Risk perception and impact of Severe Acute Respiratory Syndrome (SARS) on work and personal lives of healthcare workers in Singapore: what can we learn?
BACKGROUND
Healthcare workers (HCWs) were at the frontline during the battle against Severe Acute Respiratory Syndrome (SARS). Understanding their fears and anxieties may hold lessons for handling future outbreaks, including acts of bioterrorism.


METHODS
We measured risk perception and impact on personal and work life of 15,025 HCWs from 9 major healthcare institutions during the SARS epidemic in Singapore using a self-administered questionnaire and Impact of Events Scale and analyzed the results with bivariate and multivariate statistics.


RESULTS
From 10,511 valid questionnaires (70% response), we found that although the majority (76%) perceived a great personal risk of falling ill with SARS, they (69.5%) also accepted the risk as part of their job. Clinical staff (doctors and nurses), staff in daily contact with SARS patients, and staff from SARS-affected institutions expressed significantly higher levels of anxiety. More than half reported increased work stress (56%) and work load (53%). Many experienced social stigmatization (49%) and ostracism by family members (31%), but most (77%) felt appreciated by society. Most felt that the personal protective measures implemented were effective (96%) and that the institutional policies and protocols were clear (93%) and timely (90%).


CONCLUSIONS
During epidemics, healthcare institutions have a duty to protect HCWs and help them cope with their personal fears and the very stressful work situation. Singapore's experience shows that simple protective measures based on sound epidemiological principles, when implemented in a timely manner, go a long way to reassure HCWs.
Koh
David
D
Department of Community, Occupational and Family Medicine (MD3), Faculty of Medicine, National University of Singapore, Singapore. cofhead@nus.edu.sg
Lim
Meng Kin
MK
Chia
Sin Eng
SE
Ko
Soo Meng
SM
Qian
Feng
F
Ng
Vivian
V
Tan
Ban Hock
BH
Wong
Kok Seng
KS
Chew
Wuen Ming
WM
Tang
Hui Kheng
HK
Ng
Winston
W
Muttakin
Zainal
Z
Emmanuel
Shanta
S
Fong
Ngan Phoon
NP
Koh
Gerald
G
Kwa
Chong Teck
CT
Tan
Keson Beng-Choon
KB
Fones
Calvin
C
D000223:Adaptation, Psychological; D000328:Adult; D004196:Disease Outbreaks / Q000517:prevention & control; D004644:Emotions; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D045169:Severe Acute Respiratory Syndrome / Q000453:epidemiology / Q000523:psychology*; D012846:Singapore / Q000453:epidemiology; D011795:Surveys and Questionnaires; D016526:Workload