Impact of COVID-19 on the mental health of Singaporean GPs: a cross-sectional study

Abstract

BackgroundCovid-19 has stressed healthcare systems and workers worldwide. General practitioners (GPs), as first points-of-contact between suspected cases and the healthcare system, assume frontline roles in this crisis. While the prevalence of mental health problems and illnesses arising in healthcare workers (HCWs) from tertiary care settings during Covid-19 is well-examined,(1) the impact on GPs remains understudied.AimTo describe the prevalence and predictors of anxiety, burnout, depression, and post-traumatic stress disorder (PTSD) amongst GPs during the Covid-19 pandemicDesign & settingSurvey of GPs operating in Singapore primary care clinicsMethodGPs completed a survey which comprised of four validated psychometric instruments. Open-ended questions asked of respondents’ challenges and their envisaged support. Data were analysed with multiple logistic regression with demographic data as covariates; concepts of grounded theory were used to analyse the qualitative responses.Results257 GPs participated. 55 (21.4%) met the scales’ criteria for anxiety, 211 (82.1%) for burnout, 68 for (26.6%) for depression, and 23 (9.1%) for PTSD. Multivariate regression analysis showed working in a public primary care setting was associated with anxiety and depression. Qualitative analyses uncovered possible stressors: changes to clinical and operational practices, increased workloads, and financial difficulties.ConclusionMental health issues were found present in Singaporean GPs during the pandemic. Prevalence of anxiety, burnout and depression were found to be higher than those reported pre-Covid-19. Our findings also provide determinants of the issues which serve as possible foci for targeted interventions.

Depression, Anxiety and Associated Factors among Frontline Hospital Healthcare Workers in the Fourth Wave of COVID-19: Empirical Findings from Vietnam

“…All the items were rated on a four-point scale scoring from 0 (not at all) to 3 (nearly every day). The total score ranges from 0 to 21, and symptom severity was interpreted as follows: absence of anxiety (0-4), mild anxiety (5)(6)(7)(8)(9), moderate anxiety (10)(11)(12)(13)(14), and severe anxiety (15)(16)(17)(18)(19)(20)(21). Though initially designed to identify generalized anxiety disorder (GAD), the GAD-7 has also been considered as a good screening tool for other common anxiety disorders.…”

“…In a recent systematic review of updated prevalence estimates for depression and anxiety from 65 studies, Yufei Li showed a high prevalence of moderate depression and anxiety among health care workers across 21 countries during the COVID-19 pandemic [10], which can negatively impact on the quality of COVID-19 patient care [11]. In Southeast Asia alone, recent evidence has revealed that there seems to be an increasing trend for anxiety and depression over time among healthcare workers compared to the first wave of COVID-19 [12][13][14][15][16].…”

“…The total score of the PHQ-9 scale after self-reported response ranges from 0 to 27, and more severe depression symptoms are shown by a higher score. Symptom severity was based on the total score and was categorized as follows: absence of depression (0-4), mild depression (5)(6)(7)(8)(9), moderate depression (10)(11)(12)(13)(14), and severe depression (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27). In various medical settings, the validated depression scale was reported with good reliability (Cronbach's α = 0.86-0.89).…”

Psychological impact of the COVID-19 pandemic on primary care workers: a cross-sectional study

“…Despite the abundant literature on this subject, few studies specifically analyse the situation in primary care, [11][12][13][14][15] despite the relevant repercussions in this setting and the different characteristics and conditioning factors from those reported in the hospital setting.…”

General Practitioner perspectives and wellbeing during the COVID-19 Pandemic: a mixed method social media analysis

“…Indeed, high levels of stress and burnout amongst GPs during the COVID19 pandemic have been reported internationally, with an expanding literature on this topic (e.g. [6][7][8]. Two UK studies of GP pandemic experiences show greater work stress due to rapid change and uncertainty [9] and the importance of teams in creating a sense of solidarity [10].…”