Year 2021
October 2021


Abstract Title
Exploring resilient and vulnerable experiences of healthcare workers (HCW) in Singapore: a qualitative study of e-journaling shared while delivering health care under COVID-19 duress



National University of Singapore1, Tan Tock Seng Hospital2 

Background & Hypothesis

Healthcare workers (HCWs) in Singapore have been subjected to challenging personal and professional circumstances within a climate of rapid change, uncertainty and fear during the COVID-19 pandemic.


Using an ‘e-journaling’ approach we interpret e-diary entries, comments, poems and multimedia data shared by healthcare workers as they navigated the early phases of the outbreak in Singapore (from July to August 2020). 

N=663 submitted short qualitative written or multimedia journal entries. All professional cadres and range of nationalities participated. Themes were organised according to the Loads-Levers-Lifts model of resilience.


Loads under COVID-19 duress: The most common load undermining HCW mental health was expressed in a collection of themes describing degrees of anxiety, at times near crippling. In addition, the physical separation from loved ones, or isolation, and having to deal with ‘interrupted normality’, left many HCW feeling bereft. Still more wrote about experiencing heightening of emotions. Some expressed that they were unable to accept the situation. As such, they described a sense of disbelief, hopelessness or simply arriving at a state of numbness, hoping that the situation would end. 

Lifts under COVID-19 duress: The most common lift which sustained HCW mental health was conveyed though expressions of stoicism.

Discussion & Conclusion

The Loads-Levers-Lifts model of resilience assumes that resilience is a dynamic process that can change according to factors that weight towards mental health vulnerability or ones that can lift it in the face of COVID-19 duress. Levers, in the form of interventions designed to reduce loads and increase lifts in HCW, are proposed.