Skip to main content Accessibility help
×
Home

Asian-Pacific perspective on the psychological well-being of healthcare workers during the evolution of the COVID-19 pandemic

  • Nicholas W. S. Chew (a1), Jinghao Nicholas Ngiam (a1), Benjamin Yong-Qiang Tan (a2), Sai-Meng Tham (a1), Celine Yan-Shan Tan (a1), Mingxue Jing (a3), Renarebecca Sagayanathan (a3), Jin Tao Chen (a3), Lily Y. H. Wong (a3), Aftab Ahmad (a4), Faheem Ahmed Khan (a5), Maznah Marmin (a4), Fadhlina Binte Hassan (a4), Tai Mei-Ling Sharon (a6), Chin Han Lim (a7), Mohamad Iqbal Bin Mohaini (a7), Rivan Danuaji (a8), Thang H. Nguyen (a9), Georgios Tsivgoulis (a10), Sotirios Tsiodras (a10), Paraskevi C. Fragkou (a10), Dimitra Dimopoulou (a10), Arvind K. Sharma (a11), Kenam Shah (a11), Bhargesh Patel (a11), Suktara Sharma (a12), R. N. Komalkumar (a13), R. V. Meenakshi (a14), Shikha Talati (a15), Hock Luen Teoh (a16), Cyrus S. Ho (a17), Roger C. Ho (a18) and Vijay K. Sharma (a16)...

Abstract

Background

The coronavirus disease 2019 (COVID-19) pandemic has led to significant strain on front-line healthcare workers.

Aims

In this multicentre study, we compared the psychological outcomes during the COVID-19 pandemic in various countries in the Asia-Pacific region and identified factors associated with adverse psychological outcomes.

Method

From 29 April to 4 June 2020, the study recruited healthcare workers from major healthcare institutions in five countries in the Asia-Pacific region. A self-administrated survey that collected information on prior medical conditions, presence of symptoms, and scores on the Depression Anxiety Stress Scales and the Impact of Events Scale-Revised were used. The prevalence of depression, anxiety, stress and post-traumatic stress disorder (PTSD) relating to COVID-19 was compared, and multivariable logistic regression identified independent factors associated with adverse psychological outcomes within each country.

Results

A total of 1146 participants from India, Indonesia, Singapore, Malaysia and Vietnam were studied. Despite having the lowest volume of cases, Vietnam displayed the highest prevalence of PTSD. In contrast, Singapore reported the highest case volume, but had a lower prevalence of depression and anxiety. In the multivariable analysis, we found that non-medically trained personnel, the presence of physical symptoms and presence of prior medical conditions were independent predictors across the participating countries.

Conclusions

This study highlights that the varied prevalence of psychological adversity among healthcare workers is independent of the burden of COVID-19 cases within each country. Early psychological interventions may be beneficial for the vulnerable groups of healthcare workers with presence of physical symptoms, prior medical conditions and those who are not medically trained.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Asian-Pacific perspective on the psychological well-being of healthcare workers during the evolution of the COVID-19 pandemic
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Asian-Pacific perspective on the psychological well-being of healthcare workers during the evolution of the COVID-19 pandemic
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Asian-Pacific perspective on the psychological well-being of healthcare workers during the evolution of the COVID-19 pandemic
      Available formats
      ×

Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

Correspondence: Benjamin Y. Q. Tan. Email: benjamin_yq_tan@nuhs.edu.sg

Footnotes

Hide All
*

Joint first authors.

Footnotes

References

Hide All
1World Health Organization. Director-General's Remarks at the Media Briefing on 2019-nCoV on 11 February 2020. WHO, 2020 (https://www.who.int/dg/speeches/detail/who-director-general-s-remarks-at-the-media-briefing-on-2019-ncov-on-11-february-2020).
2Worldometer. COVID-19 Coronavirus Pandemic. Worldometer, 2020 (https://www.worldometers.info/coronavirus/ [cited 16 June 16 2020]).
3Driggin, E, Madhavan, MV, Bikdeli, B, Chuich, T, Laracy, J, Biondi-Zoccai, G, et al. Cardiovascular considerations for patients, health care workers, and health systems during the coronavirus disease 2019 (COVID-19) pandemic. J Am Coll Cardiol 2020; 75: 2352–71.
4Zeng, J, Huang, J, Pan, L. How to balance acute myocardial infarction and COVID-19: the protocols from Sichuan Provincial People's Hospital. Intensive Care Med 2020; 46: 1111–3.
5Tan, BYQ, Chew, NWS, Lee, GKH, Jing, M, Goh, Y, Yeo, LLL, et al. Psychological impact of the COVID-19 pandemic on health care workers in Singapore. Ann Intern Med 2020; 173: 317–20.
6Grace, SL, Hershenfield, K, Robertson, E, Stewart, DE. The occupational and psychosocial impact of SARS on academic physicians in three affected hospitals. Psychosomatics 2005; 46: 385–91.
7Tam, CW, Pang, EP, Lam, LC, Chiu, HF. Severe acute respiratory syndrome (SARS) in Hong Kong in 2003: stress and psychological impact among frontline healthcare workers. Psychol Med 2004; 34: 1197–204.
8Lam, MHB, Wing, YK, Yu, MWM, Leung, CM, Ma, RCW, Kong, APS, et al. Mental morbidities and chronic fatigue in severe acute respiratory syndrome survivors: long-term follow-up. Archiv Int Med 2009; 169: 2142–7.
9Lee, S, Chan, LY, Chau, AM, Kwok, KP, Kleinman, A. The experience of SARS-related stigma at Amoy Gardens. Soc Sci Med 2005; 61: 2038–46.
10Lovibond, SH, Lovibond, PF. Manual for the Depression Anxiety Stress Scales (2nd edn). Psychology Foundation of Australia, 1995.
11Creamer, M, Bell, R, Failla, S. Psychometric properties of the Impact of Event Scale - Revised. Behav Res Ther 2003; 41: 1489–96.
12Wang, C, Pan, R, Wan, X, Tan, Y, Xu, L, Ho, CS, et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int J Environ Res Public Health 2020; 17: 1729.
13Young, BE, Ong, SWX, Kalimuddin, S, Low, JG, Tan, SY, Loh, J, et al. Epidemiologic features and clinical course of patients infected with SARS-CoV-2 in Singapore. JAMA 2020; 323: 1488–94.
14Wong, JEL, Leo, YS, Tan, CC. COVID-19 in Singapore—current experience: critical global issues that require attention and action. JAMA [Epub ahead of print] 20 Feb 2020. Available from: https://doi.org/10.1001/jama.2020.3204.
15Huang, JZ, Han, MF, Luo, TD, Ren, AK, Zhou, XP. Mental health survey of 230 medical staff in a tertiary infectious disease hospital for COVID-19 [in Chinese]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2020; 38: E001.
16Lancet, T. India under COVID-19 lockdown. Lancet 2020; 395: 1315.
17Black, G. Vietnam may have the most effective response to Covid-19. The Nation 2020; 24 April 2020 (https://www.thenation.com/article/world/coronavirus-vietnam-quarantine-mobilization).
18Ng, Y, Li, Z, Chua, YX, Chaw, WL, Zhao, Z, Er, B, et al. Evaluation of the effectiveness of surveillance and containment measures for the first 100 patients with COVID-19 in Singapore – January 2–February 29, 2020. MMWR Morb Mortal Wkly Rep 2020; 69: 207–11.
19New Straits Times. Malaysia's Covid-19 strategy far exceeds ASEAN, some European peers. New Straits Times, 25 March 2020 (https://www.nst.com.my/business/2020/03/577996/jp-morgan-malaysias-covid-19-strategy-far-exceeds-asean-some-european-peers).
20Sutrisno, B. Indonesia's strategy to combat COVID-19: what we know so far. The Jarkata Post 2020; 3 April 2020 (https://www.thejakartapost.com/news/2020/04/03/indonesias-strategy-to-combat-covid-19-what-we-know-so-far.html).
21Li, Z, Ge, J, Yang, M, Feng, J, Qiao, M, Jiang, R, et al. Vicarious traumatization in the general public, members, and non-members of medical teams aiding in COVID-19 control. Brain Behav Immun 2020; 88: 916–9.
22Chew, NWS, Lee, GKH, Tan, BYQ, Jing, M, Goh, Y, Ngiam, NJH, et al. A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak. Brain Behav Immun 2020; 88: 559–65.
23Puri, BK, Hall, A, Ho, R. Revision Notes in Psychiatry. Taylor & Francis, 2013.
24Nezlek, JB, Wesselmann, ED, Wheeler, L, Williams, KD. Ostracism in everyday life: the effects of ostracism on those who ostracize. J Soc Psychol 2015; 155: 432–51.
25Troyer, EA, Kohn, JN, Hong, S. Are we facing a crashing wave of neuropsychiatric sequelae of COVID-19? Neuropsychiatric symptoms and potential immunologic mechanisms. Brain Behav Immun 2020; 87: 34–9.
26Matua, GA, Van Der Wal, DM. Living under the constant threat of Ebola: a phenomenological study of survivors and family caregivers during an ebola outbreak. J Nurs Res 2015; 23: 217–24.
27Zhang, J, Lu, H, Zeng, H, Zhang, S, Du, Q, Jiang, T, et al. The differential psychological distress of populations affected by the COVID-19 pandemic. Brain Behav Immun 2020; 87: 4950.
28Richards, M, Anderson, M, Carter, P, Ebert, BL, Mossialos, E.The impact of the COVID-19 pandemic on cancer care. Nat Cancer 2020; 1: 565–7.
29Donker, T, Griffiths, KM, Cuijpers, P, Christensen, H.Psychoeducation for depression, anxiety and psychological distress: a meta-analysis. BMC Med 2009; 7: 79.
30Mcnally, RJ, Bryant, RA, Ehlers, A. Does early psychological intervention promote recovery from posttraumatic stress? Psychol Sci Public Interes 2003; 4: 4579.
31Maunder, RG, Lancee, WJ, Balderson, KE, Bennett, JP, Borgundvaag, B, Evans, S, et al. Long-term psychological and occupational effects of providing hospital healthcare during SARS outbreak. Emerg Infect Dis 2006; 12: 1924–32.

Keywords

Related content

Powered by UNSILO

Asian-Pacific perspective on the psychological well-being of healthcare workers during the evolution of the COVID-19 pandemic

  • Nicholas W. S. Chew (a1), Jinghao Nicholas Ngiam (a1), Benjamin Yong-Qiang Tan (a2), Sai-Meng Tham (a1), Celine Yan-Shan Tan (a1), Mingxue Jing (a3), Renarebecca Sagayanathan (a3), Jin Tao Chen (a3), Lily Y. H. Wong (a3), Aftab Ahmad (a4), Faheem Ahmed Khan (a5), Maznah Marmin (a4), Fadhlina Binte Hassan (a4), Tai Mei-Ling Sharon (a6), Chin Han Lim (a7), Mohamad Iqbal Bin Mohaini (a7), Rivan Danuaji (a8), Thang H. Nguyen (a9), Georgios Tsivgoulis (a10), Sotirios Tsiodras (a10), Paraskevi C. Fragkou (a10), Dimitra Dimopoulou (a10), Arvind K. Sharma (a11), Kenam Shah (a11), Bhargesh Patel (a11), Suktara Sharma (a12), R. N. Komalkumar (a13), R. V. Meenakshi (a14), Shikha Talati (a15), Hock Luen Teoh (a16), Cyrus S. Ho (a17), Roger C. Ho (a18) and Vijay K. Sharma (a16)...

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.

Asian-Pacific perspective on the psychological well-being of healthcare workers during the evolution of the COVID-19 pandemic

  • Nicholas W. S. Chew (a1), Jinghao Nicholas Ngiam (a1), Benjamin Yong-Qiang Tan (a2), Sai-Meng Tham (a1), Celine Yan-Shan Tan (a1), Mingxue Jing (a3), Renarebecca Sagayanathan (a3), Jin Tao Chen (a3), Lily Y. H. Wong (a3), Aftab Ahmad (a4), Faheem Ahmed Khan (a5), Maznah Marmin (a4), Fadhlina Binte Hassan (a4), Tai Mei-Ling Sharon (a6), Chin Han Lim (a7), Mohamad Iqbal Bin Mohaini (a7), Rivan Danuaji (a8), Thang H. Nguyen (a9), Georgios Tsivgoulis (a10), Sotirios Tsiodras (a10), Paraskevi C. Fragkou (a10), Dimitra Dimopoulou (a10), Arvind K. Sharma (a11), Kenam Shah (a11), Bhargesh Patel (a11), Suktara Sharma (a12), R. N. Komalkumar (a13), R. V. Meenakshi (a14), Shikha Talati (a15), Hock Luen Teoh (a16), Cyrus S. Ho (a17), Roger C. Ho (a18) and Vijay K. Sharma (a16)...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *