Risk Perception and Impact of Severe Acute Respiratory Syndrome (SARS) on Work and Personal Lives of Healthcare Workers in Singapore

TLDR

Healthcare workers were on the frontlines during the SARS outbreak in Singapore. The study aimed to understand their fears and anxieties to inform responses to future outbreaks, including bioterrorism. Researchers surveyed 15,025 HCWs from nine major institutions using a self‑administered questionnaire and the Impact of Events Scale, then analyzed the data with bivariate and multivariate statistics. Among 10,511 respondents, 76 % perceived a high personal risk yet 69.5 % accepted it as part of their job; clinical staff and those in contact with SARS patients reported higher anxiety, over half experienced increased work stress (56 %) and workload (53 %), many faced social stigmatization (49 %) and family ostracism (31 %) but most (77 %) felt appreciated, and 96 % believed protective measures were effective while 93 % and 90 % rated institutional policies as clear and timely, highlighting the duty of healthcare institutions to protect workers and the reassuring effect of timely, evidence‑based measures.

Abstract

Introduction: Healthcare workers (HCWs) were at the frontline during the battle against Severe Acute Respiratory Syndrome (SARS). Understanding their fears and anxieties may hold lessons for handling future outbreaks, including acts of bioterrorism. Method: We measured risk perception and impact on personal and work life of 15,025 HCWs from 9 major healthcare institutions during the SARS epidemic in Singapore using a self-administered questionnaire and Impact of Events Scale and analyzed the results with bivariate and multivariate statistics. Results: From 10,511 valid questionnaires (70% response), we found that although the majority (76%) perceived a great personal risk of falling ill with SARS, they (69.5%) also accepted the risk as part of their job. Clinical staff (doctors and nurses), staff in daily contact with SARS patients, and staff from SARS-affected institutions expressed significantly higher levels of anxiety. More than half reported increased work stress (56%) and work load (53%). Many experienced social stigmatization (49%) and ostracism by family members (31%), but most (77%) felt appreciated by society. Most felt that the personal protective measures implemented were effective (96%) and that the institutional policies and protocols were clear (93%) and timely (90%). Conclusion: During epidemics, healthcare institutions have a duty to protect HCWs and help them cope with their personal fears and the very stressful work situation. Singapore's experience shows that simple protective measures based on sound epidemiological principles, when implemented in a timely manner, go a long way to reassure HCWs.