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.Effects of manipulator operation task and troubleshooting task on blood pressure indexes of oceanauts.
Jiao Jiao QIN ; Lu SHI ; Xuan Yu LI ; Yang Yang LI ; Lei YANG ; Zheng Wei YU
Chinese Journal of Industrial Hygiene and Occupational Diseases 2023;41(2):87-93
Objective: To explore the characteristics and rules of blood pressure changes in oceanauts during simulated operation of manipulator and troubleshooting tasks with different difficulty. Methods: In July 2020, 8 deep-sea manned submersible oceanauts, 6 males and 2 females, were selected as objects. In the 1∶1 model of Jiaolong deep-sea manned submersible, the oceanauts performed manipulator operation tasks and troubleshooting tasks with different difficulties, measured the continuous blood pressure of the oceanauts, filled in the NASA Task Load Index (NASA-TLX scale) after the completion of a single mission, and the changes of systolic pressure (SBP), diastolic pressure (DBP), mean arterial pressure (MAP) and mental workload were analyzed. Results: In a single task, the SBP, DBP and MAP of the oceanauts increased first and then decreased. The blood pressure values at the third minute were significantly lower than those at the first minute (P<0.01), and those at the fifth minute were significantly higher than those at the third minute (P<0.01). When performing the same task, compared with the quiet state, SBP, DBP and MAP increased when the oceanauts performed low difficulty, high difficulty, high difficulty+2-back manipulator operation task and troubleshooting task (P<0.05). When the task difficulty was the same, the SBP and MAP of oceanauts performing manipulator operation tasks were higher than those of oceanauts performing troubleshooting tasks (P<0.05). Compared with low difficulty tasks, the scores of NASA-TLX scale for oceanauts performing high difficulty manipulator operationtasks were significantly higher (P<0.05). Compared with the low difficulty task and high difficulty task, the scale score of the high difficulty+2-back troubleshooting task was significantly higher (P<0.05). When the task difficulty was the same, the scale scores of low difficulty and high difficulty manipulator operation tasks were significantly higher than those of troubleshooting tasks (P<0.05). SBP, DBP, MAP of No. 1, No. 3, No. 4, No. 5, and No. 7 oceanauts (all of whom had 6 years of diving) were positively correlated with NASA-TLX scale scores (r>0.8, P<0.05) . Conclusion: In the process of manned deep-sea diving, when the oceanauts perform manipulator operation tasks and troubleshooting tasks, with the increase of task difficulty, the mental load of oceanauts increases, and the blood pressure index increases significantly in a short time. At the same time, improving the proficiency of operation can reduce the variation range of blood pressure indexes. Blood pressure can be used as an effective reference to evaluate the difficulty of operation and guide scientific training.
Female
;
Male
;
Humans
;
Blood Pressure
;
Diving
;
Workload
8.Analysis of dust monitoring results of dust exposure enterprises in Shenxian from 2017 to 2020.
Guang Qing FU ; Huan Ling YUAN
Chinese Journal of Industrial Hygiene and Occupational Diseases 2023;41(2):123-125
Objective: In order to understand the dust concentration in the workplace of dust exposure enterprises in Shenxian. To evaluate the degree of occupational hazard factors of dust exposure enterprises. And provide basis for the formulation of occupational protection standards and management system of dust exposure enterprises. Methods: In February 2022, the dust concentration monitoring data of 89 dust exposure enterprises from 2017 to 2020 by the Shenxian Center for Disease Control and Prevention were collected, and the qualified rates of dust concentration detection of dust exposure enterprises in different years, dust types and enterprise sizes were analyzed. Results: A total of 89 dust enterprises were monitored from 2017 to 2020, 2132 dust samples were collected, and 1818 qualified samples were taken, with a total qualified rate of 85.3%. From 2017 to 2020, the dust detection qualified rates showed a year-by-year increase trend, 78.7% (447/568), 84.1% (471/560), 88.6% (418/472) and 90.6% (482/532), respectively, with statistically significant differences (χ(2)=36.27, P=0.003). The differences in the qualified rates of dust detection samples of silicon dust (66.1%, 41/62), grain dust (86.7%, 1549/1786), cotton dust (84.1%, 106/126) and wood dust (77.2%, 122/158) were statistically significant (χ(2)=29.66, P=0.002). The qualified rate of dust samples in large and medium-sized enterprises (95.1%, 1194/1256) was higher than that of small-sized enterprises (71.2%, 624/876), and the difference was statistically significant (χ(2)=1584.40, P=0.001) . Conclusion: The qualified rate of dust concentration monitoring results of dust exposure enterprises in Shenxian showed an increase trend year by year, while the pualified rate of dust concentration monitoring in small-sized enterprises was low, and the occupational hazard of silica dust was still severe.
Dust
;
Silicon
;
Wood
;
Workplace
9.Baseline survey of psychosocial factors levels and their health effects in a cohort study of natural gas field workers.
Hui WU ; Jian Zhong SHAO ; Gui Zhen GU ; Fu Ran LI ; Wen Hui ZHOU ; Shan Fa YU
Chinese Journal of Industrial Hygiene and Occupational Diseases 2023;41(3):183-188
Objective: To investigate the level of psychosocial factors in workplace and their health effects among workers in a natural gas field. Methods: A prospective and open cohort of natural gas field workers was established to study the level of workplace psychosocial factors and their health effects, with a follow-up every 5 years. In October 2018, a cluster sampling method was used to conduct a baseline survey of 1737 workers in a natural gas field, including a questionnaire survey on demographic characteristics, workplace psychosocial factors and mental health outcomes, physiological indicators such as height and weight, and biochemical indicators such as blood routine, urine routine, liver function and kidney function. The baseline data of the workers were statistically described and analyzed. The psychosocial factors and mental health outcomes were divided into high and low groups according to the mean score, and the physiological and biochemical indicators were divided into normal and abnormal groups according to the reference range of normal values. Results: The age of 1737 natural gas field workers was (41.8±8.0) years old, and the length of service was (21.0±9.7) years. There were 1470 male workers (84.6%). There were 773 (44.5%) high school (technical secondary school) and 827 (47.6%) college (junior college) graduates, 1490 (85.8%) married (including remarriage after divorce), 641 (36.9%) smokers and 835 (48.1%) drinkers. Among the psychosocial factors, the detection rates of high levels of resilience, self-efficacy, colleague support and positive emotion were all higher than 50%. Among the mental health outcomes evaluation indexes, the detection rates of high levels of sleep disorder, job satisfaction and daily stress were 41.82% (716/1712), 57.25% (960/1677) and 45.87% (794/1731), respectively. The detection rate of depressive symptoms was 22.77% (383/1682). The abnormal rates of body mass index (BMI), triglyceride and low density lipoprotein were 46.74% (810/1733), 36.50% (634/1737) and 27.98% (486/1737), respectively. The abnormal rates of systolic blood pressure, diastolic blood pressure, uric acid, total cholesterol and blood glucose were 21.64% (375/1733), 21.41% (371/1733), 20.67% (359/1737), 20.55% (357/1737) and 19.17% (333/1737), respectively. The prevalence rates of hypertension and diabetes were 11.23% (195/1737) and 3.45% (60/1737), respectively. Conclusion: The detection rates of high level psychosocial factors in natural gas field workers are high, and their effects on physical and mental health remain to be verified. The establishment of a cohort study of the levels and health effects of psychosocial factors provides an important resource for confirming the causal relationship between workplace psychosocial factors and health.
Humans
;
Male
;
Adult
;
Middle Aged
;
Natural Gas
;
Cohort Studies
;
Prospective Studies
;
Oil and Gas Fields
;
Workplace/psychology*
;
Surveys and Questionnaires
10.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

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