Results
A total of 50 doctors and 51 nurses worked in the isolation team during the study period. Of the 101 HCW who received the survey, three did not return the survey and one had incomplete BRS, hence excluded. The response rate was 96.0% (97 out of 101 HCW). The respondents’ age ranged from 21 to 60 years, with a mean age of 34 years ± 7.970. Their professional work experience ranged from 1 to 40 years (mean 9.3 years, ± 7.818).
As seen from Table 1, the mean BRS score of the respondents was 3.6 ± 0.664. The majority of respondents have normal resilience (76.3%), while the prevalence of low resilience was 11.3% and high resilience was 12.4%. There was no statistically significant difference in mean resilience scores when analysed by age (p=0.700) and years of experience (p=0.918). Doctors had statistically significantly higher BRS than nurses (mean 3.8 vs 3.4, p=0.003). Male HCW had significantly higher BRS scores than female HCW (mean 4.0 vs 3.5, p=0.043). Amongst the 49 doctors, there was no difference observed in BRS scores between male and female doctors (p=0.318). There were no male nurses in the study.
Out of the 97 respondents, 26 HCW (26.8%) reported positive attitudes when informed of their assigned isolation duties – 18 (18.6%) were excited, 7 (7.2%) were happy to start on their new duties, one (1.0%) volunteered and one felt ready (1.0%). On the other hand, 65% reported some form of negative feelings – including being worried (52.6%) or anxious (2.1%) and feeling angry (4.1%) or upset (1.0%). Twenty-five (25.8%) HCW were indifferent. Respondents were more often concerned for their families (88.8%) over themselves (62.9%) (Table 2).
During isolation duties, many respondents (out of 97) expressed negative emotions – 23.7% had low mood, 39.2% were anxious, 23.7% were irritable, 2.1% were angry and 3.1% were fearful. Nineteen (19.6%) HCW felt neutral and only a small proportion of HCW had positive emotions (6.2%) such as feeling cheerful, happy and motivated.
Three respondents refrained from responding to mental health issues. Half the respondents (47/94, 50.0%) felt that their mental health was the most affected during isolation duties, followed by social well-being (28/94, 29.8%) and lastly, physical health (19/94, 20.2%). HCW on isolation duties were instructed not to meet other colleagues in the hospital and to have less contact with family members. They reported less family time due to the 12-hour shift work for seven consecutive days. This impacted their social well-being and resulted in low mood.
When asked “What makes you happy during isolation duties”, a total of 80 participants answered (Table 3). The most common response (32.5%) emphasised that supportive team members with good teamwork made their isolation duties more enjoyable: “Going through it with friends/colleagues”, “Company of colleagues”, “Teamwork and positivity is important”, “Good team with nurses and doctors”. Many of them (23.8%) appreciated the time away from routine clinical work: “No ward rounds, no clinic, no ward duties”, “Able to have staff empowerment to do things that we don’t usually/routinely do”. There were also 22.5% of them who enjoyed the small acts or gifts of appreciation from the department, hospital and community: “Thanks from patient”, “Being appreciated”, “Care and concern from colleagues outside (of) iso(lation duties)”. Some of the respondents also commented that the well-equipped negative pressure rooms gave them confidence in managing patients who were positive for COVID-19.
Respondents were concerned that junior doctors were placed at higher risk of infection compared to the rest of the department as they were at the very frontline of patient interaction and many were assigned multiple rotations in the isolation team over the course of the study period. There were also concerns regarding financial remuneration for the additional shifts and all leave were cancelled on very short notice.