Willingness to participate in front-line work during the COVID-19 pandemic: A cross-sectional study of nurses from a province in South-West China

[Disaster Literacy Status and the Influencing Factors: A National Survey of 107997 Chinese Nurses]

Objective

To study the level of disaster literacy among nurses in China and the influcing factors and to provide scientific basis for developing effective interventions to improve the disaster literacy among Chinese nurses.

Methods

Between September 2021 and October 2021, an online survey was conducted among nurses from health care institutions in eastern, central, western, and northeastern China by using a cross-sectional survey design and convenience sampling. The content of the survey included the surveyed nurses' sociodemographic characteristics, occupational characteristics, disaster relief characteristics, self-efficacy, and disaster literacy level. A disaster literacy model developed previously was used to assess the nurses' disaster literacy.

Results

A total of 107997 nurses were covered in the survey and their disaster literacy score was found to be 255.62±53.92. According to the findings of multiple linear regression, the protective factors for disaster literacy among Chinese nurses included the following, being based in Eastern region (non-standardized regression coefficient [ B]=2.365, 95% confidence interval [ CI]: 1.647-3.082), male sex ( B=9.418, 95% CI: 7.892-10.944), bachelor's degree or higher level of education ( B=3.822, 95% CI: 3.195-4.450), tertiary-level hospitals ( B=3.569, 95% CI: 3.000-4.138), military/local public hospitals ( B=2.606, 95% CI: 1.750-3.463), emergency department ( B=2.921, 95% CI: 2.149-3.694), intermediate professional title ( B=2.918, 95% CI: 2.209-3.627), senior professional title ( B=5.801, 95% CI: 4.448-7.155), participation in disaster rescue ( B=5.566, 95% CI: 5.020-6.112), the institution being previously involved in disaster emergency rescue ( B=3.257, 95% CI: 2.429-4.084), the institution having set up disaster rescue team ( B=5.967, 95% CI: 5.103-6.831), having received nursing education in disaster preparedness in school ( B=6.205, 95% CI: 5.621-6.790), having received on-the-job disaster preparedness education and training ( B=8.776, 95% CI: 8.027-9.525), and self-efficacy ( B=5.117, 95% CI: 5.069-5.165).

Conclusions

In China, disaster literacy among nurses is at a medium to low level and needs to be improved. For the next step, efforts should be focused on nurses with the following features, being based in the central and western regions, female sex, having completed junior college education or less, no nursing education in disaster preparedness in school, having junior professional titles, being from gynecology, pediatrics, and auxiliary departments, working in grassroots medical and health institutions and primary and secondary-level hospitals, neither the individual respondent nor her institution having any experience in disaster rescue, the institution having no disaster rescue team, not having any on-the-job nursing education and training in disaster preparedness, and having low self-efficacy. Measures should be taken to improve their disaster literacy level.

The trend in density of skilled health personnel in BRICS countries: Implication for China and India

OBJECTIVE

The similarities and differences in workforce trends in BRICS (Brazil, Russia, India, China, and South Africa) may offer reciprocal lessons for emerging economies.

METHODS

We used the Global Health Observatory data to assess the secular trends between 2001 and 2017 in the number of skilled health personnel (SHP: doctors, nurses/midwives) in BRICS compared to the average of Organization for Economic Co-operation and Development (OECD) countries.

RESULTS

Substantial efforts have been made in BRICS to increase SHP availability, as demonstrated by an average exponential growth rate (AEGR) > 0.03 in Brazil, China, and India compared to 0.01 in OECD. With an AEGR as high as 0.07 after 2008, China reached the level of SHP availability commensurate with the sustainable development goals (SDGs) in 2017. Other than China, BRICS countries had a mean number of nurses and midwives per doctor between 2001 and 2017 higher than or comparable to the OECD average (2.78). The corresponding number in China was 1.04 in 2017, lower than 2.21 in India in 2001.

CONCLUSIONS

With China as the exception, BRICS countries maintained a sustainable skills mix of SHPs. China reached the level of SHP availability commensurate with the SDGs, but SHP's skill mix was imbalanced.

Association between spiritual care competency and perceived professional benefit among nurses: A cross-sectional study

AIMS

This study aimed to investigate the status quo of nurses' spiritual care competency and their relationship with perceived professional benefit.

BACKGROUND

Spiritual care has always been considered a vitally important part of holistic nursing. Understanding the spiritual care competency of nurses during the COVID-19 pandemic can help nursing managers understand the weak links in spiritual care practice and improve the quality of nursing service. As a positive emotional experience and cognitive evaluation of the profession, perceived professional benefit can serve to adjust work pressure, relieve job burnout, and promote an individual's overall growth. However, the relationship between perceived professional benefit among nurses and spiritual care competency remains unclear.

METHODS

A total of 372 nurses were recruited from 15 separate Chinese hospitals. An online questionnaire was used to assess nurses' sociodemographic, spiritual care competency, and perceived professional benefit. Statistical analyses were performed using Pearson's correlation analysis, t-test, analysis of variance (ANOVA), and multiple stepwise linear regression analysis.

RESULTS

The total mean score of spiritual care competency (99.43 ± 21.10) among nurses was found to be moderate. Nurses' spiritual care competency was positively correlated with perceived professional benefit (P < .01). The multiple stepwise linear regression model (n = 372) had an explained variance (R² = 0.218) and showed that perceived professional benefit and the manner of receiving spiritual training were the main influencing factors of nurses' spiritual care competency (P < .001).

CONCLUSION

The study findings indicated that nurses need to improve their spiritual care competency by improving their perceived professional benefit.

IMPLICATION FOR NURSING MANAGERS

Our study evaluated the spiritual care competency of nurses and explored the correlation between perceived professional benefit and spiritual care competency among nurses. The results of this study can help nursing managers to carry out relevant interventions, thus improving nurses' spiritual care competency and optimizing the quality of nursing.

Willingness to Work during Public Health Emergencies: A Systematic Literature Review

The identification of the factors underlying the willingness or lack thereof to respond to public health emergencies is paramount to informing more capable health services. The interest in this topic appears renewed with each surge of threat, either referring to natural disasters, man-made violence, or epidemic and pandemics. However, there is no systematic approach to the research patterns and related main findings concerning individual and contextual determinants. The present article contributes to this theme through a systematic literature review of a sample of 150 articles published in the last 30 years on the subject of willingness and preparedness of health professionals to deal with public health threats. Our findings show that the research is mainly phenomena and contextual driven, responding to whichever emergency threat is more salient in a given period. Geographically, research on this topic is led by USA and China, mostly solely, while European countries invest in collaborations that are more international. Universities, including health institutes and schools, and researchers at hospitals conduct most of the research on the topic. The main research areas are medicine, psychology, and psychiatry. Pandemics, including COVID-19, influenza, and natural disasters, are the phenomena gauging more attention as opposed to terrorism events and biological accidents. The specific role of health professionals within the institution, their belief in ethical duties, preparation training, and concerns regarding infection of self and family are the main variables influencing the willingness and ability to report to work in public health emergencies.

Emergency nurses' attitudes, perceptions about personal protective equipment and willingness to care for COVID-19 patients: A descriptive, cross-sectional study

Aims

This study investigated emergency nurses' attitudes and perceptions about personal protective equipment and their association with the willingness to care for COVID‐19 patients.

Background

Emergency nurses are at increased risk for COVID‐19 infection as frontline workers and must wear personal protective equipment while attending suspected and confirmed COVID‐19 patients.

Methods

In September 2021, 188 nurses in four emergency departments completed online questionnaires.

Results

Multivariable logistic regression demonstrated that as perceptions of COVID‐19 infection risk increased by 1 point, 26% of nurses were willing to care of COVID‐19 patients. The willingness to care for COVID‐19 patients increased in their attitudes by 1.16 point and perceptions by 1.08 points about PPE.

Conclusions

Perceptions of the risk of infection exposure and confidence in safety of personal protective equipment are associated with nurses' willingness to care for COVID‐19 patients.

Implications for Nursing Management

Nurse managers need to assess nurses' needs for safety and provide a supportive climate to mitigate their concerns regarding infection risk and encourage nurses' willingness to care for patients. Nurse managers should provide precise guidelines on correct personal protective equipment use. Repetitive training on personal protective equipment should be provided to encourage nurses' adaptation to its use.

Using the Theory of Planned Behaviour to explain junior nurses’ and final‐year student nurses’ intention to care for COVID‐19 patients in China: a multisite cross‐sectional study

Aim

To explore junior nurses' and final‐year student nurses' intention to care for COVID‐19 patients amidst the Delta COVID‐19 variant outbreak in China using the theory of planned behaviour (TPB) as a framework.

Background

The COVID‐19 pandemic has intensified global nursing shortage. Junior nurses and final‐year student nurses represent the backbone of the future frontline nursing workforce. The TPB is a valid theoretical model for predicting nurses' caring behaviours.

Methods

A 47‐item self‐administered questionnaire was disseminated online to a convenience sample of 547 junior nurses and final‐year student nurses located in 13 regions across mainland China.

Results

Approximately 63.4% of the participants intended to care for COVID‐19 patients voluntarily and 65.6% by non‐voluntary assignment. The TPB model significantly predicted 45% of the variance in behavioural intention, subjective norms being the strongest predictor. Gender, vaccination status and ethical perceptions regarding frontline work significantly correlated with the intention to provide care.

Conclusions

Our findings highlight the importance of social, organisational and family support underpinning future junior nurses' professional commitment in times of public health crisis.

Implications for nursing management

Pandemic‐tailored workplace training programmes for nurses/student nurses that emphasize on self‐care and ethical issue discussions are warranted. Hospital managers should collaborate with community partners to offer additional family support for nurses in need.

Willingness of Healthcare Students in Vietnam to Volunteer During the COVID-19 Pandemic

Healthcare students play an important role in volunteering activity, often addressing staff shortages. However, during the COVID-19 pandemic, the willingness of students to volunteer in contribution to the pandemic response, especially in Vietnam, has not been thoroughly investigated. This study aimed to determine the prevalence of and factors associated with the willingness of healthcare students to volunteer during the COVID-19 pandemic in Vietnam. For this, an online cross-sectional survey was conducted, between June 7th and July 6th, 2021, among healthcare students from 10 fields of study at the largest public university of medicine and pharmacy in the Mekong Delta, Vietnam. Of 2032 respondents, 1473 (72.5%) reported that they would be willing to volunteer during the COVID-19 pandemic. More than half of the students reported having a desire to volunteer in non-patient contact activities such as data entry (65.9%) and logistics (57.7%). Whereas less than 50% of the participants were willing to volunteer with activities involving patients. Year of education, study field, educational format, living arrangements, health status self-perception, chronic illness possession, COVID-19 fear level, past volunteering experience in non-healthcare sectors, and COVID-19 prevention and control training course attendance were all associated with a willingness to volunteer. The strongest barriers preventing volunteering included fear for the health of their family and lack of training/knowledge. Conclusively, healthcare students reported a high level of willingness, indicating a positive attitude toward responding to the COVID-19 pandemic. Adequate training should be employed to increase the willingness among healthcare students in Vietnam.

Frontline nurses' willingness to work during the COVID-19 pandemic: A mixed-methods study

AIM

Frontline nurses' willingness to work has significant implications for maintaining workforce stability and quality of care during the COVID-19 pandemic; however, few studies have investigated their willingness and the corresponding reasons. This study aims to examine frontline nurses' willingness to work, identify its predictors and explore its corresponding reasons.

DESIGN

A mixed-methods design was conducted.

METHODS

Based on a multilevel behavioural-diagnostic model, a questionnaire survey was used to collect quantitative and qualitative data concurrently from 13 February to 24 February 2020 to explore frontline nurses' willingness to work and the corresponding reasons in two hospitals in Wuhan, China. One was a designated hospital which only received COVID-19 patients, and the other was built up temporarily for COVID-19 patients.

RESULTS

Of the 2014 participants, most (n = 1950, 96.8%) indicated their willingness to work, and a few (n = 64, 3.2%) expressed their unwillingness. Binary logistic regression analysis identified five predictors of participants' willingness to work, including monthly family income, average working hours per shift, belief in their colleagues' preparedness, belief in their hospitals' preparedness and levels of depression. These indicators explained 27% of the variance (p < .05). Frontline nurses' willingness to work mainly arose from professional commitment, patriotism and faith, while unwillingness to do so primarily stemmed from safety concerns and family responsibility.

CONCLUSION

Most frontline nurses were willing to work and showed great professional commitment.

IMPACT

Professional commitment and patriotism were two important individual-level factors affecting frontline nurses' willingness to work during a pandemic. Strategies should be implemented, such as appreciating and acknowledging their contribution, rewarding their valuable work, arranging reasonable working hours, enhancing colleagues' and hospitals' preparedness, and providing emotional support. Moreover, adequate personal protective equipment, self-protection training and social support should be ensured to address frontline nurses' safety concerns and family responsibility.

Nurses Who Are More Willing to Participate in the Fight against COVID-19: Evidence from China

When facing an infectious disease disaster, nurses’ willingness to work is critical. Nurses’ lack of willingness to work during a pandemic may worsen the shortage of health care personnel. The purpose of this study is to assess the willingness of nurses to participate in the fight against COVID-19 in China and to identify factors associated therewith. This cross-sectional study examines nurses working in 11 Chinese cities including Macau, Hong Kong, Shenzhen, Dongguan, Huizhou, Guangzhou, Zhaoqing, Foshan, Jiangmen, Zhongshan, and Zhuhai. Questionnaires were collected from 19 May to 7 August 2020. A total of 8065 questionnaires were received, of which 8030 valid questionnaires were included for analysis. A total of 53.4% of participants reported that they had signed up to support the COVID-19 pandemic response. Multivariate logistic regression analysis revealed that being single (OR = 0.72, 95% CI: 0.60–0.87), having no children (OR = 0.81, 95% CI: 0.68–0.97), possessing higher professional qualifications (OR = 1.25, 95% CI: 1.14–1.37), having a more prestigious professional title (OR = 1.68, 95%CI: 1.50–1.90), being an administrative supervisor (OR = 0.53, 95% CI: 0.45–0.63), having a higher caring dimensions inventory score (OR = 1.01, 95% CI: 1.01–1.01), working in a hospital (OR = 0.53, 95% CI: 0.39–0.72), and receiving employer-provided care training (OR = 0.77, 95% CI: 0.68–0.87) were predictive of nurses’ willingness to participate in the fight against COVID-19. We suggest that unmarried nurses should be given priority when recruiting to fight an epidemic and, for married nurses with children who are recruited to fight an epidemic, supporting measures should be provided for childcare. We suggest strengthening workplace training of caring for nurses in order to better retain and recruit qualified support for an epidemic outbreak of infectious diseases.

Barriers and Facilitators of Nurses' and Physicians' Willingness to Work during a Respiratory Disease Outbreak: A Mixed-Methods Systematic Review

This review was undertaken to identify the perceived barriers and facilitators of nurses’ and physicians’ willingness to work during a respiratory disease outbreak. This mixed-methods systematic review involved the extraction of data from the electronic databases PubMed, Web of Science, CINAHL, and PsycINFO and from a manual search of articles published between 2003 and April 2021. The quality of the included studies was assessed using a mixed-method appraisal tool. A total of 29 studies were eligible for inclusion: 21 quantitative and 8 qualitative. Using the Integrated Behavioral Model, perceived barriers and facilitators were identified under seven categories: demographics, attitude, perceived norm, personal agency, knowledge and skills to perform the behavior, environmental constraints, and habit. The results of this study broaden the understanding of various factors that affect nurses’ and physicians’ willingness to work during a respiratory disease outbreak. These findings will facilitate the modification of current pandemic workplace staffing strategies and practices and will inform preparedness planning for similar situations in the future.

Willingness to participate in front-line work during the COVID-19 pandemic: A cross-sectional study of nurses from a province in South-West China

Aim

To explore the current status of Chinese nurses’ willingness to work during the COVID‐19 pandemic and the factors that influence them.

Background

The demand for front‐line nurses continues to grow during the COVID‐19 pandemic, but their willingness varies significantly. Therefore, it is crucial to explore nurses’ willingness to report for front‐line work.

Methods

A cross‐sectional study of 1,310 nurses from six tertiary hospitals was conducted. The participants completed self‐administered online questionnaires.

Results

A total of 90.5% of nurses reported that they would like to voluntarily participate in front‐line work. Those with previous training, higher self‐efficacy scores, and lower perceived risk and self‐worth scores were more likely to participate in front‐line work, while nurses, who had 11–15 years of work experience and were worried about their family and the lack of family support, were less likely to be involved in front‐line work.

Conclusion

This study found that the vast majority of nurses were willing to participate in front‐line work and affirmed the positive effects of previous infection prevention training, self‐efficacy and self‐worth.

Implications for Nursing Management

This research emphasizes the necessity of infection prevention training and provides evidence for further emergency workforce deployment and incentives.