Journal Article Epublish
PubMed: 42793484 DOI: 10.3390/healthcare14182947
Psychological Distress Among Primary Care Professionals in Singapore: Repeated-Measures Analyses of Two Independent Observation Windows (HADS and GHQ-12).
Healthcare (Basel) 14(18)
Authors: Sky Wei Chee Koh, Yixuan Chuah, Si Hui Low, Alicia Ying Ying Boo, Thomas Soo, Yii Jen Lew, Howard Bauchner, Lynette Mei Lim Goh
Affiliations
- National University Polyclinics, National University Health System, Singapore 119228, Singapore.
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore.
- National University Polyclinics, National University Health System, Singapore 119228, Singapore. School of Physical and Mathematical Sciences, Nanyang Technological University, Singapore 639798, Singapore.
- Department of Health & Wellness, Ng Teng Fong General Hospital, National University Health System, Singapore 609606, Singapore.
- Avedisian School of Medicine, Boston University Chobanian, Boston, MA 02118, USA.
Abstract
Background: Healthcare professionals in Singapore's primary care face sustained workload pressures and increasing complexity. Grounded in the Job Demands-Resources model, this study identifies demographic, clinical, and lifestyle factors associated with psychological distress among staff across two independent windows spanning the pre- and post-pandemic periods. Methods: The study was conducted among staff in National University Polyclinics (NUP) Singapore. De-identified health screening data included demographics, occupation, clinical measures, medical history, and lifestyle behaviours. Primary outcome was psychological distress, assessed across 2 distinct observation windows: the Hospital Anxiety and Depression Scale (HADS) from 2018-2022 (abnormal ≥ 8) and the General Health Questionnaire-12 (GHQ-12) from 2023-2025 (abnormal ≥ 2). Multivariate mixed-effects logistic regression identified factors associated with psychological distress while accounting for within-person clustering. Results: We analysed 3307 screening visits from 1260 staff. Within the HADS observation window (2018-2022), abnormal scores were significantly higher in 2022 compared with 2018 (OR 2.28, 95% CI 1.64-3.17). Within the GHQ-12 observation window (2023-2025), a non-significant decline in abnormal scores was observed. Older age (2018-2022: OR 0.967, 95% CI 0.948-0.987; 2023-2025: OR 0.955, 95% CI 0.928-0.983) and regular exercise (2018-2022: OR 0.724, 95% CI 0.529-0.991; 2023-2025: OR 0.357, 95% CI 0.231-0.551) were consistently associated with lower odds of distress. Medical staff had significantly lower odds of distress compared to ancillary staff in 2018-2022 (OR 0.391, 95% CI 0.207-0.739). Regular alcohol use was associated with higher distress in 2018-2022 (OR 1.56, 95% CI 1.05-2.31), while active smoking (OR 5.79, 95% CI 1.75-19.10) and family history of chronic disease (OR 2.22, 95% CI 1.28-3.87) were significant in 2023-2025. Conclusions: Older age and regular exercise were consistently associated with lower odds of psychological distress across both windows, while ancillary staff and alcohol use (HADS window), and smoking and family history of chronic disease (GHQ-12 window) were period-specific determinants. These findings support the implementation of proactive, targeted wellness initiatives alongside the routine mental health surveillance among primary care staff.
MeSH
Exercise, Chronic Disease, Life Style, Psychological Distress, History, Smoking, Mental Health, Demography