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Published in: BMC Primary Care 1/2021

Open Access 01-12-2021 | Care | Research article

Prepared and highly committed despite the risk of COVID-19 infection: a cross-sectional survey of primary care physicians’ concerns and coping strategies in Singapore

Authors: Jerrald Lau, David Hsien-Yung Tan, Gretel Jianlin Wong, Yii-Jen Lew, Ying-Xian Chua, Lian-Leng Low, Han-Kwee Ho, Thiam-Soo Kwek, Sue-Anne Ee-Shiow Toh, Ker-Kan Tan

Published in: BMC Primary Care | Issue 1/2021

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Abstract

Background

Primary care physicians (PCPs) are first points-of-contact between suspected cases and the healthcare system in the current COVID-19 pandemic. This study examines PCPs’ concerns, impact on personal lives and work, and level of pandemic preparedness in the context of COVID-19 in Singapore. We also examine factors and coping strategies that PCPs have used to manage stress during the outbreak.

Methods

Two hundred and sixteen PCPs actively practicing in either a public or private clinic were cluster sampled via email invitation from three primary care organizations in Singapore from 6th to 29th March 2020. Participants completed a cross-sectional online questionnaire consisting of items on work- and non-work-related concerns, impact on personal and work life, perceived pandemic preparedness, stress-reduction factors, and personal coping strategies related to COVID-19.

Results

A total of 158 questionnaires were usable for analyses. PCPs perceived themselves to be at high risk of COVID-19 infection (89.9%), and a source of risk (74.7%) and concern (71.5%) to loved ones. PCPs reported acceptance of these risks (91.1%) and the need to care for COVID-19 patients (85.4%). Overall perceived pandemic preparedness was extremely high (75.9 to 89.9%). PCPs prioritized availability of personal protective equipment, strict infection prevention guidelines, accessible information about COVID-19, and well-being of their colleagues and family as the most effective stress management factors.

Conclusions

PCPs continue to serve willingly on the frontlines of this pandemic despite the high perception of risk to themselves and loved ones. Healthcare organizations should continue to support PCPs by managing both their psychosocial (e.g. stress management) and professional (e.g. pandemic preparedness) needs.
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Literature
2.
go back to reference Wong TY, Koh GC, Cheong SK, Sundram M, Koh K, Chia SE, et al. A cross-sectional study of primary-care physicians in Singapore on their concerns and preparedness for an avian influenza outbreak. Ann Acad Med Singap. 2008;37(6):458–64.PubMed Wong TY, Koh GC, Cheong SK, Sundram M, Koh K, Chia SE, et al. A cross-sectional study of primary-care physicians in Singapore on their concerns and preparedness for an avian influenza outbreak. Ann Acad Med Singap. 2008;37(6):458–64.PubMed
7.
go back to reference Ministry of Health Ontario. COVID-19 Guidance: Primary Care Providers in a Community Setting. 2020. Ministry of Health Ontario. COVID-19 Guidance: Primary Care Providers in a Community Setting. 2020.
9.
go back to reference Razai MS, Doerholt K, Ladhani S, Oakeshott P. Coronavirus disease 2019 (covid-19): a guide for UK GPs. BMJ. 2020;368:m800.CrossRef Razai MS, Doerholt K, Ladhani S, Oakeshott P. Coronavirus disease 2019 (covid-19): a guide for UK GPs. BMJ. 2020;368:m800.CrossRef
10.
go back to reference The National Academy of Medicine. The neglected dimension of global security: a framework to counter infectious disease crises. Washington: The National Academies Press; 2016. p. 142. The National Academy of Medicine. The neglected dimension of global security: a framework to counter infectious disease crises. Washington: The National Academies Press; 2016. p. 142.
11.
go back to reference Chee Y. Heroes and heroines of the war on SARS. Singap Med J. 2003;44(5):221–8. Chee Y. Heroes and heroines of the war on SARS. Singap Med J. 2003;44(5):221–8.
12.
go back to reference Wong JE, Leo YS, Tan CC. COVID-19 in Singapore—current experience: critical global issues that require attention and action. Jama. 2020;323:1243.CrossRef Wong JE, Leo YS, Tan CC. COVID-19 in Singapore—current experience: critical global issues that require attention and action. Jama. 2020;323:1243.CrossRef
13.
go back to reference Bai Y, Lin C-C, Lin C-Y, Chen J-Y, Chue C-M, Chou P. Survey of stress reactions among health care workers involved with the SARS outbreak. Psychiatr Serv. 2004;55(9):1055–7.CrossRef Bai Y, Lin C-C, Lin C-Y, Chen J-Y, Chue C-M, Chou P. Survey of stress reactions among health care workers involved with the SARS outbreak. Psychiatr Serv. 2004;55(9):1055–7.CrossRef
14.
go back to reference Wong W, Lee A, Tsang K, Wong S. How did general practitioners protect themselves, their family, and staff during the SARS epidemic in Hong Kong? J Epidemiol Community Health. 2004;58(3):180–5.CrossRef Wong W, Lee A, Tsang K, Wong S. How did general practitioners protect themselves, their family, and staff during the SARS epidemic in Hong Kong? J Epidemiol Community Health. 2004;58(3):180–5.CrossRef
15.
go back to reference Wong TY, Koh GC, Cheong SK, Lee HY, Fong YT, Sundram M, et al. Concerns, perceived impact and preparedness in an avian influenza pandemic--a comparative study between healthcare workers in primary and tertiary care. Ann Acad Med Singapore. 2008;37(2):96.PubMed Wong TY, Koh GC, Cheong SK, Lee HY, Fong YT, Sundram M, et al. Concerns, perceived impact and preparedness in an avian influenza pandemic--a comparative study between healthcare workers in primary and tertiary care. Ann Acad Med Singapore. 2008;37(2):96.PubMed
16.
go back to reference Abolfotouh MA, AlQarni AA, Al-Ghamdi SM, Salam M, Al-Assiri MH, Balkhy HH. An assessment of the level of concern among hospital-based health-care workers regarding MERS outbreaks in Saudi Arabia. BMC Infect Dis. 2017;17(1):4.CrossRef Abolfotouh MA, AlQarni AA, Al-Ghamdi SM, Salam M, Al-Assiri MH, Balkhy HH. An assessment of the level of concern among hospital-based health-care workers regarding MERS outbreaks in Saudi Arabia. BMC Infect Dis. 2017;17(1):4.CrossRef
17.
go back to reference Khalid I, Khalid TJ, Qabajah MR, Barnard AG, Qushmaq IA. Healthcare workers emotions, perceived stressors and coping strategies during a MERS-CoV outbreak. Clin Med Res. 2016;14(1):7–14.CrossRef Khalid I, Khalid TJ, Qabajah MR, Barnard AG, Qushmaq IA. Healthcare workers emotions, perceived stressors and coping strategies during a MERS-CoV outbreak. Clin Med Res. 2016;14(1):7–14.CrossRef
23.
go back to reference Corp IBM. IBM SPSS statistics for windows, version 22.0. Armonk: IBM Corp; 2013. Corp IBM. IBM SPSS statistics for windows, version 22.0. Armonk: IBM Corp; 2013.
24.
go back to reference Tavakol M, Dennick R. Making sense of Cronbach’s alpha. Int J Med Educ. 2011;2:53–5.CrossRef Tavakol M, Dennick R. Making sense of Cronbach’s alpha. Int J Med Educ. 2011;2:53–5.CrossRef
25.
go back to reference Koh D, Lim MK, Chia SE, Ko SM, Qian F, Ng V, et al. Risk perception and impact of severe acute respiratory syndrome (SARS) on work and personal lives of healthcare Workers in Singapore What can we Learn? Med Care. 2005;43:676–82.CrossRef Koh D, Lim MK, Chia SE, Ko SM, Qian F, Ng V, et al. Risk perception and impact of severe acute respiratory syndrome (SARS) on work and personal lives of healthcare Workers in Singapore What can we Learn? Med Care. 2005;43:676–82.CrossRef
26.
go back to reference Preti E, Di Mattei V, Perego G, Ferrari F, Mazzetti M, Taranto P, et al. The Psychological Impact of Epidemic and Pandemic Outbreaks on Healthcare Workers: Rapid Review of the Evidence. Curr Psychiatry Rep. 2020;22(8):43.CrossRef Preti E, Di Mattei V, Perego G, Ferrari F, Mazzetti M, Taranto P, et al. The Psychological Impact of Epidemic and Pandemic Outbreaks on Healthcare Workers: Rapid Review of the Evidence. Curr Psychiatry Rep. 2020;22(8):43.CrossRef
27.
go back to reference Matsuishi K, Kawazoe A, Imai H, Ito A, Mouri K, Kitamura N, et al. Psychological impact of the pandemic (H1N1) 2009 on general hospital workers in Kobe. Psychiatry Clin Neurosci. 2012;66(4):353–60.CrossRef Matsuishi K, Kawazoe A, Imai H, Ito A, Mouri K, Kitamura N, et al. Psychological impact of the pandemic (H1N1) 2009 on general hospital workers in Kobe. Psychiatry Clin Neurosci. 2012;66(4):353–60.CrossRef
29.
go back to reference Min AH. COVID-19 outbreak: what you need to know about the public health preparedness clinics. Channel News Asia; 2020. Min AH. COVID-19 outbreak: what you need to know about the public health preparedness clinics. Channel News Asia; 2020.
30.
go back to reference Elhadi M, Msherghi A, Alkeelani M, Zorgani A, Zaid A, Alsuyihili A, et al. Assessment of healthcare Workers’ levels of preparedness and awareness regarding COVID-19 infection in low-resource settings. Am J Trop Med Hyg. 2020;103(2):828–33.CrossRef Elhadi M, Msherghi A, Alkeelani M, Zorgani A, Zaid A, Alsuyihili A, et al. Assessment of healthcare Workers’ levels of preparedness and awareness regarding COVID-19 infection in low-resource settings. Am J Trop Med Hyg. 2020;103(2):828–33.CrossRef
31.
go back to reference Elhadi M, Msherghi A, Alkeelani M, Alsuyihili A, Khaled A, Buzreg A, et al. Concerns for low-resource countries, with under-prepared intensive care units, facing the COVID-19 pandemic. Infect Dis Health. 2020;25(4):227–32.CrossRef Elhadi M, Msherghi A, Alkeelani M, Alsuyihili A, Khaled A, Buzreg A, et al. Concerns for low-resource countries, with under-prepared intensive care units, facing the COVID-19 pandemic. Infect Dis Health. 2020;25(4):227–32.CrossRef
32.
go back to reference Tabah A, Ramanan M, Laupland KB, Buetti N, Cortegiani A, Mellinghoff J, et al. Personal protective equipment and intensive care unit healthcare worker safety in the COVID-19 era (PPE-SAFE): an international survey. J Crit Care. 2020;59:70–5.CrossRef Tabah A, Ramanan M, Laupland KB, Buetti N, Cortegiani A, Mellinghoff J, et al. Personal protective equipment and intensive care unit healthcare worker safety in the COVID-19 era (PPE-SAFE): an international survey. J Crit Care. 2020;59:70–5.CrossRef
33.
go back to reference Lee S-H, Juang Y-Y, Su Y-J, Lee H-L, Lin Y-H, Chao C-C. Facing SARS: psychological impacts on SARS team nurses and psychiatric services in a Taiwan general hospital. Gen Hosp Psychiatry. 2005;27(5):352–8.CrossRef Lee S-H, Juang Y-Y, Su Y-J, Lee H-L, Lin Y-H, Chao C-C. Facing SARS: psychological impacts on SARS team nurses and psychiatric services in a Taiwan general hospital. Gen Hosp Psychiatry. 2005;27(5):352–8.CrossRef
34.
go back to reference Simonds A, Sokol D. Lives on the line? Ethics and practicalities of duty of care in pandemics and disasters. Eur Respir J. 2009;34(2):303–9.CrossRef Simonds A, Sokol D. Lives on the line? Ethics and practicalities of duty of care in pandemics and disasters. Eur Respir J. 2009;34(2):303–9.CrossRef
35.
go back to reference Chan AO, Huak CY. 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. 2004;54(3):190–6.CrossRef Chan AO, Huak CY. 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. 2004;54(3):190–6.CrossRef
36.
go back to reference Kuriansky J. The psychosocial aspects of a deadly epidemic: what Ebola has taught us about holistic healing: what Ebola has taught us about holistic healing: ABC-CLIO; 2016. Kuriansky J. The psychosocial aspects of a deadly epidemic: what Ebola has taught us about holistic healing: what Ebola has taught us about holistic healing: ABC-CLIO; 2016.
37.
go back to reference Verma S, Mythily S, Chan Y, Deslypere J, Teo E, Chong S. Post-SARS psychological morbidity and stigma among general practitioners and traditional Chinese medicine practitioners in Singapore. Ann Acad Med Singap. 2004;33(6):743–8.PubMed Verma S, Mythily S, Chan Y, Deslypere J, Teo E, Chong S. Post-SARS psychological morbidity and stigma among general practitioners and traditional Chinese medicine practitioners in Singapore. Ann Acad Med Singap. 2004;33(6):743–8.PubMed
38.
go back to reference Krasner MS, Epstein RM, Beckman H, Suchman AL, Chapman B, Mooney CJ, et al. Association of an educational program in mindful communication with burnout, empathy, and attitudes among primary care physicians. Jama. 2009;302(12):1284–93.CrossRef Krasner MS, Epstein RM, Beckman H, Suchman AL, Chapman B, Mooney CJ, et al. Association of an educational program in mindful communication with burnout, empathy, and attitudes among primary care physicians. Jama. 2009;302(12):1284–93.CrossRef
Metadata
Title
Prepared and highly committed despite the risk of COVID-19 infection: a cross-sectional survey of primary care physicians’ concerns and coping strategies in Singapore
Authors
Jerrald Lau
David Hsien-Yung Tan
Gretel Jianlin Wong
Yii-Jen Lew
Ying-Xian Chua
Lian-Leng Low
Han-Kwee Ho
Thiam-Soo Kwek
Sue-Anne Ee-Shiow Toh
Ker-Kan Tan
Publication date
01-12-2021
Publisher
BioMed Central
Keywords
Care
COVID-19
Published in
BMC Primary Care / Issue 1/2021
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-021-01370-7

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