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NOV-DEC 2018

A HEALTHIER, HAPPIER LIFE

中文由 25页起

Easy ways toDO GOOD

Meet our staff volunteers who go the extra mile

BEAT BURNOUT COPING WHEN YOU'RE RUNNING ON EMPTY

HEART AFLUTTER WHAT YOU NEED TO KNOW ABOUT PALPITATIONS

Life can be very unpredictable. Sometimes, it gets tough, while at others, beautiful moments appear. We can live fully in each and every one of these moments – both the good and the not-so good. Caring hopes to partner you in this journey.

In this issue, we learn to take care of that one organ that does not sleep – our heart! Learn about palpitations and what you can do if you suffer from them (page 6).

When we reach out to others and offer help, we find joy in unexpected ways. Read how a group of healthcare staff did just that (page 12). But you need not be a hospital staff to be in a position to lend others a helping hand. Healing does not belong only to doctors and nurses – it also involves the community. Learn how a special group of volunteers has made our hospital environment more lively and homely for everyone through their love of music (page 15).

If you feel the year has not been kind to you, with your days filled with endless routine and work, could you be suffering from burnout (page 10)? Take a timeout for some self-care – it can only do you good. While you are at it, read our GPFirst stories (page 22), and you may find some of your health queries answered.

I shall end this note with a line from a song that everyone sings as the new year beckons: “Should auld acquaintance be forgot and never brought to mind?” We think not! We thank you for staying with us through the years and hope that our content has been useful.

A toast to auld lang syne (days gone by) and a step forward to better and healthier days!

Sarah Abdul KarimEditor

Supervising Editor Vivian Song

Editor Sarah Abdul Karim

Contributors Ashikin Bte Osman Wee Jun Chiang Dr Colin Yeo Dr David Teo Retna Devi Sng Miuh Tin Dr Juliana Bahadin Dr Belle Wong Translators Yip Laimei Alan Li

Photographer Lumiere Photography

Design & Production NewBase Content

Media Specialist: Sarin Wee Email: [email protected]

Materials: Doreen Lau Email: [email protected]

MCI (P) 123/12/2017. Company registration number: 198904226R. All rights reserved. Copyright © 2017. No part of this publication can be reproduced in any form or by any means without the permission of the publisher. The views and opinions expressed or implied in are those of the authors or contributors and do not necessarily reflect those of the publisher.

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Caring is published bi-monthly for Changi General Hospital by NewBase Content

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EDITOR’S NOTE

NOV-DEC 2018 CARING 1

CONTENTS

0630

2425

0226

1034

02 MEDICAL IMAGING: WHAT TO EXPECT Learn what medical imaging does and how it is conducted

06 WHEN YOUR HEART GOES AFLUTTER What are palpitations, and what should you do if you have them?

10 REACH OUT BEFORE YOU BURN OUT Realise when you are burnt out and learn the ways to deal with it

12 AN EASY GUIDE TO DOING GOOD CGH shares the ways to making a difference in the lives of others

15 THE JOY OF MUSIC Get to know our musically talented CGH volunteers

18 UNDER ONE ROOF AT OUR SILVERCARE HUB Seniors can now receive integrated care at our new facility in Tampines

21 NEW YEAR, NEW YOU Changing for the better in the upcoming year

22 YOUR GPs CAN TREAT THESE CONDITIONS A GPFirst series

24 HEALTHY EATS Chrysanthemum Agar-Agar

25 吃出健康菊花果冻

26 医学成像:您知道多少了解什么是医学成像以及其过程

30 当您心乱如麻的时候什么是心悸，惹上它又该怎么办

34 倦怠不可懈怠知道自己何时已有倦怠并学习应对方法

36 简易指南之做好事樟宜综合医院与您分享点亮他人生命的方法

38 银发关怀站-乐龄医疗保健的一站式服务年长者现可在我们位于淡滨尼的崭新设施中享受一体化的照护服务

40 您的家庭医生能治疗这些病症！ “家庭医生首选”系列

2 CARING NOV-DEC 2018

HEALTH NOTES

MEDICALIMAGINGWHAT TO EXPECT

Mrs Tan is scheduled for an abdominal Computed Tomography (CT) scan at the Radiology department.

She is accompanied by her daughter, Elizabeth, who is also a radiographer in the department. As Mrs Tan has never undergone such procedure before, she feels anxious and has many doubts. However, Elizabeth took time off to walk her mother through the entire procedure, explaining what is involved and helping to clear any confusion or misconceptions she had. Not only did the conversation allay Mrs Tan’s fears, it also helped her feel more confident about the procedure and her daughter’s safety as a radiographer.

Medical imaging can detect a health condition, help doctors make an accurate diagnosis and guide the right treatment. Unsure what is involved in a scan? Join Mrs Tan on her first medical imaging journey.

No Food and Drin

k


George (patient service assistant): Good morning, Mrs Tan, how can I help you?Mrs Tan: Good morning, my CT scan appointment is at 9am. How do I register?George: Here, let me help you. You can register through this e-kiosk by scanning your Identity Card. You will receive a queue slip with a number, and you may wait at the waiting area for your queue number to be called.

Elizabeth: Mum, I know it is but it is really important to follow the preparation to ensure that the results of the procedure will be accurate. For example, do you know why you have to fast before doing the scan?Mrs Tan: Hmm, is it to make sure the scan is clear?Elizabeth: You are partially correct. Some scans require fasting, which means no food and drinks for about four hours before the scan. This is because the bowel’s contents will appear on the images, which may lead to difficulty in making a correct diagnosis. A full stomach may also cause discomfort after the contrast (dye) is injected or consumed.

Mrs Tan: I see...Elizabeth: Yes, and some scans also require you to drink water to expand the bowels or to fill the bladder so that the doctors can get more information during the scan.

Elizabeth and Mrs Tan are directed to a waiting area

Elizabeth: Mum, did you follow the preparation instruction given to you previously at the clinic? Mrs Tan: Yes I did, but I found it a bit troublesome. I had to skip my usual breakfast at Ya Kun!


HEALTH NOTES

Mrs Tan: Elizabeth, do you know Uncle John just underwent a CT scan last November and is scheduled for a follow-up scan this year? Is it safe for him? Elizabeth: Actually mum, there is no minimum period that Uncle John should wait between the scans, as long as his doctor feels that he needs it.Mrs Tan: I see. Okay, I will let him know. Speaking of ward patients and staff, aren’t they exposed to all the radiation when bedside X-rays are done?Elizabeth: Don’t worry mum, all our hospital staff are educated on radiation safety. For example, when we perform portable X-rays in the wards, the radiographer will announce that an X-ray is about to be conducted so the ward’s staff can move to stand

Mrs Tan: Are you sure it is safe to work in a department with radiation?Elizabeth: Mum, please don’t worry about me. I work in a safe environment. Do you know that all the walls in the X-ray procedure rooms are shielded with lead so the X-rays can’t pass through? Radiographers also wear a TLD, or Thermo-Luminescence Dosimeter, so that their exposure to radiation is measured and monitored while they perform radiation work.

Mrs Tan: Elizabeth, what is that red light on top of the CT scan door?Elizabeth: Oh, that red light is a warning alert to indicate that radiation is taking place, so no one is allowed to open the door for safety reasons. If you see a radiation logo on the front door, it means radiation is being used in that procedure room.

Mrs Tan starts looking around the department, as she checks out the equipment and premises. Elizabeth explains that besides radiation, magnetic field and sound energies are also commonly used in medical imaging.

Mrs Tan looks impressed at the set-up


2 metres away from the X-ray machine. The beds in the ward are also spaced about 2 metres apart, so other patients are safe from the radiation, too.

Mrs Tan: That’s good to know. What about MRI (Magnetic Resonance Imaging) and ultrasound, could they expose you to radiation, too?Elizabeth: No, mum. MRI or ultrasound scans do not involve any radiation. The MRI scanner uses a very strong magnet to produce images. That’s why before any MRI scan, we always check if the patient has any cardiac pacemaker, electronic devices or metallic implants in the body because sometimes it can interact with the magnet. And we always check if female patients are pregnant before any radiology procedure.

Mrs Tan (shaking her head): If radiation is harmful to people, I wonder why we are exposing ourselves to this danger.Elizabeth: Mum, you worry too much! In everyday life, we are already exposed to background radiation. It happens naturally everywhere in our environment. And while we should not take radiation exposure lightly, if the test is clinically indicated, its benefits outweigh the risk of exposure.Mrs Tan (nods): Oh, that’s interesting to know! I guess medical imaging is safe as long as it is done only when needed and when we take the necessary precautions.

That marked the end of Mrs Tan’s journey. With the relevant information, a medical imaging appointment need not be scary and is one that can ease your patient care journey.

Mrs Tan is called into the CT-scan room for her procedure. Her scan is completed in 10 minutes. Mrs Tan and Elizabeth are then directed back to the front counter to settle the final bill, after which they head home.

While we should not take radiation exposure

lightly, if the test is clinically indicated, the

benefits of the test outweigh the risk of

exposure.

Credits: Ashikin Bte Osman and Wee Jun Chiang, Radiography Team, CGH. Special thanks to Jolene Ooi Wei Ling for her contributions and feedback.

CGH celebrated Radiographer’s Day on 8 November with booth games, fun activities and mystery gifts up for grabs at the CGH atrium. More importantly, members of the public and staff were able to learn more about the myths and facts surrounding radiography.


HEALTH NOTES


WHEN YOUR

GOESAFLUTTER

Palpitations as a symptom are a manifestation of a wide range of conditions. How do we know what is acceptable and when should we seek medical attention?

Have you ever felt your heart skip a beat? Or a sensation of fluttering in your chest? These are common

descriptions of palpitations. Palpitations are described as an awareness of heart beat.

Common causes and symptoms Normally, we are not aware of our heart beating except perhaps during intense physical or emotional episodes. Our heart rate may be fast during such instances as it is our body’s way of coping with the metabolic demands of our vital organs.

Other common symptoms include skipped beats or feeling an extra beat. These are usually fleeting and due to ectopic beats in the background of regular heart rhythm. These ectopic beats usually occur randomly and are usually not associated with physical activities.

In some individuals, they may feel their heart racing out of the blue, lasting from minutes to hours, and these are typically not associated with any specific activities or emotional states. These sustained palpitations may be regular or completely chaotic in rhythm and may sometimes be


HEALTH NOTES

relieved with deep breathing. Individuals may experience other associated symptoms, such as chest tightness, tiredness, lethargy or simply anxiety. In such cases, medical attention should be sought.

What can we do about it?If you find palpitations affecting your quality of life, try to identify triggers and activities that tend to bring them on. In some cases, avoidance of caffeine, nicotine (commonly found in cigarettes), excess sugar and other stimulants may help reduce the frequency of palpitations. You may be surprised how prevalent stimulants are in our regular food and beverages (see table on right).

If you are experiencing sustained or

recurrent palpitations, inform your physician. You can help your physician arrive at an accurate diagnosis by assessing the rate and rhythm. You can do this by feeling your own pulse just below the angle of your jaw or at your wrist. In many instances, you can also assess the rhythm simply by being aware of how your heart is beating in your chest and tapping out the rhythm!

With today’s prevalent use of wearable technology such as smartwatches and smartphones, you are also able to assess

You can assess the rhythm of your

palpitations simply by being aware of how your heart is beating in your

chest and tapping out the rhythm


Adjunct Assistant Professor Colin Yeo is Consultant, Department of Cardiology, at CGH

WATCH OUT!

TRIGGERS WHERE TO FIND THEMCaffeine Coffee, tea, chocolate, energy drinksFoods high in simple sugars Energy drinks, sodaNicotine Cigarette smokeDrugs Weight loss pills, energy pills, recreational drugs (please check with your doctor)Lack of sleep/poor sleep (work with your doctor to

identify the cause of poor sleep)

your heart rate accurately. Although rhythm assessment in most consumer grade technologies today is less reliable, wearable technologies are expected to play a bigger role in rhythm assessment in the coming years.

When palpitations become more than a nuisanceOccasionally, palpitations can become debilitating. These are usually sustained episodes and associated with other symptoms such as chest tightness, lethargy, blackout or near blackout episodes. If you experience such symptoms, you should definitely seek early or immediate medical treatment.

Sometimes, palpitations can become catastrophic. Atrial fibrillation (AF) is an irregular, chaotic rhythm that can result in irreversible damage to the brain from the blood clots thrown off from the heart, resulting in debilitating functional deficits. AF is the most common rhythm condition in the general population and its prevalence increases with age. Risk factors include medical conditions such as hypertension, obesity, diabetes mellitus, heart disease and sleep apnoea.

What are the treatments available? Based on the symptoms described, your physician will perform a physical examination and run some medical tests to arrive at a diagnosis. Your physician may refer you to the relevant specialists, such as a cardiologist, for further investigations.

Sometimes, a definitive diagnosis can only be obtained through an electrical recording of your heart rhythm during the palpitations to corroborate the rhythm with the symptoms. The aim is to discover if your palpitations are due to a rhythm disturbance and if so, what kind. Ultimately, your doctor would want to find and treat the cause of the palpitations.

In cases where the cause is due to a heart condition that affects your quality of life, your physician may prescribe medications or an invasive procedure called catheter ablation. In many instances, catheter ablation can cure you of the condition or better manage it compared to medications.

Your physician will discuss the pros and cons of various treatment options and as a patient, you should participate actively in the discussion. Sometimes, this may require a multi-pronged approach to tackle the problem, such as modifying certain lifestyle practices.

Palpitations are a common symptom which, unfortunately, tend to be brushed aside without much thought by many patients. However, you do not need to suffer in silence. The good news is, most causes of palpitations are benign and medical treatment may not be necessary. It is important to talk to your physician and work together with us to find the best means to manage your condition.

RED FLAG SYMPTOMS • Sustained episodes of palpitations• Blackout or near blackout episodes• Chest pain/tightness• Shortness of breath• Cold sweats• Difficulty performing your usual

activities during episodes of palpitations


MENTAL WELLNESS

The signs can be subtle and tend to build up over time. If not treated early, burnout can take a toll on your quality of life

When I first met Mr Tan, he was 50 and married with two children. He was also the sole caregiver

for his mother, who suffered from multiple medical conditions. His daily commitments in caring for her affected his time with his wife and children. Gradually, he grew tired and resentful of his caregiver role. He felt like he was taking on this responsibility out of obligation and developed feelings of guilt. Mr Tan was suffering from burnout.

Spot the signsBurnout is a state of mental and physical exhaustion caused by excessive and prolonged stress typically arising from work

or caregiving activities. It is characterised by emotional exhaustion, detachment or cynicism, and a decreased sense of accomplishment. This leads to a loss of purpose. The effects of burnout can spill over into one’s personal life and strain relationships. It can also have detrimental effects on your physical and mental health, predisposing you to illnesses such as flu and depression.

Burnout develops gradually when you face persistent stress over time. Feeling overworked and unappreciated, lifestyle choices, and certain personality traits can also contribute to burnout.

If you constantly feel exhausted,

BURN OUTREACH OUT BEFORE YOU


unappreciated, and find no meaning in your

work and family, you may be suffering from burnout. Fortunately, you can take steps towards better self-care and

get back on track towards better

emotional and physical health.

Beat burnoutOne key step is to reach out to people around you to strengthen relationships. • Make the time you spend with friends and

loved ones enjoyable• Making friends at work bolsters the

camaraderie between you and your co-workers, which can help you feel less alone in facing challenges at work

• Joining a social, support or religious group can also mobilise a renewed sense of purpose and meaning in life

Reframing how you look at your work or role, and life, is also important. • Our minds naturally tend to focus on the

negative. If you can train your mind to focus on the things to be grateful for, you will be more optimistic and have a greater sense of well-being

• It is possible to discover some meaning in what you do. Even if you hate your job and cannot move on, you can still find meaning in other areas of your life such as family, friends, hobbies and volunteer work

Sometimes, burnout is an alarm bell that some aspect of your life is not working. • It is a signal to rest, reflect and

re-evaluate your goals and priorities. It can be an opportunity for personal growth and a change in outlook and direction in life

• It is also a reminder not to overstretch yourself. Set aside time for relaxation, get enough sleep, eat well and exercise.

If you have problems managing stress and are experiencing signs of burnout, consult your general practitioner who will be able to assess, manage, and if necessary, direct you to appropriate sources of help such as community-based counselling services.

It starts with self-careI recently saw Mr Tan again after he recovered from an episode of depression triggered by burnout. During his treatment, he learnt that self-care is pivotal in leading a happy and healthy life, better equipping him to care for others. He remarked that it amazed him how I was always smiling each time he came to see me. He mused that many patients I see as a psychiatrist would probably tell me sad stories and wondered how I could stay cheerful and optimistic. After a brief pause, I remarked that he was very insightful and admitted that my work could be emotionally draining at times.

Have I ever experienced signs of burnout? I certainly have at various points in my career. However, seeing patients like Mr Tan recover and rediscover their zest for life brings me much satisfaction as a doctor. Such encounters give me a sense of purpose and drive in the work I do each day and go a long way in preventing burnout.

To counter burnout among healthcare staff, the Health Wellness Programme (HWP) team published and distributed the book, Flourishing Lives – Preventing Burnout through Self-Care for primary healthcare providers, as well as all CGH staff. In the book, readers can learn about signs of burnout and identify them early, as well as pick up tips to prevent burnout through self-care.

The effects of burnout can spill over into one’s personal life and strain relationships

Dr David Teo is Consultant, Department of Psychological Medicine, and Deputy Director, Health Wellness Programme, at CGH

COVER STORY


Doing good is great for others and for you. Take it from CGH’s staff volunteers and learn how you can make a difference with this guide.

AN EASY GUIDE TODOING GOOD

To quote the great Dr Martin Luther King Jr: “Life’s most persistent and urgent question is: What are you

doing for others?” Going the extra mile does not have to be arduous, nor does it require great sacrifices – begin with simple and small actions coupled with good intentions. Still uncertain? Let us share some steps.

STEP 1: Help others feel goodPutting a smile on another person’s face is not a difficult feat. At CGH, a group of 15 staff members from different departments get together every Tuesday and Thursday as the volunteer group, Sounds of Joy in the Wards. They sing a selection of songs,


assistance to needy patients with chronic illnesses or conditions so they can continue to be cared for in their own homes after being discharged from hospital.

“The reality is that achieving a good level of care at home can be difficult even in the best of circumstances, with difficulties (ranging from) caregiver stress to financial strain,” explained Dr Roy Debajyoti Malakar, Chairperson of the HCA Committee. “This situation is even more challenging for low-income families. When the HCA team engages them, we always do our best to address their challenges and empower them to continue caring for their loved ones.”

Dr Roy, who is also Senior Consultant in CGH’s Department of Renal Medicine, noted that since HCA’s inception in 2002, the needs of its beneficiaries have gradually evolved. They are now more likely to require assistance in specific areas such as renal dialysis and respiratory equipment, compared to the past, when nutritional supplementation and consumables, such as wound dressings or adult diapers, formed the bulk of their needs.

“Regardless, it is due to programmes like HCA that we can help needy

patients become aware (of) help

Going the extra mile does not have to be arduous, nor

does it require great sacrifices

including local classics like Chan Mali Chan, to the patients in two wards in The Integrated Building just before lunchtime.

The Sounds of Joy initiative, launched in 2016, aims to bring cheer to the wards through song. This weekly activity has brought cheer to both patients and staff volunteers, who draw energy from bonding with colleagues and patients while engaging in an activity they really enjoy. Meanwhile, patients look forward to the days that volunteers visit, and would often sing along with gusto!

Read more about Sounds of Joy in the Wards in “The Joy of Music” on page 15.

STEP 2: There is more than one way to make a differenceHelping people can simply involve donating to a good cause, and there is no shortage of initiatives that reach out to different vulnerable groups to provide the necessary assistance.

HomeCare Assist (HCA) is one such example. This programme provides interim


COVER STORY

available, so that they can be more confident and empowered,” noted Dr Roy.

Contributing to HCA is simple and every little bit counts to our needy patients.

STEP 3: Remember that lending a hand is an enriching experience Helping those around you benefits everyone involved, sometimes in the most unexpected ways.

CGH’s Community Partnership Council is a fine example. It comprises 11 nurses who arrange and coordinate volunteering opportunities for their nursing colleagues at Infant Jesus Homes & Children’s Centre and All Saints Home. Additionally, the council also organises ad hoc events at places such as Jamiyah Home for the Aged. The response has been immensely and uniformly positive, spurring council members to keep exploring different avenues to help their colleagues

contribute to the less privileged. Sahnan bin Rahim, Assistant Nurse

Clinician (ANC) in Specialty Nursing, and Karen Tan, Senior Clinical Instructor (SCI) in Nursing Education, shared that not only is it heartening to receive positive feedback from the people they help, but that these activities have also proven to be great learning experiences for both themselves and their volunteers.

“By organising and planning these activities, we have picked up skills such as partnership-building and proposal-writing, which are very helpful,” adds SCI Tan, who is an advisor on the council.

For the volunteers, interacting with people beyond the hospital during these activities has helped them understand the behaviour of their own patients and be more in tune with their needs. Volunteering has thus been quite an eye-opening experience for some of them.

The council hopes to introduce new initiatives that will continue to benefit the community and hone nurses’ abilities as healthcare professionals. Despite having to juggle their daily work and council-member responsibilities, both ANC Sahnan and SCI Karen declared that being part of the council has been a memorable experience, and that they would not have it any other way. “The programmes have shown us how compassionate our nurses can be and that they are eager to contribute beyond work,” remarked ANC Sahnan. SCI Karen summed up her experiences in one word: “Satisfying!”

With these stories about the volunteering experiences of our friends and colleagues at CGH, we hope to have given you enough ideas and encouragement to embark on your own journey to make a difference!

Retna Devi is Executive, Corporate Affairs, at CGH

For the volunteers, interacting with people

beyond the hospital during these activities have helped

them understand the behaviour of their own

patients and be more in tune with their needs

Inspired by what CGH’s HomeCare Assist does? If you would like to donate to it, simply scan this QR code to find out how you can contribute


FEATURE

The universal language of music is one of the ways through which CGH volunteers choose to speak

to their community. We look at some of these individuals who have brought joy to many through their gift of song.

The FlautistMr Tan Kah Wah has been a volunteer with the Singapore Association for the Visually Handicapped (SAVH) since 1985, guiding members in outdoor activities. In one of his many visits to family and friends at CGH, he passed by a pianist playing the piano in the Main Building Atrium, which ignited his interest in

JOY MUSICCGH volunteers share how they use their biggest passion to spread happiness

THEOF


FEATURE

using his Native American flute to volunteer at CGH. Since August 2017, he has been volunteering every Friday for an hour at CGH Integrated Building.

Kah Wah likes the soothing notes of semi-classical, country, Celtic, Irish and traditional hymns, which induce a certain mellow and soft mood within and calms the person. The Native American flute he uses is able to produce the softness, melodic and nostalgic notes that resonate with the patients and people sitting in the lobby.

He believes that if a person is able to express himself adequately with a musical instrument in a carefree and easy-going manner, then it is time to volunteer. During his time as one, members of public who passed him by would often ask if he were taking donations for his performance, giving him the “thumbs up” gesture and clapping loudly as he played tune after melodious tune. These moments spur him on to continue his weekly flute-playing at CGH.

The PianistMrs Tan Peck Yin first volunteered as a teenager with her church to support its various ministries. She took on various roles, piano-playing being one of them. Prior to volunteering at CGH, she had been looking for an opportunity to use her piano playing skills to generate enjoyable music to lift the spirits of others. One day, when she accompanied her daughter to CGH for a medical appointment, she saw the grand piano at the Main Building Atrium. Being

curious, she went to have a closer look and saw a sign asking for volunteers

to play the piano, as part of music therapy. That started her journey as a volunteer pianist at CGH.

Peck Yin enjoys listening and playing light classical music, pop music with catchy melodies as well

as upbeat tempos. In Peck Yin’s opinion, soothing music is conducive

to generating a sense of well-being as well as speeding up recovery of the

person. Music is also a good element to have in a hospital, where the atmosphere is typically sombre.

Her advice to new volunteers is to know what their own talents are, and be ready to use them. There are many needs in the society and organisations like CGH are always looking for volunteers. One of her most memorable moments was seeing a patient dance when she played the Chinese song “The Moon Represents My Heart”. Peck Yin shares, “I am glad I am able to make some kind of difference to

I am glad I am able to make some kind of difference

to the lives of patients here

at CGH


If you would like to volunteer with CGH, scan this QR code to register or email [email protected]

the lives of patients here at CGH.” This is what has motivated her to continue to be a music volunteer.

The Joyful VoicesThe Joyful Voices is made up of four members: Richard, Sybil, Cindy and Victor who can play the ukulele, tambourine, guitar as well as sing. Volunteering at CGH started after one of the members witnessed how a patient in CGH came “alive” with a cheerful countenance when entertained by a group of musicians. Joyful Voices was the pioneer group that started music therapy at the Geriatric Day Hospital (GDH) in CGH more than three years ago. Their motivation for volunteering is to pay it forward and cheer people up.

Sng Miuh Tin is Assistant Manager, Office of Patient Experience and Transformation, at CGH

To them, music is a universal language that brings motivation and happiness not only to themselves but also to those around them. They believe that music is a form of therapy and can be beneficial to one’s mental health. One incredible moment for them during their music therapy at GDH was when a patient started to sing enthusiastically in Japanese when they were singing in English.

Having volunteered for many years, what do they have to say to potential volunteers? Be passionate about helping people, be happy doing it and look for areas that interest them.


FEATUREFEATURE

New facility allows seniors living in the east to receive integrated care within their community

Located in the heart of Tampines, Our SilverCare Hub (OSH) brings together various healthcare and social care

providers to deliver a unique blend of integrated care services for seniors across different care settings.

The hub was officially launched on 22 September by Mr Heng Swee Keat, Minister for Finance and Adviser to Tampines Grassroots Organisations. In his speech, he spoke about how we need to approach ageing and health issues as a community and with a positive attitude, to support seniors in enjoying their golden years. “Our SilverCare Hub adds to our landscape of care for our seniors in Tampines, together with the Community Networks for Seniors programme and our Silver Generation Ambassadors. It is a concrete manifestation of the government’s efforts to partner the people and private sectors to marry health and social care to properly support our seniors in ageing in place,” said Mr Heng.

UNDER ONE ROOF AT OUR SILVERCARE HUB

At Our Silvercare Hub, seniors plan, buy and cook meals for one another


Adjunct Professor Lee Chien Earn, Deputy Group CEO of the SingHealth Regional Health System, added, “Our SilverCare Hub enables senior residents in the east to receive comprehensive and integrated care within their community. With health and social needs assessment available under one roof, the care needs of senior residents can be identified early so that the right help and support can be given. This will provide seniors peace of mind, so that they have the confidence to live and age well in their community, knowing that support and help is available close by, when needed.”

How seniors can benefit from Our SilverCare HubThree facilities are located in close proximity to one another in OSH: St Andrew’s Senior Care (Tampines), the Eastern Community Health Centre (Eastern CHC) and the Tampines Family Medicine Clinic (TFMC).

They work in close collaboration with CGH and community partners like the national Community Network for Seniors, grassroots leaders and community care providers, to collectively provide a rich, connected range of healthcare and social services for seniors.

This enables seniors to stay healthy and socially engaged in the community, and allows them to receive timely, appropriate care and help when necessary.

Convenient access to healthcare services such as eye screenings is available to diabetic patients

(From left) Dr Benjamin Koh, Deputy Secretary (Development) at the Ministry of Health; Prof Teo Eng Kiong, Chairman of CGH’s Medical Board; Adj Prof Lee Chien Earn, Deputy Group CEO of the SingHealth RHS; Mr Heng Swee Keat, Minister for Finance and Adviser to Tampines Grassroots Organisations; Mdm Laila Kadir, a client of Our SilverCare Hub; Dr Loh Yik Hin, CEO of St Andrew’s Community Hospital; Dr Leong Choon Kit, Director of Tampines Family Medicine Clinic; and Dr Adrian Ee, CEO of SingHealth Polyclinic at the official launch of Our SilverCare Hub.


FEATURE

INTEGRATED HOLISTIC CAREINTEGRATED CARE AND SUPPORT THROUGH PARTNERSHIPS AND COLLABORATION This close working relationship between partners enhances the management of geriatric and chronic conditions within the community.With the patient’s consent, his or her care plan and information may be shared with identified partners that provide the required services. This gives patients a seamless experience across the different care providers. For example, seniors can receive comprehensive GP and care team services at TFMC, ancillary services for better chronic disease management at the Eastern CHC, and day care or community rehabilitation services at SASC (Tampines). And seniors can be referred to CGH if their condition becomes more complex and specialist support is required.

Tampines Family Medicine Clinic1 Tampines Walk Our Tampines Hub, #03-34Tel: 6702 6022

Eastern Community Health Centre1 Tampines Walk Our Tampines Hub, #03-33Tel: 6782 6885

St Andrew’s Senior Care (Tampines)1 Tampines Walk Our Tampines Hub, #04-33Tel: 6240 0366

For more information, contact the three OSH facilities at:

CONVENIENT ACCESS TO HEALTH, SOCIAL AND COMMUNITY CARE Seniors benefit from having all services under one roof. For example, seniors enrolled with the SASC (Tampines) can receive community rehabilitation, maintenance and dementia day care services, as well as participate in recreational activities, such as visiting the Eco-Community Garden on Level 5. They can participate in growing, harvesting and cooking of vegetables, and share them with others. Meanwhile, physically active seniors can enjoy playing games like table tennis in the Community Auditorium on Level 3.

TIMELY ASSESSMENT FOR SENIORS MAKES A DIFFERENCE Care needs should be identified early, so that the right help and support can be given. Community partners who know seniors who may require support can refer them to the TFMC for a Comprehensive Geriatric Assessment (CGA), which includes:• A holistic assessment of the patient’s physical and

functional abilities as well as psycho-social needs• Early identification of immediate and long-term needs • A customised care plan for seniors to receive appropriate

treatments and referrals to the right services


FEATURE

NEW YEAR, NEW YOU!

1. I will continue to eat healthy, with vegetables and fruits being a part of each meal.

2. I will develop positive lifestyle habits and drop those that are harmful to me.

3. Exercise, no matter how light, will be a part of my daily routine.

4. I will go for all my medical appointments and check-ups as required.

5. I will aim for balance in my work and personal life.

6. Mental health is as important as physical health. I will make time for self-care by taking time out when needed.

7. To keep mentally active, I will pick up new skills or attend relevant courses.

8. My loved ones are important to me and I will make time for them.

9. I will live each day with gratitude for the little things in life.

10. I choose to be positive, no matter how tough it gets.

Now is a great time to think about the changes you would like to see in your life. If you’ve not made your resolutions for

2019 yet, here’s a list that can help you.

Thank you for being with Caring all these years. We would love to hear how you have benefited from our stories, as well as which topics you would like to learn more about.

To drop us feedback, simply email [email protected] or write to: Editor, Caring Magazine, Changi General Hospital, 2 Simei Street 3, Singapore 529889

We would like to hear from you!

Dr Juliana Bahadin is Adjunct Assistant Professor at Duke Graduate Medical School and Adjunct Senior Lecturer at the Yong Loo Lin School of Medicine. She also practises at Saudara Clinic by A+J General Physicians. Prior to this, she was Clinic Director at SingHealth Polyclinic in Bedok, and later completed a fellowship under the HMDP scholarship programme in Primary Care Women’s Health at British Columbia Women’s Hospital in Canada.


MY GP ANSWERS

YOUR GPs CAN TREAT THESE CONDITIONS

The GPFirst Programme was launched in 2014 to encourage patients in eastern

Singapore to see their general practitioners (GPs) for mild to moderate medical conditions, rather than head straight to the emergency department. In this regular series, our eastern community GPs offer advice on common ailments Caring readers might face.

In this issue, we focus on hypertension and adult acne. Do visit www.gpfirst.sg or see your GP for more information on other common conditions such as nausea, headaches, sprains, fevers, cuts and bruises and mild scalds.

HYPERTENSIONI am a 45-year-old female. I love to indulge in good food. Recently my colleagues commented that I had put on some weight. A recent health screening revealed that my blood pressure was 141/90 and I have a 28.3 Body Mass Index (BMI). Lately, I have also been having headaches, especially in the morning when I rush for work. Am I suffering from hypertension? Can my GP help me?

Blood pressure (BP) changes from minute to minute, and can vary a lot in a day. Thus, your diagnosis of high blood pressure should be based on multiple BP measurements taken on several separate occasions and over four to seven consecutive days, before diagnosis of

hypertension can be confirmed. You can also buy a home blood pressure

monitor (HBPM), which is widely available and can be used repeatedly to show day-to-day blood pressure variation. If your HBPM average blood pressure is equal or more than 135/85 mmHg when measured repeatedly, you may be regarded as hypertensive. You should, however, consult your doctor to confirm and, more importantly, address the diagnosis.

Hypertension is associated with an increased risk of cardiovascular disease, including heart attack and stroke. Besides raised blood pressure, other risk factors for cardiovascular disease include a body mass Index (BMI) of over 27.5, a lack of physical


Dr Belle Wong is a GP who practises at Cana Medical Clinic & Surgery. She is trained in Surgery and Emergency Medicine, and has a special interest in women’s health, teenage medicine, preventive dermatology, acne and eczema. She battled acne for more than seven years, and is convinced healthy skin can be achieved with a carefully selected, customised skincare routine of medical and non-medical products.

activity, smoking, high stress levels, high cholesterol and diabetes.

In your case, losing weight can minimise your risk for cardiovascular disease. Aim to keep your BMI to less than 23kg/m2. Talk to your GP, who can assist you in your weight loss plan. Reducing stress, such giving yourself adequate time in the morning to get ready instead of rushing, helps too. Other small lifestyle changes can make a difference in cardiovascular health: eat a healthier diet high in fibre, veggies and whole grains, and low in fat and cholesterol, exercise regularly, limit alcohol and avoid smoking.

Hypertension is often called the silent killer because, even when severe, it may not manifest any symptoms. You may have headaches or giddiness when the hypertension is severe, but these symptoms are not specific to hypertension, they are also present in other diseases. It is best to talk to your GP who can evaluate the cause of your headache and suggest the right treatment.

ADULT ACNEI am a 20-something female suffering from acne breakouts. Is this unusual? What causes adult acne and how do I manage it?

You are not alone, about 50 per cent of women aged 20 to 29 have acne!

Acne is caused by the inflammation of the skin’s sebaceous glands. These glands become blocked, producing whiteheads and blackheads. Bacteria on the skin multiply in the blocked glands and causes inflammation, which can lead to nodules or pustules with or without heads, and sometimes, cysts, which are deep under the skin and can be tender and last for quite a while.

With teenage acne, pimples are found on the T-zone (forehead, nose and chin); these are usually caused by the increase in the levels of male hormones during puberty in both sexes. In adult hormonal acne, pimples usually form on the lower half of the face

(jawline, lower cheeks and chin). Hormonal fluctuations, emotional stress, change in weather/environment and unsuitable skincare products are possible causes. As a rule of thumb, wash your face no more than twice a day, as over-cleansing may encourage sebum production, potentially resulting in more clogged pores. After cleansing, use non-comedogenic moisturiser and sunblock. Avoid foods that may aggravate your acne, like chocolate or milk, refined carbs and sugar, and red meat. Maintain a healthy diet, drink plenty of water, and exercise regularly. Don’t pick at your acne no matter how tempting or it may scar!

Mild adult acne may be managed by topical treatments. Tea tree oil is a natural antiseptic which is effective in some cases. Your GP may recommend products containing alpha-hydroxy acids (fruit acids), glycolic acid or retinoids, as these help to slough off dead skin cells and prevent further blockage of sebaceous glands, even help lighten scars. In moderate to severe cases, oral therapy may include antibiotics, retinoids, or hormone pills. It usually takes at least two months for a new skin routine to take full effect, so be patient. If it persists, see a GP with a special interest in dermatology, or a dermatologist.


HEALTHY EATS

CHRYSANTHEMUM AGAR-AGAR

METHOD• Combine maltitol and agar-agar powder in

a mixing bowl and mix well. Sift to remove any lumps and set aside.

• Separate petals from chrysanthemum flowers and set aside.

• Combine chrysanthemum leaves and water in a pot and bring to boil.

• Once water is boiling, remove pot from heat and set aside to cool. Strain liquid into a mixing bowl or pot and squeeze excess liquid from leaves. Return liquid to the boil, add maltitol and agar-agar mixture.

• Stir constantly until liquid has thickened, then add water chestnuts and chrysanthemum petals. Remove from heat and set aside to cool.

• Pour liquid into a square tray measuring 20 x 20 x 7.5-cm (8 x 8 x 3-in) , then refrigerate to chill until set.

• Slice the agar-agar into desired shapes and serve chilled.

WHAT YOU’LL NEEDMaltitol (sugar substitute) 250g Agar-agar powder 25gDried white chrysanthemum flowers 5, soaked until soft and drainedDried white chrysanthemum leaves 100gWater 2.5l (10 cups)Water chestnuts 4, peeled and finely diced

NUTRITIONAL INFO (PER SERVING)Calories 77kcalCarbohydrate 0.3gFat nilCholesterol nilFibre 0.2g

1-2h cm tray

PREPARATION TIME MAKES

20

Try this refreshing dessert – perfect for cooling down on a warm day or right after a hot, spicy meal

One


吃出健康

营养信息（每份）卡路里 77千卡碳水化合物 0.3公克脂肪无胆固醇无纤维 0.2公克

所需材料麦芽糖醇 250克果冻粉 25克白菊花干 5朵（浸泡在水里至软化，滤干水分）白菊花叶 100克清水 2.5公升（10杯）马蹄 4个（削皮后切碎）

做法• 把麦芽糖醇和果冻粉倒入一个搅拌碗

里，搅拌均匀。把硬块去掉，备用。• 把菊花的花瓣摘下来，备用。• 把菊花叶和水倒入一个锅里，将其煮

开。• 当水开始煮开时，关火，然后把锅放一

旁冷却。把菊花叶水里的叶子过滤掉，并且把叶子里的水挤出。再次将菊花叶水煮开，加入之前搅拌好的麦芽糖醇和果冻粉。

• 不停地搅拌，直到液体变稠，然后加入马蹄碎和菊花瓣。关火，让其冷却。

• 把液体倒入20x2x7.5（8x8x3寸）的方形模具，然后放入冰箱里制冷直到液体凝固。

• 把果冻切成心怡的形状，冷冻上桌。

This recipe was first

published in A Cookbook

for Diabetics by a Dietitian and a Chef, which is available at all major bookstores. 该食谱于《A

Cookbook for Diabetics by a Dietitian and a Chef》中首

次出版，现已在各大书局出售。

1 2到小时长20公分的果冻

准备时间可制作

菊花果冻不妨尝试一下这道清凉的甜点 ——在炎热天或吃完辛辣餐食后享用最合适不过了！


保健小笔记

医学成像

您知道多少医学成像能探测出疾病，帮助医生做出准确诊断，并进行正确的治疗。对这个扫

描过程一知半解？现在就跟随陈太太一同体验她的首个医学成像扫描检查吧！

陈太太预约好了时间到放射部门接受腹部电脑断层扫描（Computed Tomography Scan）。陈太

太由在该部门担任放射照像技师的女儿Elizabeth陪同前去。由于陈太太是第一次接触医学成像，她感到很紧张，并且对于检查的程序有很多疑问。在接受检查的过程中，Elizabeth不断与母亲进行讲解，并且消除她对医学成像的误解。这不但让陈太太安心许多，也提高了她对女儿担任放射照像技师工作的安全性的信心。


No Food and Drin

k

Elizabeth与陈太太来到了等候厅

病人服务助理George：早啊，陈太太。您今天有预约吗？

陈太太：早安，我预约了早上9点接受电脑断层扫描。登记手续要怎么办？

病人服务助理George：让我来帮您吧。您可以使用E-Kiosk扫描您的身份证进行登记。您在获得一张号码纸条后，便能前往等候厅等待。您的号码将被呼叫。

Elizabeth：妈，你有遵照之前诊所给你的准备指示吗？

陈太太：有，我照做了。只是我觉得有点麻烦。我都没吃我平时爱吃的亚坤早餐呢！

Elizabeth：妈，我知道是有点麻烦，但遵照指示做好准备可确保检查结果的准确性。例如，你知道为什么我们总叫病人在做检查前必须禁食吗？

陈太太：（想了一下）是不是出来的图像会清楚一些？

El izabeth：你说对了一半。有些检查要求病人禁食，也就是在检查前的 4 个小时内不可以吃或喝东西。这是由于粪便会出现在图片上，从而提高诊断的难度。空腹也有助避免病人在被注射或服用了对比染剂后呕吐。

陈太太：啊，原来如此。El izabeth：是的，而

有些检查则需要病人喝水把粪便充大或增加膀胱的尿液量，以便医生能够从图片中获得更多的信息。

陈太太开始东张西望，巡视周围的环境和仪器。Elizabeth解释说，医学成像除了使用辐射外，也会使用磁场能量和声能量来为病人进行检查。

陈太太对这样的安排感到满意

保健小笔记


陈太太：在拥有辐射的放射部门工作真的安全吗？

Elizabeth：妈，你不用担心我。我的工作环境很安全。你知道吗，放射部门的X-光检查室里所有的墙壁都铺上了很厚的铅，这样X射线才不会穿墙泄漏到外面去。所有的放射照像技师都会穿上热致发光剂量计以监察他们在执行放射工作时所承受的个人辐射剂量，以确保他们的安全。

陈太太：Elizabeth，那个电脑断层扫描检查室门上的红灯有什么用途？

El izabeth：啊，那盏红灯是警惕我们检查室内正在启动辐射，任何人都不许开门。如果你在门上看到一个辐射的标志，这表示该检查室里正在使用辐射。

陈太太：Elizabeth，你知道John叔叔在去年11月份已接受了一次电脑断层扫描，但今年又得接受一次复诊扫描吗？这样做安全吗？

El izabeth：妈，其实扫描间并没有需间隔多长时间的说法，而只要医生认为John叔叔需要接受扫描，他都能这么做。

陈太太：哦好的。我会转告他的。那些放置在病床边的X-光机不会使病房里的病人和医护人员饱受辐射的危险吗？

El izabeth：妈，你不用担心。我们医院里所有的员工都接受过辐射安全培训的。例如，当我们在病房里使用手提 X - 光机时，放射照像技师都会宣布我们将进行放射扫描，而其他医护人员便会移动至距离X-光机至少两米的地方。此外，病房里病床之间也有约两米的距离，所以其他病人也不会被辐射影响。

这时，陈太太被呼叫，进入了电脑断层扫描检查室接受检查。她在10分钟后完成了扫描，并且回到了前台缴付费用，然后就回家了。

鸣谢：来自樟宜综合医院放射照像团队的Ashikin Bte Osman及Wee Jun Chiang特别感谢Jolene Ooi Wei Ling的贡献和所给予的反馈

樟宜综合医院于11月8日庆祝了放射照像技师日。当天的樟宜综合医院大厅，除了设有有趣的游戏、好玩的活动、神秘奖品外，最重要的是，公众及其他医护人员也能借此机会了解更多有关放射照像的迷思和信息。


陈太太：那还好。可是磁共振成像（Magnetic Res-onance Imaging）和超声波呢？它们对我们人体有害吗？

El izabeth：不会啦，妈。因为磁共振成像和超声波都和辐射没有任何关系。磁共振成像使用的是一个吸力非常强的磁铁，所以我们才会在进行检查前询问病人身上是否有安装心脏起搏器、电子设备或金属移植物，因为这些东西会影响磁铁。我们也会在进行任何放射检查前询问女士们是否有孕。

陈太太：（摇着头）哎哟，既然辐射对人们有害，我们为何还要以身犯险啊？

Elizabeth：妈，你想太多了啦。其实我们每时每刻都在接触所谓的背景辐射，这是自然存在在我们环境里的辐射。虽然我们不能对辐射掉以轻心，但如果检查受临床认可，其好处就胜过辐射的风险了。

陈太太：哦这挺有趣的！我猜想，只要我们只在有需要时接受医学成像检查并采取适当预防措施，这个过程应该是安全的。

这结束了陈太太的医学成像扫描检查。获知相关信息，医学成像扫描检查其实一点都不可怕，而且还能减轻您照护病人的负担。

虽然我们不能对辐射掉以轻心，但

如果检查受临床认可，其好处就胜过

辐射的风险了

保健小笔记



心悸的发生可能是不同疾病的症状。我们该如何辨别什么时候属于正常，什么时候该寻求医药协助呢？

您是否曾感觉心脏暂停了一下？或是有心跳加速的感觉？这些都是对心悸的常见描述。心悸指的是

对心跳产生意识。

心悸的常见导因在正常的情况下，我们并不会对自己的

心跳有所意识。然而，当生理或心理受到刺激时，我们可能会对自己的心跳产生意识。在我们接触到刺激物时，心跳加速是身体应对主要器官代谢需要的方式。

其他常见导因还包括心律不整。一般，这些症状漂浮不定，并且是由规律律动背后的异位搏动所引起。这些异位搏动通常随机发生，并且通常与从事体力活动没有关联。

有些人会感觉自己心跳突然加速，并且可能维持几分钟到几小时不等。一般，这种情况的出现与任何特定的活动或精神状态无关。这些持续性的心悸可能是有规律或是杂乱的，而且偶尔还可以通过深呼吸加以缓解。某些人则可能会有其他的症状，如胸口紧绷、疲倦、精神不振、或焦虑。如果出现以上所述的症状，您便应该求医。

当您

乱如麻的时候心


保健小笔记

您可以通过有意识地感受您的心跳，并敲打出节奏来评

估自己心悸的节律


客座助理教授Colin Yeo 是樟宜综合医院心脏科的顾问医生

我们应该如何应对？如果您觉得心悸的问题影响到您的

生活，您或许可以识别出引发心悸的刺激物或活动，并在某些情况下，避免摄取咖啡因、尼古丁（香烟里的常见物质）、过多的糖分和其他的刺激物都有助减低心悸发生的频率。您或许会感到惊讶，但事实上我们每天所吃的食物和饮料里所含有的刺激物成分其实相当高（见表）。

如果您持续不断或重复性地面对心悸问题，不妨考虑求医。通过自行测量心律和心率，您可以帮助医生做出准确的诊断。您可以在下巴的后侧或手腕上测量自己的心率。此外，您也可以通过有意识地感受您的心跳，并敲打出节奏来评估自己心悸的节律。随着智能手表和智能手机等可穿戴技术的普及化，您也可以准确的自行测量心率。虽然目前大多数消费级的科技在测量心律方面还不太可靠，但穿戴技术在不久的未来相信将会扮演更重要的角色。

若心悸变成一件麻烦事有时候，心悸会使人感到虚弱。这种心

悸通常会持续发作，并且和其它的症状如胸口紧绷、精神不振、昏厥或晕眩有关联。如果你有以上所述症状，请及早或立即求医。

此外，心悸也可能会带来严重的不良后果，如心房颤动就是心脏出现不规律、杂乱的心律，并且可能对脑部造成永久性损害。这是由于心房内所形成的血栓在脱落后流到全身各处，从而导致肢体动脉栓塞。心房颤动是最常见的心律疾病，并且其流行性会随着年龄的增长而提高。

其风险因素包括其他疾病，如高血压、肥胖、糖尿病、心脏病和睡眠呼吸暂停等。

治疗方式有哪些？根据您所形容的症状，医生讲为您进

行身体检查和化验，以做出诊断。医生也可能会将您转诊到相关的专科医生，如心脏科医生，以做进一步的检查。在某些情况下，只有通过在心悸发作时使用仪器记录心律，并测量它是否与症状相吻合，才能够做出确定的诊断。这样做是为了查出您的心悸是否源于心律失常，如果是的话，又究竟是哪一类的心律失常。医生的最终目的是找出导致心悸的根本原因。

如果心悸是由于心脏疾病所引起，并且影响了您的生活质量，医生便可能让您服用药物或接受一个名为心导管消融的手术。在许多情况下，心导管消融手术可将心悸问题完全治愈，或与药物相比更能有效可让你更好的管理这个病症。您的医生会与您商讨不同治疗方案的利与弊，而身为病人的您应当积极参与其中。有时候，这还需采用多重的治疗方案如改变生活习惯，才能有效应对问题。心悸虽然是一种常见症状，但却很不幸地经常被病人不假思索地将其忽视。然而，您无需在沉默中煎熬。不妨与您的医生分享您的问题，并且一起找出帮助您控制病情的最佳方法。

警示症状• 心悸持续发作• 昏厥或晕眩• 胸口紧绷／疼痛• 气短• 冒冷汗• 在心悸发作时无法从事日常活动

罪魁祸首藏身之处咖啡因咖啡、茶、巧克力、能量饮料单糖量高的食品能量饮料、苏打饮料尼古丁香烟药物减肥药、能量药丸、休闲药物（请和医生查询）缺乏睡眠／睡眠质量差（与医生合作，找出睡眠质

量差的原因）

小心！

保健小笔记


保健小笔记

其症状可能不明显，且会随着时间而加剧。若不及早治疗，倦怠将严重影响您的生活质量

当我第一次见到陈先生时，他年过 5 0 岁，已婚并且育有两名子

女。自从父亲过世后，他便成为了患有多种慢性疾病的母亲唯一的看护者。陈先生为了照料母亲每日的大小事项而无法抽出时间陪伴妻儿。他开始感到疲倦并且憎恨自己做为看护者的角色。他觉得自己照顾母亲的举动似乎只是在尽做儿子的义务而感到内疚。陈先生开始呈现出倦怠的症状。

倦怠不可懈怠

发现症状倦怠是一种在工作上或进行看护时，

长时间承受过大压力而产生身心疲劳的状态。它的特征是情绪衰竭、自我感丧失或愤世嫉俗，以及成就感下降。这使人失去使命感。倦怠会影响个人生活和其人际关系。虽然倦怠不是一个疾病，但它会对您的生理和心里健康造成重大的不良影响，从而使您更容易患上疾病如感冒和抑郁症等。


David Teo医生是樟宜综合医院心理医学科的顾问医生，也是身心保健小组的副总监

倦怠是在您长时间承受压力的情况下逐渐形成的。导致倦怠的因素包括过度劳累而其努力却不被认可、生活习惯，以及某些人格特征。

如果您经常觉得精疲力尽、不被赏识，并且感觉工作和家庭对自己毫无意义，您或许已陷入倦怠的状态中。所幸，您可以采取行动来更好地照顾自己，让自己的身心健康恢复到正常水平。

击败倦怠其中一个重要的步骤是与您周边的人建

立坚强的人际关系。• 当您与亲朋好友聚会时，尽可能制造

一个欢快的气氛• 在工作上与同事结成朋友会培养出友

爱的精神，并有助您应对日常工作中所碰到的问题

• 加入一个社交、援助或宗教团体也有助您重新寻获生命意义

换一个角度看待你的工作、职责和生命也是非常重要的。

• 我们经常会往坏的方面想。但如果您能锻炼自己的思维式，让自己专注在好的方面，对所有事持有感恩的心态，您将发现自己会变得更乐观、幸福健康。

• 要在平凡的工作中寻找意义是有可能的。即使您讨厌自己的工作但却无法离职，您可在生活中的其他方面，如家庭、朋友、嗜好和志愿工作中寻找到意义。

倦怠的出现就如警钟响起，告诉您其实• 它让您停下脚步、反思和重新评估

自己的人生目标和优先排序。这是个助您获得个人成长和对人生的前景改观的机会。

• 它也提醒着您不要过于操劳。抽出时间让自己放松、获得充足的睡眠、保持均衡饮食和定期做运动。

如果你发现自己无法应付压力并且有倦怠的症状或其并发症，你应该去看医生。家庭医生将能够评估、管理你的

倦怠，并且在有需要的情况下转介你到相应

的援助服务，如社区里的辅导服务。

一切从自我关爱开始

我最近又和陈先生见面了。他因倦

怠而患上抑郁症，但已痊愈。在治疗的过程

中，他学习到自我关爱有助您走向愉快和健康的生活的

重要性，并且给予他力量去照顾其他人。陈先生注意到当他每次来见我时，我总是以微笑迎接他。他猜想我在做为心理医生的工作中所接触到的病人应该大都和我述说他们的伤心事，因此他很好奇我是如何保持乐观积极的态度的。那我是否有过倦怠期？有的，在我的职业生涯中，我曾发生过几次。然而，当我看见像陈先生这样的病人能够逐渐康复，并且重新找到对生命的热忱，对身为医生的我给予了极大的满足感。他们给予我在工作上的推动力，并且有助预防我对工作产生倦怠。

为了帮助医护人员对抗倦怠，身心保健计划小组出版和发行了名为《幸福人生，自我关爱，预防倦怠》的书籍。所有的樟宜综合医院员工和医护人员将从书中学习倦怠的症状，并及早发现它，以及如何通过自我关爱预防倦怠的小贴士。

倦怠会影响个人生活和其

人际关系

封面故事


做好事不但利人也利己！窥探樟宜综合医院的员工志愿者的善行，并从中了解您如何能够享受助人的乐趣

好事人生最长久且迫切的问题是：您为他

人做了什么？”这句来自著名民运领袖马丁·路德·金的名言至今仍受用。

帮助他人无需是一件艰巨或需要做出巨大牺牲的事情。它可以从简单、带着好意的小举动开始。仍不知如何开始？让我们与您分享一些简单步骤供您参考。

第一步：让他人感到快乐让他人脸上展露笑容其实并非难事。樟

宜综合医院有一个由15名来自院内各部门员工所组成的小组，他们每个星期二和星期四聚集一堂就是为了做这件事。取名为‘病房的欢快之声’，其成员会在这两天的午饭时间前到综合大楼的其中两个病房为病人献唱。他们会演唱多首歌曲，其中包括一些本地的金典创作如Chan Mali Chan。小组是在2016年成立的，目的是希望通过歌声增添病房里欢快的气氛。病人们通常都会非常期待小组到来，并且还会和小组一起合唱呢！

这个每周一次的活动不仅为病人带来快乐，也给予了这群来自各部门的员工志愿者一个建立友谊的机会，并且一起参与一项他们都喜欢的活动。

您可翻阅第15页，以了解更多“病房的欢乐之声”的相关信息。

第二步：让他人快乐的方式不只一种其实通过捐赠也是一种帮助

他人的方法。社区里有许多帮

“简易指南之做


Retna Devi是樟宜综合医院企业事务部门的执行人员

助弱势群体的项目，主要为他们提供所需的援助。HomeCareAssist便是其中一项。通过该项目，需要援助的慢性病患可获得过渡援助，以便他们出院后能够在家里继续接受照护。

H o m e Ca r e A s s i s t项目委员会主席 Roy Debajyoti Malakar医生解释说： “事实上，要在家中获得良好的照护需面对不同挑战，如看护着的压力及财务问题等。这种情况在低收入家庭中更加严峻，所以当HCA在接触他们时，我们会尽可能地帮助他们应对他们的难题，并授权于他们以助他们能够继续照料他们的亲人。”

同样身为樟宜综合医院肾内科部门高级顾问医生的他也注意到，HCA自2002年成立至今，其受益人的需求正在逐渐改变。与早期所需的营养品、纱布和成人纸尿布等物品相比，他们现在可能在特定地方较需要援助，如购买洗肾及呼吸器等。

Roy医生说：“无论如何，我们只有通过如HCA的项目，才能让有需要的病人获知寻求援助的管道，从而让他们更有信心及获得保障。”为HCA做出贡献其实一点都不难，即使是小金额的捐款也能帮助不少有需要的病人。

第三步：为他人伸出援手可丰富您的人生经验

帮助身边的人能让参与的人受益，有时还会有意外的惊喜。樟宜综合医院的社区合作伙伴委员会便应证了这个说法。该委员会是由11名护士组成，主要为其护士同事安排和协调各种义工活动。

一整年里，委员会在耶稣基督之家与儿童中心（Infant Jesus Homes & Children’s Centre）和圣徒之家（All Saints Home）定期举办一系列的活动，并且也会在如Jamiyah老人之家的机构举办活动。护士们对活动的热烈积极反应与态度促使委员会成员不断寻找不同的活动地点，让同事们可以为弱势群体尽一份力。分别是委员会顾问和成员的助理临床专科护士Sahnan bin Rahim及护士教育高级临床导师Karan Tan分享说，她们不仅感到非常高兴能够获得这么好的反馈，同时也觉得这些活动对委员会成员及所有志愿者都是一个很好的学习经验。

“通过策划和安排这些活动，我们学习到了很多有用的技能，如建立合作伙伴

关系和编写协议书等。”Karen补充道。对于志愿者而言，这也是让她们增广见闻的机会，因为她们会接触到病房以外的人群，从而让她们能够更好地了解自己病人的行为和需要。委员会希望能够推出新项目，以持续让更多人受益，并且加强护士们的保健专业技能。

即便委员会成员们都需兼顾日常工作与委员会的职责，Sahnan和Karen都认为，能够成为委员会的一员是一段非常难忘的经历。“委员会所开展的项目让我们看见了护士们的关爱之心。这表示她们有能力并且都愿意在工作以外为他人付出。”Sahnan说道。对于Karen而言，她从中获得的最大收获就是“满足感”。

有了以上三个步骤和我们樟宜综合医院员工们的经验分享，我们希望您已做好足够的心理准备，一起来开启您的助人为乐的道路吧！


特写

崭新设施让居住在东部的年长者在社区中享有一体化的护理

银发关怀站-乐龄医疗保健的一站式服务

左图：卫生部副秘书长Benjamin Koh医生、樟宜综合医院医疗董事会主席Teo Eng Kiong教授、新保区域保健系统集团副总裁李建恩客座教授、财政部兼淡滨尼基层组织顾问王瑞杰、银发关怀站受益人Laila Kadir女士、圣安德烈社区医院总裁Loh Yik Hin医生、淡滨尼家庭医疗诊所董事Leong Choon Kit医生以及新保集团综合诊疗所总裁Adrian Ee医生一同出席银发关怀站的揭幕仪式

下图：患有糖尿病的病人可轻易获得如眼睛检查的医疗服务


及时获得评估对于年长者很重要及时发现年长者的照护需要，才能及

早给予正确的帮助和支持。社区合作伙伴若得知有哪些可

能需要帮助的年长者也可以把他们转介到淡滨尼家庭医疗诊所进行综合性老年评估（ C o m p r e h e n -sive Geriatric Assessment），其中就包括：

• 为年长者的身体机能与功能和心理社会需要做出整体性的评估

• 可及早发现当前和长期的需要• 设计个性化的照护计划，让年长者

获得适当的治疗和转介到正确的医疗服务

可轻易获得保健、社会及社区护理年长者可以轻松地在一个屋檐下获得

保健、社会和社区护理。例如，受圣安德烈（淡滨尼）乐龄服

务中心照顾的年长者可获得社区复健、复诊和失智症日间照护服务，并且参与由中心所安排的活动，如在第五层的生态社区花园种植蔬菜，并且收割和烹煮，然后在午餐时间与中心内的其他人一起分享。此外，喜欢运动的年长者也能在第三层的社区礼堂打乒乓球等。

通过合作和伙伴关系提供一体化的护理与支持

该紧密的合作关系可加强社区内年长和慢性疾病的管理能力。

在病人的同意下，照护方案和病人的资料可与提供服务的合作伙伴分享。这有助病人在所有的照护环境里获得无间断的照护体验。

例如，年长者可在淡滨尼家庭医疗诊所获得综合性的全科护理和关怀小组服务，在东部社区保健中心获得辅助服务以更好管理其慢性疾病，并且还可以在圣安德烈（淡滨尼）乐龄服务中心获得日间照护或社区复健服务。如果年长者的情况变得较为复杂并且需要专科协助，他们也会被转诊到樟宜综合医院接受治疗。

欲知更多详情，请联络以下三家机构：

淡滨尼家庭医疗诊所1 Tampines Walk, Our Tampines Hub, #03-34Singapore 528523电话：6702 6022营业时间：早上9点至下午5点（星期一至星期五）；早上9点至下午1点（星期六）

东部社区保健中心1 Tampines Walk, Our Tampines Hub, #03-33Singapore 528523电话：6782 6885营业时间：早上8点半至中午12点；下午1点至下午5点（星期一至星期五）

圣安德烈（淡滨尼）乐龄服务中心1 Tampines Walk, Our Tampines Hub, #04-33Singapore 528523电话：6240 0366营业时间：早上7点半至下午6点（星期一至星期五）

一体化的全面护理

位于淡滨尼中心的银发关怀站（Our SilverCare Hub）聚集各保健护

理和社会关怀者于一个屋檐下，目的是为有不同照护需要的年长者提供独特的一体化照护服务。

银发关怀站于2018年9月22日由财政部长兼淡滨尼基层组织顾问王瑞杰先生正式揭幕。在他的揭幕演讲中，他提到社区需一起去面对老龄化和保健问题，并且帮助年长者享受其晚年的黄金岁月。他说：“银发关怀站进一步扩大了在淡滨尼内的年长者照护服务范围，为年长者社区网络计划和银发族大使计划助力。这尤其展现了政府与人民和私人企业合作，结合保健护理和社会关怀来帮助我们的年长者在社区内安享晚年。”

新保区域保健系统集团副总裁李建恩医生补充说：“银发关怀站让居住在东部的年长者能够在社区中享有全面和一体化的护理。把保健和社会需要的评估工作集中在一个屋檐下有助于及早发现年长居民的关怀需要，从而让他们获得正确的帮助和支持。这样我们的年长者才能够放心，并且有信心的在社区中生活及安享晚年，因为他们知道当他们需要帮助时，援助就近在咫尺。”

年长者如何从银发关怀站中受惠在我们的银发关怀站内有三个距离

相近的设施，分别为圣安德烈（淡滨尼）乐龄服务中心（St. Andrew’s Senior Care (Tampines)）、东部社区保健中心（Eastern Community Health Centre）及淡滨尼家庭医疗诊所 (Tampines Family Medicine Clinic)。

这些机构与樟宜综合医院及社区合作伙伴，如全国年长者社区网络、基层领袖和社区关怀者有密切的合作，共同为年长者提供内容丰富及具连接性的保健护理和社会服务。这将有助年长者在社区里维持健康和积极的生活，并且让他们在有需要时，获得及时和适当的照护和帮助。

家庭医生解答


您的家庭医生能治疗这些病症！

成人痤疮我是一名20几岁的女性，患有痤疮。

这是正常的吗？是什么导致成人痤疮的发生，而我又该如何处理？

您并非孤军作战，因为有约50%年龄介于20至29岁的女性患有痤疮！痤疮是由皮脂腺发炎所致。皮脂腺受堵，以致白头和黑头的产生。细菌迅速在受堵的皮脂腺里繁殖，引起发炎，从而形成小瘤或脓疱（有脓痂或无脓痂），或甚至囊肿。囊肿藏在皮肤深层，并使病人感到疼痛，而且还可能维持很长时间。

在青春期的痤疮中，痘痘一般会出现在脸部的T型部位（额头、鼻子和下巴）；这通常是由于两性在发育期间体内的男性荷尔蒙增加所引起。但如果是成人荷尔蒙痤疮的话，痘痘一般会出现在脸部的下半部（下巴的轮廓线、脸颊下方和下巴）。

荷尔蒙的变动、精神上的压力、天气／环境的变化和使用不合适的护肤品都是可能导致痤疮的原因。

护肤的首要原则为每天洗面两次（过度清洗会引起更多皮脂的产生，从而导致毛孔阻塞）。清洗后，使用不会堵塞毛孔的润肤霜和防晒霜。避免吃那些可能会加剧痤疮问题的食物（如巧克力或牛奶、精制碳水化合物和糖及红肉）。保持健康的饮食、多喝水和定期做运动。无论脸上的痘痘多让您讨厌，您也千万不要把它们抓

东部医疗联盟于 2 0 1 4 年 1 月份推出了“家庭医生首选”计划，为的是

要鼓励居住在新加坡东部的病人在碰到轻微或中度的医疗状况时首先向家庭医生求助。在这个专栏里，东部医疗联盟的社区家庭医生将帮助《关怀》的读者解答一些常见的疾病问题。

浏览www.gpfirst.sg或咨询您的家庭医生更多有关常见的医疗状况，如割伤、撞伤、轻微烧伤、呕吐、流鼻血、伤风、蚊虫咬、头痛、扭伤及发烧。以下是读者发来有关高血压及成人痤疮的询问。

王贝儿医生是迦拿诊疗所的家庭医生。她主修外科与急诊医学，并且对妇女保健、青少年医学、预防性皮肤科、痤疮和湿疹有着浓厚兴趣。她本人被痤疮问题困扰了七年，因此相信每个人都能通过使用特制的医疗或非医疗产品及个性化护肤疗程来获得健康的肌肤。


高血压你好，我是一名45岁的女性。我是一个

美食爱好者。最近，我的同事说我好像胖了。在最近的体检中也验出了我的血压为141/90，身体质量指数（BMI）为28.3。我也注意到了自己近期经常头疼，尤其是在早上赶着去上班的时候。我是不是患上了高血压？我的家庭医生能够帮助我吗？

一个人体内的血压其实每分钟都在改变，并且在一天内可能经历很多变动。因此，高血压的诊断应根据多次而且在不同的时间段进行测量的血压结果才算准确。换言之，在确诊是否患有高血压之前，病人必须在连续四至七天内，接受几次的血压检查。

家庭血压监测可助您发现自己是否患有高血压。它可显示每天血压的变动，重复使用也非常简易。如果您进行了多次家庭血压监测后的平均血压是相等于或超过135/85毫米汞柱，您可能已患上高血压。

高血压与提高患上心脏病和中风等心血管疾病的风险息息相关。除了高血压之外，导致心血管疾病的其他风险因素还有身体质量指数超过27.5、缺乏锻炼、抽烟、压力大、高胆固醇和糖尿病。

根据您的情况来看，减轻体重可能有助您减低患上心血管疾病的风险。尽量将身体质量指数维持在少于23。请与您的家庭医生谈谈，让他帮助您减轻重量。另外，减轻生活中的压力，如在早上给予自己充裕的时间去上班，将有助减低患病的风险。

在生活上做出的一些小变化也会对您的心血管健康起正面影响。您可以通过食用较健康的高纤维、蔬菜和全谷类食品以及低脂肪和低胆固醇的饮食，并且定期运动、少抽烟和喝酒。

高血压经常被称为隐形杀手，因为即便您的病情非常严重，它也未必会呈现任何症状。您可能会感觉头疼或头晕，但这些症状并不专属高血压，而其他疾病也会呈现相同的症状。因此，建议您与您的家庭医生谈谈，让他为您分析您头疼的原因，并为您提供治疗方案。

破，因为这样做是会留疤的！轻微的成人痤疮可通过局部性治疗。茶

树油是一种天然的消毒剂，在某些情况下使用是相当有效的。您的家庭医生可能会推荐你使用含有果酸、乙醇酸或类维生素A的产品，因为它们有助于去掉死皮和避免皮脂腺进一步受堵。它们也可能有助减轻疤印。

痤疮中度严重或非常严重的病人则需接受口服治疗，其中包括抗生素、类维生素A或荷尔蒙药片。

一般，一个新的护肤疗程须最少两个月才会见效，因此您需要有点耐心。如果情况没有好转，您可以考虑寻求对皮肤科比较有经验的家庭医生，或是直接寻找皮肤专科医生的协助。

朱莉雅娜峇哈玎医生是杜克医学院客座助理教授及新加坡国立大学林永禄医学院客座高级讲师。她目前在Saudara Clinic by A+J General P h y s i c i a n s 的诊所从医，并且曾担任新保综合诊疗所（勿洛）的诊所总监。她曾经在加拿大的哥伦比亚妇女医院荣获HMDP奖学金，完成了她的妇女保健初级护理研究课程。

OBC_CAR_ Ad.indd 42 5/4/18 12:09 PM

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