Coping responses of emergency physicians and nurses to the 2003 severe acute respiratory syndrome outbreak
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Objectives: During the 2003 severe acute respiratory syndrome (SARS) outbreak, health care workers (HCWs) experienced unusual stressors. The study hospital introduced psychosocial interventions to help HCWs. This study aimed to examine the coping strategies adopted by the emergency department (ED) HCWs who cared for the SARS patients. Methods: In November 2003, a self‐administered questionnaire of physicians and nurses was conducted in the hospital ED that is the national SARS screening center in Singapore. Data collected included demographics and responses to these instruments: 1) the Coping Orientation to Problems Experienced (COPE) to assess coping strategies, 2) the Impact of Event Scale (IES) to measure psychological reactions, and 3) the General Health Questionnaire 28 (GHQ 28) to measure psychiatric morbidity. Results: Thirty‐eight of 41 (92.7%) physicians and 58 of 83 (69.9%) nurses responded. The respondents reported a preference for problem‐focused and emotion‐focused coping measures. The physicians chose humor as a coping response significantly more frequently (p < 0.001) than nurses, scoring 9.61/16 (95% CI = 8.52 to 10.69), compared with the nurses' score of 7.05/16 (95% CI = 6.28 to 7.83). The Filipino HCWs turned to religion as a coping response significantly more frequently (p < 0.001) than the non‐Filipino HCWs, scoring 14.38/16 (95% CI = 13.33 to 15.42), compared with 9.93/16 (95% CI = 9.00 to 10.87) for the non‐Filipinos. Psychiatric morbidity was 17.7% on the IES and 18.8% on the GHQ 28, with the trend for physicians to report lower psychiatric morbidity. Conclusions: With a supportive hospital environment, ED HCWs chose adaptive coping in response to the outbreak and reported low psychiatric morbidity. Physicians chose humor and Filipinos chose turning to religion as their preferred responses. Psychosocial interventions to help HCWs need to take these preferences into account.
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Participants were instructed to rate their symptoms and coping measures specifically with respect to their SARS experiences, following methods used in other studies.
“The participants had all been instructed to rate their symptoms and coping measures based on their experiences specifically with respect to SARS akin to similar methods used in other studies [16], [32].”
From Psychosocial and coping responses within the community health care setting towards a national outbreak of an infectious disease (2010) · cites this paper as [32]
The observed rate of SARS-related psychiatric morbidity was consistent with the range of rates (18.8% to 75.3% using GHQ) reported in hospital health care workers and SARS survivors.
“was consistent with the range of found rates of SARS-related psychiatric morbidity (ranging from 18.8% to 75.3% using GHQ) assessed in health care workers working within the hospitals [32], [33] as well as survivors of SARS [16].”
From Psychosocial and coping responses within the community health care setting towards a national outbreak of an infectious disease (2010) · cites this paper as [32]
The finding of less substance use is in line with a previous local study of coping responses of emergency room staff but contrary to previous studies that noted increased substance use in individuals facing stress.
“The less use of substance in our study is in line with a previous local study of coping responses of staff within an emergency room setting [32] but is contrary to the findings of some previous studies [44], [45], which had noted increased substance use in individuals facing stress.”
From Psychosocial and coping responses within the community health care setting towards a national outbreak of an infectious disease (2010) · cites this paper as [32]
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- Authors
- Phua, D. H., Tang, H. K., & Tham, K. Y.
- Affiliations
- Tan Tock Seng Hospital (SG)
- ORCID
- Phua, D.H.
- Venue
- Academic Emergency Medicine
- Publisher
- Wiley
- Published
- 2005-04
- Volume
- 12
- Issue
- 4
- Pages
- 322-328
- ISSN
- 1069-6563 (ISSN-L)
- 1553-2712
- OpenAlex
- W2075316770
- Cited by
- 176
- References
- 31
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 8 · 2023: 16 · 2022: 24 · 2021: 59 · 2020: 49 · 2019: 2 · 2018: 1 · 2016: 1 · 2012: 1
- FWCI
- 3.86
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Academic Emergency Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Burnout
- Keywords
- SARS epidemic, coping strategies, healthcare workers, emergency physicians, emergency department nurses, psychiatric morbidity, psychological stress, humor as coping, religious coping, psychosocial interventions, emergency department
- MeSH terms
- Workforce, Adaptation, Psychological, Adolescent, Adult, Disease Outbreaks, Emergency Medicine, Emergency Service, Hospital, Female, Humans, Male, Medical Staff, Hospital, Middle Aged, Nursing Staff, Hospital, Religion, Singapore, Stress, Psychological, Wit and Humor as Topic, Emergency Nursing, Severe Acute Respiratory Syndrome
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