Risk Perception and Psychosocial Impact During the Early Period of the COVID-19 Pandemic on Healthcare Workers
Authors: Lim Chau Sian , See Brian , Liang Teo David Choon , Qing Tan Michelle Su , Hassan Norasyikin , Tee Augustine 
Published: July 2023

Aims

This study sought to elucidate the occupational health risk perception and psychological impact during the early phase of the COVID-19 pandemic on healthcare workers in a general hospital in Singapore, and factors that influenced risk perception and psychological impact.

Methods

Healthcare workers from a general hospital in Singapore were invited to participate in an online survey in June 2020. It posed questions on demographic and occupational information (age, gender, nationality, marital status, profession, working area, length of working experience in healthcare), 20 items on occupational health risk perception and psychological impact of COVID-19, and the Depression Anxiety and Stress Scale-21 (DASS-21).

The 20 items were adapted from a previous study during the 2003 Severe Acute Respiratory Syndrome (SARS) outbreak and designed to assess participants’ perceived exposure risk, risk acceptance, families’ perception, stigmatisation, feelings of appreciation, workload, and perceived effectiveness of workplace protective measures. Participants’ responses were obtained on a 6-point Likert scale (strongly agree, agree, somewhat agree, somewhat disagree, disagree, strongly disagree).

For data analysis, responses on occupational risk perception were regrouped into three levels. Depression, anxiety, and stress scores were categorised into quartiles. Ordinal logistics regression was used to compare the association of occupational risk perception with DASS-21 scores, and demographic factors with occupational risk perception. Variables that showed statistical significance (set at P <0.05) in univariate analysis were included in the multivariate ordinal logistics regression model to identify independent predictors.

Results

There were 1252 respondents (92 doctors, 661 nurses, 318 allied health professionals, 181 administrative and support personnel). 85% felt an increased risk of exposure to COVID-19 while 90% accepted the risk as part of their jobs. Stigmatisation against healthcare workers was present, with 45% reported they were shunned and 21% reported their families were avoided. 78% experienced increased workload. Fortunately, most (94%) found workplace protective measures adequate, and felt appreciated by their employer (87%) and society (81%).

Increased perception of occupational health risk was significantly associated with nursing profession, workers in patient-facing areas, and staff with shortest working experience in healthcare.

The mean DASS-21 scores were 9.2 (borderline normal) for Depression, 8.5 (borderline mild) for Anxiety, and 10.9 (normal) for Stress. Increased DASS-21 scores were significantly associated with greater occupational risk perception, younger age, and less years of working experience.

Conclusion

Occupational risk perception amid the early COVID-19 pandemic is associated with adverse mental health among healthcare workers. Nurses, younger staff, and staff with least working experience are more vulnerable.