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Delacruz NM, Anderson KL, Smith BS. Dental hygiene clinical faculty attitudes and likelihood of working during the COVID-19 pandemic. Int J Dent Hyg 2024; 22:313-320. [PMID: 37720993 DOI: 10.1111/idh.12752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 08/22/2023] [Accepted: 08/28/2023] [Indexed: 09/19/2023]
Abstract
OBJECTIVE To identify circumstances that influenced dental hygiene clinical faculty's likelihood of working during the COVID-19 pandemic, and to explore attitudes (responsibilities, personal issues, ethics, and policy statements) about working. METHODS This cross-sectional study used a purposive sample of dental hygienists (n = 1710) employed in academic clinical settings that held full-time, part-time, or adjunct appointments. The Health Care Workers' Attitudes to Working During a Pandemic survey was utilized. Likelihood scores were calculated based on respondents more or less likely to work under differing circumstances. Frequencies of agreement for attitudes were developed. Correlations were explored between likelihood scores and demographic data. Answers to the open-ended questions were categorized and described. RESULTS The response rate was 13.5% (225/1710). Only one-third of respondents had a likelihood score of 100%. Factors with the greatest impact on likelihood to work were personal protective equipment. Almost all respondents' attitudes of working indicated that their employer is responsible for providing PPE. Over 90% felt their main responsibility was to themselves/family. Correlation analyses resulted in no significant associations between likelihood scores and age, etc. Faculty are considering leaving their jobs because of pay cuts and/or not feeling safe. CONCLUSION Likelihood of working for dental hygiene faculty represents several personal and ethical decisions. Most respondents want employers to be responsible for their on-the-job safety. In addition, personal and work-related issues were causes of unease. The pandemic has had far-reaching implications on day-to-day work of dental hygiene clinical faculty as well as on the long-term trajectories and views on employment in higher education.
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Affiliation(s)
- Natalie M Delacruz
- Department of Dental Hygiene, Wichita State University, Wichita, Kansas, USA
| | - Kelly L Anderson
- Department of Dental Hygiene, Wichita State University, Wichita, Kansas, USA
| | - Barbara S Smith
- Department of Physical Therapy, Wichita State University, Wichita, Kansas, USA
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Ali A, Abodunrin A, Al Khayyat S, Novakovic D, O’Connor N, Hussein G. Medical School Curriculum Relating to Clinical Ethical Decision Making During a Pandemic: A Scoping Review. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2024; 11:23821205241240610. [PMID: 38510930 PMCID: PMC10953083 DOI: 10.1177/23821205241240610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 03/01/2024] [Indexed: 03/22/2024]
Abstract
Background The COVID-19 pandemic has demonstrated the need for medical students to be prepared to make adequate decisions during unique challenges presented during pandemics. Objective This review aims to provide a comprehensive look into the current global literature that discusses medical curricula on clinical ethical issues during a pandemic. Methods The scoping review methodology was divided into three stages. Phase 1, planning, involved identifying key terms, selecting databases, creating a search criterion, and deciding on inclusion and exclusion criteria. Phase 2, study selection and data extraction, included screening the title and abstract, reviewing the complete text, and extracting data. Phase 3, analysis and write-up, comprised analyzing the extracted information and composing the review. Results 10 studies were included and underwent data extraction as part of the review. The studies varied by country, study design, institution, education setting, and course titles. Ethical issues identified while reviewing the curriculums were resource allocation, healthcare worker obligations, personal protective equipment, disease control, communication, management protocols, and patient care. Conclusion This review revealed a lack of literature regarding the curriculum for medical students on ethical issues during a pandemic. This indicates a need for reform in medical education to cover pandemic preparedness and ethical concerns during a pandemic. If medical schools do not address this gap, future physicians may encounter the same issues healthcare workers faced during the COVID-19 pandemic.
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Affiliation(s)
- Aliza Ali
- Trinity College, School of Medicine, Dublin, Ireland
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Rivera-Cuadrado W. Healthcare practitioners' construction of occupational risk during the COVID-19 pandemic. Soc Sci Med 2023; 331:116096. [PMID: 37478661 DOI: 10.1016/j.socscimed.2023.116096] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 07/23/2023]
Abstract
RATIONALE AND OBJECTIVE In the pandemic's first year, frontline healthcare practitioners (HCPs) experienced a disproportionate burden of COVID-19's negative effects, including infection, death, trauma and burnout. Qualitative research is needed to understand practitioners' experiences to address the unique challenges they face. To this end, this article investigates occupational factors identified by practitioners as relevant to their risk perceptions. By positioning HCPs as a distinctive risk group in the hierarchical space of risk group prioritization, this analysis extends thinking about such classifications within medicine. METHODS Remote interviews were conducted between 2020 and 2022 with 45 U.S. practitioners, including physicians, nurse practitioners, physician associates, registered nurses and technicians. Interviews were audio recorded, transcribed, and coded using NVivo to analyze how practitioners understood their occupational risk. RESULTS Participants' risk perceptions focused on three concerns. First, working within spatial concentrations of COVID-19 required adapting procedures and reimagining their bodies as potentially hazardous. Second, the limitations of protective measures elevated concerns about healthcare work, and were perceived as pitting practitioners' health against patient care and administrative needs. Third, managing the many uncertainties about COVID-19 meant HCPs risked both its known and unknown effects. CONCLUSION This study examines frontline practitioners' perceptions of occupational risk during the pandemic. It argues two tensions underlie practitioners' risk perceptions. First, like other essential workers, HCPs constituted a unique risk group that distinguished them from other vulnerable populations - due to risks arising from occupational rather than biomedical factors. Second, unlike other essential workers, practitioners were directly exposed to infectious patients that posed risks to their health. These elements each highlight a perceived gap between practitioners' and administrators' risk perceptions that facilitated HCP cynicism about guidelines. Future research may fruitfully investigate if these themes persist outside the U.S. and across healthcare systems.
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Affiliation(s)
- Wayne Rivera-Cuadrado
- Northwestern University, Department of Sociology, 1810 Chicago Avenue, Evanston, IL, 60208, USA.
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Capili JT, Luis LMG, Asuncion JEL, Luyun JL, Canapi JB, Rimban EL. Narratives of hospital health care professionals during the pandemic in the Northern Philippines: A phenomenological study. JAMBA (POTCHEFSTROOM, SOUTH AFRICA) 2022; 14:1284. [PMID: 36263158 PMCID: PMC9575383 DOI: 10.4102/jamba.v14i1.1284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 06/03/2022] [Indexed: 11/06/2022]
Abstract
Hospital health care professionals (HCPs) play a vital and crucial role in saving the lives of patients afflicted with the coronavirus disease 2019 (COVID-19). As the incidence of the disease keeps increasing, health care workers in hospitals face difficulties in discharging their duties. This study aimed to describe the lived experiences of HCPs. Particularly, it determined their challenges, motivations and coping strategies to craft grassroots policies for the enhancement of health care delivery in the Northern Philippines. Employing a phenomenological study design, 24 study participants were purposively selected and their narratives were elicited through focus group discussion. Responses were transcribed verbatim. After data analyses, the challenges, coping strategies and motivations of HCPs were identified. Results revealed that HCPs experienced a lot of challenges. Some of these were brought by the rapid changes in their environment as HCPs. Moreover, there was lack of comprehensive strategies that made them unprepared along with a lack of human and material resources. Furthermore, they experienced physical fatigue because of overwhelming workload, anxiety, fear and discrimination that led to depression. Despite these difficulties, they remain resilient because of religious coping, being true to their duty as HCPs and the support they receive from their fellows. Thus, the study recommends that protocols to ensue should centre on adequate pandemic preparedness and capacitation of HCPs.
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Affiliation(s)
- Julius T. Capili
- College of Allied Health Sciences, Faculty of Medical Laboratory Science, Cagayan State University, Tuguegarao City, Cagayan, Philippines
| | - Lara Melissa G. Luis
- College of Allied Health Sciences, Faculty of Public Health, Cagayan State University, Tuguegarao City, Cagayan, Philippines
| | - Jay Emanuel L. Asuncion
- College of Allied Health Sciences, Faculty of Medical Laboratory Science, Cagayan State University, Tuguegarao City, Cagayan, Philippines
| | - Jennifer L. Luyun
- College of Allied Health Sciences, Faculty of Medical Laboratory Science, Cagayan State University, Tuguegarao City, Cagayan, Philippines
| | - Jake B. Canapi
- College of Allied Health Sciences, Faculty of Public Health, Cagayan State University, Tuguegarao City, Cagayan, Philippines
| | - Erwin L. Rimban
- College of Allied Health Sciences, Faculty of Medical Laboratory Science, Cagayan State University, Tuguegarao City, Cagayan, Philippines
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Experiences of redeployed healthcare workers in the fight against COVID-19 in China: A qualitative study. PLoS One 2022; 17:e0273429. [PMID: 36006945 PMCID: PMC9409527 DOI: 10.1371/journal.pone.0273429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 08/08/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction
Public health responses were triggered while COVID-19 was spreading. China redeployed healthcare workers to serve the most vulnerable populations and communities in the initial epicentre—Wuhan. However, it is not known how redeployment processes impacted on healthcare workers in a pandemic crisis.
Aims
To explore the experiences and needs of frontline healthcare workers who were redeployed to care for COVID-19 patients in Wuhan, China, and understand the long-term impacts of the redeployment experience on their work and life.
Methods
A qualitative study was conducted with redeployed healthcare workers using semi-structured interviews and thematic analysis. This study is reported in accordance with the consolidated criteria for reporting qualitative research (COREQ) guidelines.
Findings
A total of 20 redeployed healthcare workers (13 nurses and seven physicians) participated, and four themes were generated: (1) Initial feelings and emotions of redeployment—Participants experienced worries and concerns, a sense of isolation and loneliness on their arrival to the epicentre. (2) ‘It is like a war zone’—Healthcare workers faced a range of risks and challenges of caring for COVID-19 patients in Wuhan in the context of resource strain. (3) Uncertainty and coping strategies in patient care—Despite the hardships experienced, participants continued to deliver high-quality patient care including psychological care and palliative care, good communication and building mutual trusting relationships. (4) Reflection and far-reaching impacts of caring for COVID-19 patients—Participants felt motivated and encouraged as efforts were recognised by the government and wider society.
Conclusions
Redeployed healthcare workers shared their unique needs and experiences of coping with redeployment and challenges they faced in the context of resource strain, which has significant implications for policy and future practice. The reality of a pandemic may reduce healthcare workers’ willingness to work due to various reasons including inadequate preparedness of facilities and workplace safety. It is important to support frontline healthcare workers in order to maintain an adequate healthcare workforce in pandemic crises. Continuously evolving pandemic circumstances and uncertainty highlight the importance of an organized national pandemic response plan for subsequent waves of COVID-19 and future pandemics.
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The Need for Psychological Support of Health Workers during the COVID-19 Pandemic and the Influence on Their Work. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19158970. [PMID: 35897342 PMCID: PMC9332561 DOI: 10.3390/ijerph19158970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/16/2022] [Accepted: 07/20/2022] [Indexed: 02/05/2023]
Abstract
The aim of this research was to analyze how the need for psychological support of health workers (HCWs) influenced the beliefs, perceptions and attitudes towards their work during the COVID-19 pandemic and to predict the need of psychological assistance. A descriptive transversal study was conducted based on a self-administered questionnaire distributed to health professionals working in the Canary Islands, Spain. The data were analyzed using Pearson’s chi-squared test and the linear trend test. The correlation test between ordinal and frequency variables was applied using Kendall’s Tau B. Multiple logistic regression was used to predict dichotomous variables. The sample included 783 health professionals: 17.8% (n = 139) of them needed psychological or psychiatric support. Being redeployed to other services influenced the predisposition to request psychological help, and HCWs who required psychological support had more negative attitudes and perceptions towards their work. After five waves of COVID-19, these HCWs reported to be physically, psychologically and emotionally exhausted or even “burned out”; they did not feel supported by their institutions. The commitment of health personnel to fight against the COVID-19 pandemic decreased after the five waves, especially among professionals who required psychological support.
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Tripković K, Šantrić-Milićević M, Vasić M, Živković-Šulović M, Odalović M, Mijatović-Jovanović V, Bukumirić Z. Factors Associated with Intention of Serbian Public Health Workers to Leave the Job: A Cross-Sectional, Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010652. [PMID: 34682398 PMCID: PMC8535250 DOI: 10.3390/ijerph182010652] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 10/06/2021] [Accepted: 10/07/2021] [Indexed: 01/28/2023]
Abstract
Recruitment and retention of public health workers (PHWs) is crucial for the optimal functioning of the public health system at a time of budget cuts and the threat of a pandemic. Individual and job-related variables were examined by univariate and multivariate logistic regression to identify predictors of the intention to leave a job during the COVID-19 outbreak among Serbian PHWs in 25 institutes of public health (n = 1663 respondents, of which 73.1% were female). A total of 20.3% of PHWs intended to leave their current job within the next five years. Males and persons aged younger than 55 years who had additional practice were more likely to report an intention to leave their job than females, those older than 54 years and those without additional work. While uncertainty and fear of infection during the COVID-19 pandemic were almost perceived as job attractiveness, other job-related characteristics were identified as significant barriers to maintaining the sufficient capacity of qualified PHWs in the future. Authorities need to address these factors, including the following: the feeling of tension, stress or pressure, and unavailability of information during the COVID-19 pandemic, as well as dissatisfaction with respect, valuation, and the job in general.
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Affiliation(s)
- Katica Tripković
- Department for Analysis, Planning and Organization of Health Care, City Institute of Public Health Belgrade, 11000 Belgrade, Serbia
- Correspondence:
| | - Milena Šantrić-Milićević
- Centre–School of Public Health and Health Management, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
- Faculty of Medicine, Institute of Social Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Milena Vasić
- Faculty of Dentistry Pancevo, University Business Academy in Novi Sad, 26000 Pancevo, Serbia;
- Institute of Public Health of Serbia “Dr Milan Jovanović Batut”, 11000 Belgrade, Serbia;
| | | | - Marina Odalović
- Department of Social Pharmacy and Pharmaceutical Legislation, Faculty of Pharmacy, University of Belgrade, 11000 Belgrade, Serbia;
| | - Vesna Mijatović-Jovanović
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia;
- Institute of Public Health of Vojvodina, 21000 Novi Sad, Serbia
| | - Zoran Bukumirić
- Faculty of Medicine, Institute of Medical Statistics and Informatics, University of Belgrade, 11000 Belgrade, Serbia;
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Mohammadpour M, Zarifinezhad E, Ghanbarzadegan A, Naderimanesh K, Shaarbafchizadeh N, Bastani P. Main Factors Affecting the Readiness and Responsiveness of Healthcare Systems during Epidemic Crises: A Scoping Review on Cases of SARS, MERS, and COVID-19. IRANIAN JOURNAL OF MEDICAL SCIENCES 2021; 46:81-92. [PMID: 33753952 PMCID: PMC7966936 DOI: 10.30476/ijms.2020.87608.1801] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background: Given the significance of the preparedness and responsiveness of healthcare systems in relation to epidemics, this study aimed to determine their influencing factors during epidemic crises with a view to utilizing the findings in the battle against the coronavirus disease 2019 (COVID-19) outbreak. Methods: This scoping study was conducted in 2020 via the Arksey and O’Malley approach. A systematic search was conducted on five online databases from January 2000 to June 15, 2020. Initially, 1926 English articles were retrieved based on their abstracts. After the screening process, 60 articles were considered for the final analysis. Data were charted by applying Microsoft Office Excel 2013 and were synthesized via thematic analysis. Results: Five main factors have affected the responsiveness and preparedness of countries during the epidemics of severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and COVID-19: community-related interventions, managerial interventions, socioeconomic factors, the readiness of hospitals and health centers, and environmental factors. These themes are associated with 38 related sub-themes. The thematic framework shows that interactions between these five determinantes can affect the preparedness and responsiveness of healthcare systems during pandemics/epidemics. Conclusion: According to the results, healthcare systems need to pay attention to their internal capacities, managerial interventions, and health centers to overcome the current pandemic. They should also consider such external factors as socioeconomic and environmental determinants that can affect their potential preparedness against pandemic/epidemic crises. Community-related interventions such as improvement of the community health literacy, teamwork, and social responsibility can enhance the readiness of healthcare systems against the COVID-19 outbreak.
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Affiliation(s)
- Mohammadtaghi Mohammadpour
- Department of Health Care Management and Health Economics, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Effat Zarifinezhad
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Arash Ghanbarzadegan
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia
| | - Khodadad Naderimanesh
- Social Determinant of Health Research Centre, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Nasrin Shaarbafchizadeh
- Health Management and Economics Research Centre, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Peivand Bastani
- Health Human Resources Research Centre, School of Health Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
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Jalili M, Niroomand M, Hadavand F, Zeinali K, Fotouhi A. Burnout among healthcare professionals during COVID-19 pandemic: a cross-sectional study. Int Arch Occup Environ Health 2021; 94:1345-1352. [PMID: 33864490 PMCID: PMC8052946 DOI: 10.1007/s00420-021-01695-x] [Citation(s) in RCA: 127] [Impact Index Per Article: 42.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 01/17/2021] [Indexed: 12/11/2022]
Abstract
Purpose To describe the prevalence of burnout among healthcare professionals dealing with COVID-19 patients and the associated factors. Methods In this cross-sectional survey, healthcare workers at six university-affiliated hospitals, who had been taking care of COVID-19 patients were studied. Age, gender, marital status, having children, hospital, job category, experience, and work load, as well as the level of burnout in each subscale were measured. Results 326 persons (53.0%) experienced high levels of burnout. The average score in emotional exhaustion, depersonalization and lack of personal accomplishment was 26.6, 10.2, and 27.3, respectively. The level of burnout in the three subscales varied based on the personal as well as work-related factors and gender was the only variable that was associated with high levels of all three domains. Conclusions Burnout is prevalent among healthcare workers caring for COVID-19 patients. Age, gender, job category, and site of practice contribute to the level of burnout that the staff experience.
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Affiliation(s)
- Mohammad Jalili
- Emergency Medicine Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahtab Niroomand
- Department of Internal Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, 7th Floor, Bldg. No.2 SBUMS, Arabi Ave, Daneshjoo Blvd, Velenjak, 19839-63113, Tehran, Iran.
| | - Fahimeh Hadavand
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kataun Zeinali
- Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
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Shrivastava D, Alduraywish AA, Srivastava KC, Alsharari AF, Al-Johani K, Sghaireen MG, Alam MK. Assessment of knowledge and attitude of allied healthcare professionals about COVID-19 across Saudi Arabia. Work 2021; 68:305-315. [PMID: 33492261 DOI: 10.3233/wor-203377] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The coronavirus disease (COVID-19) has shown a catastrophic effect on mankind. The allied healthcare professionals (AHPs) play a pivotal role against COVID-19. OBJECTIVES To appraise the knowledge and attitude about COVID-19 of AHPs working across Saudi Arabia. METHODS This cross-sectional study was conducted using Qualtrics software to gather data from all five regions of Saudi Arabia during the nationwide lockdown in April 2020. Complete responses of 195 AHPs were considered for analysis. The questionnaire consisted of 15 and 14 questions on knowledge and attitude, respectively. The overall scores of each domain were calculated and modified Bloom's criterion was applied to categorize them into a three-point ordinal scale. Statistical analysis was performed using Chi-square test along with multivariate logistic regression for significant parameters. RESULTS The AHPs displayed a moderate level of knowledge (58.2%) and a good level of attitude (80%). The AHPs were found to have a non-significant (P > 0.05) difference in the level of knowledge within age, gender, region, occupation, educational level, organizational setup and years of experience. The attitude of AHPs working in a private setup has shown a 2.8 times (P = 0.020) higher risk for having moderate/poor attitude compared to the AHPs working in a government organization. CONCLUSIONS AHPs displayed a moderate level of knowledge and good attitude towards COVID-19. Emphasis should be given to continuous professional development in order to enhance their knowledge. Furthermore, strategies should be developed in the private sector to positively reinforce the attitude of AHPs.
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Affiliation(s)
- Deepti Shrivastava
- Periodontics, Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Saudi Arabia
| | | | - Kumar Chandan Srivastava
- Oral Medicine & Radiology, Oral and Maxillofacial Surgery & Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka, Saudi Arabia
| | - Abdalkarem F Alsharari
- Nursing Department, College of Applied Medical Sciences, Jouf University, Sakaka, Saudi Arabia
| | - Khalid Al-Johani
- Department of Oral Diagnostic Sciences, Faculty of Dentistry, King Abdulaziz University, Saudi Arabia
| | - Mohammed G Sghaireen
- Prosthodontics, Prosthetic Dental Sciences, College of Dentistry, Jouf University, Sakaka, Saudi Arabia
| | - Mohammad Khursheed Alam
- Orthodontics, Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Saudi Arabia
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Rafi MA, Hasan MT, Azad DT, Alam SF, Podder V, Hossain S, Akther SMQ, Ashraf F, Hossain MG. Willingness to work during initial lockdown due to COVID-19 pandemic: Study based on an online survey among physicians of Bangladesh. PLoS One 2021; 16:e0245885. [PMID: 33561180 PMCID: PMC7874948 DOI: 10.1371/journal.pone.0245885] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 01/10/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND During the catastrophic situation of the COVID-19 pandemic, the role of the health care workers (HCWs) is the most crucial, and their absenteeism, whether due to inability or unwillingness, becomes a major concern for the national health system. Hence, the present study aimed to determine the willingness and its associated factors to work during the COVID-19 pandemic among the physicians of Bangladesh. METHODS This was a cross-sectional study conducted from April 21 to May 10, 2020, using an online survey among the Bangladeshi physicians living in the country. Both univariate and multivariable binary logistic regression models were used to determine the predictors of the willingness of the physicians to work during the COVID-19 pandemic. RESULTS More than 69% physicians reported that they were willing to work during the COVID-19 pandemic, 8.9% reported that they were not willing, while 21.4% of participants were not sure about their willingness. Younger age, having experience of treating patients during previous pandemics, working in the emergency departments and high self-reported compliance to the recommended PPE were important predictors of being willing to work during COVID-19 pandemic. Concern for family and risk of transmitting the infection to family members were most commonly reported as major barriers of working during the pandemic (30%) followed by having comorbidities (25%), lack of adequate safety measures (25%), fear of being infected (12.2%), not involved in clinical practice (12.5%) etc. CONCLUSIONS Though the majority of the physicians were willing to work during the COVID-19 pandemic, sufficient supply of PPE, support to maintain recommended quarantine and isolation policy after risky hospital duty along with adequate and effective training can increase their willingness to continue their sacred duty during this crucial pandemic.
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Affiliation(s)
| | - M. Tasdik Hasan
- Department of Primary Care and Mental Health, University of Liverpool,
Liverpool, United Kingdom
- Public Health Foundation, Dhaka, Bangladesh
| | | | | | - Vivek Podder
- Tairunnessa Memorial Medical College and Hospital, Gazipur,
Bangladesh
| | - Sahadat Hossain
- Public Health Foundation, Dhaka, Bangladesh
- Department of Public Health and Informatics, Jahangirnagar University,
Dhaka, Bangladesh
| | | | - Fatema Ashraf
- Public Health Foundation, Dhaka, Bangladesh
- Shaheed Suhrawardy Medical College Hospital, Dhaka,
Bangladesh
| | - Md. Golam Hossain
- Department of Statistics, Health Research Group, University of Rajshahi,
Rajshahi, Bangladesh
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Zewudie A, Regasa T, Kebede O, Abebe L, Feyissa D, Ejata F, Feyisa D, Mamo Y. Healthcare Professionals' Willingness and Preparedness to Work During COVID-19 in Selected Hospitals of Southwest Ethiopia. Risk Manag Healthc Policy 2021; 14:391-404. [PMID: 33568957 PMCID: PMC7868776 DOI: 10.2147/rmhp.s289343] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 01/01/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Many healthcare professionals are dying of COVID-19 while trying to save others. The loss in the healthcare workforce due to sickness and absence will double the risk of a crisis. Identifying barriers of willingness to work during epidemics outbreak and preparedness of healthcare professionals is important to minimize the shortage of human power. METHODS Facility-based cross-sectional study was conducted among healthcare professionals working in the selected hospitals of Southwest Ethiopia from June 1-30/2020. The data entry was done by Epi-Data Manager version 4.4.1.0 and exported to SPSS version 23 for analysis. Multivariable logistic regression analysis with a backward stepwise approach was done to identify independent predictors of poor preparedness and willingness of the healthcare professionals to work during COVID-19 and Variables with P-value <0.05 were considered as a statistically significant determinant. RESULTS Of 407 healthcare professionals who participated in the study, 246 (60.4%) were male. The mean age of the respondents was 28.47±5.60 years. Forty-seven (11.55%) Physicians, 59 (14.50%) pharmacy personnel, 52 (12.78%) Laboratory personnel, 31 (7.62%) Midwives, and 195 (47.91%) Nurses were included in the study. The healthcare professionals who were not prepared for the provision of services during COVID-19 and not willing to work during COVID-19 were 165 (40.5%) and 86 (21.1%) respectively. Having 6 to10 years' experience (AOR=4.046, CI: 1.05-15.58), and divorced marital status (AOR=7.855, CI: 1.781-34.65) were independent predictors of not willing to work during COVID-19. Similarly, lack of personal protective equipment (AOR=28.089, CI: 13.9-56.67) and shortage of infrastructure at the work place (AOR=28.1, CI: 13.9-56.67) were independent predictors of poor preparedness. CONCLUSION AND RECOMMENDATIONS Healthcare professionals' willingness and preparedness to work during COVID-19 was low. Use of Telemedicine, provision of personal protective equipment, increasing hospital's safety with adequate infection control policy, and assigning staff who have experience of more than ten years in the risky wards of the hospitals may decrease staffs absentee and increase in the provision of continuous service.
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Affiliation(s)
- Ameha Zewudie
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Tolcha Regasa
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Oliyad Kebede
- Department of Social Pharmacy and Pharmaceutics, School of Pharmacy, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Lemi Abebe
- Department of Epidemiology and Biostatics, School of Public Health, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Desalegn Feyissa
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Fikadu Ejata
- Department of Social Pharmacy and Pharmaceutics, School of Pharmacy, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Diriba Feyisa
- Department of Social Pharmacy and Pharmaceutics, School of Pharmacy, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Yitagesu Mamo
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
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Maraqa B, Nazzal Z, Zink T. Mixed Method Study to Explore Ethical Dilemmas and Health Care Workers' Willingness to Work Amid COVID-19 Pandemic in Palestine. Front Med (Lausanne) 2021; 7:576820. [PMID: 33469543 PMCID: PMC7813812 DOI: 10.3389/fmed.2020.576820] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 11/25/2020] [Indexed: 12/22/2022] Open
Abstract
Background: The high potential risks involved in working in a healthcare setting during a pandemic and the associated fear that may affect health care workers' (HCWs') willingness to work are important to understand to eliminate potential barriers to working. This study aimed to assess Palestinian HCWs' willingness to work and the related factors as well as to explore their ethical dilemmas during the coronavirus disease 2019 (COVID-19) pandemic. Materials and Methods: Quantitative (survey questionnaire) and qualitative (semi-structured interviews) data were collected. Frontline HCWs (n = 550) received an online survey link via closed institutional networks. Frequencies summarized the data, and chi-square compared variables and outcomes. Odds ratios (ORs) and multivariable analysis examined predictors for willingness to work. Fifteen HCWs (physicians, nurses, and lab and radiology technicians) were purposefully sampled and agreed to interviews to explore their thoughts, motivations, and worries. Thematic analysis focused on ethical dilemmas to enhance the breadth and the depth of the study. Results: Almost 25% of surveyed HCWs were not willing to work during the pandemic. Logistic model results showed that physicians and nurses had higher willingness to work than others (p = 0.004, Adj. OR = 3.5). Lower stress levels and longer professional experience were predictors of more willing to work (p = 0.03, Adj. OR = 2.5; p = 0.03, Adj. OR = 2.6, respectively). Interviews showed that willingness to work did not preclude HCWs from fulfilling their duties despite grueling workloads and grave fears about safety and security. HCWs felt poorly prepared, unappreciated, and frustrated by unfair work distribution. The occupation presented additional safety issues. Conclusion: Physicians and nurses were more likely to comply with a commitment to their professional ethics and the duty or obligation to work. Stress levels could be mitigated in the future with better leadership, adding supports to address mental health and psychosocial challenges to enhance HCWs' well-being and improve quality of care. The realities of the occupation added additional threats and uncertainty.
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Affiliation(s)
- Beesan Maraqa
- Primary Health Directorate, Ministry of Health, Ramallah, Palestine.,Family Medicine Residency Program, Faculty of Graduate Studies, An-Najah National University, Nablus, Palestine
| | - Zaher Nazzal
- Department of Family and Community Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Therese Zink
- Department of Family Medicine & School of Public Health, Brown University, Providence, RI, United States
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Karimi Dehkordi N, Abbasi AF, Radmard Lord M, Soleimanpour S, Goharinezhad S. Interventions to Improve the Willingness to Work Among Health care Professionals in Times of Disaster: A Scoping Review. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2021; 58:469580211059959. [PMID: 34903077 PMCID: PMC8679035 DOI: 10.1177/00469580211059959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
The critical role of the health workforce in the function of the health care system is undeniable. In times of disaster and public health emergency, the importance of this valuable resource for the organization multiplies. This scoping review was conducted to identify, analyze, and categorize interventions to improve willingness to work in times of disaster as well as the existing knowledge gaps in the topic. For this purpose, four databases were searched. These included Scopus, PubMed, WOS, and World Health Organization observatory, and they were searched for papers published from July 2000 to September 2020. Studies of the English language that described strategies to improve human resources for health willingness to work during times of disaster/public health emergency were included. Full-text papers were screened by authors and data extraction was done according to self-designed form. Framework analysis identified key interventions based on human resources for health action framework. From 6246 search results, 52 articles were included, a great portion of which was published in 2020 probably due to the COVID-19 pandemic. Northern America was the region with most studies. From 52 included studies, 21 papers have reported the interventions to improve willingness to work and 31 papers have explored factors that affected a willingness to work. The interventions used in the studies were categorized into five themes as Leadership, Partnership, Financing, Education, and Organizational policies. The most and least interventions were financial and partnership respectively. The review identified a wide range of feasible strategies and interventions to improve human resources for health's willingness to work at times of disaster that are expected to be effective. Organizations should let the staff know these decisions and as a necessary step in every organizational intervention remember to evaluate the impacts.
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Affiliation(s)
- Negin Karimi Dehkordi
- Student Research Committee, School
of Medicine, Iran University of Medical
Sciences, Tehran, Iran
| | - Amir Farhang Abbasi
- Student Research Committee, School
of Medicine, Iran University of Medical
Sciences, Tehran, Iran
| | - Mostafa Radmard Lord
- Student Research Committee, School
of Medicine, Iran University of Medical
Sciences, Tehran, Iran
| | - Samira Soleimanpour
- Department of Medical Library and
Information Sciences, School of Health Management and Information Sciences, Iran University of Medical
Sciences, Tehran, Iran
| | - Salime Goharinezhad
- Preventive Medicine and Public
Health Research Center, Psychosocial Health Research Institute, Iran University of Medical
Sciences, Tehran, Iran
- Health Management and Economics
Research Center, Health Management Research Institute, Iran University of Medical
Sciences, Tehran, Iran
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Morgantini LA, Naha U, Wang H, Francavilla S, Acar Ö, Flores JM, Crivellaro S, Moreira D, Abern M, Eklund M, Vigneswaran HT, Weine SM. Factors contributing to healthcare professional burnout during the COVID-19 pandemic: A rapid turnaround global survey. PLoS One 2020; 15:e0238217. [PMID: 32881887 PMCID: PMC7470306 DOI: 10.1371/journal.pone.0238217] [Citation(s) in RCA: 285] [Impact Index Per Article: 71.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 08/12/2020] [Indexed: 02/07/2023] Open
Abstract
Background Healthcare professionals (HCPs) on the front lines against COVID-19 may face increased workload and stress. Understanding HCPs’ risk for burnout is critical to supporting HCPs and maintaining the quality of healthcare during the pandemic. Methods To assess exposure, perceptions, workload, and possible burnout of HCPs during the COVID-19 pandemic we conducted a cross-sectional survey. The main outcomes and measures were HCPs’ self-assessment of burnout, indicated by a single item measure of emotional exhaustion, and other experiences and attitudes associated with working during the COVID-19 pandemic. Findings A total of 2,707 HCPs from 60 countries participated in this study. Fifty-one percent of HCPs reported burnout. Burnout was associated with work impacting household activities (RR = 1·57, 95% CI = 1·39–1·78, P<0·001), feeling pushed beyond training (RR = 1·32, 95% CI = 1·20–1·47, P<0·001), exposure to COVID-19 patients (RR = 1·18, 95% CI = 1·05–1·32, P = 0·005), and making life prioritizing decisions (RR = 1·16, 95% CI = 1·02–1·31, P = 0·03). Adequate personal protective equipment (PPE) was protective against burnout (RR = 0·88, 95% CI = 0·79–0·97, P = 0·01). Burnout was higher in high-income countries (HICs) compared to low- and middle-income countries (LMICs) (RR = 1·18; 95% CI = 1·02–1·36, P = 0·018). Interpretation Burnout is present at higher than previously reported rates among HCPs working during the COVID-19 pandemic and is related to high workload, job stress, and time pressure, and limited organizational support. Current and future burnout among HCPs could be mitigated by actions from healthcare institutions and other governmental and non-governmental stakeholders aimed at potentially modifiable factors, including providing additional training, organizational support, and support for family, PPE, and mental health resources.
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Affiliation(s)
- Luca A. Morgantini
- Department of Urology, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, United States of America
- * E-mail:
| | - Ushasi Naha
- Department of Urology, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Heng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Simone Francavilla
- Department of Urology, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Ömer Acar
- Department of Urology, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Jose M. Flores
- Department of Urology, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Simone Crivellaro
- Department of Urology, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Daniel Moreira
- Department of Urology, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Michael Abern
- Department of Urology, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Martin Eklund
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Hari T. Vigneswaran
- Department of Urology, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, United States of America
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Stevan M. Weine
- Department of Psychiatry, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, United States of America
- Center for Global Health, University of Illinois at Chicago, Chicago, Illinois, United States of America
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Flexman AM, Abcejo AS, Avitsian R, De Sloovere V, Highton D, Juul N, Li S, Meng L, Paisansathan C, Rath GP, Rozet I. Neuroanesthesia Practice During the COVID-19 Pandemic: Recommendations From Society for Neuroscience in Anesthesiology and Critical Care (SNACC). J Neurosurg Anesthesiol 2020; 32:202-209. [PMID: 32301764 PMCID: PMC7236852 DOI: 10.1097/ana.0000000000000691] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 04/13/2020] [Indexed: 12/12/2022]
Abstract
The pandemic of coronavirus disease 2019 (COVID-19) has several implications relevant to neuroanesthesiologists, including neurological manifestations of the disease, impact of anesthesia provision for specific neurosurgical procedures and electroconvulsive therapy, and health care provider wellness. The Society for Neuroscience in Anesthesiology and Critical Care appointed a task force to provide timely, consensus-based expert guidance for neuroanesthesiologists during the COVID-19 pandemic. The aim of this document is to provide a focused overview of COVID-19 disease relevant to neuroanesthesia practice. This consensus statement provides information on the neurological manifestations of COVID-19, advice for neuroanesthesia clinical practice during emergent neurosurgery, interventional radiology (excluding endovascular treatment of acute ischemic stroke), transnasal neurosurgery, awake craniotomy and electroconvulsive therapy, as well as information about health care provider wellness. Institutions and health care providers are encouraged to adapt these recommendations to best suit local needs, considering existing practice standards and resource availability to ensure safety of patients and providers.
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Affiliation(s)
- Alana M. Flexman
- Department of Anesthesiology and Perioperative Care, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Arnoley S. Abcejo
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, NY
| | - Rafi Avitsian
- Department of General Anesthesiology, Cleveland Clinic, Cleveland, OH
| | - Veerle De Sloovere
- Department of Anesthesiology, University Hospitals Leuven, Leuven, Belgium
| | - David Highton
- Princess Alexandra Hospital, University of Queensland, Woolloongabba, Australia
| | - Niels Juul
- Department of Anesthesia, Aarhus University Hospital, Aarhus, Denmark
| | - Shu Li
- Department of Anesthesiology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, P.R. China
| | - Lingzhong Meng
- Department of Anesthesiology, Yale University School of Medicine, New Haven, CT
| | | | - Girija P. Rath
- Department of Neuroanesthesiology and Critical Care, Neurosciences Centre, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Irene Rozet
- Department of Anesthesiology and Pain Management, University of Washington, Seattle, WA
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Lee JY, Hong JH, Park EY. Beyond the fear: Nurses' experiences caring for patients with Middle East respiratory syndrome: A phenomenological study. J Clin Nurs 2020; 29:3349-3362. [PMID: 32498126 DOI: 10.1111/jocn.15366] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/25/2020] [Accepted: 05/24/2020] [Indexed: 12/20/2022]
Abstract
AIM AND OBJECTIVES To explore the experiences of Korean nurses who had directly cared for patients with Middle East respiratory syndrome (MERS) and to derive the structure and meaning of these experiences. BACKGROUND In 2015, the MERS epidemic struck Korea, and ill-prepared nurses had to care for patients with MERS. Nurses experienced conflict between their fear of the disease and their work and professional ethic. DESIGN We employed a phenomenological qualitative approach. METHODS Inductive, qualitative, in-depth interviews were performed with 17 nurses. The study process followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. RESULTS The qualitative inductive content analysis generated seven theme clusters and 18 themes. The theme clusters were "Fear of Uncertainty," "Beyond Hesitation," "A Scene Like a Battlefield," "Chaotic Nursing Identity," "Buttresses for Sustainability," "Lingering Trauma" and "Expanded Horizon of Nursing." The final analysis revealed that the core theme was "Beyond the fear of uncertainty." CONCLUSIONS This study contrives a more in-depth, holistic understanding by describing the experiences of nurses who directly cared for patients with MERS-the first large-scale infectious disease in Korea. Although nurses saw themselves as vital caregivers, they were frightened of the disease, had to work in a harsh environment, experienced various internal conflicts and had to deal with varying forms of uncertainty. RELEVANCE TO CLINICAL PRACTICE This study sheds light on the nursing situation during crises involving serious infectious diseases; to combat these, more medical facilities are needed, and staff should be proactively guided on how to care for patients. It can serve as part of a good foundation for further study of medical staff during recurring epidemics.
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Affiliation(s)
- Jin Young Lee
- College of Nursing, Ewha Womans University, Seoul, South Korea
| | - Jeong Hee Hong
- Nursing Administrative Support Team, Samsung Medical Center, Graduate School of Clinical Nursing Science, Sungkyunkwan University, Seoul, South Korea
| | - Eun Young Park
- College of Nursing, Gachon University, Incheon, South Korea
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18
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Morgantini LA, Naha U, Wang H, Francavilla S, Acar Ö, Flores JM, Crivellaro S, Moreira D, Abern M, Eklund M, Vigneswaran HT, Weine SM. Factors Contributing to Healthcare Professional Burnout During the COVID-19 Pandemic: A Rapid Turnaround Global Survey. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020. [PMID: 32511501 PMCID: PMC7273269 DOI: 10.1101/2020.05.17.20101915] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Healthcare professionals (HCPs) on the front lines against COVID-19 may face increased workload, and stress. Understanding HCPs risk for burnout is critical to supporting HCPs and maintaining the quality of healthcare during the pandemic. METHODS To assess exposure, perceptions, workload, and possible burnout of HCPs during the COVID-19 pandemic we conducted a cross-sectional survey. The main outcomes and measures were HCPs self-assessment of burnout and other experiences and attitudes associated with working during the COVID-19 pandemic. FINDINGS A total of 2,707 HCPs from 60 countries participated in this study. Fifty-one percent of HCPs reported burnout. Burnout was associated with work impacting household activities (RR=1.57, 95% CI=1.39-1.78, P<0.001), feeling pushed beyond training (RR=1.32, 95% CI=1.20-1.47, P<0.001), exposure to COVID-19 patients (RR=1.18, 95% CI=1.05-1.32, P=0.005), making life prioritizing decisions (RR=1.16, 95% CI=1.02-1.31, P=0.03). Adequate personal protective equipment (PPE) was protective against burnout (RR=0.88, 95% CI=0.79-0.97, P=0.01). Burnout was higher in high-income countries (HICs) compared to low- and middle-income countries (LMICs) (RR=1.18; 95% CI=1.02-1.36, P=0.018). INTERPRETATION Burnout is prevalent at higher than previously reported rates among HCPs working during the COVID-19 pandemic and is related to high workload, job stress, and time pressure, and limited organizational support. Current and future burnout among HCPs could be mitigated by actions from healthcare institutions and other governmental and non-governmental stakeholders aimed at potentially modifiable factors, including providing additional training, organizational support, support for family, PPE, and mental health resources. FUNDING N/A.
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Affiliation(s)
- Luca A Morgantini
- Department of Urology, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Ushasi Naha
- Department of Urology, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Heng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, United States
| | - Simone Francavilla
- Department of Urology, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Ömer Acar
- Department of Urology, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Jose M Flores
- Department of Urology, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Simone Crivellaro
- Department of Urology, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Daniel Moreira
- Department of Urology, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Michael Abern
- Department of Urology, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Martin Eklund
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Hari T Vigneswaran
- Department of Urology, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States.,Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Stevan M Weine
- Department of Psychiatry, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States.,Center for Global Health, University of Illinois at Chicago, Chicago, IL, United States
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19
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Abstract
OBJECTIVES This study aims to assess the perception and attitude of emergency medical services (EMS) providers toward working during disease outbreaks, and the factors that may influence their decisions to ultimately work or not. METHODS This is a cross-sectional study assessing the attitude of EMS providers to work during disease outbreaks. Descriptive statistics and regression analyses were performed to assess attitudes toward reporting for duty and factors that influence providers' decisions. RESULTS Of the 500 surveys distributed, 466 (93.2%) were complete and included for analysis. The majority of participants (70.2%) are male with a mean age of 27 (SD 4.3) years. The study found that the majority (71.1%) of participants are willing to come to work during disease outbreaks. The study found 7 predictors of reporting for duty. Confidence that employer will provide adequate protective gear was the most significant predictor (odds ratio [OR], 3.95; 95% confidence interval [CI] = 2.31-5.42). Concern for family safety was the most important barrier against coming to work (OR, 0.40; 95% CI = 0.21-0.73). CONCLUSIONS Providing adequate supplies of protective gear along with knowledge and training for disease outbreak are the main factors that enhance providers to fulfill their work expectations.
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20
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Alwidyan MT, Trainor JE, Bissell RA. Responding to natural disasters vs. disease outbreaks: Do emergency medical service providers have different views? INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2020; 44:101440. [PMID: 32363141 PMCID: PMC7185370 DOI: 10.1016/j.ijdrr.2019.101440] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 12/02/2019] [Accepted: 12/04/2019] [Indexed: 05/24/2023]
Abstract
INTRODUCTION Our planet has been experiencing a huge burden of natural disasters and public health emergencies in the last three decades. Emergency medical service providers are expected to be in the frontlines during such emergencies. Yet, this system is badly understudied when it comes to its roles and performance during disasters and public health emergencies. This study is designed to enhance understanding by assessing a sample U.S EMS providers' views about working during natural disasters and disease outbreaks and explores whether they are coming to work during such conditions. METHODS This study utilized a qualitative approach using face-to-face interviews with EMS workers from the State of Delaware, USA. Participants were asked about their views, insights, and potential behavior of working during natural disasters and disease outbreaks. Data collected were transcribed and coded using ATLAS.ti software to develop themes of the study using an inductive approach. RESULTS Three themes were emerged from interviews regarding working during natural disasters; respondents expressed excitement, concern, or no real differences. For disease outbreaks, however, the two themes were concerned and no additional risk. While participants expressed varying concerns about working during disasters and pandemic conditions, everyone felt willing and obligated to come to work despite the perceived high risk for some of them to work in some conditions. CONCLUSION This study helps to provide the base upon which EMS, public health, and emergency management agencies can formulate actions that emerged from the views of EMS providers concerning work during disasters and public health emergencies.
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Affiliation(s)
- Mahmoud T. Alwidyan
- Department of Allied Medical Science, Jordan University of Science and Technology, Irbid, Jordan
| | - Joseph E. Trainor
- Biden School of Public Policy & Administration, University of Delaware, Newark, United States
| | - Richard A. Bissell
- Department of Emergency Health Services, University of Maryland, Baltimore County, Baltimore, United States
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21
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Santana-López B, Santana-Padilla YG, Martín Santana JD, Santana-Cabrera L. [Risk of absenteeism in health personnel during a hypothetical flu pandemic]. J Healthc Qual Res 2019; 34:41-43. [PMID: 30630687 DOI: 10.1016/j.jhqr.2018.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 09/11/2018] [Accepted: 09/17/2018] [Indexed: 11/18/2022]
Affiliation(s)
| | - Y G Santana-Padilla
- Servicio de Medicina Intensiva, Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Las Palmas de Gran Canaria, España
| | | | - L Santana-Cabrera
- Servicio de Medicina Intensiva, Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Las Palmas de Gran Canaria, España.
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22
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Abstract
AbstractIntroductionChildren, with their specific vulnerabilities and needs, make up to more than 20% of society, so they are at risk of getting involved in disasters. Are the specialists treating them for medical problems in daily life also capable to deal with them in disaster situations?Hypothesis/ProblemThe goals of this study were to evaluate perceived knowledge and capability of tertiary pediatricians to deal with disasters, to identify promoting factors, and to evaluate education need and willingness to work.MethodsA survey looking for demographics, hospital disaster planning, estimated risk and capability for disasters, training, and willingness to work, and a set of six content assessment questions to evaluate knowledge, were presented to emergency pediatricians and pediatric emergency physicians in specialized tertiary centers.ResultsThe response rate was 51%. Thirty-five percent had disaster training and 53% felt that disaster education should be obligatory in their curriculum. Risk for disasters was estimated from 2.4/10 for nuclear incidents to 7.6/10 for major trauma. Self-estimated capability for these situations ranged from 1.8/10 in nuclear incidents to 7.6/10 in major trauma. Unconditional willingness to work ranged from 37% in nuclear situations to 68% in pandemics. Mean score on the questions was 2.06/6. Training, knowledge of antidote and personal protective equipment (PPE) use, self-estimated capability, and exposure were significant predictors for higher scores. Willingness to work correlated significantly with age, self-estimated capability, and risk estimation. In case of chemical and nuclear incidents, there was correlation with knowledge on the use of decontamination, PPE, and radio-detection devices.ConclusionDespite a clear perception of the risks and a high willingness to work, preparedness is limited. The major conclusion is that basics of disaster management should be included in pediatric training.MortelmansLJM, MaebeS, DieltiensG, AnseeuwK, SabbeMB, Van de VoordeP. Are tertiary care paediatricians prepared for disaster situations?Prehosp Disaster Med. 2016;31(2):126–131.
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23
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Kim JS, Choi JS. Factors predicting clinical nurses' willingness to care for Ebola virus disease-infected patients: A cross-sectional, descriptive survey. Nurs Health Sci 2015; 18:299-305. [PMID: 26661457 DOI: 10.1111/nhs.12269] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 11/07/2015] [Accepted: 11/15/2015] [Indexed: 11/30/2022]
Abstract
The purpose of this study was to identify factors predicting clinical nurses' willingness to care for Ebola virus disease (EVD)-infected patients. Data were collected from 179 nurses employed at 10 hospitals in Korea using self-reporting questionnaires. Only 26.8% of the participants were willing to care for EVD-infected patients. Factors predicting their willingness to provide care were their belief in public service, risk perception, and age. Nurses' willingness to provide care was high when their belief in public service was high, low when their risk perception was high, and low as their age increased. In order to strengthen nurses' willingness to care for EVD-infected patients, education that targets the enhancement of belief in public service should be included in nurse training. Efforts should be directed toward lowering EVD risk perception and developing systematic responses through government-led organized support.
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Affiliation(s)
- Ji Soo Kim
- College of Nursing, Gachon University, Incheon, Republic of Korea
| | - Jeong Sil Choi
- College of Nursing, Gachon University, Incheon, Republic of Korea
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24
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[Factors influencing the uptake of vaccines by adolescents with migration background. A qualitative study of adolescents, mothers, and physicians]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2014; 56:1368-75. [PMID: 23978983 DOI: 10.1007/s00103-013-1800-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
One of the special challenges in immunization policy is communication and access to adolescents. To identify barriers and enablers for the immunization of this specific target group, we conducted 11 focus group discussions with adolescents with and without migration background, mothers with Turkish and Russian migration background, and physicians in private practice in March 2011. The results showed that for adolescents, the utilization of immunization was guided by informational and organizational processes in families and by the consulting physician. The low awareness of immunization-related issues that was observed among adolescents is especially challenging, because routine visits to the doctor often stop with the transition from pediatric to adult health care. Immigration-related factors may additionally affect the utilization of immunization services. Besides improving access to information and lowering the barriers to immunization for adolescents in general, culturally sensitive interventions may be a promising approach for improving communication between mothers and the immunizing physician and thereby improving vaccination coverage in the adolescent target group.
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Factors associated with the willingness of health care personnel to work during an influenza public health emergency: an integrative review. Prehosp Disaster Med 2012; 27:551-66. [PMID: 23031432 DOI: 10.1017/s1049023x12001331] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
INTRODUCTION The first decade of the 21st century has witnessed three major influenza public health emergencies: (1) the severe acute respiratory syndrome of 2002-2003; (2) the avian flu of 2006; and (3) the 2009 H1N1 pandemic influenza. An effective public health response to an influenza public health emergency depends on the majority of uninfected health care personnel (HCP) continuing to report to work. The purposes of this study were to determine the state of the evidence concerning the willingness of HCP to work during an influenza public health emergency, to identify the gaps for future investigation, and to facilitate evidence-based influenza public health emergency planning. METHODS A systemic literature review of relevant, peer-reviewed, quantitative, English language studies published from January 1, 2001 through June 30, 2010 was conducted. Search strategies included the Cochrane Library, PubMed, PubMed Central, EBSCO Psychological and Behavioral Sciences Collection, Google Scholar, ancestry searching of citations in relevant publications, and information from individuals with a known interest in the topic. RESULTS Thirty-two studies met the inclusion criteria. Factors associated with a willingness to work during an influenza public health emergency include: being male, being a doctor or nurse, working in a clinical or emergency department, working full-time, prior influenza education and training, prior experience working during an influenza emergency, the perception of value in response, the belief in duty, the availability of personal protective equipment (PPE), and confidence in one's employer. Factors found to be associated with less willingness were: being female, being in a supportive staff position, working part-time, the peak phase of the influenza emergency, concern for family and loved ones, and personal obligations. Interventions that resulted in the greatest increase in the HCP's willingness to work were preferential access to Tamiflu for the HCP and his/her family, and the provision of a vaccine for the individual and his/her family. CONCLUSIONS Understanding the factors that contribute to the willingness of HCP to report to work during an influenza public health emergency is critical to emergency planning and preparedness. Information from this review can guide emergency policy makers, planners, and implementers in both understanding and influencing the willingness of HCP to work during an influenza public health emergency.
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Bensimon CM, Smith MJ, Pisartchik D, Sahni S, Upshur REG. The duty to care in an influenza pandemic: a qualitative study of Canadian public perspectives. Soc Sci Med 2012; 75:2425-30. [PMID: 23089615 PMCID: PMC7126096 DOI: 10.1016/j.socscimed.2012.09.021] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Revised: 08/11/2012] [Accepted: 09/13/2012] [Indexed: 11/30/2022]
Abstract
Ever since the emergence of SARS, when we were reminded that the nature of health care practitioners' duty to care is greatly contested, it has remained a polarizing issue. Discussions on the nature and limits of health care practitioners' duty to care during disasters and public health emergencies abounds the literature, ripe with arguments seeking to ground its foundations. However, to date there has been little public engagement on this issue. This study involved three Townhall meetings held between February 2008 and May 2010 in three urban settings in Canada in order to probe lay citizens' views about ethical issues related to pandemic influenza, including issues surrounding the duty to care. Participants included Canadian residents aged 18 and over who were fluent in English. Data were collected through day-long facilitated group discussions using case scenarios and focus group guides. Participant's views were organized according to several themes, including the following main themes (and respective sub-themes): 1. Legitimate limits; a) competing obligations; and b) appeal to personal choice; and 2. Legitimate expectations; a) reciprocity; and b) enforcement and planning. Our findings show that participants moved away from categorical notions of the duty to care towards more equivocal and often normative views throughout deliberations. Our analysis contributes a better understanding of the constitutive nature of the duty to care, defined in part by taking account of public views. This broadened understanding can further inform the articulation of acceptable norms of duty to care and policy development efforts. What is more, it illustrates the urgent need for policy-makers and regulators to get clarity on obligations, responsibilities, and accountability in the execution of HCPs' duty to care during times of universal vulnerability.
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Affiliation(s)
- Cécile M Bensimon
- University of Toronto, Joint Centre for Bioethics, 155 College Street, Suite 754, Toronto, ON M5T 1P8, Canada.
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Sorell T, Draper H, Damery S, Ives J. "Dunkirk spirit:" differences between United Kingdom and United States responses to pandemic influenza. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2009; 9:21-22. [PMID: 19882448 DOI: 10.1080/15265160903197648] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Campbell VA, Gilyard JA, Sinclair L, Sternberg T, Kailes JI. Preparing for and responding to pandemic influenza: implications for people with disabilities. Am J Public Health 2009; 99 Suppl 2:S294-300. [PMID: 19797741 DOI: 10.2105/ajph.2009.162677] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
State, local, tribal, and territorial emergency managers and public health officials must address the specific needs of people with disabilities in their pandemic influenza plans. Evidence from Hurricane Katrina indicated that this population was disproportionately affected by the storm and aftermath. People with disabilities, particularly those who require personal assistance and those who reside in congregate care facilities, may be at increased risk during an influenza pandemic because of disrupted care or the introduction of the virus by their caregivers. Emergency and public health planners must ensure that personal assistance agencies and congregate care operators make provisions for backup staffing and that those who provide critical care are given adequate antiviral drugs and vaccines as they become available.
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Affiliation(s)
- Vincent A Campbell
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS-E-88, Atlanta, GA 30329, USA
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Draper H, Sorell T, Ives J, Damery S, Greenfield S, Parry J, Petts J, Wilson S. Non-Professional Healthcare Workers and Ethical Obligations to Work during Pandemic Influenza. Public Health Ethics 2009. [DOI: 10.1093/phe/php021] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Morrison LG, Yardley L. What infection control measures will people carry out to reduce transmission of pandemic influenza? A focus group study. BMC Public Health 2009; 9:258. [PMID: 19627568 PMCID: PMC2720966 DOI: 10.1186/1471-2458-9-258] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2009] [Accepted: 07/23/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pandemic influenza poses a future health threat against which infection control behaviours may be an important defence. However, there is little qualitative research examining perceptions of infection control measures in the context of pandemic influenza. METHODS Eight focus groups and one interview were conducted with a purposive sample of 31 participants. Participants were invited to discuss their perceptions of infection transmission and likely adherence to infection control measures in both non-pandemic and pandemic contexts. Infection control measures discussed included handwashing, social distancing and cough hygiene (e.g. covering mouth, disposing of tissues immediately etc.). RESULTS Thematic analysis revealed that although participants were knowledgeable about infection transmission, most expressed unfavourable attitudes toward control behaviours in non-pandemic situations. However, with the provision of adequate education about control measures and appropriate practical support (e.g. memory aids, access to facilities), most individuals report that they are likely to adhere to infection control protocols in the event of a pandemic. Of the behaviours likely to influence infection transmission, handwashing was regarded by our participants as more feasible than cough and sneeze hygiene and more acceptable than social distancing. CONCLUSION Handwashing could prove a useful target for health promotion, but interventions to promote infection control may need to address a number of factors identified within this study as potential barriers to carrying out infection control behaviours.
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Affiliation(s)
- Leanne G Morrison
- School of Psychology, University of Southampton, University Road, Southampton, Hampshire, UK
| | - Lucy Yardley
- School of Psychology, University of Southampton, University Road, Southampton, Hampshire, UK
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Damery S, Wilson S, Draper H, Gratus C, Greenfield S, Ives J, Parry J, Petts J, Sorell T. Will the NHS continue to function in an influenza pandemic? A survey of healthcare workers in the West Midlands, UK. BMC Public Health 2009; 9:142. [PMID: 19442272 PMCID: PMC2690584 DOI: 10.1186/1471-2458-9-142] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2009] [Accepted: 05/14/2009] [Indexed: 11/22/2022] Open
Abstract
Background If UK healthcare services are to respond effectively to pandemic influenza, levels of absenteeism amongst healthcare workers (HCWs) must be minimised. Current estimates of the likelihood that HCWs will continue to attend work during a pandemic are subject to scientific and predictive uncertainty, yet an informed evidence base is needed if contingency plans addressing the issues of HCW absenteeism are to be prepared. Methods This paper reports the findings of a self-completed survey of randomly selected HCWs across three purposively sampled healthcare trusts in the West Midlands. The survey aimed to identify the factors positively or negatively associated with willingness to work during an influenza pandemic, and to evaluate the acceptability of potential interventions or changes to working practice to promote the continued presence at work of those otherwise unwilling or unable to attend. 'Likelihood' and 'persuadability' scores were calculated for each respondent according to indications of whether or not they were likely to work under different circumstances. Binary logistic regression was used to compute bivariate and multivariate odds ratios to evaluate the association of demographic variables and other respondent characteristics with the self-described likelihood of reporting to work. Results The survey response rate was 34.4% (n = 1032). Results suggest absenteeism may be as high as 85% at any point during a pandemic, with potential absence particularly concentrated amongst nursing and ancillary workers (OR 0.3; 95% CI 0.1 to 0.7 and 0.5; 95% CI 0.2 to 0.9 respectively). Conclusion Levels of absenteeism amongst HCWs may be considerably higher than official estimates, with potential absence concentrated amongst certain groups of employees. Although interventions designed to minimise absenteeism should target HCWs with a low stated likelihood of working, members of these groups may also be the least receptive to such interventions. Changes to working conditions which reduce barriers to the ability to work may not address barriers linked to willingness to work, and may fail to overcome HCWs' reluctance to work in the face of what may still be deemed unacceptable risk to self and/or family.
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Affiliation(s)
- Sarah Damery
- Department of Primary Care Clinical Sciences, University of Birmingham, Edgbaston, Birmingham, UK.
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Ives J, Greenfield S, Parry JM, Draper H, Gratus C, Petts JI, Sorell T, Wilson S. Healthcare workers' attitudes to working during pandemic influenza: a qualitative study. BMC Public Health 2009; 9:56. [PMID: 19216738 PMCID: PMC2654560 DOI: 10.1186/1471-2458-9-56] [Citation(s) in RCA: 161] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2008] [Accepted: 02/12/2009] [Indexed: 12/02/2022] Open
Abstract
Background Healthcare workers (HCWs) will play a key role in any response to pandemic influenza, and the UK healthcare system's ability to cope during an influenza pandemic will depend, to a large extent, on the number of HCWs who are able and willing to work through the crisis. UK emergency planning will be improved if planners have a better understanding of the reasons UK HCWs may have for their absenteeism, and what might motivate them to work during an influenza pandemic. This paper reports the results of a qualitative study that explored UK HCWs' views (n = 64) about working during an influenza pandemic, in order to identify factors that might influence their willingness and ability to work and to identify potential sources of any perceived duty on HCWs to work. Methods A qualitative study, using focus groups (n = 9) and interviews (n = 5). Results HCWs across a range of roles and grades tended to feel motivated by a sense of obligation to work through an influenza pandemic. A number of significant barriers that may prevent them from doing so were also identified. Perceived barriers to the ability to work included being ill oneself, transport difficulties, and childcare responsibilities. Perceived barriers to the willingness to work included: prioritising the wellbeing of family members; a lack of trust in, and goodwill towards, the NHS; a lack of information about the risks and what is expected of them during the crisis; fear of litigation; and the feeling that employers do not take the needs of staff seriously. Barriers to ability and barriers to willingness, however, are difficult to separate out. Conclusion Although our participants tended to feel a general obligation to work during an influenza pandemic, there are barriers to working, which, if generalisable, may significantly reduce the NHS workforce during a pandemic. The barriers identified are both barriers to willingness and to ability. This suggests that pandemic planning needs to take into account the possibility that staff may be absent for reasons beyond those currently anticipated in UK planning documents. In particular, staff who are physically able to attend work may nonetheless be unwilling to do so. Although there are some barriers that cannot be mitigated by employers (such as illness, transport infrastructure etc.), there are a number of remedial steps that can be taken to lesson the impact of others (providing accommodation, building reciprocity, provision of information and guidance etc). We suggest that barriers to working lie along an ability/willingness continuum, and that absenteeism may be reduced by taking steps to prevent barriers to willingness becoming perceived barriers to ability.
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Affiliation(s)
- Jonathan Ives
- Centre for Biomedical Ethics, The University of Birmingham, Birmingham, UK.
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