Cover JulAug15 V9.indd - National Healthcare Group

Transcription

WINNER
AWARD OF EXCELLENCE
Lifewise
APEX 2015
J U L
AU G
2 01 5
ISSUE
no.58
ELDERLY
AND ACTIVE
The road to getting t
t
can begin at any age
A NIGHT
TO REMEMBER
R
NHG’s birthday
celebration
Consume
when hot
Tips to reheating
food safely p32
de-stress
with a
tune
WHY MUSIC
SOOTHES BODY,
MIND AND SOUL
HARRIS ABDUL RAZAK >
RADIOGRAPHER,
NATIONAL HEALTHCARE GROUP
DIAGNOSTICS
LIFESPACES
Cover JulAug15 V9.indd C1
> AVOID A PAINFUL SLIP-UP IN THE BATHROOM p28
7/2/15 1:35 PM
Lifewise Ads.indd 5
8/27/14 5:53 PM
Lifewise
CONTENTS
J U L- A U G 2 0 1 5 I S S U E no . 5 8
features
10 A NIGHT TO
REMEMBER
The National
Healthcare Group
celebrated its 15th
birthday as ONE Family.
14 COVER STORY
GET IN TUNE WITH
YOUR FEELINGS
Music can have a profound
effect on mental and
physical well-being.
18 MEN AT MIDLIFE
Why does the libido seem
to be the first to go?
20 MORE ACCESSIBLE
MENTAL HEALTHCARE
General Practitioners play a vital
role in reintegrating patients with
mental
illness into
m
the
t community.
18
14
22 DYING WITH DIGNITY
Palliative care can bring
peace amid the prospect of
an otherwise painful death.
24 IN PERSON
Get to know the Chief Nurses
of Tan Tock Seng Hospital and
the Institute of Mental Health.
NHG IS THE REGIONAL HEALTH SYSTEM FOR CENTRAL SINGAPORE
1-3 Contents Ed Note V3.indd 1
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Lifewise
CONTENTS
J U L- A U G 2 0 1 5 I S S U E n o . 5 8
26 NEVER TOO LATE TO START
How exercise can boost a senior’s
physical and mental health.
28 AVOID A BAD TIME
AT BATH TIME
Prevent a slip-up and keep things
squeaky-clean with these tips.
30 FITNESS TO A TEE
Golfing can be more beneficial for
your health than you think.
32 WORTHY OF HEATING UP
Be aware of the need to store
leftovers properly and warm them
up thoroughly before consumption.
34 LOCALISING POSITIVE
MENTAL HEALTH
32
Measuring positive
mental health by taking
king
into account uniquely
y
Singaporean traits.
26
regulars
30
2
Lifewise
EDITOR’S NOTE
NEWSROOM
ASK THE EXPERTS
SPOTLIGHT/NHG NEWS
NHG DIRECTORY
03
04
36
40
48
J U L- A U G 2 0 1 5
7/2/15 1:47 PM
WINNER
AWARD OF EXCELLENCE
Lifewise
APEX 2015
J U L
AU G
2 01 5
ISSUE
no.58
ELDERLY
AND ACTIVE
The road to getting ît
ît
can begin at any age
A NIGHT
TO REMEMBER
R
NHG’s birthday
celebration
Consume
when hot
Tips to reheating
food safely p32
de-stress
with a
tune
ON THE COVER:
HARRIS ABDUL RAZAK
WHY MUSIC
SOOTHES BODY,
MIND AND SOUL
PHOTOGRAPHER KELVIN CHIA
ART DIRECTION DON LEE
STYLING SHEH
HAIR & MAKEUP MELISSA YEO
CLOTHES H&M AND UNIQLO
HARRIS ABDUL RAZAK >
RADIOGRAPHER,
DIAGNOSTICS
LIFESPACES
> AVOID A PAINFUL SLIP-UP IN THE BATHROOM p28
Cover JulAug15 V9.indd C1
6/30/15 6:43 PM
Listen to
your heart
E
EDITORIAL
Wong Fong Tze, WilliamƬNg, JasonƬChiew,
HamidahƬAidillah, Praveen Nayago, NgƬSi Jia,
NathalieƬNg, ElizabethƬSim, Clara Poh, Clara Lim
LIFEWIS E ADV IS OR Y PA NE L
A/Prof Lim Tock Han, A/Prof Thomas Lew,
A/Prof Chua Hong Choon,
A/Prof Chong Phui-Nah, Prof Roy Chan
MEDIACORP PTE LTD
EDITORIAL & DES I GN
Supervising Senior Editor
Senior Editor
Editor
Assistant Editor
Art Director
Senior Writers
Senior Photographer
Photographer
Agatha Koh Brazil
Ronald Rajan
Amir Ali
Chia Ee Khim
Don Lee
Fairoza Mansor
Wanda Tan
Kelvin Chia
Mark Lee
CONTRIBUTOR S
Ashutosh Ravikrishnan, Elisabeth Lee,
David Loh, Ang Jo Ann
BUS INES S DEV ELOPME NT
Senior Business
Relationship Manager
Michele Kho
[email protected]
For advertisement enquiries, please email:
[email protected]
For subscription enquiries, please email:
[email protected]
Eve r y c a re h a s b e e n t a ke n i n t h e p ro d u c t i o n o f t h i s
magazine, but National Healthcare Group (NHG), the
publisher, editor and employees assume no responsibility
for any errors, inaccuracies or omission arising thereof.
Opinions expressed by contributors and advertisers are
not necessarily those of NHG, the publisher or the editor.
The information produced is for reference and educational
purposes only. As each person’s medical condition is
unique, you should not rely on the information contained
in this magazine as a substitute for personal medical
attention, diagnosis or hands-on treatment. If you are
concerned about your health or that of your child, please
consult your family physician or healthcare professional.
VEN IF YOU DID NOT KNOW IT as a
medical fact, you may have noticed that
listening to music can influence your emotions and
affect your psyche. What you might not know is that
listening to and playing music can have physical
and neurological effects as well, even altering the
shape of the brain. And while it would be hard to
know just how our cover model Harris Abdul Razak
has changed as the result of his musical endeavours,
he can attest to being more relaxed when playing
the guitar and piano. Read about how music might
affect you on page 14.
Like music, hormones affect the body in profound
ways. For example, if you are a man reaching middle
age and feel you might be losing your ‘mojo’, this
could be because of a testosterone deficit. Find out on
page 18 how this can be managed.
Not quite so easy to mitigate though, particularly
in later life, are the long-term effects of a sedentary
lifestyle. Thankfully, it is never too late to begin
exercising, as you will learn in our Silverglow feature
on page 26. There are plenty of ways to go about
starting an exercise regime. This is especially true if
you embark on a fitness plan with friends or family.
Speaking of family, this year the National
Healthcare Group (NHG) celebrates its 15th anniversary
as ONE Family. To commemorate the occasion, a
gala dinner was held at Resorts World Sentosa with
over 3,000 staff in attendance (page 10). Group CEO
Professor Philip Choo also unveiled a new model of
care for NHG — one that is sustainable relationshipbased healthcare. This means a shift in focus “from
illness care to wellness care”; a system in which
individuals are cared for by multi-disciplinary teams.
This is a milestone moment for NHG. Indeed,
this August marks a milestone month for the entire
nation, as Singapore reaches its 50th anniversary as
an independent nation. So, here’s wishing all readers
a happy SG50!
THE EDITORIAL TEAM
Copyright © is held by the publishers. All rights reserved.
Reproduction in whole or in part without permission is prohibited.
Printed in Singapore by KHL Printing, www.khlprint.com.sg.
MCI (P) 058/11/2014.
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newsroom
SNIPPETS FROM THE HEALTHCARE WORLD
ONCOLOGY
WHEN BAD BREATH = CANCER
THE NEW ‘NANOARRAY’
BREATH TEST CAN DISTINGUISH
CANCEROUS SAMPLES FROM
NON-CANCEROUS ONES
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PHARMACOLOGY
An ancient
cure for a
modern bug
Historians and
microbiologists at the
University of Nottingham
in the United Kingdom
may have found the key to
defeating the Methicillinresistant Staphylococcus
aureus (MRSA) “superbug”.
The 10th century remedy
was discovered in an ancient
medical textbook, and
contains two species of
allium (which include garlic
and onion), wine and cow
bile. The team recreated the
potion using wine from a
vineyard that existed when
the book was written and
found that it killed up to
90 per cent of MRSA bacteria
in samples from mice.
While the researchers
are not entirely certain how
the potion works, they hope
it might hold the key for a
new class of antibiotics that
will prove effective against
MRSA. Microbiologist
Dr Freya Harrison who led
the study said, “When we
got the first results we were
just utterly dumbfounded.
We did not see this coming
at all.”
PHOTOS: CORBIS, SHUTTERSTOCK
S cientists have developed a simple breath test that can sniff out precancerous changes in the gut, according to a study published in the journal
Gut. Researchers studied breath samples from 145 patients — 30 of whom
were already known to have stomach cancer — with worrying gut symptoms.
The new “nanoarray” breath test can identify minute chemical compounds
linked to pre-cancerous developments in each patient’s unique breath signature.
Sufferers of stomach cancer have a low survival rate because diagnosis often
comes too late, as early symptoms such as indigestion and pain can be mistaken
for other diseases. The new test can distinguish cancerous samples from noncancerous ones, and can also identify pre-cancerous changes, though less
accurately. A larger study is now underway in Europe.
J U L- A U G 2 0 1 5
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GENETICS
Some of us will
always be bigger
R
esearchers
say they have
proven that
individual biology
affects how easy it is to
lose weight. A recent
study conducted by the
metabolic unit of the
Phoenix Epidemiology
and Clinical Research
Branch (PECRB) at the
National Institute of
Health in the US state
of Arizona worked
with 12 obese men and
women who displayed
varying levels of
baseline metabolism.
After a day of fasting,
metabolism was
measured again.
Participants were
then put on a sixweek diet involving a
50-per-cent reduction
in calories. Those
whose metabolism
went down during the
fasting day lost the
least weight during
the six weeks of
dieting. This indicated
that some had faster
metabolism than
others. The study’s
author and PECRB
clinical investigator
Dr Susanne Votruba
said, “When people
who are obese decrease
the amount they eat,
metabolic responses
vary greatly, with a
‘thrifty’ metabolism
possibly contributing
to less weight lost.”
When it comes to
weight loss strategies,
“we should consider
individual physiology”.
NUTRITION
THE DANGER OF A BAD DIET
PHOTOS: GETTY IMAGES, SHUTTERSTOCK
A study of 40 volunteers who swapped diets for just two weeks
showed how damaging a Western diet can be to health. Researchers
asked 20 Americans to switch diets with 20 rural Africans — the
Americans moved to a low-fat, high-bre diet rich in grains and
beans, and the others ate more junk food such as burgers and fries.
The study found that the junk food diet caused deterioration in
bowel health, while the healthy diet caused a reduction in bowel
inammation. Lead researcher Dr Stephen O’Keefe told the BBC,
“In just two weeks, a change in diet from a Westernised composition
to a traditional African high-bre, low-fat diet reduced these
biomarkers of cancer risk, indicating that it is likely never too late
to modify the risk of colon cancer.”
JUNK FOOD HARMED
BOWEL HEALTH WHILE A
HEALTHY DIET REDUCED
INFLAMMATION
EPIDEMIOLOGY
WHY
MOSQUITOES
LIKE YOU
Scientists from the London
School of Hygiene and
Tropical Medicine have
discovered that there might
be a genetic reason for your
attractiveness to the little
bloodsuckers. In a study
published in medical journal
PLOS ONE, Aedes aegypti
mosquitoes were released
into a tube with two sections
leading to a set of twins.
The bugs were equally
attracted to identical twins,
while fraternal twins (who
have differences in their
genes) displayed varying
levels of attractiveness.
Scientists say this suggests
a genetic component to the
“mosquito law of attraction”.
Earlier studies have shown
that blood type and body
odour are other
factors in this
attractiveness.
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IMMUNOLOGY
Fighting
aƬbacterial
infection...
with bacteria
A
C DIFFICILE
INFECTIONS
KILL 29,000
PEOPLE IN THE
UNITED STATES
EVERY YEAR
novel way of treating
gut infections of potentiallylethal Clostridium difficile has
been discovered by doctors in the
United States. The treatment uses the
same bacteria, only this time, they
used a milder version that does not
produce toxins. Trials on 173 people
showed that the new treatment
dramatically reduced the odds of
a repeat infection, according to a
study published in the Journal of the
American Medical Association.
C difficile infections kill 29,000
people in the United States every
year. It is usually treated with strong
antibiotics, but the treatment often
leaves the gut vulnerable to another
infection. In the trial, odds of a repeat
infection were just one in 50 for
those given the non-toxic bacteria,
compared to one in three among those
given a dummy treatment.
ONCOLOGY
PERSONALISED CANCER VACCINES
German researchers have taken the first step towards
creating a personalised cancer vaccine, according to the
study published in the journal Nature. The team, led
by Dr Ugur Sahin from Johannes Gutenberg University,
created customised vaccines using snippets of messenger
RNA to prime mice immune systems into recognising and
attacking lung, skin and bowel tumours.
The novel technique “profoundly retarded” tumour
growth, and greatly improved the mice’s survival rates.
Two-thirds of the treated mice survived 100 days.
Clinical trials are now underway and the researchers hope
to eventually produce a “universally applicable blueprint”
for vaccines against a wide range of human cancers.
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J U L- A U G 2 0 1 5
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VIROLOGY
Ebola,
an STI?
CARDIOLOGY
DIVORCE
LITERALLY
HURTS
THE HEART
In a paper published in the journal Circulation, researchers from
Duke University in the United States have found a link between
divorce and heart attack risk. Based on an analysis of 15,827 people
between 1992 and 2010, the study found that women who have
divorced once were 24 per cent more likely to have had a heart
attack than women who were continuously married. Women who
have had more than one divorce were 77 per cent more likely.
In men, the risk was an extra 10 per cent for one divorce, and an
additional 30 per cent for multiple divorces.
The study found that changes in lifestyle, such as loss of
income, could not explain the increased risk. Professor Linda
George told the BBC, “My educated speculation is that we know
that psychological distress is a constant stress on the immune
system, higher levels of inammation and stress hormones increase.
Immune function is altered for the worse and if that continues for
many years it does take a physiological toll.”
HAEMATOLOGY
New enzyme changes blood type
PHOTOS: GETTY IMAGES, CORBIS, ISTOCKPHOTO
S
cientists from the University of
British Columbia have created
an enzyme that can make
blood types A and B look more like
universal donor type O, according to
a study published in the Journal of the
American Chemical Society. While the
concept itself is not new, the
Canadian researchers
have found a better
way of modifying
the enzyme using
a process known
as “directed
evolution”. “We
produced a mutant
enzyme that is very efficient at
cutting off the sugars in A and B
blood, and is much more proficient
at removing the subtypes of the
A-antigen that the parent enzyme
struggles with,” said David Kwan,
the lead author of the study. While
the new enzyme became
170 times more
effective in just
five generations
of evolution, it
is not yet totally
effective at
removing all the
A and B antigens.
The World Health Organization
(WHO) has urged Ebola
survivors to be even more
cautious during sexual contact
to ensure the virus is not
passed on to their partners. The
warning comes after a survivor
was found to have traces of
Ebola in his semen almost six
months after recovery. This
is some 90 days later than
previously documented.
There have been no
proven cases of Ebola being
transmitted through sexual
contact but officials have
launched further investigations
to evaluate the risks. According
to WHO medical officer
Dr Nathalie Broutet, the case
prompted experts to strengthen
their safe sex advisory for
survivors. But Dr Broutet
cautioned on the need for
further analysis. “Even though
the sample was positive for the
virus, this does not prove it was
passed on sexually,” she said.
Ebola is known to spread
through close contact with the
bodily fluids of a person who
has the active virus and shows
symptoms of the disease.
Experts however emphasise
that people who have recovered
from Ebola do not pose any
risks to the general public.
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GENETICS
A ‘LIVING BIOBANK’
TO TREAT CANCER
G
eneticists in the United Kingdom have created the world’s
first “living biobank” of tumour cells, paving the way for
personalised cancer treatment protocols in the future,
according to a study published in the journal Cell. Researchers
cultured both healthy and cancerous cells taken from 20 patients
with bowel cancer, and tested more than 80 anti-cancer drugs on
resultant growths, known as organoids.
“Cancer is very diverse and we often find that some patients
respond to a drug while others do not. The reasons are often poorly
understood, but we can use the organoids to try and understand
that better,” researcher Dr Mathew Garnett told The Guardian
newspaper. “This biobank should enable us to identify populations
of patients that we can predict will be most likely to benefit
from a specific drug.”
CARDIOLOGY
PHARMACOLOGY
Tumour
dissolved in
only 3 weeks
Doctors at the Memorial Sloan
Kettering Cancer Center in New
York were astounded by a patient’s
reaction to a cocktail of skin
cancer drugs, according to a report
published in the New England
Journal of Medicine. After receiving
a single treatment of a cocktail
of the FDA-approved melanoma
drugs Yervoy (ipilimumab) and
Opdivo (nivolumab), a woman’s
tumour “dissolved” from her chest
in just three weeks. The 49 year-old
woman had advanced melanoma
and had already undergone surgery
and chemotherapy.
However, researchers have
expressed concerns, since if
such an overly-vigorous reaction
were to happen to a tumour
elsewhere in the body, such as
the bowel or heart, it could have
graveƬconsequences.
SCIENTISTS REGENERATE HEART MUSCLE CELLS
A global team of scientists from the Weizmann Institute of Science in
Israel and the Victor Chang Institute in Sydney have discovered how
to regenerate heart muscle cells, according to a study published in
the scientific journal Nature Cell Biology. Unlike skin, blood and hair
cells, heart cells do not renew themselves, but study author Professor
Richard Harvey and his team have found that by using a hormone called
neuregulin, mice heart cells could be stimulated to divide and regenerate.
The next step is to replicate the results in humans. “We will now
examine what else we can use, other than genes, to activate that
pathway, and it could be that there are already drugs out there that can
trigger this response in humans,” Prof Harvey added.
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TRICHOLOGY
PLUCKING HAIRS MAKE MORE GROW BACK
PHOTOS: GETTY IMAGES, CORBIS, SHUTTERSTOCK
A
team of researchers at the
University of Southern California
in the United States have found
that plucking hairs in a precise pattern
can cause even more to grow, according to
a study published in the journal Cell. In a
series of experiments, scientists removed
200 hair follicles from mice in varying
patterns. Low-density plucking led to
no regeneration at all, and high-density
plucking led to some regeneration. But
medium-density plucking, with 200 hairs
removed from a 5mm circle, led to an
astounding 1,300 hairs being regenerated.
The study demonstrated that
inflammation levels under the skin
were well correlated to the scale of the
damage caused by plucking, which in turn
controlled the amount of regeneration.
Lead researcher Dr Cheng-Ming Chuong
told the BBC, “The work leads to potential
new targets for treating alopecia,
a form of hair loss.”
INFLAMMATION LEVELS UNDER THE SKIN
WERE WELL CORRELATED TO THE SCALE
OF THE DAMAGE CAUSED BY PLUCKING
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9
7/2/15 1:42 PM
A NIGHT TO
Remember
ƬI
T WAS A MEMORABLE
evening on 23 May 2015 as the
National Healthcare Group
(NHG) celebrated its 15th anniversary with
pomp and pride. For the very first time, more
than 3,000 NHG and institutional staff as well
as community partners gathered at Resorts
World Sentosa’s Compass Ballroom to
commemorate the occasion as “One Family”.
The theme for the night was “One NHG.
One RHS. One Team: Everyone Is A Gem”.
Gracing the milestone event were
Guest-of-Honour and NHG Chairman
Mdm Kay Kuok, and event host Group CEO
Professor Philip Choo.
In his welcome speech, Prof Choo unveiled
a new model of care — Relationship-based
Healthcare that is Sustainable (RHS).
10
Lifewise
“Our population is ageing. By 2030, one in
three will be over 65. To ensure sustainability
for our healthcare system, we must look at
keeping our population healthy, not just
managing diseases when they strike,” he said.
This new model of care “will be
relationship-based and person-centred
— a paradigm shift from illness care to
wellness care”.
But enough about work, Prof Choo
concluded. It was a Saturday night after
all, and his audience and guests were there
dressed to the nines and in ‘bling-bling’ —
reflecting the theme of the night — for a
great night of fun.
Masters-of-Ceremony DJ Joe Augustin
and Lydia Soh from NHG Group Corp Comms
led the celebration that saw live performances
PHOTOS COURTESY NHG
THE NATIONAL HEALTHCARE GROUP
CELEBRATED ITS 15TH BIRTHDAY AS ONE FAMILY.
J U L- A U G 2 0 1 5
10-13 NHG Dinner_V16.indd 10
7/2/15 2:10 PM
Right: NHG Senior
Management
beating to the
Rhythm of ONE!
Above: Dressing
up and doing it
well was one of
the highlights of
the evening.
NHG Group CEO Professor Philip Choo welcomed the 3,000-strong crowd.
by the T’ang Quartet, Wayne Sandz and
Wayne Gideon.
Guests were also treated to an
entertaining programme that included the
recital and performance of the winning
4P7R poem “One” and song “Our 4P7R,
Our NHG” from the inaugural culturebuilding 4P7R Picture, Poetry and Song
Contribution held last year. Other highlights
included a friendly NHG Teams talent
contest, Best-Dressed Awards presentation,
lucky draw, cake-cutting ceremony and
a grand finale by the Urban Drum Crew
ending the night with a resounding bang.
Above: The acclaimed
T’ang Quartet added
class to the evening.
Left: The ‘NHG Dollies’.
11
7/2/15 2:10 PM
A friendly talent contest
was held comprising
teams from all
institutions in NHG.
The emcees for the evening,
Lydia Soh from NHG
Group Corp Comms and
radio DJ Joe Augustin.
YEARS OF NHG, ONE FAMILY
2000
15 March 2000:
National Healthcare
Group is formed
2001
Institute of
Mental Health
(IMH) launches
Early Psychosis
Intervention
Programme (EPIP)
2002
NHG College
officially opens
2003
Tan Tock Seng
NHG launches Clinical
Practice Improvement
Programme (CPIP)
Hospital (TTSH)
is designated
the hospital to
combat SARS
in Singapore
2004
2006
National Skin Centre NHG Diagnostics
(NSC) rolls out first
fully-integrated
electronic medical
records (EMR) system
in Singapore
launches its
Mammobus
and mobile
diagnostics services
First NHG Annual
Scientific Congress
(ASC) is held
NHG launches first NHG and SingHealth Centre for Geriatric Mobile Community
establish mutual
Medicine opens
Health Centre
recognition of
(TTSH)
review boards
Unity Family Launch of Medicine Clinic
Rehabilitation
opens in Serangoon
Research Institute
Central (NHGP)
of Singapore (RRIS)
Outpatient thTTSH Celebrates Automated
System
170 Founder’s Day
(OPAS) launched in
LEGEND:
TTSH Pharmacy
Clinical highlights
Research highlights
Education highlights
12
Lifewise
2015
2014
of Skin Launch
Research Institute
of Singapore (SRIS)
NHG-Staff Collective Agreement signed
Health City Novena is launched
NHG launches Ang Mo Kio Family 4 Principles & 7 Rules,
Medicine Clinic
Our Shared
opens (NHGP)
Future (4P7R)
Official launch of Launch of Patient Lee Kong Chian School of
Health Portal at NSC
Medicine (LKCMedicine)
(NHG is the primary
Pharmacy NHG
clinical training partner
launches ConviDose
for LKCMedicine)
Medication
Management System
Official opening of Family Medicine TTSH celebrates Academy in
100 years of
Bukit Batok Polyclinic
Surgical Excellence
2013
2012
J U L- A U G 2 0 1 5
7/2/15 2:11 PM
VOICES OF NHG
National Healthcare Group staû were
upbeat
b t about
b t th
the G
Gro
Group’s future.
Above: Prof Choo enjoying a lighthearted moment.
N i patients back to health is
Nursing
very
y fful
llling. We may be just doing our
jobs but
jobs,
bu it is a big deal to the patients.
Over the eight years I’ve worked in
Over
the eld has changed a lot.
NHG th
NHG,
Educating nurses with relevant skills is
Educatin
increasingly important. The expansion
increasi
building
of new facilities are also
and
db
buil
bui
il
crucial ffor us as a healthcare group.
CALVIN LEOW
LEOW, SENIOR STAFF NURSE/CLINICAL INSTRUCTOR,
(PSYCHIATRIC GERIATRIC ACUTE WARD)
IMH (PSYCHIA
In just two years, I’ve taken on
many roles from nance to business
development and operations.
At NHG, continuous learning is
a big part of the culture.
BERTINA BAY, EXECUTIVE, NHG DIAGNOSTICS
Above: NHG staff came dressed to the nines.
Left: The Urban Drum Crew gave a dynamic performance.
It feels great when patients and their
family thank us for taking care of them.
And when a patient is discharged,
you feel a sense of accomplishment.
These moments make us feel
very proud to be nurses, to be
members of the NHGƬfamily.
2007
Primary Care Academy
is established to meet
training needs of primary
healthcare professionals
ZAINAL ABIDEEN, STAFF NURSE, TTSH (SUBACUTE WARD)
2007-2012: Initiation
of NHG/IMH Singapore
Mental Health Blueprint
NHG is a very culture-oriented workplace,
very professional. We observe good
values and practices, as articulated in
our ‘4 Principles 7 Rules’ culture, orƬ4P7R.
DINESH S/O ANANDA RAJAN, ACCOUNTS ASSISTANT, NHG HQ
is renamed NHG Eye Institute ASC
the Singapore Health
and Hougang
and Biomedical
Polyclinic pilot
Congress (SHBC)
Tele-Opthalmology
service
2010-2014: Biennial Asia-Pacific Research
National Ethics Conference
Addictions
Management
Service (NAMS) is
launched at IMH
2010
2009
Seeing that there are plans
See
build more polyclinics and
to b
improve the standard of healthcare
imp
Singapore, we are really moving
in S
forward. There have been more focus
forw
groups to discuss future plans; we
gro
are stepping up on training and
are trying to serve the patients
we a
better. It is all work-in-progress.
bett
MADELINE FAN, OPERATIONS EXECUTIVE, BUKIT BATOK POLYCLINIC
MADEL
13
7/2/15 2:11 PM
W ELL N ESS
ƬM
USIC HAS CHARMS TO SOOTH
A SAVAGE BREAST, as the
saying goes. And although that
saying comes from the 17th century, it still holds
true. Making and listening to music for
therapeutic reasons dates back thousands of
years. Spiritual leaders around the world have
long used chanting to promote healing.
Even today, listening to music has multiple
healing benefits — for example reducing
chronic pain and anxiety. Playing an instrument
or singing can have neurological effects, causing
the brain to develop differently.
Get
In
Lifewise examines how music can improve
your overall state of wellness.
Let’s Get Physical
If you have ever heard a piece of music so
moving and emotive that you got goose bumps,
you would have experienced first-hand a
physical effect of music. According to
a Canadian study published in the journal
Nature Neuroscience, the emotional “chill”
felt — called a frisson (French for shiver) —
is the result of the body releasing the chemical
dopamine into the part of the brain associated
with reward, motivation and addiction.
(Dopamine is associated with the good feelings
the body gets in response to eating chocolate,
for example, or being in love.)
Tune
with Your
MUSIC CAN HAVE A PROFOUND
EFFECT ON YOUR
PHYSICAL AND MENTAL
WELL-BEING.
WELL-BEING
BY AMIR ALI
14
Lifewise
J U L- A U G 2 0 1 5
14-16 Coverstory Music V4.indd 14
7/2/15 1:48 PM
PHOTOS: KELVIN CHIA STYLING: SHEH HAIR & MAKEUP: MELISSA YEO
CLOTHES: H&M AND UNIQLO.
Heal the World
Of perhaps more clinical importance, however,
is the effect music has in relieving anxiety —
which in turn can further promote physical
healing. In 2009, the non-profit Cochrane
Collaboration conducted a review on the
effects of recorded music on nearly 1,500
people with coronary heart disease. Heart
patients tend to aggravate their condition with
feelings of worry or anxiety, which in turn can
lead to severe complications and even death.
The results of the Cochrane review
warranted further study, as there was also
evidence of pain reduction in some of the
patients. In addition, the authors concluded
that listening to music could have a beneficial
effect on blood pressure and heart rate in
people with coronary heart disease. According
to the review, in the heart attack patients
studied, “listening to music also appears to be
effective in reducing anxiety”.
Could this relaxation factor explain why
many of us turn to our favourite tunes or
instruments when feeling blue? It does, in the
case of cover model Harris bin Abdul Razak.
Says the effervescent 28 year-old, “To me,
playing music has a de-stressing element.”
Feelings
Playing and
listening to music
helps NHG Diagnostics
radiographer Harris
bin Abdul Razak
to de-stress.
MUSIC CAN ALTER
MOOD BY CAUSING
THE BODY TO RELEASE
THE NEUROCHEMICALS
THAT CAN INDUCE
POSITIVE FEELINGS AND
HEIGHTENED AROUSAL.
The avid guitarist and piano player surrounds
himself with music every chance he gets, from
during the day — at his job as a radiographer
with National Healthcare Group Diagnostics —
to late at night, just before bed.
Due to the “dynamic and fast-paced”
nature of Harris’ job, he finds relaxation in
listening to popular female singers like Adele
and Amy Winehouse, a pair of women with big
voices, full of feeling.
The emotional power of music is wellknown. After all, music is what feelings sound like.
According to Scientific American magazine,
music can alter mood by causing the body to
release the neurochemicals that can induce
positive feelings and heightened arousal. This
leads to an increase in the rate of change of the
brain, which in turn speeds up rehabilitation.
The ramifications of this are difficult
to quantify as not everybody responds to
music in the same way, but there is an
argument to be made for using music as
a tool to promote wellness. As clinical
psychologist Dr Michael Friedman, who
studies how psychology impacts society,
told Psychology Today, “The public health
implications are considerable as mental
health issues cost the world US$2.5 trillion
15
7/2/15 1:49 PM
W ELL N ESS
(S$3.3 trillion) a year in health costs.” Because
it is so easily available, music has the greatest
potential to reach people who do not otherwise
have access to care.
Expand Your Mind
For some, then, music can be a way to help
them in times of need; but for others, it is a
way of life. Indeed, playing music has been a
lifelong passion for Harris. “I picked up the
guitar by emulating how people play. A little
more than 10 years ago, I joined the guitar
ensemble in my junior college. Besides
learning a new skill, I was drawn to the idea
of teamwork.” (In case you were wondering,
his team went on to clinch the silver in the
Singapore Youth Festival one year.)
Beyond this social aspect, music is a
powerful medical tool that can help patients
regain impaired functions. It can even
stimulate the brain to physically develop
in new ways — which can aid people who
suffer aphasia or the inability to speak.
One famous case involved a young girl
in the United States who regained her
ability to speak through singing. Nearly a
decade ago, at age 11, Laurel Fontaine had
a massive stroke that left her unable to
utter even a single word. Though she could
still understand people, there had been
permanent damage to the part of the brain
needed for speech.
However, through “melodic
intonation” therapy in which
she would sing words rather than
state them, Ms Fontaine ‘trained’
the undamaged parts of her brain to
compensate for the inactive speech areas
— thus she relearned to speak. Singing
effectively remoulded a part of her brain in a
matter of months. Today, a person without
prior knowledge of Ms Fontaine’s stroke
would not be able to tell that she had suffered
permanent brain damage before.
Instrumental to Learning
BESIDES THE SOCIAL
ASPECTS OF IT, MUSIC IS A
POWERFUL MEDICAL TOOL
THAT CAN HELP PATIENTS
REGAIN IMPAIRED SPEECH
AND REDUCE PAIN.
16
Lifewise
Ms Fontaine is a rare case, but the educational
effects of music do apply to just about
everybody. If you have ever tried to play
in a band, or just watched an orchestra in
action, you would have seen that the act of
making music poses a challenge to the brain.
Coordinating brain signals with hand actions,
processing what is heard and then playing
to stay in time and in-tune is no easy feat.
Picking up musical skills thus has multiple
benefits to cognitive function.
Harris, who is learning the piano — thus
fulfilling a childhood ambition — would
know. “It was initially maddening, but
I was impressed by how well my hands can
‘remember’ the scales.” Adds the Grade 2
pianist, “The feeling of being able to play a
difficult piece is satisfying.” J U L- A U G 2 0 1 5
7/2/15 1:49 PM
Life Wise Ad.indd 3
6/30/15 7:17 PM
HORMONES & AGEING
ƬS
TORIES OF MEN UNDERGOING
a midlife crisis are often told in a
tongue-in-cheek manner, with sex-pill jokes
and anecdotes about them acting on impulse
to attract a new mate, for instance. But by
making light of these men’s experiences, we
risk forgetting that behind the laughs is a
distressing medical condition.
Even though midlife crisis should not be
confused with a physical deficiency, one of
the things some men can expect as they age is
late-onset hypogonadism (LOH). This refers
to the age-related gradual decline in serum
testosterone levels in men. Testosterone
(or T), the main male sex hormone or androgen,
is responsible for the development and
maintenance of male sexual characteristics
as well as the production of sperm.
T levels are highest in a man’s 20s and
thereafter fall at a rate of about one per cent
each year once they pass 30. This is a natural
part of ageing, but in some cases lower-thannormal testosterone levels may result in LOH.
Typical symptoms include reduced libido, loss
Men at MIDLIFE
EVER WONDERED WHY THEY
SEEM TO LOSE THEIR LIBIDO AS THEY GET OLDER? HERE’S WHY.
BY WANDA TAN IN CONSULTATION WITH
DR RONNY TAN CONSULTANT //
DEPARTMENT OF UROLOGY // TAN TOCK SENG HOSPITAL
18
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J U L- A U G 2 0 1 5
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of morning erections, erectile dysfunction
and fatigue; mood swings and depression
can also occur. In Singapore, the Society for
Men’s Health (Singapore) estimates that one
in four men aged 45 years and older has some
degree of testosterone deficiency.
LOH is often likened to menopause in
middle-aged women, and is thus called
‘male menopause’, ‘andropause’ or even
‘man-opause’. However, Dr Ronny Tan,
Consultant in Tan Tock Seng Hospital’s
Department of Urology, says this comparison
is inaccurate. “Unlike menopause in women
where there is a sharp drop in oestrogen levels,
there is no sharp drop in testosterone levels
in patients with LOH,” he says. Rather, the
decline in testicular function is incremental
and the male reproductive system does not
completely shut down.
A Thorough Assessment
PHOTO: GETTY IMAGES
“We use testosterone replacement therapy
or TRT to treat LOH in men if they have
symptoms, and if their testosterone level falls
below 8 nmol/L,” says Dr Tan. For patients
with total testosterone levels between 8 and
12 nmol/L, a calculated free testosterone
should be performed.
Because T levels fluctuate during the day,
blood tests should be drawn between 7am to
11am when levels are highest. “In LOH, there
is a drop in the daily peak testosterone level,”
he explains. “It is this drop in the peak that
accounts for the patient’s symptoms.”
A number of tests have to be carried
out before TRT is given. A digital rectal
examination (DRE) and a prostate-specific
antigen (PSA) blood test must be performed.
Patients with elevated PSA and/or DRE need to
be reviewed by a urologist before starting TRT.
Another factor to consider before TRT is
1 in 4 men
AGED > 45 YEARS
HAS SOME DEGREE
OF TESTOSTERONE
DEFICIENCY
WOMEN EXPERIENCE A
SHARP FALL INƬOESTROGEN
WHILE TESTOSTERONE
IN MEN DROPS GRADUALLY.
DR RONNY TAN, CONSULTANT, DEPARTMENT OF UROLOGY, TAN TOCK SENG HOSPITAL
the patient’s desire for children. The use of
T supplementation suppresses testosterone
production in the testes, lowering sperm count.
Treatment Choices
TRT can be administered orally, topically or
via intramuscular injection. “Oral tablets of
testosterone undecanoate have to be taken
daily with a fatty meal for better absorption,”
says Dr Tan. “Topical testosterone gels have to
be applied daily on the shoulders.” He also lists
two types of injectable testosterone: shortacting testosterone cypionate or enanthate,
which is injected every fortnight; and slowrelease testosterone undecanoate, which is
injected every three months.
The aim of TRT is to bring patients’
testosterone back up to normal levels, thus
relieving LOH symptoms. “Patients report
the return of energy levels, libido, morning
erections and improved erectile function,”
says Dr Tan. Cognitive function has also been
shown to improve, with some men reporting
increased alertness and mental concentration.
A follow-up investigation is conducted
a month after starting TRT. Serum levels of
testosterone and PSA are then tested every
three months to ensure they remain stable,
and DREs scheduled annually. Although TRT is
not recommended for patients with prostate
cancer cells which have spread to other parts
of the body, it does not increase the risk of
prostate cancer in normal men or in men with
a benign enlarged prostate gland.
However, TRT is known to raise levels of
haematocrit, or the proportion of red blood
cells to total blood volume. This has been
theorised (but disproved by studies) to increase
the likelihood of cardiac events and strokes.
Hence, haematocrit tests have to be performed
every three months. Should haematocrit be at
an unhealthy level, TRT will be stopped.
Despite these potential side-effects, TRT
offers men who suffer from LOH better quality
of life as they enter their twilight years. NHG IS THE REGIONAL HEALTH SYSTEM FOR CENTRAL SINGAPORE
18-19 Feat Hormones V3.indd 19
19
7/2/15 1:50 PM
PRIMARY CARE
More ACCESSIBLE
mental healthcare
GENERAL PRACTITIONERS PLAY A VITAL ROLE
IN HELPING PATIENTS WITH MENTAL ILLNESS
RE-INTEGRATE INTO THE COMMUNITY.
BY WANDA TAN
IN CONSULTATION WITH
ASSOCIATE PROFESSOR
CHIAM PEAK CHIANG
SENIOR CONSULTANT //
DEPARTMENT OF GERIATRIC
PSYCHIATRY // INSTITUTE OF
MENTAL HEALTH AND
DR WAN JINHUI
FAMILY PHYSICIAN //
NATIONAL HEALTHCARE
GROUP POLYCLINICS
ƬS
LOWLY BUT SURELY, progress is
being made to reduce the stigma
attached to mental illness by ensuring that
patients have easier access to care within the
community. To this end, over the last decade,
General Practitioners (GPs) have taken on a
larger role in treating patients with mental
health conditions.
A crucial step was the establishment in
2005 of the Mental Health–GP Partnership
Programme, in which psychiatrists from the
Institute of Mental Health (IMH) train and
work with GPs to manage patients with stable
mental illness.
Once an IMH patient is assessed to be
stable, he or she is referred to a GP near his or
her home for continued care. The patient is
only sent back to IMH if required; in the case
of a relapse, for example.
Should the GPs need advice themselves,
they can seek help from IMH case managers
or call IMH’s 24-hour hotline.
As of April 2015, about 100 GPs were
participating in the programme, and more
than 1,700 IMH patients had been referred to
their care. These patients benefit from shorter
waiting times, personalised care and reduced
stigma associated with GP clinics, compared
to what they might face if they were to visit a
psychiatrist. It is easier to explain an absence
with a note from a GP, rather than IMH.
These GPs thus manage the patients’
physical and mental health.
Just like post-graduate training in family
medicine is available for GPs who wish to
become Family Physicians, the Graduate
Diploma in Mental Health (GDMH) was
introduced in 2010 to increase the capability
of GPs in mental healthcare.
Jointly offered by IMH and the National
University of Singapore, the GDMH is a one-
20
Lifewise
PHOTO: GETTY IMAGES
Developing GP Expertise
J U L- A U G 2 0 1 5
20-21 GPs Mental Health V6.indd 20
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A NATION-WIDE SURVEY
In 2010, IMH conducted the first-ever Singapore Mental
Health Study (SMHS) to shed light on the state of mental
health among adults in Singapore. Out of a representative
sample of 6,616 participants, it was found that:
The three most common mental illnesses in Singapore were
major depressive disorder (MDD), alcohol abuse and obsessive
compulsive disorder (OCD).
The majority of mental illnesses occurred by age 29.
The average time taken to seek help from the start of illness
was 14 years for those with alcohol abuse, nine years for OCD
and five years for MDD.
Only 22.1 per cent of people with mental illness had consulted
a psychiatrist. Others went to a counsellor (21.6 per cent),
a GP (18 per cent) or a religious/spiritual healer (12.0 per cent).
year part-time course that equips GPs with
clinical skills such as psychiatry and counselling.
They are thus empowered to assess,
diagnose and treat common mental health
disorders such as mild anxiety and depression.
A Senior Consultant in IMH’s Department
of Geriatric Psychiatry, Associate Professor
Chiam Peak Chiang is Programme Director for
the GDMH. “GPs are the first port of call for
the majority of the population; hence, a welltrained GP would be equipped to detect and treat
patients with minor mental health problems,”
she says.
“Having trained GPs provide mental
healthcare makes such care more accessible for
the community.”
A Doctor’s Experience
Dr Wan Jinhui, Family Physician at National
Healthcare Group Polyclinics (NHGP) and GDMH
holder, was interested in the course because of
the wide scope of topics.
“I previously did my General Psychiatry
THE GDMH BROADENED
MYAWARENESS OF HOW
DYSFUNCTIONAL PATIENTS
COULD BECOME DUE TO
THEIR MENTAL CONDITIONS,
AND THE LEVEL
OF ASSISTANCE
THEY COULD
GET TO HELP
THEMƬCOPE.
DR WAN JINHUI
HAVING TRAINED GPS
PROVIDE MENTAL
HEALTHCARE MAKES
SUCH CARE MORE
ACCESSIBLE.
A/PROF CHIAM PEAK CHIANG
posting at IMH and saw mainly adult patients,”
he recalls. “The GDMH exposes participants to
child, adolescent and geriatric psychiatry, which
I did not previously manage. It broadened my
awareness of how dysfunctional patients could
become due to their mental conditions, and
the level of assistance they could get to help
them cope.”
These days, Dr Wan runs the Health and
Mind Clinic at Woodlands Polyclinic where he
sees mental health patients of all ages. Common
conditions he encounters include bereavement
issues and health anxiety in the elderly; anxiety
arising from work stress and depression from
strained marital relationships in working adults;
and adjustment disorders in youths stemming
from relationship- and school-related stress.
“With the GDMH training, I feel more
confident treating patients who have mental
health issues,” says Dr Wan. In particular,
the course has sharpened his ability to screen
patients for mood disorders. “Many patients
have responded very well to both counselling
and medication.” NHG IS THE REGIONAL HEALTH SYSTEM FOR CENTRAL SINGAPORE
20-21 GPs Mental Health V6.indd 21
21
7/2/15 1:51 PM
END
D OF LIF
FE IS
SSUES
ƬF
OR SEVERAL MONTHS,
Mr T’s family noticed he was
becoming increasingly gaunt and that
his abdomen looked bloated.
The elderly man, who was suffering
from chronic diseases including diabetes,
high blood pressure and high cholesterol,
had refused to see a doctor. He was finally
admitted to hospital after suffering a fall.
While warded, he developed breathing
difficulties and his condition swiftly
deteriorated. An X-ray scan confirmed
the presence of a chest infection.
Soon after, he was taken to the
intensive care unit (ICU) and placed on a
respirator. Another scan revealed a large
mass in the lung as well as spots in his
liver and abdominal cavity.
He was diagnosed with advanced
lung cancer which had already spread.
Within two days, Mr T had to depend fully
on the machine to breathe. His condition
was “terminal”.
The traditional goals of the ICU are
to prolong life and decrease the chances
of death and any adverse outcomes.
Despite technological and medical
advances, some patients do not have
any prospect of meaningful recovery
and death is inevitable.
Dying with
DIGNITY
PALLIATIVE CARE CAN
BRING PEACE AMID AN
OTHERWISE PAINFUL DEATH.
BY DR POI CHOO HWEE
CONSULTANT // GENERAL MEDICINE //
PALLIATIVE CARE CLINIC //
TAN TOCK SENG HOSPITAL
22
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22-23 End of Life Issues V3.indd 22
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RELIEVING A PATIENT’S
SUFFERING IS DONE BY
IDENTIFYING AND
TREATING PROBLEMS,
PHYSICAL OR SPIRITUAL.
I was part of the palliative care
team that received a call from the
ICU to help Mr T and work with his
family on a palliative care plan.
When we sat down with the
family and talked, we found out that Mr T
was a very pious man.
As a healthcare attendant working
in a hospital operating theatre, he had
witnessed unsuccessful attempts at
resuscitation and did not wish to undergo
the same treatment. His family said he
believed that living and dying were part
of the circle of life. To him, a good death
would be one where he is surrounded by
loved ones and in his own home instead
of the hospital.
PHOTO: GETTY IMAGES
A Diþcult Decision
Mr T was dying. He was put on
medication to ease his pain. At the
same time, support was given to family
members as they were faced with the
reality of having to say goodbye soon.
On top of the sea of emotions they
were grappling with, the family had to
make the difficult decision of whether
to keep Mr T on the respirator or respect
his final wishes.
After several discussions with the
palliative care team, they decided there
was nothing more important than to
honour Mr T’s wish to spend his final
days at home.
With the assurance that the hospital
and the home hospice team would
support them, plans to bring Mr T home
swung into action. The day came and he
was taken home on a portable ventilator
and a portable device to administer
medication for breathlessness and pain.
The home hospice team took over the
care at home and his breathing tube
was removed.
He passed away peacefully the
following day, surrounded by his loved
ones, in the comfort and familiarity
of his own home. His family was able
to carry out the ritual cleansing and
prayers for him, in accordance with his
religious beliefs.
A Peaceful Passing
Death can be dignified and consistent
with the values and wishes that the
patient holds dear.
According to the World Health
Organization (WHO), palliative care is
an approach that improves the quality
of life of patients (and their families)
facing problems associated with
life-threatening illness, through the
prevention and relief of suffering.
This can be done by accurately
identifying and treating the patient’s
pain and other problems — be they
physical, psychosocial and/or spiritual
— early on.
Outside of the ICU, palliative care
helps to reduce patients’ pain and
symptoms so as to provide the highest
quality of life. Inside the ICU, palliative
and critical care go hand in hand to
help patients (and their families) in
the final days. Doctors, nurses and
therapists provide medical care, while
social workers provide much-needed
counsel to families to help them make
decisions based on what is important
and meaningful to the patient.
While death may be inevitable, the
process need not be painful, lonely
or traumatic. When patients die, the
manner in which they do so lives on in
their loved ones’ memories. A peaceful
death often provides some comfort for
those who live on.
In the words of a family member
of another patient who had received
palliative care in the ICU, “It was a
difficult decision to have the tube
removed, but thank you for making
the process more humane and for giving
us the chance to have closure.” THIS ARTICLE FIRST APPEARED IN
THE STRAITS TIMES’ MIND YOUR BODY
SUPPLEMENT ON 9 APRIL 2015.
22-23 End of Life Issues V3.indd 23
23
7/2/15 1:52 PM
IN PERSON
A Rewarding
Profession
MS SAMANTHA ONG, 49, ON WHY PSYCHIATRIC NURSING
IS A GREAT CHARACTER BUILDER. INTERVIEW WANDA TAN
W
HEN I WAS YOUNG, my ambition was to be a
police officer! But I had a change of heart after seeing
how active the government was in recruiting nurses. In 1986,
I was posted to Woodbridge Hospital — now Institute of
Mental Health (IMH) — straight out of nursing school.
Mental healthcare has since changed tremendously.
Previously, people with mental illness were inclined to see a
bomoh or spiritual healer rather than a psychiatrist. Now, more
are willing to come to IMH for treatment, and this is largely
thanks to IMH’s community outreach and public education
programmes. Stigma against mental health disorders has
lessened owing to an increase in public awareness.
Unfortunately, there is still a shortage of nurses — not just
in Singapore, but all over the world. Being a nurse is far from
glamorous; it is difficult to attract people into the industry
and retain them. The problem
is worse for psychiatric nursing
because patients often lack the
mental capacity to understand
that we want to help, and some
PASSION to serve
can turn aggressive.
and take care of people.
Despite the challenges,
LISTENING SKILLS
I tell new nurses at IMH that
to connect with patients.
there are intangible benefits
A NEVER-GIVE-UP
to the job. Psychiatric nursing
ATTITUDE to believe
builds character and helps you
patients can recover, even if
they have a long-term illness.
become more resilient. It gives
insight into human behaviour,
and improves your communication skills and interpersonal
relationships. In fact, family members and friends sometimes
ask me for advice on personal matters.
Outside of work, I like to relax by brisk walking twice
a week, and cycling twice a month along the various park
connectors around Singapore. Occasionally, my daughters
who are aged 19 and 24 join me, but I usually go alone or
with friends. We may live in a concrete jungle, but there are
many opportunities to engage in outdoor exercise and get
some fresh air!
TO BE A GOOD
NURSE, YOU NEED:
Ms Samantha Ong is Chief Nurse at the Institute of Mental Health.
24
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IN PERSON
Breaking New Ground
TTHESE
HES DAYS, SAYS MR YONG KENG KWANG, 44, NURSES
HHAVE
AV A WEALTH OF CAREER-ADVANCING OPPORTUNITIES.
PHOTO:
PHOT
PHO
PH
P
HOT
H
OTO:
O
O M
MARK
ARK
A
AR
RK
R
KL
LEE
LE
EE
E
E
INTERVIEW WANDA TAN
INTE
AS CHIEF NURSE of Tan Tock Seng Hospital (TTSH),
I have to match the aspirations of my nurses and look
for opportunities for them to move up the career ladder.
The good news is that the nursing career track has been
widened and expanded under the National Nursing
Taskforce’s recommendations in 2014. Post-graduate
training opportunities will also be increased to upgrade the
competencies of nurses.
I joined TTSH in 1996 as a staff nurse and went on to
pursue the management track. Those who stay on the
clinical track can specialise in a wide variety of medical
disciplines such as palliative care and diabetes care. Those
with a Master’s degree in nursing can become Advanced
Practice Nurses (APNs) and run their own outpatient
clinics. Unlike before, APNs can now conduct consultations,
initiate non-drug treatments, order laboratory tests and
carry out advanced procedures.
Although their job scope has expanded, APNs currently
do not have the authority to prescribe medications. But this
will change once regulations are revised, possibly later this
year. It is not a matter of if, but when.
Nursing is a physically- and emotionally-demanding
profession, so it is important that nurses keep up their
motivation and reduce ‘care fatigue’. In my case, sports
helps me to de-stress.
Football is my first love, having played it a lot in my
younger days. I still play fortnightly as part of a social team.
I’ve also encouraged my three kids — aged 8, 10 and 14 —
to pick up sports as a hobby. My youngest child has yet to
find a sport she is interested in, but my 10 year-old son is
in his school’s wushu club. My eldest likes badminton,
so I play with her as often as possible, to spend quality
family time as well as nurture her love for the sport.
Mr Yong Keng Kwang is Chief Nurse at Tan Tock Seng Hospital.
OTHER TRACK OPTIONS:
EDUCATION
Train nurses to meet
rising healthcare
demands and improve
the standard of care.
RESEARCH
Discover new ways to
deliver care and enhance
the credibility of the
nursing profession.
INFORMATICS
Bring nursing into the digital
(paperless) era for faster
access to patient data and
evidence-based information.
24-25 InPerson V5.indd 25
25
7/2/15 1:54 PM
SILVERGLOW
NEVER
TOO LATE TO
START
EXERCISE CAN BOOST A SENIOR’S PHYSICAL AND
MENTAL HEALTH. HERE’S HOW TO GET GOING.
BY ELISABETH LEE IN CONSULTATION WITH
DR JOANNE KUA CONSULTANT // FALLS AND BALANCE CLINIC AND INSTITUTE
OF GERIATRICS AND ACTIVE AGEING // TAN TOCK SENG HOSPITAL
I
F YOU HAD THE
OPPORTUNITY to
add years of healthy life without
having to make much of a sacrifice,
would you not jump at the chance?
According to researchers, half an
hour of light exercise, six days a
week is all that is needed for an
elderly person to reduce their
chances of mortality by more than
40 per cent. This was the
conclusion drawn after a 12-year
Norwegian study of 6,000 men
aged 73 and above. Those who took
a brisk walk daily reduced their
mortality rate by almost half
compared to the sedentary group.
This is because exercise reduces
the risk of coronary heart disease
and helps to maintain muscle
strength, thereby preventing falls,
26
Lifewise
says Dr Joanne Kua, Consultant,
Falls and Balance Clinic and
Institute of Geriatrics and Active
Ageing at Tan Tock Seng Hospital.
Exercise can also enhance
cognitive health and reduce
feelings of anxiety and depression.
Says Dr Kua, “All these benefits
work together to prevent
disabilities, thus enabling the older
adult to live as independently as
possible for as long as possible,
improving their quality of life.”
Start Slow
It is never too late to start getting
active but sedentary older adults
should have a thorough medical
check-up before starting any
activity. This is to rule out any
medical conditions that could
preclude them from exercising,
recommends Dr Kua.
If your doctor gives you the
go-ahead, start slow. Begin with
short intervals of light-intensity
physical activity — say, five to 10
minutes at a time — and gradually
increase the duration of this light
activity and the number of days a
week of exercising before slowly
building up to the desired amount.
The Health Promotion Board’s
National Physical Activity Guidelines
recommend that adults and
seniors get 150 minutes a week of
moderate-intensity activity such
as brisk-walking, or 75 minutes
of vigorous aerobic activity such
as jogging, in addition to musclestrengthening activities two
days per week. In other words,
J U L- A U G 2 0 1 5
26-27 Silverglow V3.indd 26
7/2/15 1:55 PM
GET UP AND GO
going for a brisk half-hour walk
five days a week and doing tai chi
twice a week is sufficient to meet
the recommendations.
However, if you have existing
medical conditions such as
diabetes, osteoarthritis or heart
disease, ask your doctor to design
a regimen more suited to you.
It should take into account the
type, frequency, intensity and the
progression of the activity.
What If It Hurts?
PHOTOS: GETTY IMAGES
Stop if you experience discomfort,
and consult a doctor. “In older
adults, chest discomfort,
breathlessness and excessive joint
pains may be signs to stop and
discuss with their physician the
right intensity and type of exercises
they are doing,” says Dr Kua.
A common myth is that
exercise can contribute to knee
pain. Exercise can actually reduce
pain and improve mobility, but
solving this requires a collaborative
effort with the physician
and physiotherapist.
“The physician will need to
control the pain with medication.
The physiotherapist will then
introduce them to stretching,
aerobic and strengthening
exercises in stages, to help with
their osteoarthritis.”
Where To Go
To get started, all you need
is a good pair of comfortable
walking shoes. Remember to
stay cool and hydrated. Bring
along a water bottle and wear a
hat, and consider timing your
walks for the early morning or
evening. Lengthen your walks
gradually to avoid overdoing it.
If a brisk walk sounds
boring, try a group exercise
class, such as Zumba Gold at
your local community centre.
Or find a buddy to exercise
with — not only will a friend
keep you entertained, he or
she can help you stick to your
fitness plan.
“Exercising in groups for older
adults has the added benefits of
social engagement and mutual
encouragement which can help to
motivate them to continue to be
active,” says Dr Kua.
But if full-on exercising is not
your cup of tea, there are plenty of
In addition to the many new
fitness corners with elderlyfriendly equipment in housing
estates in Singapore, here are
some resources to help you find
a workout that’s right for you.
one.pa.gov.sg
FIND YOUR CLOSEST COMMUNITY
CENTRE AND SIGN UP FOR A CLASS.
BiTPAL
A FREE, SUPERVISED 12-WEEK
FITNESS PROGRAMME UNDER
THE BISHAN-TOA PAYOH ACTIVE
LIVING FOR BISHAN-TOA PAYOH
RESIDENTS AGED 50 AND UP.
Project Gym Tonic
“EXERCISE-AS-MEDICINE”
PROGRAMME FOR SENIORS WHICH
FOCUSES ON EXERCISE AS A
MEANS OF IMPROVING PHYSICAL,
EMOTIONAL AND MENTAL HEALTH.
WWW.GYMTONIC.SG
other ways to stay active — dancing,
playing golf and even vacuuming
the floor can be aerobic in nature.
Meanwhile, carrying groceries and
walking instead of taking the public
transport and washing windows or
the floor can double up as musclestrengthening activities. ADULTS AND
SENIORS NEED
ABOUT HALF AN
HOUR OF MODERATE
EXERCISE PER DAY.
26-27 Silverglow V3.indd 27
27
7/2/15 1:55 PM
LIFESPACES
Avoid a BAD TIME
at bath time
PREVENT A SLIP-UP AND KEEP THINGS
SPARKLING WITH THESE TIPS.
BY ASHUTOSH RAVIKRISHNAN
IN CONSULTATION WITH
MS SHIRLEEN SIM OCCUPATIONAL THERAPIST //
OCCUPATIONAL THERAPY DEPARTMENT //
TAN TOCK SENG HOSPITAL AND
DR ANTHONY GOON SENIOR CONSULTANT //
NATIONAL SKIN CENTRE
Unstable support
Towel rails and taps are often
not made to support heavy
weight, so holding on to these
for support is likely to cause
injury. “Install grab bars for
additional support,” says Ms Sim.
Towels and other items should
not be hung on these grab
bars as they can reduce grip.
ƬI
N 2011, THE NEWƬYORKƬTIMES newspaper
reported that the bathroom is possibly the most
dangerous room in the house. In fact, more than one-third
of bathroom injuries happen during showering.
Slick surfaces inside a bathroom pose problems for
the elderly, who are already more prone to falling. Indeed,
the Health Promotion Board (HPB) estimates that one in
three senior citizens above the age of 60 has fallen more
than once.
Ms Shirleen Sim, an Occupational Therapist at Tan Tock
Seng Hospital, and Dr Anthony Goon of the National Skin
Centre, point out some of the risks inherent in bathrooms.
Clutter
Bathrooms filled with clutter
can limit walking space and
increase the risk of tripping.
Many cleaning chemicals are
poisonous too, so keep these
away from young children.
Slippery floors
“Keep the bathroom floor dry after showering,”
advises Ms Sim. Mop up excess water and keep
the bathroom door open to enable the floor to dry.
Applying a slip-resistant chemical solution or laying
non-slip mats also prevents slippage. Be sure to
wash the mats regularly to decrease the build-up of
algae or mildew — these can also be fall hazards.
28
Lifewise
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Dim lighting
Poor lighting and a habit of not switching
on the toilet light at night can also lead to
falls. Ms Sim recommends that bathrooms
be well-lit to ensure adequate visibility.
Germ Attack!
Ge
PUT IT DOWN!
A 2011 study by the University of Leeds
showed that closing the toilet lid before
ushing helps to reduce the spread of
harmful bacteria and germs signicantly.
According to the study, ushing with the
lid open releases a cloud of bacteria and
germs into the air. These eventually settle
on nearby surfaces such as toothbrushes.
HOTor
COLD?
PHOTOS: SHUTTERSTOCK
Keep clean with a shower, but watch
the temperature. “Showering in water
which is too hot can wash off natural oils,
causing dry skin, while cold water can
cause discomfort,” says Dr Anthony Goon,
Senior Consultant at the National
Skin Centre. He advises showering
in either lukewarm or
cool water.
THIS MIGHT COME AS A SURPRISE,
BUT BATHROOMS ARE OFTEN NOT
THE DIRTIEST ROOMS IN THE HOUSE
— ACCORDING TO STUDIES, THE
KITCHEN IS WORSE. HOWEVER, THAT
DOES NOT MEAN YOU SHOULD GO
EASY ON THE DISINFECTANT IN THE
BATHROOM: MOIST SURROUNDINGS
ARE IDEAL FOR BACTERIA AND
GERMS TO THRIVE IN.
MOULD &
MILDEW
These fungi can cause
headaches and infections,
and are an allergen to
some. Be sure to scrub
thoroughly under faucets
and below mirrors, too.
A touch of greenery might
also help; the Peace Lily is
known to remove mould
from the air and is easy to
maintain, requiring only
weeklyƬwatering.
Toilet
Tips!
Fill yyour toilet bowl brush holder
disinfe
with a disinfectant
to keep it germ-free in
clea
between cleanings.
Be sure to change the
solution regularly to minimise contamination.
Clean in between tiles with
an old toothbrush dipped in a
paste of baking soda and water.
Then spray a solution of vinegar
and water, and rinse off.
28-29 Lifespaces Bathroom V6.indd 29
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7/2/15 1:57 PM
WORKOUT
ƬG
OLF IS OFTEN ASSOCIATED WITH
retirement and relaxation, but do not let
this low-intensity sport fool you into discounting
it as a means of burning calories or a reason to
work out to build muscle.
“Although golf is primarily a game of skill,
a golfer can derive health benefits from the
sport,” says Dr Jason Chia, Head of Tan Tock Seng
Hospital’s Sports Medicine and Surgery Clinic.
Get In Shape
By walking from hole to hole on an 18-hole course
and not relying on a golf cart, golfers
cover at least eight kilometres of
ground. That totals more than the
10,000 steps a day that the Health
Promotion Board (HPB) recommends
for good health and calorie-burning.
In addition, a golf course is
typically undulating, and walking across this
terrain is a gentle form of hill training suitable
for older folks or those just starting out.
Many of golf’s health benefits are also derived
from the exercises that a golfer can perform off
the green to improve his game, and thus the sport
can be a source of motivation for those keen to
get fit. In fact, many top professional golf players
like Lee Westwood and Tiger Woods spend hours
in the gym working out to build strength and
flexibility, thereby improving their game.
“The golf swing can require explosive strength.
It uses muscles from the trunk, as well as upper
Fitness
TO A TEE
30
Lifewise
GOLFING CAN BE MORE BENEFICIAL
FOR YOUR HEALTH THAN YOU THINK.
BY ASHUTOSH RAVIKRISHNAN IN CONSULTATION WITH
DR JASON CHIA HEAD // SPORTS MEDICINE & SURGERY CLINIC //
and lower limbs,” says Dr Chia. He recommends
a golf-specific weight-training regime including
deadlifts, burpees and squats to improve flexibility,
core strength and stability to improve the swing.
Strengthening muscles and improving flexibility
can also prevent common golfing injuries
(see sidebar).
J U L- A U G 2 0 1 5
30-31 Workout Golf V6.indd 30
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COMMON INJURIES
These two conditions are exacerbated if the muscles are
weak, so be sure to engage in regular strength training.
} GOLFER’S ELBOW
} LOWER BACK PAIN
Also known as medial
epicondylitis, golfer’s elbow
is characterised by a dull
pain emanating from the
inner side of the elbow. It is
caused by the inammation
of the tendons connecting
the forearm to the elbow.
PREVENTIVE EXERCISE
Strengthen forearm muscles
by performing wrist curls
with a lightweight dumbbell.
Squeezing an old tennis
ball several times a day is
also eûective.
When you swing, you exert a
lot of pressure on your spine
and muscles. Poor exibility
coupled with inadequate
muscle strength can lead
to muscle strain, which can
cause pain in the lower back.
PREVENTIVE EXERCISE
Strengthen your back
with dumbbell rows and
cable pulldown exercises,
beginning with light weights.
Increase weights gradually.
Yoga and pilates have also
proven to be eûective.
These conditions are treated with regular icing with
ice packs, painkillers and adequate rest.
RISKS
WHEN
PLAYING
GOLF
Having Fun In The Sun
Golf exposes players to the sun,
and thus increases vitamin D levels.
A healthy dose of this vitamin is
essential to maintain strong bones,
teeth and a healthy immune system.
Various studies have shown that
vitamin D deficiencies can lead
to sleep disorders, particularly
daytime sleepiness.
Unless you are competing in a
tournament, chances are you are
golfing to relax with a friend or two.
The highly social nature of the
game can increase self-esteem and
happiness, and this in turn can
help alleviate depressive
symptoms. The fresh air and
green spaces of the golf course
have also been shown to reduce
stress levels. Sun
Lightning
Golf and lightning do not mix. Singapore has
one of the highest rates of lightning activity
in the world according to the National
Environment Agency, and thunderstorms
can develop without warning. Check with
your golf club for lightning precautions
before heading out.
A beautiful sunny day is perfect for a game —
if you’re prepared for it. Singapore has one
of the world’s highest ultraviolet indexes,
so one can get sunburnt after just five
minutes of continuous exposure to
harsh sunlight. Wear sunscreen (SPF 30
is sufficient) and sunglasses, and if
possible, long-sleeved clothing and a cap.
Dehydration
Ensure that you remain sufficiently
hydrated when out on the greens.
Do not wait till you’re thirsty to drink — make it a point
to sip water every 15 minutes, recommends HPB.
30-31 Workout Golf V6.indd 31
31
7/2/15 1:58 PM
EAT WELL
ƬE
VEN A TINY AMOUNT of bacteria can be a
dangerous thing when it comes to food. While
that packet of nasi lemak bought earlier in the morning
might still seemingly smell and taste fine later in the
day, it might have already harboured enough toxic
pathogens to leave you feeling nauseated and ill.
“The immune system in healthy adults can deal
with small amounts of bacteria and viruses. But
larger numbers of such bugs can make us quite sick,”
explains Ms Charmaine Toh, a dietitian with National
Healthcare Group Polyclinics (NHGP).
Indeed, vulnerable people such as pregnant
women, people with weakened immune systems
or the elderly can die from food poisoning.
Worthy of
Common symptoms of food-borne illness —
usually known as food poisoning — can be mild or
severe. These can include nausea, vomiting, diarrhoea,
stomach cramps, headaches and fever. While most
episodes last only a day or two, some infections can be
nasty. Hepatitis A or typhoid can cause severe illnesses
lasting many weeks. Some food-borne illnesses can
even result in long-term health issues involving the
immune system, gut or kidneys.
Ms Toh says one of the most common causes of
food-borne illness is the improper storage of cooked
foods. While cooking destroys most pathogens, bacteria
can be reintroduced to food later on, and leftovers can
become a breeding ground for toxic strains such as
Staphylococcus aureus, Salmonella enteritidis, Escherichia
coli and Campylobacter. Here are the best ways to take
care of leftovers.
SOMETHING AS INNOCUOUS AS STORING LEFTOVERS AND WARMING
THEM UP PROPERLY CAN BE A VERY SERIOUS MATTER.
BY ELISABETH LEE IN CONSULTATION WITH
MS CHARMAINE TOH DIETITIAN // NATIONAL HEALTHCARE GROUP POLYCLINICS
Tip 1
Time is of
the essence
Once food has been cooked,
it should be refrigerated or
frozen within two hours,
says Ms Toh. Leftovers must
be put in shallow containers
or distributed into smaller
portions for quick cooling,
and refrigerated at or below
4°C within two hours.
In general, food can be
stored for three to four days
in a covered container in the
refrigerator. Food destined
for the freezer should be
labelled with the freeze date
and stored in freezer-quality
resealable bags or sturdy
glass/plastic containers.
32
Lifewise
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BACTERIA TYPICALLY DO
NOT CHANGE THE TASTE,
SMELL OR LOOK OF FOOD.
THEREFORE YOU CANNOT
TELL WHETHER A FOOD IS
DANGEROUS TO EAT.
IF YOU ARE IN DOUBT
ABOUT A FOOD’S SAFETY,
IT IS BEST TO THROW IT OUT.
Tip 5
Put the right
food in the
right place
MS CHARMAINE TOH
Tip 2
Thaw food in the refrigerator
When food is left to thaw at room temperature, bacteria that may be
present can multiply to unsafe levels. While freezing does inactivate
bacteria, some may remain alive and can begin to multiply when the
food returns to room temperature.
Thaw frozen food in the refrigerator in a container to catch the drips
(thereby preventing cross-contamination), or use a microwave oven.
If thawing small items quickly under running water, place them in a leakproof bag. Cook all thawed food immediately and do not refreeze.
Tip 4
Avoid cross-contaminating
your food by storing
cooked and ready-to-eat
items separately from raw
food, especially raw meats,
advises Ms Toh. Use a
separate, properly-covered
container for each food
item, and adopt a “rst in,
rst out” principle when
consuming leftovers.
Adds Ms Toh, “Do not
store perishable food in the
refrigerator door, especially
milk. The temperature of
food stored in the door
can increase when the
refrigerator is opened, so
store foods that can go bad
quickly on the main shelves
of the refrigerator.” Get hot, hot, hot!
Tip 3
Use the right container
Take-out food containers are often made of foam, plastic or
paper and may not be microwave-safe. Store and reheat
take-out items in food-safe containers. Certain plastics are
safe, while ceramics and glass are best. “Never reheat or
store food in plastic containers that were not intended for
food. Containers meant for one-time use, such as margarine
tubs, tend to warp or melt in the microwave, and this may
allow harmful substances in certain plastics to leach into
the food,” says Ms Toh. Avoid plastics and containers that
are visibly damaged, stained or have a bad smell.
It is important to use the right method
of reheating to ensure all bacteria
are destroyed. Whether oven-baking,
sautéing or microwaving, Ms Toh
recommends that leftovers be brought
to a minimum temperature of 74°C
— use a food thermometer to check —
and soups, sauces and gravies should
be brought to a rolling boil.
If using a microwave oven, give
your leftovers a good stir in the middle
of heating and allow the food to stand
for a few minutes afterwards, as the
heat will continue to radiate through
the food. Do not forget to use a
microwave-safe covered container —
leftovers heat more evenly and retain
their moisture better when covered.
32-33 Eatwell Food storage V2.indd 33
33
7/2/15 2:00 PM
Localising
POSITIVE
Mental
Health
IT IS IMPORTANT TO MEASURE
POSITIVE MENTAL HEALTH
TAKING INTO ACCOUNT UNIQUELY
SINGAPOREAN TRAITS.
BY MS JANHAVI VAINGANKAR
SENIOR MANAGER // RESEARCH DIVISION //
INSTITUTE OF MENTAL HEALTH
34
Lifewise
ƬA
PERSON’S MENTAL HEALTH REFERS
to the feelings they experience as a
result of what they do in their daily life.
Positive Mental Health (PMH) refers to the positive
aspects of a person’s state of mental health.
How a person copes with stress or unpleasantness;
his reserves of emotional and social support; his
feelings of being in control of things around him;
and his idea of achievement, happiness and faith all
contribute to mental health. If we can understand how
these variables of PMH determine a person’s overall
well-being, and understand how other factors such as
stressful events influence them in return, efforts can
then be made to improve mental well-being.
J U L- A U G 2 0 1 5
34-35 Catalyst V3.indd 34
7/2/15 2:01 PM
A LOCALLY-VALIDATED
SCALE WILL REFLECT
A MORE ACCURATE
MEASUREMENT OF
POSITIVE MENTAL
HEALTH IN SINGAPORE.
This is especially relevant for those at risk of
poor mental health. Thus, being able to measure
PMH offers several advantages towards having
a healthy and productive society.
Understanding Positive
Mental Health
Traditionally, mental health has been measured
by assessing the negative aspects of mental
health, such as estimating the proportion
of people with depression or other mental
disorders. However, developments in the field
of mental well-being over the last decade have
shown that the absence of mental illness does
not constitute presence of PMH.
There is also a growing acceptance that PMH
can co-exist with mental illness and by virtue
of this, even a person with a mental illness can
have PMH as long as he can cope with situations
around him, function well and play a meaningful
role in society. Measuring PMH therefore needs
a better understanding of all of its components
and in the population or group of relevance to
service providers and policy-makers.
PHOTO: GETTY IMAGES
A Local Look
There are benefits to having a locally-validated
scale to measure PMH in Singapore. At present,
those that are available are either developed
entirely in Western populations or lack
important factors such as spirituality. An earlier
qualitative study conducted on multi-ethnic
representatives of Singapore’s population
showed the importance of religious or spiritual
beliefs on PMH. Cultural influences therefore
need to be carefully considered for the holistic
and comprehensive measurement of PMH.
To this end, the PMH instrument was
developed and validated to assess the level
of PMH in the multi-ethnic adult population
in Singapore. The instrument is based on the
definition of PMH as derived from Chinese,
Malay and Indian adult Singaporeans. The PMH
instrument is a self-administered 47-item
measure that covers six culturally appropriate
domains of mental health:
1
general coping
2 emotional support
3 spirituality
4 interpersonal skills
5 personal growth
and autonomy, and
6 global affect
The scale presents statements referring
to these six domains and asks the person to
select a number showing how much the item
described them using a response scale ranging
from 1 to 6, where ‘1’ represents ‘not at all like
me’ and ‘6’ corresponds to ‘exactly like me’.
Total PMH and domain-specific scores can be
obtained from the scale. The measure can be
applied to compare levels of mental health
across different age, gender and ethnic groups.
Its validity and reliability in the local multiethnic population as well as its correlation with
depression, anxiety, health related quality of life
and satisfaction with life make it an appropriate
instrument to investigate psychological wellbeing among Singaporean adults.
At present, the instrument can be used
among English-speaking adults aged between
21 and 65 years. It is not available for individual
use as further research is needed to understand
the implications of scoring and selfassessment. The scale can, however, estimate
the levels of PMH of a person or group(s) at
a specific point in time or observe trends over
time. It can also be used to understand the
association of PMH with important health
outcomes. The instrument thus has wide
applications in the Singapore population and
potential for use in the evaluation of mental
health interventions here. If you wish to use or enquire about the instrument,
please contact Ms Janhavi Vaingankar at 6389 2794 or
[email protected]. The PMH instrument
is governed by copyright laws, but is available free of
charge for non-commercial use involving research,
routine care, evaluation and policy making.
34-35 Catalyst V3.indd 35
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7/2/15 2:02 PM
&
QA
THE
EXPERTS
M E D I CAL Q U E STI O N S AN SWE R E D
Meditation Hesitation
Q1
Many have spoken of the benets of
meditation. Does it really work in improving
physical/mental well-being? Can anyone
meditate? Is meditation used as a form of
treatment at the Institute of Mental Health?
Meditative practices have been in use for thousands of years. One
of the most widely used forms of meditation is prayers in many
faith-based traditions. Other traditional forms of meditation include
those that combine meditation with physical movement such as in
qigong, tai chi and yoga. These forms of meditation seek to improve
the balance and flexibility of the body as well as to increase calmness
of the mind. Yet another two other forms of meditation are mantra
meditation and guided meditation. The former uses a specific word,
sound or phrase, and the latter utilises visualisation techniques to
instill calmness.
In psychology and medicine,
the application of meditation may
take the form of ‘mindfulness
meditation’. The objective is
to increase the moment-tomoment awareness of one’s
experience without judgment.
Research has shown that
such meditation can bring about
improvements in regulating
emotions, decreased reactivity
and increased response flexibility.
Inter- and intrapersonal aspects
may be improved, too, and all
these can benefit people with
mental or physical health issues.
In addition, mindfulness
meditation serves as a self-care
technique for therapists, some
of whom have reported increases
in empathy and compassion for
their clients as well as decreased
stress and anxiety. Regular
meditation is recommended for
its positive effects to be felt
and maintained.
IMH has some interventions
that include mindfulness
meditation. These include
Mindfulness Based Stress
Reduction group therapy and
therapeutic approaches such as
Dialectical Behavioral Therapy
and Acceptance and Commitment
Therapy. These approaches
are not faith-based but are
rather, evidence-based practices.
MR WONG CHIN MENG
SENIOR CLINICAL PSYCHOLOGIST //
36
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36-38 QnA V4.indd 36
PHOTOS: GETTY IMAGES, CORBIS, SHUTTERSTOCK
YO U R
ASK
J U L- A U G 2 0 1 5
7/2/15 2:02 PM
Bugging Out
Q3
All my life I have had a phobia
of certain insects. I’ve tried to
ght this but am gripped by
a crippling sense of fear that
causes me to ‘freeze’ and my
breathing becomes diþcult.
Do I have a mental disorder?
Q2
The Importance of Diet
I am a man in my 60s who exercises regularly and
who has been given a clean bill of health. However,
I have a fondness for oily food. But as my decadeslong eating habits seem to have no adverse eûects
on my health, is it okay to stick to my current diet?
The answer is ‘no’. Consuming unhealthy or oily food may not
cause immediate health issues, but in the long run it may lead to
chronic diseases like diabetes mellitus, hypertension and high
cholesterol. A balanced diet is important to help you stay well for
life. Use the Health Promotion Board’s My Healthy Plate as your
guide: A quarter of your plate should consist of carbohydrates,
preferably whole-grains. Another quarter should be meat or
meat alternatives, for protein. Protein plays an important role in
maintaining muscle mass in the elderly. It also promotes a better
immune system and prevents unintentional weight loss. The
remaining half of the plate should consist of fruits and vegetables.
Limit your oil intake by choosing healthy cooking methods such
as steaming, grilling, microwaving or broiling. Staying hydrated
with water is important too, and you should avoid sugary drinks.
Last but not least, continue to be active. Physical activity is an
essential part of a healthy lifestyle to prolong good health. Adults
should aim to engage in 150 minutes of physical activity per week.
Many people have a fear of insects,
though some more than others.
However, when the fear is more than
usual as in your case causing you to
freeze and having difficulty breathing,
it could be classified as a Phobic
Anxiety Disorder.
The first step to addressing this
would be to see a psychiatrist who
will do a detailed assessment to
diagnose the disorder and rule out any
other physical problems. If a Phobic
Anxiety Disorder is confirmed, then
the psychiatrist will discuss with you
treatment options. These usually
comprise a combination of medications
and Cognitive Behavioral Therapy.
DR PALANIVELU SENDHIL KUMAR
CONSULTANT // DEPARTMENT OF
GENERAL PSYCHIATRY //
MS ABBIE SIM
DIETITIAN // NATIONAL HEALTHCARE GROUP POLYCLINICS
ASK THE
S
S
SEXPERTS
DON’T
D
ON’T
T
B
EJ
ELLY
BE
JELLY
Is it true that certain people can develop an allergic
reaction to chemically-based lubricants used during sex?
There have been reported cases of contact allergies to nonoxynol-9,
a spermicide found in lubricants and some condoms. Some people
may also be allergic to the preservatives, glycerine, chlorhexidine
and fragrances found in lubricants which can irritate the vagina. But
the most common sexual contact allergy is to natural latex or rubber
chemicals in latex condoms. Consider using water-based and siliconebased lubricants which do not contain spermicide, preservatives and
fragrance — as it is very rare to develop a contact allergy to silicone.
DR SUZANNE CHENG
CONSULTANT // NATIONAL SKIN CENTRE
37
7/2/15 2:02 PM
Q&A
Q4
‘Itchy’ Perfume
The blotching is most commonly due to skin irritation or a contact
allergy to fragrance. The fact that your skin reaction appears soon
after application of perfume and resolves within minutes suggests
that is it more likely to be irritant contact dermatitis.
Skin irritation occurs when chemicals (such as fragrances)
penetrate and damage the skin surface, causing inflammation,
itchiness and soreness. The degree of irritation depends on the
amount or concentration of the chemical, as well as duration and
frequency of application. Irritation is more common in those with
a pre-existing tendency to eczema or previously-damaged skin.
Irritant contact dermatitis can affect anyone if they have had
enough exposure to the irritant.
In contrast, allergic contact dermatitis is caused by an allergic
reaction to a particular substance, fragrance being one of the most
common known allergens. Such reactions require repeated contact
to develop. The reaction usually takes 24 to 48 hours after contact
to appear at the site of contact. A patch test can be performed
to confirm a contact allergy. Once the allergen is identified and
removed, the skin reaction takes several days to resolve. Only those
who are allergic will react to the allergen.
The only way to prevent such a skin reaction is to avoid contact
with the irritant (or allergen). Repeated contact with the offending
substance will heighten the severity of the skin reaction. Using a
gentle, soap-free cleanser and a regular skin moisturiser is a good
way to maintain and repair the skin barrier.
DR SUZANNE CHENG
CONSULTANT // NATIONAL SKIN CENTRE
38
Lifewise
Knowing Q5
the Nose
Are procedures such as
non-surgical rhinoplasty
permanent? I am considering
enhancement to my nose
bridge but have been told that
the llers dissolve. Would I
need follow-up procedures?
Does the surgical alternative
oûer a permanent solution?
Non-surgical rhinoplasty most
commonly refers to the use of dermal
fillers to camouflage nasal defects or for
nasal augmentation. There are several
types of dermal fillers and the most
common ones are semi-permanent types
that last between six months to a year
or more. Once these semi-permanent
fillers dissolve, you need to repeat the
procedure to maintain your appearance.
Permanent fillers are uncommon
and used only with extreme caution as
they can potentially result in long-term
complications or infections. They can
also hinder any further changes to the
shape of the nose. Take note that these
fillers change the nose shape but do not
correct symptoms of nasal obstruction.
Although referred to as “non-surgical”,
complications occasionally arise.
Surgery in the form of rhinoplasty
would be a more permanent solution,
and would correct symptoms of nasal
obstruction. However, there are several
ways to “enhance” your nose bridge
using implants or your own cartilage. A
discussion of the pros and cons with your
surgeon is important before deciding.
DR DENNIS CHUA
CONSULTANT // DEPARTMENT OF
OTORHINOLARYNGOLOGY (ENT) //
DIRECTOR OF FACIAL PLASTIC SERVICE //
TANƬTOCKƬSENG HOSPITAL
Whenever I use perfume, itchy red blotches
that last a few minutes develop on my skin.
What could my body be reacting to and is
there a way to overcome this? Does more
frequent exposure help to build immunity?
J U L- A U G 2 0 1 5
7/2/15 2:03 PM
ALL ABOUT
MIGRAINE
WHAT YOU NEED TO
KNOW ABOUT THAT
THROBBING HEADACHE.
BY DR KEE KOK WAI
FAMILY PHYSICIAN //
NATIONAL HEALTHCARE
GROUP POLYCLINICS
WHAT IS IT?
HOW IS IT TREATED?
Migraine is a type of headache in which sufferers
feel a localised pulsating pain that can be moderate
or severe in intensity. There are two major subtypes:
either with or without aura. Auras are complex
symptoms, often lasting under an hour, and occur
just before or at the onset of a migraine attack.
Sufferers of auras may see bright spots or lines, or
have jagged peripheral vision; they may also feel
tingling or numbness of the hand or lower face.
There are no specific diagnostic tests for
migraine and there is no single definite
cure. Sufferers can get relief by lying
down in a quiet dark room. Migraines
eventually dissipate without treatment.
Typically however, migraine is treated with
medication which can be either abortive
in nature (taken during an attack) or
preventive. Pain relievers, anti-nausea
medications and some migraine-specific
medications (e.g. ergots and triptans) are
used during an acute attack.
PHOTO: GETTY IMAGES
WHAT ARE THE SYMPTOMS?
Migraines usually start gradually before intensifying
over minutes or hours. Untreated, the pain lasts
four to 72 hours and is often accompanied by
nausea or vomiting as well as sensitivity to light
or noise. Sneezing, physical activity or rapid head
movements can aggravate it.
Women and those with a family history
of attacks are at higher risk. Migraine can be
triggered by stress, anxiety, menstrual periods, oral
contraceptives, lack of sleep or food, strong light or
noise, and by consuming food or drinks that contain
nitrates, aspartame, glutamate and tyramine. It can
co-exist with depression, anxiety, epilepsy, stroke
and irritable bowel syndrome.
HOW TO AVOID IT?
When migraine frequency or severity
increases to a point of significantly
interfering with work or social life, one
may consider preventive medications.
Common preventive medications
for migraine include blood pressure
medication (such as beta-blocker
and calcium channel blocker), anticonvulsants and anti-depressants.
However, it is important to discuss the
indication and treatment with a doctor.
39 AllAbout V2.indd 39
39
7/2/15 2:03 PM
CORPORATE NEWS + EVENTS
+ FORUMS
EXTRAORDINARY PEOPLE
OUTSTANDING HEALTHCARE WORKERS WERE HONOURED
AT THE ANNUAL HEALTHCARE HUMANITY AWARDS.
E
President Tony Tan with some
of the recipients. With Dr Tan
are Minister for Health Mr Gan
Kim Yong (in yellow tie),
Senior Minister of State for
Health Dr Amy Khor (in pink
dress), and NHG Chairman
Mdm Kay Kuok (in white blouse).
very year since The Courage Fund was
Mdm Wong, 54, started a career in public
set up after the 2003 SARS outbreak, it
healthcare in 2005 after being inspired by
has been used to recognise the selfless
the team who had taken care of her husband
efforts of healthcare workers at the Healthcare
who was then seriously ill. Mdm Wong had a
Humanity Awards (HHA). At this year’s ceremony
basic education and spoke only Mandarin, but
on 27 April at The Matrix@Biopolis, President
she challenged herself with intensive skills
of Singapore and The Courage Fund Patron
training and language classes. She now
Dr Tony Tan Keng Yam presented awards to 62
holds healthcare certifications in patient
outstanding individuals. They included 56 HHA
care, activities and hospital procedures,
winners and six HHA Honourable Mentions.
all of which are endorsed by the Workforce
For the first time, the HHA has been
expanded to include individuals who volunteer
Development Agency.
Today, Mdm Wong is a certified Senior
in community organisations. Said Dr Tan,
Healthcare Assistant at IMH where she cares
“As we celebrate SG50, we celebrate our
for 50 patients with intellectual disability.
healthcare workers’ contributions towards
Outside of work, she also volunteers regularly
nation building. I congratulate the recipients
with the Tzu Chi Foundation, a Buddhist
of the awards. They are all inspiring role
compassionate relief organisation.
models to fellow healthcare workers.”
About her Award, Mdm Wong said,
“I believe that serving others is far superior
40
Lifewise
A LIFE OF PURPOSE
to what we gain from only serving ourselves.
One of the HHA Honourable Mention
Being a healthcare worker allows me to
winners this year is Madam Wong Kuan Ying
reach out to those in need; to me, this is
from the Institute of Mental Health (IMH).
living a life of purpose.”
J U L- A U G 2 0 1 5
40-48 Spotlight _V4.indd 40
7/2/15 2:04 PM
Healthcare Humanity Award Winners 2015
HONOURABLE MENTION:
A/Prof Lim Sok Bee
Mdm Wong Kuan Ying
SENIOR CONSULTANT AND HEAD,
DEPARTMENT OF CHILD DEVELOPMENT
SENIOR HEALTHCARE ASSISTANT
KK WOMEN’S AND CHILDREN’S HOSPITAL
Sister Bernadette Mary Yeo Geok Tho
CLINICAL PASTORAL CARE COUNSELLOR
MOUNT ALVERNIA HOSPITAL
Ms Thilagamangai
ASSISTANT DIRECTOR OF NURSING
Dr Goh Wei Leong
VOLUNTEER DOCTOR, GENERAL PRACTITIONER
PRIVATE PRACTICE
Dr Tan Lai Yong
VOLUNTEER DOCTOR, RESIDENT FELLOW
COLLEGE OF ALICE & PETER TAN,
NATIONAL UNIVERSITY OF SINGAPORE
Dr Tony Tan presenting an Honourable Mention
award to Madam Wong Kuan Ying of IMH.
Mr Anthony Chandren
Ms Jane Tay Eng Choo
Dr Noeline Tan
PRINCIPAL ENROLLED NURSE
SENIOR NURSE MANAGER
SENIOR DENTAL REGISTRAR
SINGAPORE GENERAL HOSPITAL
HEALTH PROMOTION BOARD
Dr Chan Keen Loong
Ms Jasmine Goh Bee Bee
Ms Norbayah Binte Md Yasin
HEAD & SENIOR CONSULTANT,
DEPARTMENT OF PSYCHOLOGICAL MEDICINE
MANAGER, NURSING
JURONG HEALTH SERVICES
HEALTH PROMOTION BOARD
Ms Jennilyn Repulda Moreno
Ms Norlidah Binte Mohd Noor
KHOO TECK PUAT HOSPITAL
Ms Cheng Hong
SENIOR STAFF NURSE
Prof Chng Hiok Hee
SENIOR CONSULTANT, DEPARTMENT OF
RHEUMATOLOGY, ALLERGY & IMMUNOLOGY
SENIOR STAFF NURSE
SENIOR STAFF NURSE
CHANGI GENERAL HOSPITAL
Ms Juvena Gan Chew Huang
Ms Nurshifa Binte Shaik Hussain
ADVANCED PRACTICE NURSE (NURSE CLNICIAN)
NURSE CLINICIAN
NATIONAL UNIVERSITY HEALTH SYSTEM
Ms Karen Chua Hui Ling
Ms Ong Qiu Feng
Dr Chong Poh Heng
ASST MANAGER, COMMUNITY CASE MANAGEMENT SERVICES
SENIOR STAFF NURSE
AGENCY FOR INTEGRATED CARE
HCA HOSPITAL CARE
Mr Koh Chee Wai
Ms Ong Shihui
Dr Chong Shu-Ling
Mr Kothubutheen Mohamed Farook
Dr Png Hong Hock
DEPUTY MEDICAL DIRECTOR AND
PROGRAMME DIRECTOR, STAR PALS
STAFF PHYSICIAN,
DEPARTMENT OF EMERGENCY MEDICINE
Ms Cing Khan Lian
SENIOR STAFF NURSE
Professor Dale Fisher
HEAD & SENIOR CONSULTANT,
DIVISION OF INFECTIOUS DISEASES
PRINCIPAL MEDICAL SOCIAL WORKER
SENIOR RESEARCH OPTOMETRIST
SENIOR STAFF NURSE
DEPUTY DIRECTOR OF NURSING
SINGAPORE NATIONAL EYE CENTRE
Ms Lee Ang Noi
Ms Priscilla Fu Qixin
SENIOR STAFF NURSE
Ms Lee Mui Yok
Ms Rasedah Mohd Ismail
SENIOR STAFF NURSE
Dr Dominique Phang Pei Yue
Ms Lim Hen Jia
Ms Reeja Jose
FAMILY PHYSICIAN
NATIONAL HEALTHCARE GROUP POLYCLINICS
Ms Evelyn Qua Ruo Qi
Ms Lim Soo Ting
SENIOR STAFF NURSE
ADVANCED PRACTICE NURSE (NURSE CLINICIAN)
Ms Florence Cheong Wai Fong
Ms Lim Tin Tin
HEAD, DEPARTMENT OF OCCUPATIONAL THERAPY
SENIOR STAFF NURSE
Ms Guo Lixia
Ms Lo Chew Yong
SENIOR STAFF NURSE
ADVANCED PRACTICE NURSE (NURSE CLINICIAN)
Mr Haanusia Prithivi Raj
Ms Low Ei Fern
SENIOR CLINICAL PSYCHOLOGIST
SENIOR STAFF NURSE
Ms Hariati Binte Sahak
A/Prof Malcolm Mahadevan
NURSE CLINICIAN
HEAD, DEPARTMENT OF EMERGENCY MEDICINE
HOME NURSING FOUNDATION
Ms Heidi Ho Mei Kiu
Ms Margaret Rajeswary d/o Manickam
SENIOR PATIENTS SERVICES ASSISTANT
NURSE CLINICIAN
ST LUKE’S HOSPITAL
Ms Ho Pei Wah
Ms Melissa Chew Mei Mei
SENIOR STAFF NURSE
Ms Rozana Binte Arshad
Ms Sarah Lo Kai Lin
OCCUPATIONAL THERAPIST
Ms Sng Bee Li
SENIOR MEDICAL SOCIAL WORKER
Ms Sukhdev Kaur d/o Ranjit Singh
SENIOR STAFF NURSE
ASSISI HOSPICE
Ms Suraidah Binte Selamat
SENIOR STAFF NURSE,
DEPARTMENT OF EMERGENCY MEDICINE
Dr Tan T’zu-Jen
SENIOR CONSULTANT, DEPARTMENT OF SURGERY
KHOO TECK PUAT HOSPITAL
Ms Vhaney
PRINCIPAL MEDICAL SOCIAL WORKER
Ms Ho Soo Fung
Dr Nandakumar Mooppil
DIRECTOR, MEDICAL SERVICES
Dr Wong Wei Teen
PRINCIPAL OCCUPATIONAL THERAPIST
NATIONAL KIDNEY FOUNDATION
SINGHEALTH POLYCLINICS
Ms Irene Tan Cheng Gaik
Ms Neo Yu Shan
Ms Yeoh Lin Dai
NURSE CLINICIAN
STAFF NURSE
SENIOR STAFF NURSE
SENIOR STAFF NURSE
FAMILY PHYSICIAN
41
7/2/15 2:04 PM
LIST OF NHG AWARDEES 2015
LEE FOUNDATION NHG
LIFETIME ACHIEVEMENT AWARD
Prof Chng Hiok Hee TTSH
A/Prof Wong Kim Eng IMH
NHG DISTINGUISHED ACHIEVEMENT AWARD
A/Prof Vijayan Appasamy TTSH
(POSTHUMOUS)
A/Prof Alan Ng Wei Keong TTSH
Prof Roy Chan NSC
NHG OUTSTANDING CITIZENSHIP AWARD
HONOURING
OUTSTANDING
HEALTHCARE
WORKERS
NHG Outstanding Citizenship Award
recipients A/Prof Chua Sze Hon,
Ms Lim Yee Juan, Dr Tan Hui Ling,
Mrs Olivia Tay and A/Prof Wong
Hon Tym with NHG Chairman
Mdm Kay Kuok (third from left).
Dr Tan Hui Ling TTSH
Dr Wong Hon Tym TTSH
Dr Karen Ng Ming Yann NHGP
A/Prof Chua Sze Hon NSC
Mrs Olivia Tay NHG
Ms Lim Yee Juan NHG
NHG DISTINGUISHED CONTRIBUTOR AWARD
Mr Peter Lee Lian Heng NSC
HIGHLIGHTS FROM THE NHG AWARDS CEREMONY.
A
t this year’s annual National Healthcare
Group (NHG) Awards, 12 exemplary
individuals were honoured for their
significant contributions to the community, as
well as to the local and international healthcare
landscape. NHG Chairman Mdm Kay Kuok presented
the awards at a ceremony held on 26 May 2015 at the
Tan Tock Seng Hospital (TTSH) theatrette.
The top honour, the Lee Foundation NHG
Seven other NHG staff received the NHG
Lifetime Achievement Award, went to Associate
Outstanding Citizenship Award. One of them
Professor Wong Kim Eng of the Institute of Mental
was Associate Professor Wong Hon Tym,
Health (IMH). Also receiving this prestigious award
Medical Director of the NHG Eye Institute
was Professor Chng Hiok Hee (see story on page 43).
at TTSH. A/Prof Wong was instrumental in
The NHG Distinguished Achievement Award
clinics and tele-ophthalmology, initiatives
Centre (NSC). The expert in sexually-transmitted
aimed at reducing unnecessary hospital visits.
Director of NSC from 2004 to 2014.
Associate Professor Alan Ng of TTSH also
Notably, two of the seven recipients of
the NHG Outstanding Citizenship Award
are non-clinical staff. NHG Group Human
received the NHG Distinguished Achievement
Resources Officer Mrs Olivia Tay and NHG
Award. The Senior Consultant in TTSH’s Department
Group Chief Financial Officer Ms Lim Yee Juan
of Respiratory and Critical Care Medicine is one
were each instrumental in the development and
of only a few doctors in Singapore who perform
implementation of policies in NHG.
tracheobronchial stenting for breathing disorders.
The other recipients of the NHG Outstanding
A third NHG Distinguished Achievement Award
Citizenship Award were Dr Tan Hui Ling of
was bestowed posthumously on Associate Professor
TTSH, Dr Karen Ng Ming Yann of National
Vijayan Appasamy. The renowned trauma expert
Healthcare Group Polyclinics, and A/Prof Chua
and Senior Consultant in TTSH’s Department of
Sze Hon and Mr Peter Lee Lian Heng of NSC.
Lifewise
Mdm Kay Kuok
with (from left)
the daughter and
wife of the late
A/Prof Vijayan
Appasamy;
A/Prof Alan Ng;
and Prof Roy Chan.
setting up optometrist-led “step-down” eye
went to Professor Roy Chan of the National Skin
infections and president of Action for AIDS was
42
General Surgery passed away earlier this year.
J U L- A U G 2 0 1 5
7/2/15 2:04 PM
CARING IS THEIR
LIFE’S WORK
NHG LIFETIME ACHIEVEMENT AWARD WINNERS.
W
hen Associate Professor Wong Kim Eng
joined the Woodbridge mental hospital as a
psychiatrist some 40 years ago, her family
was worried. As A/Prof Wong told The Straits Times, “Back
then, mental health patients were perceived as violent,
especially those who were institutionalised.”
Her own preconceptions of the patients changed
soon after, as she found out that people with mental
health issues are rarely violent. “With some help, they
opened up about their lives,” she recalled. She also liked
that her job enabled her to understand people better.
Since then, the 66-year-old has made mental
WiSE-ing up
on dementia
IMH STUDY OF LOCAL ELDERLY UNCOVERS
FACTS AND FIGURES ABOUT THE DISORDER.
healthcare her life’s work. On 26 May 2015, the Emeritus
Consultant for Addiction Medicine at the Institute of
Mental Health was given the Lee Foundation-National
Healthcare Group Lifetime Achievement Award.
Through various outreach programmes, A/Prof Wong
has reduced the stigma against mental health patients.
Also receiving the award was Professor Chng Hiok
E
lderly folk are widely known to be prone
to developing depression and dementia
as they age, and now a Singapore study is
putting a number to this hypothesis.
The Well-being of the Singapore Elderly
(WiSE) study, spearheaded by the Institute of
Hee, 61, a Senior Consultant in Tan Tock Seng Hospital’s
Mental Health, was conducted in 2013. It sought
Rheumatology, Allergy and Immunology Department.
to establish the prevalence and risk factors of
With more than 30 years of experience under her belt,
dementia and depression among those aged
the pioneer in her field has trained many doctors.
60 and above. Further analysis of the data is
Over the years, Prof Chng has treated many patients
in progress and the depression results will be
with the potentially-fatal autoimmune disease lupus.
presented in due course. However, the first
As she told The Straits Times, “With good medication,
results pertaining to dementia are now available.
I’ve seen some grow up, get married and have the life
they thought they could not. It is most satisfying.”
A/Prof Wong (left) and
Prof Chng (right) receiving
their awards from Mdm Kay Kuok.
KEY FINDINGS:
• 10 per cent of the population aged 60 and
above have dementia
• Older age is a signicant factor in dementia
Likelihood of dementia for those aged
75 to 84 is 4.3x that of those aged 60 to 74
Likelihood of dementia for those aged 85
and up was 18.4x
• Elderly individuals who have had a stroke
were at higher risk of dementia
• A lower education level and unemployment
may be linked to dementia
The study also examined the burdens
dementia placed on elderly people and their
caregivers, including economic costs. It found
that a high proportion of individuals with
dementia (56 per cent) needed care much of
the time compared to those without dementia
(2.4 per cent). Finally, caregivers of people with
dementia reported higher stress levels than
those caring for elderly without dementia.
43
7/2/15 2:04 PM
DEBUNKING
STEREOTYPES
THIS YEAR’S 24-HOUR PLAYWRITING COMPETITION
WAS HELD AT THE INSTITUTE OF MENTAL HEALTH (IMH).
Enjoying
Their Time
in the Sun
PATIENTS AT IMH CAN NOW
RELAX OUTDOORS AT THE NEW
FRIENDSHIP GARDEN.
S
ome 950 long-stay patients at the
Institute of Mental Health (IMH)
can now enjoy sunshine and outdoor
F
exercise at the newly-renovated Friendship
ollowing a tradition of
being held at unusual
Garden. The facility was made possible
venues to provide
by a generous donation of $186,000 from
MINDSET Care Ltd.
participants with inspiration, the
18th annual 24-Hour Playwriting
The Friendship Garden features exercise
Competition was held at IMH for
stations that have been specially chosen
the first time. The competition,
and modified with patients’ safety in mind.
organised by TheatreWorks
There are also netball poles, a space for
in partnership with the South
gardening activities, a swing and a gazebo.
Nurses and IMH administrative staff take
East Community Development
Council, attracted 85 would-be
playwrights who drew inspiration
Game master Becca D’Bus engaging
budding playwrights.
from the institution to conceptualise a full play script within a
day — from the afternoon of 6 June 2015 to the next day.
CEO of IMH, Associate Professor Chua Hong Choon
turns to accompany patients to the garden
every morning, making it possible for more
of them to enjoy the outdoors.
The garden was officially opened with
a tree-planting ceremony on 9 March 2015.
welcomed the writers, who were aged 15 to 49. Lending
Jointly officiating the opening were IMH
support were playwright and TheatreWorks Managing Director
Chief Executive Officer Associate Professor
Tay Tong; and Mayor of South East District Dr Maliki Osman,
Chua Hong Choon and Chairman of
who revealed the first of five script stimuli to the participants.
MINDSET Care Ltd Mr Alex Newbigging.
The affair was a spirited one, with flamboyant personality
Becca D’Bus taking on the role of game master. There were
educational, stereotype-busting moments, as playwright
MINDSET Care Limited Steering Committee members,
led by Chairman Mr Alex Newbigging (third from right),
were hosted by IMH management at the
Friendship Garden opening ceremony.
Ms Yane Usagi recounted in a piece about the experience
to TODAY newspaper. Describing IMH as “resort-like” and
tranquil, Ms Usagi was struck by the lack of understanding
society has about mental illness. Indeed, she concluded
that people with mental illness should be viewed differently
— as individuals with lives and dreams — and not just as
irredeemable characters used to move a plot along.
The winners of the competition will be announced by
TheatreWorks in October.
44
Lifewise
J U L- A U G 2 0 1 5
7/2/15 2:04 PM
NEW POLYCLINIC IN JURONG WEST
GROUNDBREAKING CEREMONY HELD AT SITE OF THE NEW PIONEER FAMILY HEALTHCARE CENTRE.
The new polyclinic will fill the gap in
comprehensive primary care clinics in
the Jurong West and Pioneer area.
R
esidents of the Jurong West Extension and
Pioneer areas can look forward to a new
Joining Hands
for Hygiene
primary care facility in 2017. The upcoming
Pioneer Family Healthcare Centre will enhance
the health of individuals and families in the
community. On 29 May 2015, Senior Minister of
State for Health and Manpower, Dr Amy Khor, was
Guest-of-Honour at the groundbreaking ceremony.
Also present at the ceremony were National
TAN TOCK SENG HOSPITAL RAISES AWARENESS OF
THE IMPORTANCE OF KEEPING OUR HANDS CLEAN.
Healthcare Group (NHG) Chairman Mdm Kay Kuok
and NHG Group CEO Professor Philip Choo.
The building will be built adjacent to Jurong
West Primary School, near Pioneer MRT Station.
To better reflect the facility’s mission, the
‘polyclinic’ moniker has been dropped. However,
the tagline reads “Your Community Polyclinic”.
Said Associate Professor Chong Phui-Nah,
P
athogens such as bacteria can be spread through
the sharing of personal belongings, handshakes and
even by touching surfaces such as tabletops. This
makes good hand hygiene extremely essential in a hospital.
To raise awareness of this, Tan Tock Seng Hospital
(TTSH) held a hospital-wide campaign in conjunction with
World Hand Hygiene Day. The “I Have Washed My Hands”
Chief Executive Officer of NHGP, “Polyclinics
campaign ran for six weeks from early May 2015. It was
have been trusted by generations of Singaporeans
led by TTSH patient leaders and volunteers and supported
to provide accessible, affordable, quality
by the hospital’s Infection Control Unit. More than
comprehensive care. We need to continuously
500 volunteers were trained in good hand hygiene. In turn,
reinvent ourselves to deliver greater value to
they invited patients, visitors and staff to practise washing
patients and their families.”
their hands effectively.
A FUTURE-READY CLINIC
hands” badge/sticker as well as a pamphlet to help spread
The Pioneer Family Healthcare Centre is being
the word. In all, the campaign successfully reached 6,832
developed to support the healthcare needs of
participants.
Those who passed the test received a “I have washed my
a greying population. NHGP is looking to
Mr Michael Poh, Co-Chairman of TTSH’s
improve on the chronic care model as
CareConnect Volunteer Committee said
well as overall care for patients. Another
possibility is for patients to be treated
this is the first time patient leaders and
volunteers have led a hand hygiene
by a regular team of healthcare
campaign, together with the hospital.
professionals so as to build strong
“As a patient myself, it is reassuring to
relationships between patients and
know that the hospital is prioritising
their healthcare teams.
our safety and involving us in this
The Pioneer Family Healthcare
Centre will also promote health awareness.
meaningful endeavour,” he said.
Hospital staff at the TTSH education event.
45
7/2/15 2:04 PM
LENDING A HAND
IN QUAKE-HIT NEPAL
NHG STAFF ASSISTED IN THE HUMANITARIAN
EFFORTS AFTER THE 25 APRIL DISASTER.
Dr Wayne Yap: We discovered
that the media significantly hyped up
information. The best judge [of the
situation] would be local organisations
or individuals on the ground.
Another important lesson we
learnt is humility. Helping the Nepali
people in the relief effort teaches
you to simplify life and deconstruct
I
n the wake of the massive earthquake that struck Nepal on
yourself. In that way, this has been
25 April 2015, staff from across the National Healthcare Group
one of the most humbling experiences
(NHG) were mobilised to lend a hand in the humanitarian effort.
of my life.
Dr Ranjana Acharya from Tan Tock Seng Hospital (TTSH)’s
Department of General Medicine was part of a SAF-MOH led
team that provided medical aid to about 3,000 casualties.
Dr Zhang Jun Ren and Dr Leonard Ho, both Registrars at TTSH,
were also part of SAF’s medical team. TTSH Orthopaedic Surgery
Dr Wayne Yap
and Dr Kumaran
Rasappan.
Residents Dr Wayne Yap and Dr Kumaran Rasappan were part
of Mercy Relief’s disaster response team stationed at district
hospitals to assist with surgeries. They also helped patients at
village clinics, treating over 100 sick and wounded patients a day.
Dr Chua Ying Xian and Dr Pang Ningyi from the National
Healthcare Group Polyclinics (NHGP) assisted in Nepal
as well, though not as part of an official relief team. They
had arrived in the Himalayan nation before the quake to
carry out social work. They stayed on to help the community
after the disaster.
Here are snippets of the doctors’ experiences.
46
Dr Chua Ying Xian:
Dr Pang Ningyi: We slept in
Dr Ranjana Acharya:
Supporting the local medical
tents on a farm as advised by the
From my department head, to
professionals is more important
local authorities. One of our friends
TTSH’s Chairman Medical Board
than sending just manpower
spotted two tigers. We lived through
to the emergency planning team,
over for relief work. The
the earthquakes with our Nepalese
the support was swift, efficient
locals understand their people
friends, serving one another. Besides
and encouraging. I would say
better, and have a clearer
food, water and shelter, the locals
TTSH and MOH are responsive
grasp of system-level issues
also need people and friends who
to global requests for medical
which foreigners might not be
would stand with them through the
assistance in an organised and
familiar with.
months ahead.
structured way.
Lifewise
J U L- A U G 2 0 1 5
7/2/15 2:04 PM
From left, A/Prof Benjamin Wong, Director of Medical
Services, MOH; Mr Gan Kim Yong, Minister for Health;
and Dr Lam Pin Min, Minister of State for Health.
Above:
Dr Lam Pin Min
with (from left)
A/Prof Thomas Lew,
A/Prof Chin Jing Jih
and Adjunct A/Prof
Daniel Fung.
ENGAGING
THE MINISTER
MR GAN KIM YONG HELD A TOWNHALL WITH
THE NATIONAL HEALTHCARE GROUP (NHG).
M
inister for Health Mr Gan Kim Yong held a
Associate Professor Benjamin Ong. The session opened
Minister’s Townhall Session with 300 staff
with an address from then Acting NHG Group CEO
of NHG on 30 April 2015 at Tan Tock Seng
Mr Linus Tham before a presentation by MOH on their
vision for Healthcare 2020.
Hospital (TTSH).
The session engaged staff to ensure the Ministry of
The panel emphasised the importance of
Health (MOH)’s messages on healthcare affordability,
developing an integrated, sustainable health system
accessibility and quality were aligned with those of
that delivers quality care to the community. Thereafter,
public health institutions.
Mr Gan and Dr Lam took questions from NHG staff.
Joining Mr Gan were Minister of State for Health
Dr Lam Pin Min, and Director of Medical Services
The two-hour Townhall was constructive, with
active staff participation.
Long Service Awards
were given out.
Sharing Group objectives
NHG HQ’S FIRST TOWNHALL FOR 2015
WITH GROUP CEO PROFESSOR PHILIP CHOO.
O
ver the course of two
days, NHG HQ held
its first Townhall
sessions for the year, with
Group CEO Professor Philip
Choo marking his debut
proactive healthy living,
helming the event.
and to engage with patients,
Prof Choo shared NHG’s
strategic objectives for
Prof Choo reiterated
the need to engage
with patients, partners
and the community.
partners and the community.
In addition, Long Service
2015 and beyond, as well as
Awards were presented to
highlighted the importance
recognise staff for their
of working towards a
contributions. Group Human
sustainable, relationship-
Resources also talked about
based healthcare system
the new Code of Conduct
centred around patients.
to remind staff to act with
He also encouraged
everyone to focus on
integrity when engaging with
external vendors.
47
7/2/15 2:04 PM
DIRECTORY
AN EASY GUIDE FOR YOU TO CONTACT OR LOCATE US
NATIONAL
HEALTHCARE GROUP
CORPORATE OFFICE
3 Fusionopolis Link
#03-08, Nexus @
one-north
Singapore 138543
Tel: 6496-6000 /
Fax: 6496-6870
www.nhg.com.sg
The National Healthcare
Group (NHG) is a leader in
public healthcare in Singapore,
providing care through our
integrated network of nine
primary care polyclinics, acute
care hospital, national specialty
centres and business divisions.
NHG’s vision of “Adding Years
of Healthy Life” is more than
just about healing the sick.
It encompasses the more
difficult but more rewarding
task of preventing illness and
preserving health and quality
of life. As the Regional Health
System (RHS) for Central
Singapore, it is vital for NHG to
partner and collaborate with
other stakeholders, community
advisers, volunteer welfare
organisations and others in
this Care Network together
with our patients, their families
and caregivers to deliver
integrated healthcare services
and programmes that help in
“Adding Years of Healthy Life”
to all concerned.
Specialist mental health
services are provided to meet
the special needs of children
and adolescents, adults and
the elderly. There are subspecialty clinics such as the
Neuro-Behavioural Clinic,
Psychogeriatric Clinic, Mood
Disorder Unit and an Addiction
Medicine Department. The
treatment at IMH integrates
evidence-based therapies,
supported by the departments
of Clinical Psychology, Nursing,
Occupational Therapy and
Medical Social Work, to provide
holistic care for patients.
IMH also provides a 24-hour
Psychiatric Emergency Service.
11 Jalan Tan Tock Seng
Tel: 6256-6011 /
Fax: 6252-7282
www.ttsh.com.sg
The second largest acute care
general hospital in Singapore
with specialty centres in
Endoscopy, Foot Care &
Limb Design, Rehabilitation
Medicine and Communicable
Diseases. It covers 27
clinical specialties, including
cardiology, geriatric
medicine, infectious diseases,
rheumatology, allergy and
immunology, diagnostic
radiology, emergency
medicine, gastroenterology,
otorhinolaryngology,
orthopaedic surgery,
ophthalmology and
general surgery.
INSTITUTE OF
MENTAL HEALTH
Buangkok Green Medical Park,
10 Buangkok View
Singapore 539747
Tel: 6389-2000 /
Fax: 6385-1050
www.imh.com.sg
48
Lifewise
e
2 Teck Whye Crescent
Fax: 6765-0851
CLEMENTI POLYCLINIC
Blk 451 Clementi Ave 3
#02-307 Fax: 6775-7594
HOUGANG POLYCLINIC
89 Hougang Ave 4
Fax: 6386-3783
JURONG POLYCLINIC
190 Jurong East Ave 1
Fax: 6562-0244
TOA PAYOH POLYCLINIC
2003 Toa Payoh Lor 8
Fax: 6259-4731
WOODLANDS POLYCLINIC
10 Woodlands St 31
Fax: 6367-4964
YISHUN POLYCLINIC
NATIONAL
SKIN CENTRE
1 Mandalay Road
Tel: 6253-4455 /
Fax: 6253-3225
www.nsc.com.sg
The centre has a team of
trained dermatologists to
treat patients with various skin
problems. To serve patients
better, there are sub-specialty
clinics for the different skin
disorders and laser surgeries.
NATIONAL HEALTHCARE
GROUP POLYCLINICS
Contact centre: 6355-3000
www.nhgp.com.sg
TAN TOCK SENG
HOSPITAL
CHOA CHU KANG POLYCLINIC
Polyclinics (NHGP) forms
NHG's primary healthcare arm.
NHGP's nine polyclinics serve
a significant proportion of
the population in the central,
northern and western parts
of Singapore. NHGP's onestop health centres provide
treatment for acute medical
conditions, management of
chronic diseases, womenand-child health services
and dental care. NHGP also
enhances the field of family
medicine through research
and teaching. NHGP has also
been awarded the prestigious
Joint Commission International
(JCI) accreditation under
the Primary Care Standards.
Through the Family Medicine
Academy and the NHG
Family Medicine Residency
Programme, NHGP plays an
integral role in the delivery
of primary care training at
medical undergraduate and
post-graduate levels.
30A Yishun Central 1
Fax: 6852-1637
NHG COLLEGE
Tel: 6340-2362 /
Fax: 6340-3275
www.nhg.com.sg/college
The unit develops healthcare
professionals to their maximum
potential so that they will
provide quality, cost-effective
and safe evidence-based care
to patients.
NHG DIAGNOSTICS
Call centre: 6275-6443
(6-ASK-NHGD) /
Fax: 6496-6625
www.diagnostics.nhg.com.sg
Diagnostics (NHG Diagnostics)
is a business division of NHG.
It is the leading provider
in primary healthcare for
one-stop imaging and
laboratory services that is
accessible, cost effective,
seamless, timely and accurate.
NHG Diagnostics supports
polyclinics, community
hospitals, nursing homes,
general practitioners and
the community at large via
its extensive network in
Singapore, Indonesia and
Vietnam. Its services are
available in static and mobile
centres. Mobile services
include general X-ray,
mammogram, ultrasound,
bone mineral densitometry,
and medical courier. It also
provides tele-radiology service,
laboratory and radiology
management, and professional
consultancy services in setting
up of imaging centres and
clinical laboratories.
ANG MO KIO POLYCLINIC
Blk 723 Ang Mo Kio Ave 8
#01-4136 Fax: 6458-5664
BUKIT BATOK POLYCLINIC
50 Bukit Batok West Ave 3
Fax: 6566-2208
NHG PHARMACY
Tel: 6340-2300
Fill your prescription online:
www.pharmacy.nhg.com.sg
NHG Pharmacy manages
the dispensary and retail
pharmacies at all nine
NHG Polyclinics. Services
include Smoking Cessation
Clinics, pharmacist-led
Anti-Coagulation Clinics
and Hypertension-DiabetesLipidemia Clinics, where
pharmacists monitor and
help patients optimise their
medication. Patients may also
consult our pharmacists for
treatment of minor ailments
or for travel or nutritional
advice. NHG Pharmacy also
provides comprehensive
medicationmanagement
services to Intermediate Long
Term Care facilities (ILTCs)
such as nursing homes. Under
the ConviDose™ programme,
medication is conveniently
packed into individual sachets
for patients according
to the stipulated quantity
and time the pills need to
be consumed.
PRIMARY
CARE ACADEMY
Tel: 6496-6681 /
Fax: 6496-6669
www.pca.sg
The Primary Care Academy
(PCA), a member of NHG,
was set up to meet the
professional training needs
of primary healthcare
professionals in Singapore
and the region. PCA aims to
be a platform for sharing of
expertise and capacity building
among community healthcare
leaders and practitioners in
and around ASEAN.
JOHNS HOPKINS
SINGAPORE
INTERNATIONAL
MEDICAL CENTRE
11 Jalan Tan Tock Seng
Tel: 6880-2222 /
Fax: 6880-2233
www.imc.jhmi.edu
Johns Hopkins Singapore
International Medical Centre
(JHSIMC) is a licensed
30-bed medical oncology
facility located in Singapore,
a joint venture between the
NHG and Johns Hopkins
Medicine International (JHMI).
It is the only fully-branded
Johns Hopkins facility
outside the United States,
providing inpatient and
outpatient medical oncology
care, medical intensive
care, laboratory services,
hospital and retail pharmacy,
general internal medicine
and health screenings.
J U L- A U G 2 0 1 5
7/2/15 2:05 PM
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