1.In my time: A qualitative exploration of the junior doctor experience in Singapore over the years.
Caitlin Alsandria O'HARA ; Nur Haidah Ahmad KAMAL ; En Ci Isaac ONG ; De Wei Isaac CHUNG ; Siew Ngan Faith LIM ; Malcolm Ravindran MAHADEVAN
Annals of the Academy of Medicine, Singapore 2025;54(9):542-560
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
2.Prevalence of impostor phenomenon and burnout in a Singapore health system.
Jun Hui TAN ; Ke Xin EH ; Zheng Jye LING
Singapore medical journal 2025;66(10):540-544
INTRODUCTION:
Impostor phenomenon (IP) is a set of feelings encountered by individuals of being incompetent, despite experiencing successes. IP affects not only individuals on a personal level, but also organisations where the leadership diversity decreases due to employees' self-doubt. We aim to investigate the prevalence of IP and burnout among employees in the National University Health System (NUHS).
METHODS:
All permanently employed full-time NUHS employees aged 21 years and above were invited to participate in this self-administered cross-sectional study between April 2021 and August 2021. Mass emails with the embedded study link were sent every 2-3 weeks to the employees' corporate email accounts.
RESULTS:
In our study, 61% of our study respondents reported having IP experiences and 97% reported having burnout. The associations of IP with ethnicity and age group were significant. Post hoc tests, however, showed that the association was statistically significant only in the 21-29 years age group.
CONCLUSION
We found that there was no statistical significance between gender and the Maslach Burnout Inventory (MBI) profile types. However, we found that IP was significantly associated with individuals in the 21-29 years age group. This could be because younger individuals who just entered workforce may feel uncomfortable with their newfound independence and responsibility. Workplace support, such as workshops, and emotional support were found to be useful in helping individuals cope with IP. Future studies could be done post coronavirus disease 2019 (COVID-19) pandemic among healthcare workers to have a larger sample size to determine true IP and burnout prevalence.
Humans
;
Singapore/epidemiology*
;
Adult
;
Male
;
Female
;
Burnout, Professional/psychology*
;
Cross-Sectional Studies
;
Prevalence
;
Middle Aged
;
Young Adult
;
Surveys and Questionnaires
;
COVID-19/epidemiology*
;
Workplace/psychology*
3.Burnout among COVID-19 hospital-based contact tracers in Singapore: results of a mixed-method, cross-sectional multicentre study.
Ian Matthias NG ; Tzu-Jung WONG ; Yong YANG ; Indumathi VENKATACHALAM ; Jean Xiang Ying SIM ; Liang En WEE ; Tau Ming LIEW ; Evelyn BOON ; Tong Yong NG ; Hwi Kwang HAN ; Diana Yuen Lan TAN
Singapore medical journal 2025;66(12):651-658
INTRODUCTION:
During the coronavirus disease 2019 (COVID-19) pandemic, contact tracers were under immense pressure to deliver effective and timely contact tracing, raising concerns of higher susceptibility to burnout. Our study aimed to determine burnout prevalence among hospital-based contact tracers and associated risk factors, so that interventions to reduce burnout risk could be formulated.
METHODS:
One hundred and ninety-six active contact tracers across three hospitals within a healthcare cluster were invited to complete an anonymous online survey. To identify burntout, data such as demographics, work-related variables and contact tracing-related variables were collected using the Copenhagen Burnout Inventory. Associated factors were identified using multivariate statistics. Open-ended questions were included to understand the challenges and potential improvements through qualitative analysis.
RESULTS:
A total of 126 participants completed the survey, giving a completion rate of 64%, and almost half of these participants (42.9%) reported burnout. Protective factors included being on work-from-home arrangements (adjusted odds ratio [OR] 0.22, 95% confidence interval [CI] 0.08-0.56), perception of being well supported by their institution (adjusted OR 0.25, 95% CI 0.08-0.80) and being married (adjusted OR 0.28, 95% CI 0.12-0.64). Risk factors included having an administrative role pre-COVID-19 (adjusted OR 3.62, 95% CI 1.33-9.83). Work-related burnout was related to being activated for more than 1 day in the preceding week (unadjusted OR 3.25, 95% CI 1.33-7.94) and multiple activations in a day (unadjusted OR 3.54, 95% CI 1.44-4.41). Biggest challenges identified by participants were language barrier (62.7%), followed by workflow-related issues (42.1%).
CONCLUSION
Our study demonstrated burnout and other challenges faced by a team of mostly hospital-based administrative staff redeployed on a part-time basis to ensure timely contact tracing. To mitigate burnout, we recommend choosing staff on work-from-home arrangements and ensuring adequate manpower and rostering arrangements.
Humans
;
COVID-19/epidemiology*
;
Burnout, Professional/epidemiology*
;
Singapore/epidemiology*
;
Female
;
Male
;
Cross-Sectional Studies
;
Adult
;
Middle Aged
;
Risk Factors
;
Surveys and Questionnaires
;
Contact Tracing/methods*
;
SARS-CoV-2
;
Prevalence
;
Pandemics
4.Mediating role of depression between workplace violence and job burnout among healthcare workers.
Xiaohua ZHAO ; Zheng ZHANG ; Zengyu CHEN ; Yusheng TIAN ; Haiyan CHEN ; Jiansong ZHOU
Journal of Central South University(Medical Sciences) 2023;48(6):903-908
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
5.Burnout is associated with amount of work and sleep quality of Public-school dentists in the Caraga Region.
Junhel DALANON ; Yoshizo MATSUKA
Acta Medica Philippina 2022;56(3):49-55
Objectives: Public health dentists in the Philippines are being made to treat more patients and do other tasks despite being underpaid. Despite this, there is a dearth of information on burnout and its association with Filipino public-school dentists. Thus, this study aimed to assess the burnout levels and their association with the amount of work and sleep quality.
Methods: There were 10 out of 14 dentists from the Caraga Region who responded and answered a self-directed and self-reported online questionnaire composed of 52 questions that gauged sociodemographic data, sources of burnout, level of burnout, lower back pain, and sleep quality.
Results: Based on the results of the study, dentists with more than 40,000 patients (rs=0.81, p=0.005), in charge of more than one municipality (rs=0.67, p=0.035) and more than one school (rs=0.67, p=0.035), and with poor sleep (rs=1, p=0.005) experience more burnout.
Conclusion: The level of burnout is high in Filipino public-school dentists. In this study, burnout was associated with dentists who have poor sleep, having to serve more than 40,000 patients, more than one municipality, and more than one school. The legal bases for oral health and other pertinent memorandum orders from concerned government organizations should be revisited.
Burnout, Professional
6.The effectiveness of psychological intervention on nursing staff' compassion fatigue: a meta-analysis.
Wan Qing XIE ; Jia Lin WANG ; Xia LUO ; Ping TANG ; Li ZENG ; Man JIN
Chinese Journal of Industrial Hygiene and Occupational Diseases 2022;40(1):39-45
Objective: To systematically evaluate the impact of psychological intervention on nursing staff' compassion fatigue. Methods: From March to May 2020, PubMed, Cochrane Library, EMbase, Web of Science, CNKI, VIP, Wanfang and other databases were electronically searched to collect randomized controlled trials (RCTs) on the influence of psychological intervention on nursing staff' compassion fatigue with the main search terms including compassion fatigue, nurs*, psychological intervention, mental intervention, RCT and so on from inception to March 31, 2020. Screened literature, extracted data and assessed the risk of bias of included studies. The Stata 16.0 software was used to calculate the pooled effectiveness of psychological intervention on nursing staff' compassion fatigue. Results: All 13 RCTs were enrolled, including 940 nursing staff. Meta-analysis results demonstrated that the psychological intervention group was superior to the control group in the improvement of the compassion fatigue score (SMD=-0.96, 95%CI: -1.17-0.74, P=0.001) , compassion satisfaction score (SMD=0.61, 95%CI: 0.45-0.77, P=0.002) , burnout score (SMD=-0.46, 95%CI: -0.62-0.29, P=0.006) , secondary trauma score (SMD=-0.40, 95%CI: -0.68-0.12, P=0.020) , and the difference was statistically significant. Subgroup analysis found that the psychological intervention group was more effective than the control group in improving compassion satisfaction score, reducing burnout score and secondary trauma score, and the differences were statistically significant (P<0.05) in different intervention time (<8 weeks and ≥8 weeks) and intervention methods. Conclusion: The psychological intervention can improve the level of compassion satisfaction, and reduce the compassion fatigue among nursing staff, and have a certain preventive effect on compassion fatigue.
Burnout, Professional/prevention & control*
;
Compassion Fatigue/prevention & control*
;
Empathy
;
Humans
;
Nursing Staff
;
Psychosocial Intervention
;
Quality of Life
7.The influence of workplace violence on burnout sense in clinical nurses.
Hua WEI ; Yue Juan DONG ; Min HE ; Xiao Mei SHEN ; Yan CHEN
Chinese Journal of Industrial Hygiene and Occupational Diseases 2022;40(1):45-49
Objective: To explore the influence mechanism of intrusive thoughts and ego depletion between effects of workplace violence on burnout sense in clinical nurses. Methods: In May 2019, 10 cities in Henan Province and Fujian Province were selected as sampling cities by the method of grabbing random balls. Using the stratified cluster sampling method, nurses in clinical nursing posts in 22 third class hospitals and 23 second class hospitals were selected as the research objects for a cross-sectional epidemiological survey, including 1200 nurses. A total of 1159 valid questionnaires were collected, and the effective rate was 96.6%. 1159 clinical nurses were investigated by workplace violence scale, event impact scale, self-regulation fatigue scale and job burnout scale. The items contained in the questionnaire were analyzed by exploratory factor analysis with Harman single factor test, and the demographic characteristics of nurses' workplace violence, invasive thinking, self loss and job burnout were compared and analyzed with s-n-k. Results: Those with less than 3 years of service, those with more than 3 years of aggressive thinking and self loss score, and those with less than 3 years of job burnout score; The score of job burnout of unmarried was lower than that of married; The scores of invasive thinking and self loss of non editors were higher than those of current editors; The scores of workplace violence, aggressive thinking, self loss and job burnout of clinical nurses in tertiary hospitals were higher than those in secondary hospitals; The score of job burnout of undergraduate and above is higher than that of junior college and below; The scores of workplace violence, aggressive thinking and self loss of clinical nurses in surgical departments were higher than those in non-surgical departments; The job burnout score of those aged 36 and above was higher than that of those aged <36, The difference was statistically significant (P< 0.05) . Aggressive thinking and self attrition played a mediating role between workplace violence and job burnout. Workplace violence affected job burnout through the single mediating role of aggressive thinking, the single mediating role of self attrition, and the chain mediating role of aggressive thinking self attrition (β=0.16、0.08、0.03, 95%CI: 0.251~0.190、0.121~0.028、0.050~0.012, P<0.05) . Conclusion: Workplace violence affects burnout sense through the independent mediating role of intrusive thoughts and ego depletion and the chain mediating role of intrusive thoughts and ego depletion in clinical nurses.
Adult
;
Aged
;
Burnout, Professional
;
Cross-Sectional Studies
;
Humans
;
Job Satisfaction
;
Nurses
;
Personnel Turnover
;
Surveys and Questionnaires
;
Workplace
;
Workplace Violence
8.Correlation between professional quality of life and social support of Chinese nurses: a meta-analysis.
Li ZENG ; Jia Lin WANG ; Xian Geng ZHANG ; Man JIN ; Ping TANG ; Wan Qing XIE
Chinese Journal of Industrial Hygiene and Occupational Diseases 2022;40(2):122-126
Objective: To systematically evaluate the correlation between professional quality of life and social support of Chinese nurses based on Pearson and Spearman correlation coefficients. Methods: In databases including PubMed, Cochrane Library, CINAHL, Medline, CBM, CNKI、Wanfang, and other databases were searched by computer for the literatures on correlation between Chinese nurses' professional quality of life and social support from January 2005 to July 2020. The Chinese and English search terms are "nurse" "professional quality of life" "empathy satisfaction" "empathy fatigue" "professional quality of life" "ProQOL" "comparison satisfaction" "comparison fatigue" "social support" "competent social support" "SSRS" "PSSS", etc. Literatures were screened according to the inclusion and exclusion criteria. After evaluating quality and extracting data, meta-analysis was conducted using RevMan 5.3 software. Results: A total of 12 studies were included. The meta analysis showed that nurses' compassion satisfaction, burnout, secondary traumatic stress were related to social support, summary r were 0.35, -0.26 and -0.23 respectively. The correlation between compassion satisfaction and social support were increased with sample, the south was higher than the north, and comprehensive departments were higher than other departments (P<0.05) . The correlation between burnout and social support were increased with time and sample, and the south was higher than the north, oncology was higher than others, non-random sampling was higher than random sampling, using ProQOL and Perceived Social Support Scale (PSSS) was higher than Professional Quality of Life Scale (ProQOL) and Social Support Racting Scale (SSRS) (P<0.05) . The correlation coefficient between secondary traumatic stress and social support in oncology was higher than others, random sampling was higher than non-random sampling, using ProQOL and PSSS was higher than ProQOL and SSRS (P<0.05) . Conclusion: There is a positive and weak correlation between compassion satisfaction and social support, and a negative and weak correlation between burnout and secondary traumatic stress and social support. There are differences in different time, research design, region and department.
Burnout, Professional
;
China
;
Cross-Sectional Studies
;
Humans
;
Job Satisfaction
;
Nurses
;
Quality of Life
;
Social Support
;
Surveys and Questionnaires
9.The effect of occupational stress on anxiety of nursing staff in a third-grade general hospital and mediating effect of job burnout.
Yan GAO ; Jun Qin ZHAO ; Yuan Yuan ZHAO ; Chun Xiang ZHAO ; Jin Mei SHI ; Jian Guo LI
Chinese Journal of Industrial Hygiene and Occupational Diseases 2022;40(2):127-131
Objective: To explore the mediating effect of job burnout of nursing staff in clinical departments on occupational stress and anxiety, and to provide scientific basis for the formulation of intervention measures to relieve anxiety. Methods: From November 2020 to January 2021, a cross-sectional survey was conducted to investigate the basic situation, occupational stress, job burnout and anxiety of 653 nursing staff in a third class A general hospital in Hebei Province. Spearman rank correlation was used to analyze the relationship between occupational stress, job burnout and anxiety, stepwise regression and mediating effect model were used to verify the mediating effect of job burnout on the relationship between occupational stress and anxiety. Results: 551 valid questionnaires were collected with effective recovery of 84.38%. The incidence of high occupational stress was 68.06% (375/551) , the incidence of job burnout was 63.70% (351/551) [high, moderate and moderate were 11.07% (61/551) and 52.63% (290/551) respectively], and the incidence of anxiety was 55.72% (307/551) [mild, moderate and severe were 38.11% (210/551) , 8.53% (47/551) and 9.08% (50/551) respectively]. Occupational stress was positively correlated with job burnout and anxiety (r=0.545, 0.479) , and job burnout was positively correlated with anxiety (r=0.542, P<0.05) . The mediating effect analysis showed that occupational stress had a statistically significant effect on anxiety (c=0.509, P<0.001) , and the mediating effect of job burnout on the relationship between occupational stress and anxiety accounted for 44.99% of the total effect. Conclusion: The anxiety level of the nursing staff in this third-class A general hospital was relatively high. Job burnout has a mediating effect between occupational stress and anxiety, and anxiety of nursing staff can be alleviated by reducing occupational stress or job burnout.
Anxiety/epidemiology*
;
Burnout, Professional/epidemiology*
;
Cross-Sectional Studies
;
Hospitals, General
;
Humans
;
Job Satisfaction
;
Nursing Staff
;
Occupational Stress/epidemiology*
;
Surveys and Questionnaires
10.Prevalence of burnout among healthcare professionals in Singapore.
Kok Hian TAN ; Boon Leng LIM ; Zann FOO ; Joo Ying TANG ; Mabel SIM ; Phong Teck LEE ; Kok Yong FONG
Annals of the Academy of Medicine, Singapore 2022;51(7):409-416
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


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