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Published Research

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The Psychological Impact of the COVID-19 Pandemic on Healthcare Staff in High Acuity Areas, and the Impact of Mitigation Strategies.

Publication date: April 2022

Authors: Marilyn Hui Xin Ng1, Shivani Manohara1, Anthony TB Wong2, Louis Xiang Long Ng1, Joyce SC Ng2
1Department of Anaesthesia and Surgical Intensive Care, Changi General Hospital, Singapore.
2Department of TRaCS, Changi General Hospital, Singapore.


The COVID-19 pandemic has been more than a global health crisis. Social problems such as depression, anxiety and fear of the future are common feelings amongst people, including healthcare staff. We conducted a survey of our frontline staff in a Singapore Public Hospital to evaluate stress, moral distress in hypothetical scenarios when resource triaging is needed and the perception of mitigation strategies implemented during the first spike in cases seen in Singapore in May 2020. Our study shows that, during the earlier part of the COVID-19 pandemic, frontline staff stress was mostly at moderate levels. Many measures and policies were implemented in Singapore to deal with COVID-19, of which, frontline staff felt that clear communication of the policies and guidelines from the government and from the hospital administration were most helpful. A follow up study to assess how staff stress levels have progressed and how their opinions have changed after more than 2 years of working in the pandemic will be ideal in guiding our future healthcare strategies.

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Addressing physician quality of life: understanding the relationship between burnout, work engagement, compassion fatigue and satisfaction.

Publication date: August 2015

Authors: Angelina OM Chan, Yiong Huak Chan, Kee Puay Chuang, Joyce SC Ng, Patricia SH Neo


Burnout and compassion fatigue are now recognized as occupational hazards associated with the medical profession. Interestingly, burnout and compassion fatigue do not occur in every physician and many continue to find joy, meaning and satisfaction in their work despite its challenges and stressors. Our study looked at the relationship between burnout, work engagement, compassion fatigue and satisfaction amongst doctors. We also studied the relationship between these and four measureable intrinsic human factors; self-efficacy, resilient personality type, sense of gratitude and work calling. Our study found that 37% of the doctors were at high risk of burnout and 7.5% were at high risk of compassion fatigue and only 3.3% and 1.5% were at low risk of burnout and compassion fatigue respectively. Only 2.7% and 0.3% had high rates of work engagement and compassion satisfaction respectively. There was a mild but significant negative correlation between burnout and engagement, and a poor negative correlation between compassion fatigue and satisfaction. Only intrinsic human factors were significantly correlated to burnout, work engagement, compassion fatigue and satisfaction. Our preliminary findings suggest that certain intrinsic factors increase work engagement and compassion satisfaction amongst doctors. As some of these intrinsic factors also appear to buffer against burnout and compassion fatigue, increasing work engagement and compassion satisfaction not only builds individual resilience against burnout and compassion fatigue but may also lead to improvement in overall health, professional quality of life and career longevity for doctors.

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Exposure to crises and resiliency of health care workers in Singapore.

Publication date: March 2013

Authors: A. O. M. Chan, Y. H. Chan, J. P. C. Kee



Health care workers are exposed to various work-related traumatic incidents and crises, so building emotional resiliency is important.


To examine exposure to work-related crises and resiliency of health care workers in public hospitals in Singapore.


We sent questionnaires to health care workers in seven public hospitals. Participation was voluntary and anonymous. We asked about mental health training and exposure to work-related and personal crises. We measured resiliency using a pilot 5-point Likert questionnaire reflecting resistance and resilience constructs.


We received 496 responses, a response rate of 58%. More than 70% of hospital staff experienced aggression or violence from patients and relatives, and about a third experienced significant personal crises, most commonly interpersonal conflicts. Those with mental health training were twice as likely to be resistant (OR = 1.8, 95% CI 1.2–2.7) and resilient (OR = 1.9, 95% CI 1.3–2.7) and also more likely to have experienced sudden/unexpected patient deaths (OR = 2.7, 95% CI 1.9–4.0) and aggression or violence from patients and relatives (OR = 5.1, 95% CI 3.0–8.7).


Mental health training appears to improve individuals’ perception of resistance and resilience. Hospitals should consider providing mental health and crisis intervention training to improve the emotional resiliency of health care workers.

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