Methodology
This was a cross-sectional retrospective descriptive study involving doctors and nurses who were on isolation duty from 7 February to 30 April 2020. The Brief Resilience Scale (BRS) was used to evaluate resilience (S1). This self-rating questionnaire was developed by Smith et al. in 2008, to measure individuals’ ability to bounce back or recover from stress4. This concise six-itemed questionnaire has been validated in many countries to be an accurate and reliable measure of resilience5-7.
The BRS consists of six statements. Statements 1, 3, and 5 are positively worded, while statements 2, 4, and 6 are negatively worded. The BRS is scored by reverse coding items 2, 4, and 6 and finding the mean of the six statements. Study participants report how strongly they agree or disagree with the statements. The BRS score is calculated by dividing the total sum by the total number of questions answered. The BRS score is classified into 3 categories: low resilience (1.00-2.99), normal resilience (3.00-4.30) and high resilience (4.31-5.00).
Additional survey questions were added to (i) explore the emotions of HCW when caring for suspected or confirmed COVID-19 patients, (ii) identify factors that reduced stress and (iii) determine how they feel working in isolation teams has affected their health (S2). Participants could choose more than one option for selected questions. The questions and content in the survey were developed following discussion between study investigators and key departmental leaders. The survey was piloted on junior doctors to ensure ease of use and understanding prior to distribution to participants. All HCWs who completed isolation duties were invited to participate in this study. Survey responses were anonymous to ensure confidentiality.
Completed surveys were consolidated at the end of the study period. Incomplete surveys were excluded. The responses were transcribed into Microsoft Excel. The BRS mean was analysed with paired T-test and one-way analysis of variance (ANOVA) using IBM SPSS Statistics software version 22. The p-value of less than 0.05 was taken as statistically significant. The qualitative data was summarized into themes and categories. This study was approved by the SingHealth Centralised Institutional Review Board (CIRB), reference number 2020/2471.