INTRODUCTION: Despite efforts to improve junior doctors' working conditions, burnout, distress and disillusionment persist, with implications for patient outcomes. This qualitative study analysed factors shaping the lived experiences of junior doctors in Singapore and their changes over time, thereby seeking to inform improvements to working conditions. METHOD: Thirty purposively sampled respondents who were junior doctors in Singapore between 1975 and 2022 were interviewed. Respondents were grouped into 3 cohorts: (1) junior, (2) middle and (3) senior. Employing the framework method of qualitative analysis, open coding was performed with reference to the individual, interpersonal, institutional, community and policy levels of the socioecological model (SEM). Four themes emerged: (1) inherent challenges of junior doctorship, (2) exacerbating factors, (3) alleviating factors and (4) responses of junior doctors to their experiences. Codes were reconstructed into a modified SEM, demonstrating trickle-down effects of interpersonal or structural forces on the individual doctor and pertinent factors evolving with time. RESULTS: Across cohorts, respondents echoed mental and physical challenges. While senior cohort doctors recounted higher patient-to-doctor ratios and longer working hours, junior cohort doctors cited new difficulties. These include a hostile medicolegal landscape, patients' increasingly complex needs and expectations, and higher administrative loads. Amid these difficulties, alleviating factors included good workplace relationships alongside institutional interventions. Doctors responded differently to their challenges. Some externalised difficulties through expression and advocacy; others internalised them, whether into fulfilment or distress. CONCLUSION While some facets of junior doctorship have improved with time, new challenges that warrant consideration are emerging. Junior doctors should be centred, listened to and empowered in shaping improvements to working conditions.
Singapore ; Humans ; Qualitative Research ; Medical Staff, Hospital/psychology* ; Male ; Female ; Adult ; Burnout, Professional/psychology* ; Workload/psychology* ; Attitude of Health Personnel ; Interviews as Topic ; Job Satisfaction

Objective: To analyze the equity of national stomatologist resource allocation from 2016 to 2020, providing relevantly referenced basis for further stomatologist resource allocation. Methods: Collect data of domestic and international stomatologist resources in 2016, 2018 and 2020, and analyze the relevant data by using the health resources agglomeration degree and population agglomeration degree. Results: At present, at the international level, the number of dentists per 10 000 people ranks 46th in 2010-2019. The quantity of domestic dental resources is on the rise, with a balanced gender distribution and a concentrated age distribution mainly in 25-44 years old. At the specialized technical level, the proportion of junior titles can reach 79.5%-83.0%. The ratio of resource agglomeration of dental practitioners and assistants calculated based on geographical area and population density shows that the ratio of HRAD to PAD in the eastern provinces is greater than 1, while the ratios of most provinces in the central and western regions are less than 1. The eastern regions have excessive allocations, while ones in the central and western regions are insufficient. Conclusions: Unfairness still exists in the allocation of resources for dentists in China. At the national level, it is necessary to continue to cultivate high-quality stomatologists and intensify efforts to support the grass-roots and remote areas. The ability, quality and work competence of on-the-job personnel should be comprehensively improved. Multi-point practice of stomatologists should be standardized and popularized, promoting the rational flow of oral health personnel.
Humans ; Adult ; Dentists ; Professional Role ; Health Resources ; Resource Allocation ; China

OBJECTIVES: Health workers are at risk of workplace violence, which can seriously affects their mental health and work status. This study aims to explore the mediating role of depression between workplace violence and job burnout among healthcare workers. METHODS: From January 10 to February 5, 2019, a questionnaire was distributed to frontline healthcare workers through the wenjuanxing platform using convenient sampling (snowball sampling). The questionnaire included the Chinese version of the Workplace Violence Scale, Maslach Burnout Inventory, and Patient Health Questionnaires (PHQ-2). Descriptive statistics, correlation analysis, and mediation model tests were conducted on the cross-sectional data collection. RESULTS: The study included 3 684 participants, with (31.63±7.69) years old. Among them 2 079(56.43%) were experienced workplace violence, 687(18.65%) were screened positive for depression, and 2 247(60.99%) were experienced high levels of occupational burnout. Correlation analysis showed positive association between workplace violence and depression, workplace violence and occupational burnout, depression and occupational burnout (r=0.135, r=0.107, r=0.335, respectively, all P<0.001). After controlling for covariates, workplace violence had an indirect effect on occupational burnout through depression, with a standardized coefficient of 0.25 (SE=0.02, 95% CI 0.21 to 0.28), accounting for 13.87% of the total effect. CONCLUSIONS The study highlights the close relationship between workplace violence, depression, and occupational burnout among healthcare workers, with depression acting as a mediator between workplace violence and occupational burnout. This study suggests that it is necessary to improve the communication skills of healthcare workers, increase the installation of security systems and emergency plans, use new media platforms to convey positive energy between doctors and patients, and open channels for medical consultation and complaints. It is also necessary to provide guidance for healthcare workers' depressive emotions. Addressing depression among health care workers will help reduce the harm caused by workplace violence, protect the physical and mental health of healthcare workers, and reduce work burnout.
Humans ; Young Adult ; Adult ; Burnout, Professional ; Cross-Sectional Studies ; Depression/epidemiology* ; Workplace Violence ; Burnout, Psychological ; Health Personnel

INTRODUCTION: Healthcare workers (HCWs) are a critical resource in the effort to control the COVID-19 pandemic. They are also a sentinel surveillance population whose clinical status reflects the effectiveness of the hospital's infection prevention measures in the pandemic. METHODS: This was a retrospective cohort study conducted in Singapore General Hospital (SGH), a 1,822-bed tertiary hospital. Participants were all HCWs working in SGH during the study period. HCW protection measures included clinical workflows and personal protective equipment developed and adapted to minimise the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission. HCW monitoring comprised staff contact logs in high-risk locations, twice-daily temperature monitoring, assessment of HCWs with acute respiratory illnesses (ARIs) in the staff clinic and, in the event of an exposure, extensive contact tracing, detailed risk assessment and risk-based interventions. HCW surveillance utilised monitoring data and ARI presentations and outcomes. RESULTS: In the ten-week period between 6 January 2020 and 16 March 2020, 333 (17.1%) of 1,946 HCWs at risk of occupational COVID-19 presented with ARI. 32 (9.6%) screened negative for SARS-CoV-2 from throat swabs. Five other HCWs developed COVID-19 attributed to non-clinical exposures. From the nine COVID-19 exposure episodes investigated, 189 HCW contacts were identified, of whom 68 (36.2%) were placed on quarantine and remained well. CONCLUSION Early in an emerging infectious disease outbreak, close monitoring of frontline HCWs is essential in ascertaining the effectiveness of infection prevention measures. HCWs are at risk of community disease acquisition and should be monitored and managed to prevent onward transmission.
Humans ; COVID-19/epidemiology* ; Pandemics/prevention & control* ; SARS-CoV-2 ; Infectious Disease Transmission, Patient-to-Professional/prevention & control* ; Sentinel Surveillance ; Retrospective Studies ; Infection Control ; Health Personnel

INTRODUCTION: The aim was to study the prevalence of burnout among various groups of healthcare professionals in Singapore. METHODS: An anonymous online survey questionnaire was conducted using the Maslach Burnout Inventory - Human Services to measure three categories of burnout: emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PA) from July 2019 to January 2020 in a healthcare cluster in Singapore. RESULTS: The survey was completed by 6,048 healthcare professionals out of a target survey population of 15,000 (response rate 40.3%). The study revealed 37.8% of respondents had high EE score ≥27, 29.7% of respondents had high DP score ≥10, and 55.3% of respondents had low PA score ≤33. Respondents with either high EE score or high DP score constituted 43.9% (n=2,654). The Allied Health group had the highest mean EE score, which was significantly higher than those of Medical, Nursing and Non-clinical groups (P<0.05). The Medical group had the highest mean DP score and this was significantly higher than the Nursing, Allied Health and Non-clinical groups (P<0.05). The Non-clinical group had the lowest PA, which was significantly lower than the Medical, Nursing and Allied Health groups (P<0.005). CONCLUSION There was high prevalence of burnout among healthcare professionals in Singapore, especially the allied health professionals. There were significant differences in the 3 categories of burnout (EE, DP and PA) among the different groups of healthcare professionals. There is an urgent need to address the high burnout rate.
Burnout, Professional/psychology* ; Delivery of Health Care ; Health Personnel/psychology* ; Humans ; Prevalence ; Singapore/epidemiology* ; Surveys and Questionnaires

Coronavirus Infections ; epidemiology ; prevention & control ; Elective Surgical Procedures ; statistics & numerical data ; Female ; Humans ; Infection Control ; methods ; Infectious Disease Transmission, Patient-to-Professional ; prevention & control ; Male ; Occupational Health ; statistics & numerical data ; Orthopedic Procedures ; methods ; statistics & numerical data ; Outcome Assessment, Health Care ; Pandemics ; prevention & control ; statistics & numerical data ; Patient Safety ; statistics & numerical data ; Pneumonia, Viral ; epidemiology ; prevention & control ; Risk Assessment ; Safety Management ; Singapore ; Wounds and Injuries ; diagnosis ; epidemiology ; surgery

PURPOSE: The purpose of this study was to define and clarify the concept of political competence for nurses.METHODS: A hybrid model method was used to investigate the dimensions, attributes, and definitions of the concept. In the theoretical stage of the study, literature on nursing, politics, and other discipline were reviewed. In the fieldwork stage, individual in-depth interviews and focus groups interviews were conducted with politically seasoned experts or activists who had an understanding of the concept of political competence for extensive descriptions in nursing and field of health care.RESULTS: The concept of political competence was represented in four dimensions as political knowledge, political efficacy, political interaction, and political activity. In the political knowledge dimension, there were three attributes, namely, political knowledge, political information and systematic analysis ability. The political efficacy dimension had three attributes of internal political efficacy, external political efficacy, and self-pride of nursing profession. The political interaction dimension had three attributes of organizations and community service, networking, and persuasive power. The political activity dimension had six attributes of political leadership, political expression, assertive behavior, political advocacy, political participation, and policy intervention.CONCLUSION: This concept development might provide a basic understanding of developing a measurement tool and for constructing a theory promoting nurses' political competence.
Concept Formation ; Delivery of Health Care ; Focus Groups ; Leadership ; Mental Competency ; Methods ; Nursing ; Politics ; Professional Competence ; Seasons ; Social Welfare

COVID-19/transmission* ; Equipment Design ; Health Personnel ; Humans ; Infectious Disease Transmission, Patient-to-Professional/prevention & control* ; Inventions ; Occupational Diseases/prevention & control* ; Pandemics ; Personal Protective Equipment ; Singapore/epidemiology*

PURPOSE: Annual influenza vaccination is the best strategy to prevent healthcare-associated influenza transmission. Influenza vaccination rates among healthcare workers (HCWs) vary by country, region, and year. We investigated the influenza vaccination rates for HCWs during the 2017–2018 influenza season in South Korea, where a non-mandatory vaccination campaign was conducted.METHODS: We retrospectively investigated factors affecting the influenza vaccination rate among HCWs during the 2017–2018 influenza season in three tertiary hospitals in Goyang City, where the non-mandatory influenza vaccination program is conducted.RESULTS: Consequently, 6,994 of 7,180 HCWs (97%) were included, and the overall vaccination rate was 85%. Nurses had the highest rate with 92%, followed by health technicians (88%), physicians (84%), and non-medical HCWs (79%, P<0.001). Vaccination rates differed, depending on the frequency of contact with patients in the non-medical HCWs (frequent contact vs. less-frequent contact; 90% vs. 73%, P<0.001).CONCLUSIONS: The influenza vaccination rate among HCWs during the 2017–2018 influenza season in Korea was 85%, which is among the highest rates compared with previously reported non-mandatory vaccination rates in other countries. The vaccination rate may vary depending on the HCW's occupational characteristics, including the extent of contact with the patient. Therefore, a multifaceted strategy is needed to increase the vaccination rate of HCWs.
Delivery of Health Care ; Humans ; Infectious Disease Transmission, Professional-to-Patient ; Influenza Vaccines ; Influenza, Human ; Korea ; Mass Vaccination ; Retrospective Studies ; Seasons ; Tertiary Care Centers ; Vaccination

Child development refers to the continuous but predictably sequential biological, psychological and emotional changes that occur in human beings between birth and the end of adolescence. Developmental surveillance should be incorporated into every child visit. Parents play an important role in the child's developmental assessment. The primary care physician should educate and encourage parents to use the developmental checklist in the health booklet to monitor their child's development. Further evaluation is necessary when developmental delay is identified. This article aimed to highlight the normal child developmental assessment as well as to provide suggestions for screening tools and questions to be used within the primary care setting.
Adolescent ; Checklist ; Child ; Child Development ; Child, Preschool ; Developmental Disabilities ; diagnosis ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Infant ; Infant, Newborn ; Male ; Parent-Child Relations ; Parents ; psychology ; Physicians, Primary Care ; psychology ; Primary Health Care ; Professional-Family Relations ; Singapore