medical Staff, Hospital / Q000523:psychology*; D001523:Mental Disorders / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000523:psychology*; D009784:Occupational Diseases / Q000453:epidemiology / Q000523:psychology*; D045169:Severe Acute Respiratory Syndrome / Q000453:epidemiology / Q000523:psychology*; D012846:Singapore / Q000453:epidemiology; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000209:etiology / Q000523:psychology