Originally published by 2 Minute Medicine® (view original article). Reused on AccessMedicine with permission.

1. In the care of COVID-19 patients in Singapore non-medically-trained hospital personnel were more likely to experience anxiety than physicians and nurses, though psychological effects were clearly present among all workers.

Evidence Rating Level: 2 (Good)

Singapore witnessed a total of 200 confirmed cases of COVID-19 by March 13, 2020, an increase from 84 over the previous month. A total of 11 cases were in critical condition but no deaths were reported. This cross-sectional, case-control study utilized self-administered questionnaires to examine the psychological impact on healthcare workers during this pandemic, comparing both medically- and non-medically-trained hospital staff. Psychological symptoms included distress, anxiety, stress, and depression. A total of 470 individuals (median [IQR] age = 31 [28-36] years, 68.3% female) participated in this study, comprised of nurses (34.3%), physicians (28.7%), allied healthcare professionals (13.8%), maintenance workers (7.7%), administrators (7.0%), clerical staff (6.4%), and technicians (2.1%). Only physicians and nurses were considered medically-trained, which is approximately 63.0% of the total sample. About 14.5% of individuals screened positive for anxiety, 8.9% for depression, 6.6% for stress, and 7.7% for concern for Posttraumatic Stress Disorder (PTSD). Adjusted prevalence ratio for anxiety was found to be higher in non-medically-trained personnel than physicians and nurses (1.85, 95% CI 1.15 to 2.99, p = 0.011). Components of the Depression, Anxiety, and Stress Scales (DASS-21) were all higher in non-medically-trained personnel. While rates were relatively low compared to those anticipated, this may be due to the lack of COVID-19-related deaths at the time of the study. Further, the knowledge of frontline medical professionals in Singapore may have served as a protective factor against some of the uncertainty that could result in stress in others. In general, though, this study suggests that all workers in healthcare are likely to experience some form of psychological consequences of this pandemic.

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