Methodology
This was a cross-sectional retrospective descriptive study involving
doctors and nurses who were on isolation duty from 7 February to 30
April 2020. The Brief Resilience Scale (BRS) was used to evaluate
resilience (S1). This self-rating questionnaire was developed by Smith
et al. in 2008, to measure individuals’ ability to bounce back or
recover from stress4. This concise six-itemed
questionnaire has been validated in many countries to be an accurate and
reliable measure of resilience5-7.
The BRS consists of six statements. Statements 1, 3, and 5 are
positively worded, while statements 2, 4, and 6 are negatively worded.
The BRS is scored by reverse coding items 2, 4, and 6 and finding the
mean of the six statements. Study participants report how strongly they
agree or disagree with the statements. The BRS score is calculated by
dividing the total sum by the total number of questions answered. The
BRS score is classified into 3 categories: low resilience (1.00-2.99),
normal resilience (3.00-4.30) and high resilience (4.31-5.00).
Additional survey questions were added to (i) explore the emotions of
HCW when caring for suspected or confirmed COVID-19 patients, (ii)
identify factors that reduced stress and (iii) determine how they feel
working in isolation teams has affected their health (S2). Participants
could choose more than one option for selected questions. The questions
and content in the survey were developed following discussion between
study investigators and key departmental leaders. The survey was piloted
on junior doctors to ensure ease of use and understanding prior to
distribution to participants. All HCWs who completed isolation duties
were invited to participate in this study. Survey responses were
anonymous to ensure confidentiality.
Completed surveys were consolidated at the end of the study period.
Incomplete surveys were excluded. The responses were transcribed into
Microsoft Excel. The BRS mean was analysed with paired T-test and
one-way analysis of variance (ANOVA) using IBM SPSS Statistics software
version 22. The p-value of less than 0.05 was taken as statistically
significant. The qualitative data was summarized into themes and
categories. This study was approved by the SingHealth Centralised
Institutional Review Board (CIRB), reference number 2020/2471.