1.Development of the modified Safety Attitude Questionnaire for the medical imaging department.
Ravi Chanthriga ETURAJULU ; Maw Pin TAN ; Mohd Idzwan ZAKARIA ; Karuthan CHINNA ; Kwan Hoong NG
Singapore medical journal 2025;66(1):33-40
INTRODUCTION:
Medical errors commonly occur in medical imaging departments. These errors are frequently influenced by patient safety culture. This study aimed to develop a suitable patient safety culture assessment tool for medical imaging departments.
METHODS:
Staff members of a teaching hospital medical imaging department were invited to complete the generic short version of the Safety Attitude Questionnaire (SAQ). Internal consistency and reliability were evaluated using Cronbach's α. Confirmatory factor analysis (CFA) was conducted to examine model fit. A cut-off of 60% was used to define the percentage positive responses (PPR). PPR values were compared between occupational groups.
RESULTS:
A total of 300 complete responses were received and the response rate was 75.4%. In reliability analysis, the Cronbach's α for the original 32-item SAQ was 0.941. Six subscales did not demonstrate good fit with CFA. A modified five-subscale, 22-item model (SAQ-MI) showed better fit (goodness-to-fit index ≥0.9, comparative fit index ≥ 0.9, Tucker-Lewis index ≥0.9 and root mean square error of approximation ≤0.08). The Cronbach's α for the 22 items was 0.921. The final five subscales were safety and teamwork climate, job satisfaction, stress recognition, perception of management and working condition, with PPR of 62%, 68%, 57%, 61% and 60%, respectively. Statistically significant differences in PPR were observed between radiographers, doctors and others occupational groups.
CONCLUSION
The modified five-factor, 22-item SAQ-MI is a suitable tool for the evaluation of patient safety culture in a medical imaging department. Differences in patient safety culture exist between occupation groups, which will inform future intervention studies.
Humans
;
Surveys and Questionnaires
;
Patient Safety
;
Attitude of Health Personnel
;
Diagnostic Imaging
;
Reproducibility of Results
;
Male
;
Female
;
Adult
;
Job Satisfaction
;
Factor Analysis, Statistical
;
Middle Aged
;
Hospitals, Teaching
;
Safety Management
;
Organizational Culture
;
Medical Errors/prevention & control*
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.Health profile of workers from different industries in Singapore.
Sin Eng CHIA ; Mei Ling TAN ; Elise CHEOK ; Peh Woon ONG
Singapore medical journal 2025;66(5):271-277
INTRODUCTION:
Workplace safety and health are interrelated - a worker who is not healthy may cause safety lapses at the workplace; conversely, safety lapses could affect the health of the workers. This study was part of a larger Total Workplace Safety and Health (WSH) programme run by the Workplace Safety and Health Council, Singapore. The objectives were to obtain a baseline health profile of workers across four major industries and identify important health risks for targeted workplace interventions.
METHODS:
Five service providers (SPs) were appointed to run the Total WSH programme. As part of the programme, SPs conducted an anonymous basic health survey among workers of participating companies.
RESULTS:
The responses of 6,373 respondents from the cleaning, construction, manufacturing, and transport and storage industries were studied. The overall response rate was 62%. Key health issues identified were high rates of obesity (22%) and smoking (24%) and low prevalence of regular exercise and healthy dietary habits. Chronic disease rates were similar to population self-reported rates (hypertension 15%, high lipid 12% and diabetes mellitus 6%). The workers reported high work stress (13%).
CONCLUSION
Health issues are prevalent in the workforce and may affect work and employee safety. It is increasingly important for employees' health to be considered in risk assessments and prioritised in workplace safety and health management systems and strategies. Health promotion interventions should be targeted, and multilevel and multicomponent initiatives should be integrated with pre-existing occupational safety programmes.
Humans
;
Singapore/epidemiology*
;
Occupational Health
;
Male
;
Female
;
Adult
;
Middle Aged
;
Industry
;
Workplace
;
Health Surveys
;
Surveys and Questionnaires
;
Smoking/epidemiology*
;
Obesity/epidemiology*
;
Health Status
;
Occupational Stress/epidemiology*
;
Young Adult
4.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
5.Scale development and validation of perimenopausal women disability index in the workplace.
Kyoko NOMURA ; Kisho SHIMIZU ; Fumiaki TAKA ; Melanie GRIFFITH-QUINTYNE ; Miho IIDA
Environmental Health and Preventive Medicine 2024;29():4-4
BACKGROUND:
Menopausal disorders include obscure symptomatology that greatly reduce work productivity among female workers. Quantifying the impact of menopause-related symptoms on work productivity is very difficult because no such guidelines exist to date. We aimed to develop a scale of overall health status for working women in the perimenopausal period.
METHODS:
In September, 2021, we conducted an Internet web survey which included 3,645 female workers aged 45-56 years in perimenopausal period. We asked the participants to answer 76 items relevant to menopausal symptomatology, that were created for this study and performed exploratory and confirmatory factor analyses for the scale development. Cronbach's alpha, receiver operating characteristic analysis, and logistic regression analysis were used to verify the developed scale.
RESULTS:
Approximately 85% participants did not have menstruation or disrupted cycles. Explanatory factor analysis using the maximum likelihood method and Promax rotation identified 21 items with a four-factor structure: psychological symptoms (8 items, α = 0.96); physiological symptoms (6 items, alpha = 0.87); sleep difficulty (4 items, alpha = 0.92); human relationship (3 items, alpha = 0.92). Confirmatory factor analyses found excellent model fit for the four-factor model (RMSR = 0.079; TLI = 0.929; CFI = 0.938). Criterion and concurrent validity were confirmed with high correlation coefficients between each of the four factors, previously validated menopausal symptom questionnaire, and Copenhagen Burnout Inventory scales, respectively (all ps < 0.0001). The developed scale was able to predict absenteeism with 78% sensitivity, 58% specificity, and an AUC of 0.727 (95%CI: 0.696-0.757). Higher scores of each factor as well as total score of the scale were more likely to be associated with work absence experience due to menopause-related symptoms even after adjusting for Copenhagen Burnout Inventory subscales (all ps < 0.0001).
CONCLUSION
We found that the developed scale has high validity and reliability and could be a significant indicator of absenteeism for working women in perimenopausal period.
Humans
;
Female
;
Perimenopause
;
Reproducibility of Results
;
Menopause/psychology*
;
Workplace
;
Surveys and Questionnaires
;
Psychometrics
6.Impact of nationwide COVID-19 lockdown on workload and injury patterns of major trauma cases in a regional trauma centre in Singapore.
Min Li KANG ; Woan Wui LIM ; Daniel Jin Keat LEE ; Jerry Tiong Thye GOO
Singapore medical journal 2023;64(11):677-682
INTRODUCTION:
Singapore instituted lockdown measures from 7 February 2020 to 1 June 2020 in response to the coronavirus disease 2019 (COVID-19) pandemic.
METHODS:
A retrospective analysis of cases from the national trauma registry was carried out comparing the lockdown period (from 7 February 2020 to 1 June 2020) to the pre-lockdown period (from 7 February 2019 to 1 June 2019). Data extracted included the volume of Tier 1 (injury severity score [ISS] >15) and Tier 2 (ISS 9-15) cases and epidemiology. Subgroup analysis was performed for Tier 1 patient outcomes.
RESULTS:
Trauma volume decreased by 19.5%, with a 32% drop in Tier 1 cases. Road traffic and workplace accidents decreased by 50% (P < 0.01), while interpersonal violence showed an increase of 37.5% (P = 0.34). There was an 18.1% decrease in usage of trauma workflows (P = 0.01), with an increase in time to intervention for Tier 1 patients from 88 to 124 min (P = 0.22). Discharge to community facilities decreased from 31.4% to 17.1% (P < 0.05). There was no increase in inpatient mortality, length of stay in critical care or length of stay overall.
CONCLUSION
There was an overall decrease in major trauma cases during the lockdown period, particularly road traffic accidents and worksite injuries, and a relative increase in interpersonal violence. Redeployment of manpower and hospital resources may have contributed to decreased usage of trauma workflows and community facilities. In the event of further lockdowns, it is necessary to plan for trauma coverage and maintain the use of workflows to facilitate early intervention.
Humans
;
COVID-19/epidemiology*
;
Trauma Centers
;
Retrospective Studies
;
Singapore/epidemiology*
;
Workload
;
Communicable Disease Control
7.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
8.Salutogenic factors and hospital work environments: A cross-sectional study in a small Portuguese hospital.
Andre Rafael Coutinho Faria ; Jani de Oliveira Carvalho ; Maria Margarida Silva Vieira Ferreira ; Diogo Guedes Vidal ; Joana Margarida Pinheiro Teixeira
Philippine Journal of Nursing 2023;93(1):57-65
BACKGROUND AND AIM:
A healthy work environment is one in which workers and managers cooperate in the process of continuous
improvement regarding the protection, and promotion of workers' health and well-being, for the sake of work sustainability. The
current state of the art shows that an unfavourable work environment contributes to nurses' dissatisfaction, burnout and
emotional exhaustion, and the intention to leave the workplace/service. This study aimed to identify the Nurses' Work
Environment in a small Portuguese Hospital, diagnose the situation, and focus on a healthy work environment.
METHODS AND MATERIALS:
This is a quantitative, descriptive, and cross-sectional study, with a convenience sample of 90 nurses.
The “Escala de Ambiente de Trabalho da Prática de Enfermagem” (Nursing Practice Work Environment Scale), validated and
adapted by Ferreira & Amendoeira (2014) for the Portuguese population, was applied. The statistical treatment was performed
using SPSS 27.
RESULTS:
The sample is mostly composed of female nurses (87%) with an average age of 26 years, and 75.5% are single. The
dimension "Management and Leadership of the Head Nurse" had a mean value of x̅ =3.3 (out of 4) and σ=0.5, which was the
dimension with the best assessment. The dimension with less encouraging results was "Nurses' Participation in Hospital Affairs"
with x̅ =2.8 (out of 4) and σ=0.7. Overall, all domains assessed had a mean value above 2.5, which was considered a favourable
work environment by the nurses.
CONCLUSION
The results, although generally satisfactory, show the need to carefully intervene and assess each dimension in an
integrated perspective, to promote a healthy work environment and workers' well-being, since its imbalance may negatively affect
quality of their work, impacting the quality of health care provided to the user . In addition, these results should be understood as
an important factor to be considered in the design of future care teams. Regardind future research, it would be important to
consider large samples and deepen the topic explored among different departments in the health care facilities.
Nurses
;
Workplace
;
Health Promotion
9.Analysis of the status of occupational disease prevention and control of enterprises in mining and manufacturing industries in China in 2019.
Jin Nan ZHENG ; Yue YU ; Si Yu ZHANG ; Xie Yi DU ; Hong Fei WANG ; Wei Jiang HU
Chinese Journal of Industrial Hygiene and Occupational Diseases 2023;41(5):338-344
Objective: To analyze the status of prevention and treatment of occupational diseases among mining and manufacturing industries in China in 2019, provide the scientific basis for the formulation and revision of policies and standards of prevention and treatment of occupational diseases. Methods: In May 2022, Collecting data of a project named Surveillance of Occupational Hazards in the Workplace in 2019 through the National Surveillance System for Occupational Hazards in the workplace. Compare the status of prevention and treatment of occupational diseases in 63 563 enterprises of mining and manufacturing industries among different dimensions. Results: The training rate of managers was 76.17% and that of occupational health managers was 76.97%. The rate of reporting of occupational diseases hazardous items was 67.58%, the rate of launching of the detection of occupational hazards was 57.16%, and the rate of launching of occupational health examination was 62.42%. Excluding the distribution rate of dust mask, the installation rate of various occupational prevention facilities and the distribution rate of gas mask and hearing protector were less than 80%. The differences in all the indicators among different areas, enterprise scales, economic types were statistically significant (P<0.05) . Conclusion: There are still some enterprises which are relatively weak in the ability of the prevention and treatment of occupational diseases in China. Measures such as special support, guidance and strengthen supervision should be taken towards those enterprises toimprove the awareness of prevention and treatment of occupational diseases and the level of that.
Humans
;
Occupational Exposure
;
Occupational Diseases/prevention & control*
;
Manufacturing Industry
;
Workplace
;
China/epidemiology*
;
Occupational Health
10.Determination of misoprostol in workplace air by high performance liquid chromatography.
Wei ZHAO ; Shuang SONG ; Hui Fang YAN
Chinese Journal of Industrial Hygiene and Occupational Diseases 2023;41(6):457-460
Objective: To establish a high performance liquid chromatography method for the determination of misoprostol in workplace air. Methods: From February to August 2021, the misoprostol in the workplace air was collected by glass fiber filter membrane, and theeluent was separated by C18 liquid chromatography column, determined by UV detector, and quantified by external standard method. Results: The quantitative lower limit of misoprostol determination method was 0.05 μg/ml, and the lowest quantitative concentration was 1.4 μg/m(3) (calculated by collecting 75 L air sample). The concentration of misoprostol has a good linear relationship between 0.05 to 10.00 μg/ml. The relative coefficient was 0.9998. The regression equation of the standard working curve was y=495759x-45257. The range of average recovery rates were from 95.5% to 102.8%. The intra-assay precision of the method was 1.2%-4.6%, and the inter-assay precision was 2.0%-5.9%. The samples could be stored stably for 7 days at 4 ℃. Conclusion: The high performance liquid chromatography method for the determination of misoprostol has high sensitivity, good specificity and simple procedure of sample pretreatment. It is suitable for the detection of misoprostol in the workplace air.
Chromatography, High Pressure Liquid/methods*
;
Misoprostol/analysis*
;
Air Pollutants, Occupational/analysis*
;
Workplace
;
Chromatography, Liquid


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