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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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Rotaru TȘ, Cojocaru D, Cojocaru Ș, Alexinschi O, Puia A, Oprea L. Assessment of Physicians' Willingness to Work with Patients Not Yet Diagnosed with COVID-19 in a Romanian Sample. Healthcare (Basel) 2024; 12:161. [PMID: 38255050 PMCID: PMC10815129 DOI: 10.3390/healthcare12020161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/28/2023] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND The risk to physicians who worked with patients without confirmed COVID-19 testing during the pandemic has been little studied. However, they were at high risk. METHODS In the summer of 2020, 1285 Romanian physicians participated in a single-center study. Participants (mean age = 48.21 years; 302 males and 982 females, all specialties) completed a series of single-item measures adapted from previous studies on work ethics and responsibility. This study used Mann-Whitney comparisons between physicians who reported that they knowingly had direct contact with COVID patients and those who did not regarding their willingness to work. RESULTS Compared with their colleagues, physicians who reported not knowingly having direct contact with COVID patients reported less access to protective equipment, less overall willingness to respond when asked to work with infected patients, more likely to work out of fear of losing their jobs, and fear of legal repercussions. They received less training in the use of protective equipment. CONCLUSIONS Physicians who worked with patients not yet diagnosed with COVID-19 were significantly less willing to work. The perception of invisible risk may explain the observed differences.
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Affiliation(s)
- Tudor-Ștefan Rotaru
- Department of Bioethics, University of Medicine and Pharmacy “Gr. T. Popa” Iași, 700115 Iași, Romania; (T.-Ș.R.); (L.O.)
| | - Daniela Cojocaru
- Department of Sociology and Social Work, University “Alexandru Ioan Cuza” of Iași, 700506 Iași, Romania; (D.C.); (Ș.C.)
| | - Ștefan Cojocaru
- Department of Sociology and Social Work, University “Alexandru Ioan Cuza” of Iași, 700506 Iași, Romania; (D.C.); (Ș.C.)
| | - Ovidiu Alexinschi
- Department IIIA, “Socola” Institute of Psychiatry, 700282 Iași, Romania
| | - Aida Puia
- Department of Community Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania;
| | - Liviu Oprea
- Department of Bioethics, University of Medicine and Pharmacy “Gr. T. Popa” Iași, 700115 Iași, Romania; (T.-Ș.R.); (L.O.)
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Chen D, Cojocaru S. Navigating a Pandemic: Leadership Dynamics and Challenges within Infection Prevention and Control Units in Israel. Healthcare (Basel) 2023; 11:2966. [PMID: 37998458 PMCID: PMC10671528 DOI: 10.3390/healthcare11222966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/07/2023] [Accepted: 11/13/2023] [Indexed: 11/25/2023] Open
Abstract
This study investigates the impact of the coronavirus disease 2019 (COVID-19) pandemic on leadership within infection prevention and control (IPC) units across public hospitals in Israel. Through qualitative interviews with ten IPC managers from nine hospitals, equivalent to 30% of the country's acute care facilities, the research uncovers significant changes in managerial approaches due to the health crisis. The results reveal four main themes: (1) Enhanced managerial autonomy and leadership skills, with a noted rise in self-efficacy against the pandemic's backdrop; (2) Shifted perceptions of IPC units by upper management, recognizing their strategic value while identifying the need for a more profound understanding of IPC operations; (3) The increased emphasis on adaptability and rapid decision-making for effective crisis management; (4) The dual effect on job satisfaction and well-being, where greater commitment coincides with risks of burnout. The study underscores the essential nature of effective IPC leadership during emergencies, highlighting the need for clear communication, prompt action, and empathetic leadership. The conclusions point to the necessity for continuous research into IPC leadership, promoting strategic advancements in management to bolster IPC units against future health threats.
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Affiliation(s)
- Dafna Chen
- Department of Sociology and Social Work, Alexandru Ioan Cuza University from Iasi, 700506 Iasi, Romania;
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López BNS, Adell MDB, Cabrera LS, Padilla YGS. Beliefs, attitudes and feelings about work among healthcare workers and teachers during the fifth wave of COVID-19. J Int Med Res 2023; 51:3000605231206276. [PMID: 38000012 PMCID: PMC10676073 DOI: 10.1177/03000605231206276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 09/21/2023] [Indexed: 11/26/2023] Open
Abstract
OBJECTIVE To compare the beliefs, attitudes and feelings about work of healthcare professionals (HCPs) and teachers living in the Canary Islands (Spain) during the COVID-19 pandemic. METHODS The study had two parts. In Part 1, the Delphi technique was used to adapt a questionnaire. Part 2 was a cross-sectional, comparative study, performed from August 31st to October 25th, 2021 using the questionnaire online distributed to samples of HCPs and teachers. The questionnaire had three dimensions each separated into three sections (i.e., beliefs [coping ability, prevention and organisation]; attitudes [risks, commitments, and obligations]; feelings about work [burnout, support and work satisfaction]). RESULTS In total 1423 questionnaires were available for analysis, 640 from teaching staff and 783 from HCPs. Significant differences were found in eight of the nine sections. HCPs had a more positive attitude towards work compared with teachers, but had more negative beliefs and feelings about work. In addition, by comparison with teachers, HCPs were more committed to their work, more predisposed to take risks and fulfill their obligations, even though our sample of teachers felt more supported and satisfied at work. CONCLUSIONS Our results show that the pandemic caused a greater negative impact on job satisfaction of HCPs compared with teachers because they felt less supported by their superiors, which had a greater impact on their psychological health.
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Affiliation(s)
- Borja N Santana López
- Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas, Spain
- Universitat Jaume I, Castelló, Spain
- Universidad Fernando Pessoa Canarias, Las Palmas, Spain
| | | | - Luciano Santana Cabrera
- Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Las Palmas, Spain
| | - Yeray G Santana Padilla
- Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Las Palmas, Spain
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Kang BA, Barnett DJ, Chhipa UEA, Mehmood A, Afzal B, Razzak J, Asad N. The Role of Self-Efficacy and Risk Perception in the Willingness to Respond to Weather Disasters Among Emergency Medicine Health Care Workers in Pakistan. Disaster Med Public Health Prep 2023; 17:e461. [PMID: 37477005 PMCID: PMC11103185 DOI: 10.1017/dmp.2023.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
OBJECTIVE Optimizing health care workers' (HCWs) willingness to respond (WTR) is critical in low-and-middle-income countries (LMICs) for proper health system functioning during extreme weather events. Pakistan frequently experiences weather-related disasters, but limited evidence is available to examine HCW willingness. Our study examined the association between WTR and behavioral factors among emergency department HCWs. METHODS A cross-sectional survey was conducted from August to September 2022 among HCWs from 2 hospitals in Karachi, Pakistan. Non-probability purposive sampling was used to recruit participants. A survey tool was informed by Witte's Extended Parallel Process Model (EPPM). Multivariate logistic regression analyses were performed to examine the association between WTR and attitudes/beliefs as well as EPPM profiles. RESULTS Twenty-nine percent of HCWs indicated a low WTR. HCWs using public transportation had a higher WTR. Perceived knowledge and skills, self-efficacy, and perceived impact of one's response showed positive associations with WTR if required. Perception that one's colleagues would report to work positively predicted WTR if asked. Consistent with the EPPM, HCWs with high efficacy and perceived threat were willing to respond to weather disasters. CONCLUSIONS Our findings highlight the need of strengthening WTR by promoting self-efficacy and enhancing accurate risk perception as a response motivator, among emergency department HCWs in Pakistan.
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Affiliation(s)
- Bee-Ah Kang
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Daniel J. Barnett
- Department of Environmental Health & Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ume-e-Aiman Chhipa
- Centre of Excellence for Trauma and Emergencies, Aga Khan University, Karachi, Pakistan
| | - Amber Mehmood
- Department of Public Health, University of South Florida College of Public Health, Tampa, FL, USA
| | - Badar Afzal
- Department of Emergency Medicine, Aga Khan University, Karachi, Pakistan
| | - Junaid Razzak
- Centre of Excellence for Trauma and Emergencies, Aga Khan University, Karachi, Pakistan
- Department of Emergency Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Nargis Asad
- Department of Psychiatry, Aga Khan University, Karachi, Pakistan
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Rotaru TȘ, Puia A, Cojocaru Ș, Alexinschi O, Gavrilovici C, Oprea L. Physicians' Trust in Relevant Institutions during the COVID-19 Pandemic: A Binary Logistic Model. Healthcare (Basel) 2023; 11:1736. [PMID: 37372854 DOI: 10.3390/healthcare11121736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 05/25/2023] [Accepted: 06/11/2023] [Indexed: 06/29/2023] Open
Abstract
Little research has been done on professionals' perceptions of institutions and governments during epidemics. We aim to create a profile of physicians who feel they can raise public health issues with relevant institutions during a pandemic. A total of 1285 Romanian physicians completed an online survey as part of a larger study. We used binary logistic regression to profile physicians who felt they were able to raise public health issues with relevant institutions. Five predictors could differentiate between respondents who tended to agree with the trust statement and those who tended to disagree: feeling safe at work during the pandemic, considering the financial incentive worth the risk, receiving training on the use of protective equipment, having the same values as colleagues, and enjoying work as much as before the pandemic. Physicians who trusted the system to raise public health issues with the appropriate institutions were more likely to feel that they shared the same values as their colleagues, to say they were trained to use protective equipment during the pandemic, to feel that they were safe at work during the pandemic, to enjoy their work as much as before the pandemic, and to feel that the financial bonus justified the risk.
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Affiliation(s)
- Tudor-Ștefan Rotaru
- Department of Bioethics, University of Medicine and Pharmacy "Gr. T. Popa" Iași, 700115 Iași, Romania
| | - Aida Puia
- Department of Community Medicine, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Ștefan Cojocaru
- Department of Sociology and Social Work, University "Alexandru Ioan Cuza" of Iași, 700506 Iași, Romania
| | - Ovidiu Alexinschi
- Department IIIA, "Socola" Institute of Psychiatry, 700282 Iași, Romania
| | - Cristina Gavrilovici
- Department of Mother and Child, University of Medicine and Pharmacy "Gr. T. Popa" Iași, 700115 Iași, Romania
| | - Liviu Oprea
- Department of Bioethics, University of Medicine and Pharmacy "Gr. T. Popa" Iași, 700115 Iași, Romania
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Santinha G, Forte T, Gomes A. Willingness to Work during Public Health Emergencies: A Systematic Literature Review. Healthcare (Basel) 2022; 10:healthcare10081500. [PMID: 36011158 PMCID: PMC9408569 DOI: 10.3390/healthcare10081500] [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: 06/30/2022] [Revised: 07/24/2022] [Accepted: 08/03/2022] [Indexed: 11/16/2022] Open
Abstract
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.
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Affiliation(s)
- Gonçalo Santinha
- GOVCOPP, Department of Social, Political and Territorial, University of Aveiro, 3810-193 Aveiro, Portugal
- Correspondence:
| | - Teresa Forte
- Department of Social, Political and Territorial Sciences, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Ariana Gomes
- Department of Social, Political and Territorial Sciences, University of Aveiro, 3810-193 Aveiro, Portugal
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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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The Challenges of Nurse Redeployment and Opportunities for Leadership During COVID-19 Pandemic. Disaster Med Public Health Prep 2022; 17:e134. [PMID: 35152933 PMCID: PMC8961057 DOI: 10.1017/dmp.2022.43] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Literature has previously shown that healthcare staff redeployment has been widely implemented to build capacity, with little focus on nurses. This study aims to manage redeployment more effectively by capturing and scrutinizing nurses' redeployment experiences. METHODS A cross-sectional short and structured interview was conducted. Data was analyzed using Braun and Clarkes 6 Step Thematic Analysis approach. RESULTS 55 interviews were conducted predominantly from women (85%, N = 47), over the age of 45 years (45%, N = 25), who were in the role of Specialist Nurse or Staff Nurse (78%, N = 43). 5 critical themes emerged: willingness to work in redeployed role, poor communication, stress and anxiety, feelings of being unsupported and abandoned, and positive experiences despite challenging circumstances. CONCLUSION Nurses in redeployed roles were susceptible to stress and anxiety and were seeking dedicated leadership as they worked during a pandemic with the additional challenge of unfamiliar workspaces and colleagues. Nurses play a major role in the resilience of healthcare service, which cannot be achieved without a comprehensive resilience strategy. Healthcare organisations are required to develop strategies, policies, and enforcement measures to ensure that their staff are well empowered and protected not just during potential redeployment but also in their daily operations.
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Janson DJ, Clift BC, Dhokia V. PPE fit of healthcare workers during the COVID-19 pandemic. APPLIED ERGONOMICS 2022; 99:103610. [PMID: 34740070 PMCID: PMC8516797 DOI: 10.1016/j.apergo.2021.103610] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 09/27/2021] [Accepted: 10/12/2021] [Indexed: 06/13/2023]
Abstract
Historically, PPE (Personal Protective Equipment) has generally been designed around the size and shape of an average European or US white man's face and body. There is little academic evidence to support anecdotal reports that women are at a greater disadvantage than men from ill-fitting PPE. This is especially relevant in healthcare settings where women make up at least 75% of frontline workers. The COVID-19 pandemic has exacerbated problems associated with the fit of PPE that until now have been mainly anecdotal. This research presents results and analysis of a quantitative and qualitative survey concerning the fit of PPE worn by 248 healthcare workers, in a variety of healthcare roles and settings, during the COVID-19 pandemic. The analysis of the survey results showed that women were less likely than men to feel safe carrying out their roles, with only 30.5% of women and 53.3% of men stating that they felt safe all of the time. A statistically significant link is made between women suffering more with poor fit than men with certain categories of PPE (gowns, masks, visors, goggles). Over four times as many women (54.8%) as men (13.3%) reported their surgical gowns being large to some degree and women were nearly twice as likely (53.5%) to experience oversized surgical masks than men (28.6%). However, it was recognized that PPE fit problems are not exclusive to women as many men also do not conform to the underlying shape and size of PPE designs. Survey results indicated that both sexes felt equally hampered due to the fit of their PPE and around a third of both women and men had modified their PPE to address fit issues. Oversized and modified PPE presents its own set of unintended consequences. Following strict processes for doffing and removing PPE is key to virus control but doffing modified PPE can fall outside of these processes, risking cross infection. In addition, wearers of critical items of PPE (such as respirators) currently undergo a "fit test"; however, fit does not reconcile with comfort and over-tightened PPE can cause headaches, discomfort and distraction when worn for long periods. Requirements and fit tests are also not setting-specific; qualitative responses from the survey give an indication that this must be a future consideration.
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Affiliation(s)
- D J Janson
- Department of Mechanical Engineering, University of Bath, Claverton Down, Bath, BA2 7AY, United Kingdom
| | - B C Clift
- Department for Health, University of Bath, Claverton Down, Bath, BA2 7AY, United Kingdom
| | - V Dhokia
- Department of Mechanical Engineering, University of Bath, Claverton Down, Bath, BA2 7AY, United Kingdom.
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Reyes-Luna J, Jara-Concha PDT. A Glance at the Barriers and Enablers of the Nursing Role in Pandemics: An Integrative Review. AQUICHAN 2022. [DOI: 10.5294/aqui.2022.22.1.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective: to analyze the enablers and barriers to nurses’ professional role fulfillment during pandemics and disasters.
Materials and methods: this was an integrative review based on the SALSA analytical method, carried out in eight databases, namely: Medline, Proquest, CINAHL, Web of Science, BVS, SpringerLink, Scopus, and Pubmed. The descriptors used were the following: ‘nurse’s role’ AND ‘pandemic’ AND ‘patient’ AND ‘coronavirus infection’, in English, Spanish and Portuguese. Filters along with inclusion and exclusion criteria were applied to the 11,031 articles found, after which the final sample consisted of a total of 32 articles.
Results: considering the objectives set and the results obtained, it is noted that all actions focused on three main instances, namely: a) training and updating for role performance; b) predictors, enablers, and barriers for exercising the role in the face of a pandemic; and c) evidence of the role in the face of pandemics.
Conclusion: this study allowed understanding both the barriers and the enablers that allow the fulfillment of nurses’ professional role in the face of pandemics or catastrophes. It also clarified that emerging infectious diseases must be addressed in an immediate, collaborative, and multidisciplinary way. Nurses’ experience, leadership, and professional training are key attributes that these professionals possess to enable their role to be more proactive during an emergency situation.
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Huang HL, Jan CFJ, Bih-Jeng Chang B, Chiu TY. Factors influencing the willingness of primary care physicians to provide care during the coronavirus disease pandemic: a nationwide survey in Taiwan. BMJ Open 2021; 11:e049148. [PMID: 34210735 PMCID: PMC8251678 DOI: 10.1136/bmjopen-2021-049148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The COVID-19 pandemic continues to advance worldwide with tremendous impact on public health, economy and society. Primary healthcare is crucial in every country during the pandemic for an integrated and coordinated healthcare delivery system; hence, it is of paramount importance to maintain a sufficient frontline workforce. This study aimed to identify factors influencing the willingness of primary care physicians to provide care during the COVID-19 pandemic. DESIGN Cross sectional study. SETTING Nationwide survey PARTICIPANTS: Primary care physicians working in the community in Taiwan were selected using a cluster sampling method based on practice region from May to June 2020. OUTCOME MEASURES The willingness of primary care physicians to provide care during the COVID-19 pandemic. RESULTS This study surveyed 1000 primary care physicians nationwide, and 625 valid questionnaires were received and included in the final analysis, with an effective response rate of 62.5%. Factors significantly associated with physicians willingness to provide care during COVID-19 were 'joining the Community Healthcare Group (CHCG)' (p<0.001), 'perceived more overall benefits for providing care' (p<0.001) 'perceived less overall barriers to providing care' (p<0.001), 'higher knowledge scores about COVID-19' (p=0.049) and 'physician's major specialties' (p=0.009) in the multivariate logistic regression model. CONCLUSIONS Building a comprehensive primary care system such as Taiwan's CHCG, training of more family physicians or general practitioners, and protecting and supporting primary care physicians were important in response to infectious disease pandemics. The findings of this study inform the development of guidelines to support and maintain the primary healthcare workforces during the COVID-19 pandemic and for future events.
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Affiliation(s)
- Hsien-Liang Huang
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Family Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chyi-Feng Jeff Jan
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Family Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Brian Bih-Jeng Chang
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Family Medicine, Brian's Family Doctor clinic, New Taipei City, Taiwan
- Taiwan Medical Association, Taipei, Taiwan
| | - Tai-Yuan Chiu
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Family Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
- Taiwan Medical Association, Taipei, Taiwan
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Ma Y, Zhu W, Zhang H, Zhao P, Wang Y, Zhang Q. The Factors Affecting Volunteers' Willingness to Participate in Disaster Preparedness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084141. [PMID: 33919857 PMCID: PMC8070767 DOI: 10.3390/ijerph18084141] [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] [Received: 03/15/2021] [Revised: 04/12/2021] [Accepted: 04/12/2021] [Indexed: 11/16/2022]
Abstract
Disaster preparedness is crucial for providing an effective response to, and reducing the possible impacts of, disasters. Although volunteers' participation plays an important role in disaster preparedness, their actual participation in disaster preparedness activities is still low. To find ways to encourage more volunteers to participate, this study analyzed the social background and organizational and attitudinal factors affecting the volunteers' willingness to participate. Questionnaires were distributed to 990 registered disaster volunteers across Beijing and the data were analyzed using linear regression models. Results revealed a weak willingness to participate in disaster preparedness. Only 28.08% of the respondents indicated that they were "very ready" to participate in voluntary disaster preparedness, and 14.65% showed "a little bit" of interest. The following was concluded: (1) Disaster volunteers' social background variables were related to their willingness to participate in disaster preparedness. Compared to male volunteers, female volunteers were more willing to participate. Chinese Communist Party members were more willing to participate than non-members. (2) Providing accidental life insurance for the volunteers had a positive effect on their willingness to participate in disaster preparedness. Provision of more training had a negative effect on the volunteers' willingness to participate, indicating a low quality of training. (3) Organizational identification was positively related to the volunteers' willingness to participate. According to these results, we suggest that volunteer organizations should improve their standards and procedures for disaster volunteer recruitment and selection, and gain a deeper understanding of the needs of the disaster volunteers in order to better motivate them to participate.
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Affiliation(s)
- Yingnan Ma
- Beijing Research Center of Urban Systems Engineering, Beijing 100035, China; (Y.M.); (W.Z.); (P.Z.); (Y.W.)
| | - Wei Zhu
- Beijing Research Center of Urban Systems Engineering, Beijing 100035, China; (Y.M.); (W.Z.); (P.Z.); (Y.W.)
| | - Huan Zhang
- School of Social Development and Public Policy, Beijing Normal University, Beijing 100875, China;
| | - Pengxia Zhao
- Beijing Research Center of Urban Systems Engineering, Beijing 100035, China; (Y.M.); (W.Z.); (P.Z.); (Y.W.)
| | - Yafei Wang
- Beijing Research Center of Urban Systems Engineering, Beijing 100035, China; (Y.M.); (W.Z.); (P.Z.); (Y.W.)
| | - Qiujie Zhang
- School of Social Development and Public Policy, Beijing Normal University, Beijing 100875, China;
- Department of Research Project, Beijing Vocational College of Labor and Social Security, Beijing 100029, China
- Correspondence: ; Tel.: +86-158-0161-1682
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Factors Influencing Health Care Workers' Willingness to Respond to Duty during Infectious Disease Outbreaks and Bioterrorist Events: An Integrative Review. Prehosp Disaster Med 2021; 36:321-337. [PMID: 33618789 PMCID: PMC7948100 DOI: 10.1017/s1049023x21000248] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Infectious disease emergencies are increasingly becoming part of the health care delivery landscape, having implications to not only individuals and the public, but also on those expected to respond to these emergencies. Health care workers (HCWs) are perhaps the most important asset in an infectious disease emergency, yet these individuals have their own barriers and facilitators to them being willing or able to respond. AIM The purpose of this review was to identify factors affecting HCW willingness to respond (WTR) to duty during infectious disease outbreaks and/or bioterrorist events. METHODS An integrative literature review methodology was utilized to conduct a structured search of the literature including CINAHL, Medline, Embase, and PubMed databases using key terms and phrases. PRISMA guidelines were used to report the search outcomes and all eligible literature was screened with those included in the final review collated and appraised using a quality assessment tool. RESULTS A total of 149 papers were identified from the database search. Forty papers were relevant following screening, which highlighted facilitators of WTR to include: availability of personal protective equipment (PPE)/vaccine, level of training, professional ethics, family and personal safety, and worker support systems. A number of barriers were reported to prevent WTR for HCWs, such as: concern and perceived risk, interpersonal factors, job-level factors, and outbreak characteristics. CONCLUSIONS By comprehensively identifying the facilitators and barriers to HCWs' WTR during infectious disease outbreaks and/or bioterrorist events, strategies can be identified and implemented to improve WTR and thus improve HCW and public safety.
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Abstract
Objective: This study evaluates the personal and professional experiences of physician mothers during the coronavirus disease 2019 (COVID-19) pandemic and the impact of the pandemic on the lives of physician mothers. Methods: Using social media to reach a broad range of physicians, a convenience sample of physician mothers completed an on-line survey posted between April 27 and May 11. Members were encouraged to repost on social media and share with personal contacts resulting in a passive snowball sampling effect. Results: A total of 2709 physician mothers from 48 states, Puerto Rico, and 19 countries representing more than 25 medical specialties completed the survey. Most were between 30 and 39 y of age, 67% self-identified as white, 17% as Asian, 4% as African American. Most had been working for 11-16 y. A total of 91% had a spouse/partner of the opposite sex. Over half were practicing in an area they identified as high COVID-19 density, while 50% had personally cared for a person with COVID-19. Physician mothers were most concerned about exposing their children to COVID-19 and about the morale and safety of their staff. Conclusions: This is one of the first studies to explore the personal and professional challenges facing physician mothers during a pandemic. Physician mothers were most concerned about exposing their families to COVID-19. Mothers continued to work and at times increased their work, despite having domestic, childcare, and schooling responsibilities.
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Tse DMS, Li Z, Lu Y, Li Y, Liu Y, Wong WCW. Fighting against COVID-19: preparedness and implications on clinical practice in primary care in Shenzhen, China. BMC FAMILY PRACTICE 2020; 21:271. [PMID: 33339508 PMCID: PMC7747774 DOI: 10.1186/s12875-020-01343-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 12/01/2020] [Indexed: 11/26/2022]
Abstract
Background The new coronavirus pneumonia (NCP) caused by COVID-19 has affected more than 46 million people worldwide. In China, primary care has played a vital role during the COVID-19 outbreak, and it is important to examine the challenges faced by general practitioners (GPs). This study investigated the roles, preparedness and training needs of GPs in China in managing the NCP outbreak. Based on the outcomes of the study, we hope to take lessons and identify how GPs could be supported in delivering their gatekeeping roles and clinical duties in times of infectious disease outbreak. Methods An online survey on the official website of Shenzhen Continuing Education Center. It included questions on GPs’ demographics, their awareness of COVID-19 and their preparedness in managing suspected cases of NCP, as well as referrals and their training needs. Conditional multi-variate logistic models were used to investigate the relationships between GPs’ preparedness, situational confidence and anxiety. Results GPs’ clinical practice was significantly affected. GPs endeavoured to answer a flood of COVID-19-related enquiries, while undertaking community preventive tasks. In addition to in-person consultations, GP promoted COVID-19 awareness and education through telephone consultations, physical posters and social media. Overall GPs in Shenzhen felt well supported with adequate Personal Protective Equipment (PPE) and resources from secondary care services. Higher levels of self-perceived preparedness (OR = 2.19; 95%CI, 1.04–4.61), lower level of anxiety (OR = 0.56; 95%CI, 0.29–1.09) and fewer perceived family worries (OR = 0.37; 95%CI, 0.12–1.12) were associated with better confidence in coping at work. Conclusions Training and supporting GPs while reducing their (and their families’) anxiety increase their confidence in delivering the important roles of gatekeeping in face of major disease outbreaks.
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Affiliation(s)
- Desiree Man-Sik Tse
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 3/F, Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong
| | - Zhuo Li
- Department of Family Medicine and Primary Care, The University of Hong Kong-Shenzhen Hospital, 1 Haiyuan 1st Rd, Futian District, Shenzhen, 518009, Guangdong Province, China
| | - Ye Lu
- Department of Family Medicine and Primary Care, The University of Hong Kong-Shenzhen Hospital, 1 Haiyuan 1st Rd, Futian District, Shenzhen, 518009, Guangdong Province, China
| | - Yang Li
- Shenzhen Health Capacity Building and Continuing Education Center, National Health Commission, 21 Tian Bei Yi, LuLuohu Qu, Shenzhen Shi, 518041, Guangdong Sheng, China
| | - Ying Liu
- Shenzhen Health Capacity Building and Continuing Education Center, National Health Commission, 21 Tian Bei Yi, LuLuohu Qu, Shenzhen Shi, 518041, Guangdong Sheng, China
| | - William Chi Wai Wong
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 3/F, Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong. .,Department of Family Medicine and Primary Care, The University of Hong Kong-Shenzhen Hospital, 1 Haiyuan 1st Rd, Futian District, Shenzhen, 518009, Guangdong Province, China.
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Lord H, Loveday C, Moxham L, Fernandez R. Effective communication is key to intensive care nurses' willingness to provide nursing care amidst the COVID-19 pandemic. Intensive Crit Care Nurs 2020; 62:102946. [PMID: 33139165 PMCID: PMC7528824 DOI: 10.1016/j.iccn.2020.102946] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 09/03/2020] [Accepted: 09/06/2020] [Indexed: 01/08/2023]
Abstract
Background The COVID-19 pandemic posed and continues to pose challenges for health care systems globally, particularly to Intensive Care Units (ICU). At the forefront of the ICU are highly trained nurses with a professional obligation to care for patients with COVID-19 despite the potential to become infected. The aim of this study was to explore ICU nurses’ willingness to care during the COVID-19 pandemic. Methods A prospective cross-sectional study to explore ICU nurses’ willingness to provide care during the COVID-19 pandemic was undertaken between 25 March and 3 April 2020 at a large principal and referral teaching hospital in Sydney, NSW Australia. Results A total of 83 ICU nurses completed the survey. Approximately 60% reported receiving sufficient information from managers regarding COVID-19 and about caring for a patient with COVID-19. Ninety percent of nurses were concerned about spreading COVID-19 to their family. Sixty one percent of the nurses indicated that they were willing to care for patients with COVID-19. Receiving timely communication from managers was the only predictor of willingness to care among ICU nurses. Conclusions Effective communication is a vital component during a public health emergency in order to promote nurses’ willingness to care for patients in the ICU.
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Affiliation(s)
- Heidi Lord
- Centre for Research in Nursing and Health, Level 1 Research and Education Building, St George Hospital, Kogarah, NSW, Australia; Centre for Evidence Based Initiatives in Health Care: a Joanna Briggs Centre of Excellence, Wollongong, NSW, Australia.
| | - Clare Loveday
- Intensive Care Services, St George Hospital, Kogarah, NSW, Australia
| | - Lorna Moxham
- School of Nursing, Faculty of Science, Medicine and Health, Building 41, University of Wollongong, NSW, Australia
| | - Ritin Fernandez
- Centre for Research in Nursing and Health, Level 1 Research and Education Building, St George Hospital, Kogarah, NSW, Australia; Centre for Evidence Based Initiatives in Health Care: a Joanna Briggs Centre of Excellence, Wollongong, NSW, Australia; School of Nursing, Faculty of Science, Medicine and Health, Building 41, University of Wollongong, NSW, Australia
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Hevia V, Lorca J, Hevia M, Domínguez A, López-Plaza J, Artiles A, Álvarez S, Sánchez Á, Fraile A, López-Fando L, Sanz E, Ruiz M, Alcaraz E, Burgos FJ. [COVID-19 Pandemic: Impact and rapid reaction of Urology]. Actas Urol Esp 2020; 44:450-457. [PMID: 38620218 PMCID: PMC7181986 DOI: 10.1016/j.acuro.2020.04.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 04/21/2020] [Indexed: 01/08/2023]
Abstract
The COVID-19 pandemic caused by the SARS-CoV-2 virus has caused tens of thousands of deaths in Spain and has managed to breakdown the healthcare system hospitals in the Community of Madrid, largely due to its tendency to cause severe pneumonia, requiring ventilatory support. This fact has caused our center to collapse, with 130% of its beds occupied by COVID-19 patients, thus causing the absolute cessation of activity of the urology service, the practical disappearance of resident training programs, and the incorporation of a good part of the urology staff into the group of medical personnel attending these patients. In order to recover from this extraordinary level of suspended activity, we will be obliged to prioritize pathologies based on purely clinical criteria, for which tables including the relevance of each pathology within each area of urology are being proposed. Technology tools such as online training courses or surgical simulators may be convenient for the necessary reestablishment of resident education.
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Affiliation(s)
- V Hevia
- Servicio de Urología, Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España
| | - J Lorca
- Servicio de Urología, Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España
| | - M Hevia
- Servicio de Urología, Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España
| | - A Domínguez
- Servicio de Urología, Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España
| | - J López-Plaza
- Servicio de Urología, Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España
| | - A Artiles
- Servicio de Urología, Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España
| | - S Álvarez
- Servicio de Urología, Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España
| | - Á Sánchez
- Servicio de Urología, Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España
| | - A Fraile
- Servicio de Urología, Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España
| | - L López-Fando
- Servicio de Urología, Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España
| | - E Sanz
- Servicio de Urología, Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España
| | - M Ruiz
- Servicio de Urología, Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España
| | - E Alcaraz
- Área de Diagnóstico Urológico y Pruebas Instrumentales de Urología, Servicio de Urología, Hospital Universitario Ramón y Cajal, Madrid, España
| | - F J Burgos
- Servicio de Urología, Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España
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Gan X, Shi Z, Chair SY, Cao X, Wang Q. Willingness of Chinese nurses to practice in Hubei combating the coronavirus disease 2019 epidemic: A cross-sectional study. J Adv Nurs 2020. [PMID: 32449187 PMCID: PMC7283855 DOI: 10.1111/jan.14434] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 04/17/2020] [Accepted: 05/06/2020] [Indexed: 11/30/2022]
Abstract
Aims To investigate the willingness of Chinese nurses to practice in Hubei combating the coronavirus disease 2019 and to explore the associated factors. Design A cross‐sectional survey. Methods Clinical nurses were conveniently recruited by an online link in three provinces out of Hubei, including Hunan (Central south), Chongqing (Southwest) and Xinjiang (Northwest) during 4–10 February 2020. A structured questionnaire was distributed by an online investigation system. Information on sociodemographic characteristics, willingness, possible influencing factors (previous experience, health status, training conditions, perceptions on volunteering to practice in Hubei, family attitude, and insurance) was collected. Binary logistic regression was conducted to explore the association of different factors with the willingness decision of nurses. Results A total of 11,183 nurses participated in this survey and a high proportion of them were willing to volunteer to practice in Hubei combating the epidemic. Nurses who were likely to volunteer had the following characteristics: younger, unmarried, members of the Communist Party of China, with senior professional qualification, working in critical care departments, with support from their families, with adequate training and learning, with good health status and low levels of anxiety. The regression model could explain 31.1% of the variances of the willingness decision of nurses. Conclusions A high proportion of nurses in China were willing to practice in Hubei during the coronavirus disease 2019 epidemic. Adequate training and psychological support would facilitate nurses to volunteer during the outbreak of an infectious disease. Impact The study identified a high proportion of nurses in China were willing to practice in Hubei combating the coronavirus disease 2019 epidemic. The findings will provide valuable references for nurses and decision makers to formulate better plans for increasing nursing workforce during such kind of public health crisis.
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Affiliation(s)
- Xiaoqing Gan
- Hunan Provincial People's Hospital, Changsha, China
| | - Zeya Shi
- Hunan Provincial People's Hospital, Changsha, China
| | - Sek Ying Chair
- The Nethersole School of Nursing, The Chinese University of Hong Kong, New Territories, Hong Kong
| | - Xi Cao
- The Nethersole School of Nursing, The Chinese University of Hong Kong, New Territories, Hong Kong
| | - Qun Wang
- School of Nursing, Shenzhen University, Nanshan District, Shenzhen, China
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20
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Restubog SLD, Ocampo ACG, Wang L. Taking control amidst the chaos: Emotion regulation during the COVID-19 pandemic. JOURNAL OF VOCATIONAL BEHAVIOR 2020; 119:103440. [PMID: 32390659 PMCID: PMC7206430 DOI: 10.1016/j.jvb.2020.103440] [Citation(s) in RCA: 167] [Impact Index Per Article: 41.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The COVID-19 pandemic represents a major global health crisis that continues to threaten public health and safety. Although the pandemic is still unfolding, measures to reduce the spread of the virus have spawned significant challenges to people's current work as well as their careers more generally. In this commentary, we discuss the implications of COVID-19 for maintaining one's psychological well-being and employment security, and also managing family and work responsibilities. We also bring forth evidence from the emotion regulation literature to help mitigate the downstream negative consequences of COVID-19 on people's work lives. Finally, we offer several suggestions for future scholarly investigation into how this pandemic impacts vocational behavior.
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Affiliation(s)
- Simon Lloyd D Restubog
- School of Labor and Employment Relations and Department of Psychology, University of Illinois at Urbana-Champaign, USA.,UQ Business School, University of Queensland, Australia
| | | | - Lu Wang
- Research School of Management, Australian National University, Australia
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21
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Proietti S, Gaboardi F, Giusti G. Endourological Stone Management in the Era of the COVID-19. Eur Urol 2020; 78:131-133. [PMID: 32303384 PMCID: PMC7195508 DOI: 10.1016/j.eururo.2020.03.042] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 03/25/2020] [Indexed: 10/29/2022]
Affiliation(s)
- Silvia Proietti
- European Training Center for Endourology, Department of Urology, IRCCS San Raffaele Hospital, Ville Turro Division, Milan, Italy.
| | - Franco Gaboardi
- European Training Center for Endourology, Department of Urology, IRCCS San Raffaele Hospital, Ville Turro Division, Milan, Italy
| | - Guido Giusti
- European Training Center for Endourology, Department of Urology, IRCCS San Raffaele Hospital, Ville Turro Division, Milan, Italy
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Abstract
As clinicians and support personnel struggle with their responsibilities to treat during the current COVID-19 pandemic, several ethical issues have emerged. Will healthcare workers and support staff fulfill their duty to treat in the face of high risks? Will institutional and government leaders at all levels do the right things to help alleviate healthcare workers risks and fears? Will physicians be willing to make hard, resource-allocation decisions if they cannot first husband or improvise alternatives?With our healthcare facilities and governments unprepared for this inevitable disaster, front-line doctors, advanced providers, nurses, EMS, and support personnel struggle with acute shortages of equipment-both to treat patients and protect themselves. With their personal and possibly their family's lives and health at risk, they must weigh the option of continuing to work or retreat to safety. This decision, made daily, is based on professional and personal values, how they perceive existing risks-including available protective measures, and their perception of the level and transparency of information they receive. Often, while clinicians get this information, support personnel do not, leading to absenteeism and deteriorating healthcare services. Leadership can use good risk communication (complete, widely transmitted, and transparent) to align healthcare workers' risk perceptions with reality. They also can address the common problems healthcare workers must overcome to continue working (ie, risk mitigation techniques). Physicians, if they cannot sufficiently husband or improvise lifesaving resources, will have to face difficult triage decisions. Ideally, they will use a predetermined plan, probably based on the principles of Utilitarianism (maximizing the greatest good) and derived from professional and community input. Unfortunately, none of these plans is optimal.
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Affiliation(s)
- Kenneth V Iserson
- University of Arizona, Department of Emergency Medicine, Tucson, Arizona
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23
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Shapira S, Friger M, Bar-Dayan Y, Aharonson-Daniel L. Healthcare workers' willingness to respond following a disaster: a novel statistical approach toward data analysis. BMC MEDICAL EDUCATION 2019; 19:130. [PMID: 31053130 PMCID: PMC6499969 DOI: 10.1186/s12909-019-1561-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 04/17/2019] [Indexed: 05/31/2023]
Abstract
BACKGROUND The willingness of healthcare workers (HCW) to respond is an important factor in the health system's response capacity during emergencies. Although much research has been devoted to exploring this issue, the statistical methods employed have been predominantly traditional and have not enabled in-depth analysis focused on absenteeism-prone employees during emergencies. The present study employs an innovative statistical approach for modeling HCWs' willingness to respond (WTR) following an earthquake. METHODS A validated questionnaire measuring knowledge, perceptions, and attitudes toward an earthquake scenario was distributed among Israeli HCWs in a hospital setting. Two regression models were employed for data analysis - a traditional linear model, and a quantile regression model that makes it possible to examine associations between explanatory variables across different levels of a dependent variable. A supplementary analysis was performed for selected variables using broken line spline regression. RESULTS Females under the age of forty, and nurses were the most absenteeism-prone sub-groups of employees (showed low WTR) in earthquake events. Professional commitment to care and perception of efficacy were the most powerful predictors associated with WTR across all quantiles. Both marital status (married) and concern for family wellbeing, designated as statistically significant in the linear model, were found to be statistically significant in only one of the WTR quantiles (the former in Q10 and the latter in Q50). Gender and number of children, which were not significantly associated with WTR in the linear model, were found to be statistically significant in the 25th quantile of WTR. CONCLUSIONS This study contributes to both methodological and practical aspects. Quantile regression provides a more comprehensive view of associations between variables than is afforded by linear regression alone. Adopting an advanced statistical approach in WTR modeling can facilitate effective implementation of research findings in the field.
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Affiliation(s)
- Stav Shapira
- PREPARED Center for Emergency Response Research, Ben-Gurion University of the Negev, P.O. Box 653, Beer-Sheva, Israel
- School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O. Box 653, Beer-Sheva, Israel
| | - Michael Friger
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O. Box 653, Beer-Sheva, Israel
| | - Yaron Bar-Dayan
- PREPARED Center for Emergency Response Research, Ben-Gurion University of the Negev, P.O. Box 653, Beer-Sheva, Israel
- School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O. Box 653, Beer-Sheva, Israel
| | - Limor Aharonson-Daniel
- PREPARED Center for Emergency Response Research, Ben-Gurion University of the Negev, P.O. Box 653, Beer-Sheva, Israel
- School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O. Box 653, Beer-Sheva, Israel
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24
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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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Iserson KV. Must I Respond if My Health is at Risk? J Emerg Med 2018; 55:288-293. [PMID: 29773480 PMCID: PMC7134772 DOI: 10.1016/j.jemermed.2018.04.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 03/31/2018] [Accepted: 04/10/2018] [Indexed: 11/03/2022]
Abstract
BACKGROUND Widespread epidemics, pandemics, and other risk-prone disasters occur with disturbing regularity. When such events occur, how should, and will, clinicians respond? The moral backbone of medical professionals-a duty to put the needs of patients first-may be sorely tested. DISCUSSION It is incumbent on health care professionals to ask what we must do and what we should do if a dangerous health care situation threatens both ourselves and our community. Despite numerous medical ethical codes, nothing-either morally or legally-requires a response to risk-prone situations from civilian clinicians; it remains a personal decision. The most important questions are: What will encourage us to respond to these situations? And will we respond? These questions are necessary, not only for physicians and other direct health care providers, but also for vital health care system support personnel. Those who provide care in the face of perceived risk demonstrate heroic bravery, but the choice to do so has varied throughout history. To improve individual response rates, disaster planners and managers must communicate the risks clearly to all members of the health care system and help mitigate their risks by providing them with as much support and security as possible. CONCLUSIONS The decision to remain in or to leave a risky health care situation will ultimately depend on the provider's own risk assessment and value system. If history is any guide, we can rest assured that most clinicians will choose to stay, following the heroic example established through the centuries and continuing today.
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Affiliation(s)
- Kenneth V Iserson
- International Federation for Emergency Medicine and Department of Emergency Medicine, The University of Arizona, Tucson, Arizona
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26
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von Gottberg C, Krumm S, Porzsolt F, Kilian R. The analysis of factors affecting municipal employees' willingness to report to work during an influenza pandemic by means of the extended parallel process model (EPPM). BMC Public Health 2016; 16:26. [PMID: 26757713 PMCID: PMC4711035 DOI: 10.1186/s12889-015-2663-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Accepted: 12/21/2015] [Indexed: 11/10/2022] Open
Abstract
Background The management of pandemics with highly infectious diseases in modern urban habitats depends largely on the maintenance of public services. Understanding the factors that influence municipal employees’ willingness to come to work during a pandemic is therefore a basic requirement for adequate public health preparedness. In this study the extended parallel process model (EPPM) is applied to investigate how the readiness of municipal employees to report to work during an influenza pandemic (IP) is affected by individual attitudes and environmental conditions. Methods 1.566 employees of a major German city participated in a cross-sectional online survey. The questions of the survey covered the dimensions of risk perception, role competence, self-efficacy, role importance, sense of duty, and willingness to report to work in the case of an IP. Data were analysed by means of path analyses. Results Data suggest that up to 20 % of the public service workers were not willing to come to work during an IP. Willingness to report to work was increased by the perception of a high working role competence, a high assessment of role importance, high self-efficacy expectations, and a high sense of duty. Negative effects on willingness to report to work were identified as the perception of a high risk to become infected at work and the perceived risk to infect family members. The decomposition of direct and indirect effects provided important insights into the interrelationships between model variables. Conclusions Measures to increase municipal workers’ willingness to report to work in case of an infectious pandemic should include communication strategies to inform employees clearly about their particular tasks during such critical events and training exercises to increase their confidence in their competences and skills to fulfil these tasks.
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Affiliation(s)
- Carolin von Gottberg
- Department of Psychiatry and Psychotherapy II, Section of Health Economics and Mental Health Services Research, Ulm University, Ludwig-Heilmeyer-Str. 2, D-89315, Günzburg, Germany.
| | - Silvia Krumm
- Department of General and Visceral Surgery, Working Group of Health Services Research, Ulm University, Albert-Einstein-Allee 23, D-89070, Ulm, Germany.
| | - Franz Porzsolt
- Department of Psychiatry and Psychotherapy II, Section of Health Economics and Mental Health Services Research, Ulm University, Ludwig-Heilmeyer-Str. 2, D-89315, Günzburg, Germany.
| | - Reinhold Kilian
- Department of Psychiatry and Psychotherapy II, Section of Health Economics and Mental Health Services Research, Ulm University, Ludwig-Heilmeyer-Str. 2, D-89315, Günzburg, Germany.
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Ip DKM, Lau EHY, Tam YH, So HC, Cowling BJ, Kwok HKH. Increases in absenteeism among health care workers in Hong Kong during influenza epidemics, 2004-2009. BMC Infect Dis 2015; 15:586. [PMID: 26715075 PMCID: PMC4696217 DOI: 10.1186/s12879-015-1316-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 12/10/2015] [Indexed: 12/02/2022] Open
Abstract
Background Acute respiratory infections (ARI) are a major cause of sickness absenteeism among health care workers (HCWs) and contribute significantly to overall productivity loss particularly during influenza epidemics. The purpose of this study is to quantify the increases in absenteeism during epidemics including the 2009 influenza A(H1N1)pdm09 pandemic. Methods We analysed administrative data to determine patterns of sickness absence among HCWs in Hong Kong from January 2004 through December 2009, and used multivariable linear regression model to estimate the excess all-cause and ARI-related sickness absenteeism rates during influenza epidemics. Results We found that influenza epidemics prior to the 2009 pandemic and during the 2009 pandemic were associated with 8.4 % (95 % CI: 5.6–11.2 %) and 57.7 % (95 % CI: 54.6–60.9 %) increases in overall sickness absence, and 26.5 % (95 % CI: 21.4–31.5 %) and 90.9 % (95 % CI: 85.2–96.6 %) increases in ARI-related sickness absence among HCWs in Hong Kong, respectively. Comparing different staff types, increases in overall absenteeism were highest among medical staff, during seasonal influenza epidemic periods (51.3 %, 95 % CI: 38.9–63.7 %) and the pandemic mitigation period (142.1 %, 95 % CI: 128.0–156.1 %). Conclusions Influenza epidemics were associated with a substantial increase in sickness absence and productivity loss among HCWs in Hong Kong, and there was a much higher rate of absenteeism during the 2009 pandemic. These findings could inform better a more proactive workforce redistribution plans to allow for sufficient surge capacity in annual epidemics, and for pandemic preparedness.
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Affiliation(s)
- Dennis K M Ip
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, 21 Sassoon Road, Pokfulam, Hong Kong, China.
| | - Eric H Y Lau
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, 21 Sassoon Road, Pokfulam, Hong Kong, China.
| | - Yat Hung Tam
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, 21 Sassoon Road, Pokfulam, Hong Kong, China.
| | - Hau Chi So
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, 21 Sassoon Road, Pokfulam, Hong Kong, China.
| | - Benjamin J Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, 21 Sassoon Road, Pokfulam, Hong Kong, China.
| | - Henry K H Kwok
- Hong Kong Centre of Occupational Medicine, Hong Kong Special Administrative Region, Hong Kong, China.
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Reidy M, Ryan F, Hogan D, Lacey S, Buckley C. Preparedness of Hospitals in the Republic of Ireland for an Influenza Pandemic, an Infection Control Perspective. BMC Public Health 2015; 15:847. [PMID: 26335570 PMCID: PMC4557843 DOI: 10.1186/s12889-015-2025-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 07/06/2015] [Indexed: 11/24/2022] Open
Abstract
Background When an influenza pandemic occurs most of the population is susceptible and attack rates can range as high as 40–50 %. The most important failure in pandemic planning is the lack of standards or guidelines regarding what it means to be ‘prepared’. The aim of this study was to assess the preparedness of acute hospitals in the Republic of Ireland for an influenza pandemic from an infection control perspective. Methods This was a cross sectional study involving a questionnaire completed by infection control nurses, time period from June – July 2013, (3 weeks) from acute public and private hospitals in the Republic of Ireland. A total of 46 out of 56 hospitals responded to the questionnaire. Results From a sample of 46 Irish hospitals, it was found that Irish hospitals are not fully prepared for an influenza pandemic despite the 2009 Influenza A (H1N1) pandemic. In 2013, thirty five per cent of Irish hospitals have participated in an emergency plan or infectious disease exercise and have plans or been involved in local planning efforts to care for patients at non-health care facilities. Sixty per cent of Irish hospitals did not compile or did not know if the hospital had compiled a “lessons learned” from any exercise that were then used to revise emergency response plans. Fifty two per cent of hospitals have sufficient airborne isolation capacity to address routine needs and have an interim emergency plan to address needs during an outbreak. Fifty one percent of hospitals have taken specific measures to stockpile or have reserve medical supplies e.g. masks, ventilators and linen. Conclusions This is the first study carried out in the Republic of Ireland investigating the current preparedness for an influenza pandemic from an infection control perspective. Deficits exist in the provision of emergency planning committees, testing of emergency plans, airborne isolation facilities, stockpiling of personal protective equipment (PPE) and medical supplies and organisational schemes/incentives for healthcare workers to continue to work in a pandemic. While Irish standards are comparable to findings from international studies, the health care service needs to continue to enhance preparedness for an influenza pandemic and implement standard preparedness guidance for all Irish hospitals.
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Affiliation(s)
- Mary Reidy
- Bon Secours Hospital, Tralee, County Kerry, Ireland.
| | - Fiona Ryan
- Department of Public Health, Cork, Ireland.
| | - Dervla Hogan
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland.
| | - Sean Lacey
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland.
| | - Claire Buckley
- Department of Mathematics, Cork Institute of Technology, Cork, Ireland
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Aoyagi Y, Beck CR, Dingwall R, Nguyen-Van-Tam JS. Healthcare workers' willingness to work during an influenza pandemic: a systematic review and meta-analysis. Influenza Other Respir Viruses 2015; 9:120-30. [PMID: 25807865 PMCID: PMC4415696 DOI: 10.1111/irv.12310] [Citation(s) in RCA: 109] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2015] [Indexed: 11/27/2022] Open
Abstract
To estimate the proportion of healthcare workers (HCWs) willing to work during an influenza pandemic and identify associated risk factors, we undertook a systematic review and meta-analysis compliant with PRISMA guidance. Databases and grey literature were searched to April 2013, and records were screened against protocol eligibility criteria. Data extraction and risk of bias assessments were undertaken using a piloted form. Random-effects meta-analyses estimated (i) pooled proportion of HCWs willing to work and (ii) pooled odds ratios of risk factors associated with willingness to work. Heterogeneity was quantified using the I(2) statistic, and publication bias was assessed using funnel plots and Egger's test. Data were synthesized narratively where meta-analyses were not possible. Forty-three studies met our inclusion criteria. Meta-analysis of the proportion of HCWs willing to work was abandoned due to excessive heterogeneity (I(2) = 99.2%). Narrative synthesis showed study estimates ranged from 23.1% to 95.8% willingness to work, depending on context. Meta-analyses of specific factors showed that male HCWs, physicians and nurses, full-time employment, perceived personal safety, awareness of pandemic risk and clinical knowledge of influenza pandemics, role-specific knowledge, pandemic response training, and confidence in personal skills were statistically significantly associated with increased willingness. Childcare obligations were significantly associated with decreased willingness. HCWs' willingness to work during an influenza pandemic was moderately high, albeit highly variable. Numerous risk factors showed a statistically significant association with willingness to work despite significant heterogeneity between studies. None of the included studies were based on appropriate theoretical constructs of population behaviour.
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Affiliation(s)
- Yumiko Aoyagi
- Division of Epidemiology & Public Health, University of NottinghamNottingham, UK
| | - Charles R Beck
- Division of Epidemiology & Public Health, University of NottinghamNottingham, UK
| | - Robert Dingwall
- Dingwall Enterprises Ltd, Nottingham Trent UniversityNottingham, UK
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Zagelbaum NK, Heslin KC, Stein JA, Ruzek J, Smith RE, Nyugen T, Dobalian A. Factors influencing readiness to deploy in disaster response: findings from a cross-sectional survey of the Department of Veterans Affairs Disaster Emergency Medical Personnel System. BMC Emerg Med 2014; 14:16. [PMID: 25038628 PMCID: PMC4113779 DOI: 10.1186/1471-227x-14-16] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 07/11/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Disaster Emergency Medical Personnel System (DEMPS) program provides a system of volunteers whereby active or retired Department of Veterans Affairs (VA) personnel can register to be deployed to support other VA facilities or the nation during national emergencies or disasters. Both early and ongoing volunteer training is required to participate. METHODS This study aims to identify factors that impact willingness to deploy in the event of an emergency. This analysis was based on responses from 2,385 survey respondents (response rate, 29%). Latent variable path models were developed and tested using the EQS structural equations modeling program. Background demographic variables of education, age, minority ethnicity, and female gender were used as predictors of intervening latent variables of DEMPS Volunteer Experience, Positive Attitude about Training, and Stress. The model had acceptable fit statistics, and all three intermediate latent variables significantly predicted the outcome latent variable Readiness to Deploy. RESULTS DEMPS Volunteer Experience and a Positive Attitude about Training were associated with Readiness to Deploy. Stress was associated with decreased Readiness to Deploy. Female gender was negatively correlated with Readiness to Deploy; however, there was an indirect relationship between female gender and Readiness to Deploy through Positive Attitude about Training. CONCLUSIONS These findings suggest that volunteer emergency management response programs such as DEMPS should consider how best to address the factors that may make women less ready to deploy than men in order to ensure adequate gender representation among emergency responders. The findings underscore the importance of training opportunities to ensure that gender-sensitive support is a strong component of emergency response, and may apply to other emergency response programs such as the Medical Reserve Corps and the American Red Cross.
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Affiliation(s)
| | | | | | | | | | | | - Aram Dobalian
- Veterans Emergency Management Evaluation Center, 16111 Plummer Street MS-152, North Hills, CA 91343, USA.
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Yen MY, Chiu AWH, Schwartz J, King CC, Lin YE, Chang SC, Armstrong D, Hsueh PR. From SARS in 2003 to H1N1 in 2009: lessons learned from Taiwan in preparation for the next pandemic. J Hosp Infect 2014; 87:185-93. [PMID: 24996515 PMCID: PMC7114835 DOI: 10.1016/j.jhin.2014.05.005] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 05/08/2014] [Indexed: 11/28/2022]
Abstract
In anticipation of a future pandemic potentially arising from H5N1, H7N9 avian influenza or Middle East Respiratory Syndrome, and in large part in response to severe acute respiratory syndrome (SARS) in 2003, the city of Taipei, Taiwan, has developed extensive new strategies to manage pandemics. These strategies were tested during the 2009 H1N1 outbreak. This article assesses pandemic preparedness in Taipei in the wake of recent pandemic experiences in order to draw lessons relevant to the broader international public health community. Drawing on Taiwan and Taipei Centers for Disease Control data on pandemic response and control, we evaluated the effectiveness of the changes in pandemic response policies developed by these governments over time, emphasizing hospital and medical interventions with particular attention paid to Traffic Control Bundling. SARS and H1N1 2009 catalysed the Taiwan and Taipei CDCs to continuously improve and adjust their strategies for a future pandemic. These new strategies for pandemic response and control have been largely effective at providing interim pandemic containment and control, while development and implementation of an effective vaccination programme is underway. As Taipei's experiences with these cases illustrate, in mitigating moderate or severe pandemic influenza, a graduated process including Traffic Control Bundles accompanied by hospital and medical interventions, as well as school- and community-focused interventions, provides an effective interim response while awaiting vaccine development. Once a vaccine is developed, to maximize pandemic control effectiveness, it should be allocated with priority given to vulnerable groups, healthcare workers and school children.
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Affiliation(s)
- M-Y Yen
- Section of Infectious Diseases, Taipei City Hospital, Department of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.
| | - A W-H Chiu
- Department of Surgery, Taipei City Hospital, Department of Health, Taipei City Government and National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - J Schwartz
- Department of Political Science, State University of New York, New Paltz, NY, USA
| | - C-C King
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Y E Lin
- Center for Environmental Laboratory Services, National Kaohsiung Normal University, Kaohsiung, Taiwan
| | - S-C Chang
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - D Armstrong
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - P-R Hsueh
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
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Tomizuka T, Kanatani Y, Kawahara K. Insufficient preparedness of primary care practices for pandemic influenza and the effect of a preparedness plan in Japan: a prefecture-wide cross-sectional study. BMC FAMILY PRACTICE 2013; 14:174. [PMID: 24252688 PMCID: PMC3840630 DOI: 10.1186/1471-2296-14-174] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 11/18/2013] [Indexed: 11/10/2022]
Abstract
Background Cases of emerging infectious diseases, including H5N1 influenza, H7N9 influenza, and Middle East Respiratory Syndrome, have been reported in recent years, and the threat of pandemic outbreaks persists. In Japan, primary care is the frontline against emerging infectious diseases in communities. Although the importance of pandemic preparedness in primary care has been highlighted previously, few studies have thus far investigated the preparedness among primary care practices (PCPs) or differences in the preparedness of different institutional settings. We examined PCP preparedness and response to the 2009 influenza pandemic in Japan, and explored the role of a pandemic preparedness plan during the pandemic. Methods We used a survey questionnaire to assess how well individual PCPs in Okinawa, Japan, were prepared for the 2009 influenza pandemic. The questionnaire was mailed to all eligible PCPs (N = 465) in Okinawa, regardless of their institutional setting. In addition, we assessed the differences in the preparedness of clinics and hospitals and determined whether the national preparedness plan affected individual preparedness and response. Data were analyzed using descriptive and logistic regression analyses. Results A total of 174 (37.4%) PCPs responded to our survey. In general, high-level personal protective equipment (PPE) such as N95 masks (45.4%), gowns (30.5%), and eye protection (21.3%) was stocked at a low rate. Clinic-based PCPs were significantly less prepared than hospital-based PCPs to provide N95 masks (OR 0.34), gowns (OR 0.15), and eye protection (OR 0.18). In addition, only 32.8% of PCPs adopted an adequate business continuity plan (BCP). After controlling for institutional setting, reading the national preparedness plan was significantly associated with establishment of a BCP (OR 5.86), and with knowledge of how to transfer a swab specimen to a local medical laboratory (OR 5.60). Conclusions With regard to PPE availability, PCPs (especially clinic-based PCPs) were not adequately prepared for the influenza pandemic. Awareness of the national pandemic preparedness plan is likely to promote prefecture-wide implementation of BCPs and surveillance activity.
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Affiliation(s)
- Taro Tomizuka
- Department of Health Policy Science, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan.
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Arbon P, Cusack L, Ranse J, Shaban RZ, Considine J, Kako M, Woodman RJ, Mitchell B, Bahnisch L, Hammad K. Exploring staff willingness to attend work during a disaster: A study of nurses employed in four Australian emergency departments. ACTA ACUST UNITED AC 2013; 16:103-9. [DOI: 10.1016/j.aenj.2013.05.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Revised: 04/26/2013] [Accepted: 05/09/2013] [Indexed: 10/26/2022]
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Arbon P, Ranse J, Cusack L, Considine J, Shaban RZ, Woodman RJ, Bahnisch L, Kako M, Hammad K, Mitchell B. Australasian emergency nurses’ willingness to attend work in a disaster: A survey. ACTA ACUST UNITED AC 2013; 16:52-7. [DOI: 10.1016/j.aenj.2013.05.003] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Revised: 04/16/2013] [Accepted: 05/09/2013] [Indexed: 11/17/2022]
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Bell MA, Dake JA, Price JH, Jordan TR, Rega P. A national survey of emergency nurses and avian influenza threat. J Emerg Nurs 2012; 40:212-7; quiz 294-5. [PMID: 23099013 DOI: 10.1016/j.jen.2012.05.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2012] [Revised: 04/20/2012] [Accepted: 05/11/2012] [Indexed: 10/27/2022]
Abstract
INTRODUCTION The purpose of this study was to determine the perceived likelihood of emergency nurses reporting to work during an avian influenza outbreak, to consider options if nurses decided not to report work, and to explore Protection Motivation Theory constructs as predictors of reporting to work. METHODS A descriptive, nonexperimental, cross-sectional survey of emergency nurses within the United States. RESULTS A total of 332 nurses (46%) responded. Most emergency nurses (84%) reported they would report to work (1 in 6 would not). The likelihood of reporting to work differed by education level, nurses' avian influenza information sources, and nurses who had family living with them. Of the nurses who decided not to report to work, the majority were willing to provide health information (90%), administer vaccinations (82%), and triage (74%) neighbors/friends from home. One third of nurses had not attended a disaster-preparedness drill within the past year. Only 20% identified formal training while on the job as a source of avian influenza information. A third of emergency nurses would be worried about getting an avian influenza vaccination because of potential adverse effects. Protection Motivation Theory accounted for almost 40% of the variance of likelihood to report to work, with response costs being the largest predictor. DISCUSSION Disaster drills, avian influenza job training, and vaccination education are necessary to prepare emergency nurses for an outbreak. The findings support emergency nurses' willingness to work from home if they are unable to report to work. This finding is new and may have implications for disaster planning, staffing, and ED operations.
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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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Stergachis A, Garberson L, Lien O, D'Ambrosio L, Sangaré L, Dold C. Health care workers' ability and willingness to report to work during public health emergencies. Disaster Med Public Health Prep 2012; 5:300-8. [PMID: 22146669 DOI: 10.1001/dmp.2011.77] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVES We conducted a county-wide survey to assess the ability and willingness of health care workers to report to work during a pandemic influenza and a severe earthquake and to identify barriers and strategies that would help them report to work. METHODS A stratified random sample of 9211 health care workers was selected from the Washington state licensure database and from health care agencies. We assessed correlates between self-reported ability and willingness to report to work and demographic and employer-related variables under two scenarios, influenza pandemic and a severe earthquake. RESULTS For the influenza pandemic scenario, 95% of respondents reported that they would be able and 89% reported that they would be willing to report to their usual place of work. Seventy-four percent of respondents reported that they would be able and 88% would be willing to report to their usual place of work following a severe earthquake. The most frequently cited strategies that would help respondents report to work during an influenza pandemic were the availability of anti-viral influenza treatment and the ability to work from home. For persons with children at home, the strategy to increase ability to report to work during an earthquake was the availability of child care. CONCLUSIONS The majority of the King County health care workforce is willing and able to respond to an influenza pandemic or a severe earthquake.
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Affiliation(s)
- Andy Stergachis
- Northwest Center for Public Health Practice, University of Washington, Seattle,WA98195, USA.
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Active Learning, Bioterrorism Clinics, and Continuing Professional Education: An Ideal Combination. Prehosp Disaster Med 2012. [DOI: 10.1017/s1049023x00015466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Schult TM, Awosika ER, Hodgson MJ, Martinello RA. 2009 influenza pandemic impact on sick leave use in the Veterans Health Administration: framework for a health care provider-based national syndromic surveillance system. Disaster Med Public Health Prep 2011; 5 Suppl 2:S235-41. [PMID: 21908701 DOI: 10.1001/dmp.2011.54] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To determine relations between sick leave use and the 2009 novel influenza A (H1N1) influenza pandemic among clinical and nonclinical staff in the Veterans Health Administration (VHA). METHODS Aggregate sick leave use for all VHA employees was monitored in near-real time during the 2009 H1N1 influenza pandemic and compared with historical data from 2004 to 2008. The ratio of sick leave use between clinical and nonclinical staff was examined. An autoregressive integrated moving average model was used to assess whether the pandemic had a significant effect on sick leave use. RESULTS The H1N1 influenza pandemic was associated with a significant effect on sick leave use in the VHA during the second wave of the pandemic. During this wave, the ratio of clinical to nonclinical sick leave use changed; clinical staff began taking more leave than nonclinical staff for 3 successive 2-week pay periods, with ratio measures of 1.004, 1.018, and 1.011, respectively. Using an autoregressive integrated moving average model with a pulse variable representing the pandemic, there was a significant effect on sick leave use. The average hours of sick leave used per full-time equivalent staff member per month increased by 0.3904 hours (P = .003) for clinical staff and 0.3898 hours (P = .01) for nonclinical staff over previous months during the first month of the second pandemic wave. CONCLUSIONS Work loss associated with a pandemic is an important indicator of disease activity and may be a more sensitive indicator of emerging strains than deaths. Monitoring sick leave use in near real time in a large national health care system may be an important early indicator of pandemic severity with practical implications that should be considered in addition to more traditional measures of influenza epidemic and pandemic severity.
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Affiliation(s)
- Tamara M Schult
- Veterans Health Administration, One Veterans Dr, Building 68, Room 138 (V68), Minneapolis, MN 55417, USA.
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Considine J, Shaban RZ, Patrick J, Holzhauser K, Aitken P, Clark M, Fielding E, FitzGerald G. Pandemic (H1N1) 2009 Influenza in Australia: Absenteeism and redeployment of emergency medicine and nursing staff. Emerg Med Australas 2011; 23:615-23. [PMID: 21995477 DOI: 10.1111/j.1742-6723.2011.01461.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVE The aim of the present study was to examine the impact of Pandemic (H(1)N(1)) 2009 Influenza on the Australian emergency nursing and medicine workforce, specifically absenteeism and deployment. METHODS Data were collected using an online survey of 618 members of the three professional emergency medicine or emergency nursing colleges. RESULTS Despite significant increases in emergency demand during the Pandemic (H(1)N(1)) 2009 Influenza, 56.6% of emergency nursing and medicine staff reported absenteeism of at least 1 day and only 8.5% of staff were redeployed. Staff illness with influenza-like illness was reported by 37% of respondents, and 87% of respondents who became ill were not tested for the Pandemic (H(1)N(1)) 2009 Influenza. Of the respondents who became ill, 43% (n= 79) reported missing no days of work and only 8% of respondents (n= 14) reported being absent for more than 5 days. The mean number of days away from work was 3.73 (standard deviation = 3.63). Factors anecdotally associated with staff absenteeism (caregiver responsibilities, concern about personal illness, concern about exposing family members to illness, school closures, risk of quarantine, stress and increased workload) appeared to be of little or no relevance. Redeployment was reported by 8% of respondents and the majority of redeployment was for operational reasons. CONCLUSION Future research related to absenteeism, redeployment during actual pandemic events is urgently needed. Workforce data collection should be an integral part of organizational pandemic planning.
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Affiliation(s)
- Julie Considine
- School of Nursing and Midwifery, Deakin University, Burwood, Queensland, Australia.
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Parry HM, Damery S, Fergusson A, Draper H, Bion J, Low AE. Pandemic influenza A (H1N1) 2009 in a critical care and theatre setting: beliefs and attitudes towards staff vaccination. J Hosp Infect 2011; 78:302-7. [PMID: 21481491 DOI: 10.1016/j.jhin.2011.02.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2010] [Accepted: 02/17/2011] [Indexed: 10/18/2022]
Abstract
West Midlands was particularly affected by the 2009 H1N1 influenza A (pH1N1) pandemic. Vaccination of frontline healthcare professionals (HCPs) aimed to prevent spread to vulnerable patients, minimise service disruption and protect staff. HCPs involved in upper airway management are particularly at risk of aerosol exposure. We assessed the attitudes of these HCPs towards pandemic influenza A (H1N1) 2009 vaccination uptake: primary reasons for acceptance, barriers to vaccination, and knowledge surrounding pH1N1 influenza. We performed a voluntary, anonymous questionnaire survey based in two West Midlands National Health Service Trusts, one month after introduction of the vaccine. In all, 187 useable responses were received (60.5% response rate); 43.8% (N=82) had/intended to receive vaccination. Concern over long term side-effects was the main deterrent (37.4%, N=70). Primary reasons for potentially accepting vaccination were: to protect themselves (36.9%, N=69), to protect family (35.3%, N=66), and to protect patients (10.2%, N=19). Of responders, 76.5% were unsure that the vaccines had undergone suitably rigorous clinical trials to ensure safety; 20.9% correctly identified reported vaccine efficacy. We conclude that pH1N1 vaccination uptake among high risk HCPs remained low, although twice that of peak seasonal influenza vaccination rates. HCPs' knowledge of vaccine efficacy is poor. Barriers to vaccination include concerns over safety profile given the short chronological time-span between the pandemic being declared and vaccine introduction. Side-effects, both acute and chronic, are a significant barrier to vaccination. Further reassurance/education surrounding vaccine safety/efficacy at the time of any future pandemic may improve uptake rates.
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Affiliation(s)
- H M Parry
- Critical Care, Queen Elizabeth Hospital, University Hospitals Birmingham, Birmingham, UK.
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Teasdale E, Yardley L, Schlotz W, Michie S. The importance of coping appraisal in behavioural responses to pandemic flu. Br J Health Psychol 2011; 17:44-59. [PMID: 22233104 DOI: 10.1111/j.2044-8287.2011.02017.x] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Behavioural responses to influenza pandemics can significantly influence the impact on public health. Protection motivation theory (PMT) provides a framework for understanding how people respond to health threats such as pandemics. The main aim of this study was to model the relative contribution of the components of PMT (threat and coping appraisal) to intentions to perform two behaviours recommended by the UK government in a pandemic: stay at home when ill and keep going to work when well. DESIGN A 2×2 factorial design was used to test the effect of scenarios describing pandemic severity (low vs. high threat) and advice messages (standard government advice vs. theory-based advice) on measures of threat and coping appraisal, and intentions to carry out the two recommended behaviours. METHODS A web-based survey designed to assess threat appraisal, coping appraisal, and behavioural intentions was completed by 883 adults (December 2009-January 2010) drawn from University College London staff and the local community. Structural equation modelling was used to test the PMT framework. RESULTS Perceived pandemic severity influenced threat and coping appraisals and intentions. Structural equation modelling revealed that coping appraisal (i.e., perceptions of the costs, benefits, and feasibility of the recommended behaviours) was the principal predictor of variability in intentions for both behaviours and for both pandemic scenarios. CONCLUSIONS Coping appraisals appear to be an important, and hitherto underresearched, predictor of how people may behave in pandemics, and our findings provide encouraging preliminary evidence that it may be possible to change these perceptions.
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Goulia P, Mantas C, Dimitroula D, Mantis D, Hyphantis T. General hospital staff worries, perceived sufficiency of information and associated psychological distress during the A/H1N1 influenza pandemic. BMC Infect Dis 2010; 10:322. [PMID: 21062471 PMCID: PMC2990753 DOI: 10.1186/1471-2334-10-322] [Citation(s) in RCA: 279] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2010] [Accepted: 11/09/2010] [Indexed: 12/20/2022] Open
Abstract
Background Health care workers (HCWs) presented frequent concerns regarding their health and their families' health and high levels of psychological distress during previous disease outbreaks, such as the SARS outbreak, which was associated with social isolation and intentional absenteeism. We aimed to assess HCWs concerns and anxiety, perceived sufficiency of information, and intended behavior during the recent A/H1N1 influenza pandemic and their associations with psychological distress. Method Between September 1st and 30th, 2009, 469 health-care workers (HCWs) of a tertiary teaching hospital completed a 20-item questionnaire regarding concerns and worries about the new A/H1N1 influenza pandemic, along with Cassileth's Information Styles Questionnaire (part-I) and the GHQ-28. Results More than half of the present study's HCWs (56.7%) reported they were worried about the A/H1N1 influenza pandemic, their degree of anxiety being moderately high (median 6/9). The most frequent concern was infection of family and friends and the health consequences of the disease (54.9%). The perceived risk of being infected was considered moderately high (median 6/9). Few HCWs (6.6%) had restricted their social contacts and fewer (3.8%) felt isolated by their family members and friends because of their hospital work, while a low percentage (4.3%) indented to take a leave to avoid infection. However, worry and degree of worry were significantly associated with intended absenteeism (p < 0.0005), restriction of social contacts (p < 0.0005), and psychological distress (p = 0.036). Perceived sufficiency of information about several aspects of the A/H1N1 influenza was moderately high, and the overall information about the A/H1N1 influenza was considered clear (median 7.4/9). Also, perceived sufficiency of information for the prognosis of the infection was significantly independently associated with the degree of worry about the pandemic (p = 0.008). Conclusions A significant proportion of HCWs experienced moderately high anxiety about the pandemic, and their degree of worry was an independent correlate of psychological distress. Since perceived sufficiency of information about the A/H1N1 influenza prognosis was associated with reduced degree of worry, hospital managers and consultation-liaison psychiatry services should try to provide for HCWs' need for information, in order to offer favourable working conditions in times of extreme distress, such as the current and future pandemics.
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Affiliation(s)
- Panagiota Goulia
- Consultation-Liaison Psychiatry Unit, Department of Psychiatry, Medical School, University of Ioannina, Greece
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Facing the threat of influenza pandemic - roles of and implications to general practitioners. BMC Public Health 2010; 10:661. [PMID: 21044300 PMCID: PMC2988738 DOI: 10.1186/1471-2458-10-661] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2010] [Accepted: 11/02/2010] [Indexed: 11/10/2022] Open
Abstract
The 2009 pandemic of H1N1 influenza, compounded with seasonal influenza, posed a global challenge. Despite the announcement of post-pandemic period on 10 August 2010 by theWHO, H1N1 (2009) virus would continue to circulate as a seasonal virus for some years and national health authorities should remain vigilant due to unpredictable behaviour of the virus. Majority of the world population is living in countries with inadequate resources to purchase vaccines and stockpile antiviral drugs. Basic hygienic measures such as wearing face masks and the hygienic practice of hand washing could reduce the spread of the respiratory viruses. However, the imminent issue is translating these measures into day-to-day practice. The experience from Severe Acute Respiratory Syndrome (SARS) in Hong Kong has shown that general practitioners (GPs) were willing to discharge their duties despite risks of getting infected themselves. SARS event has highlighted the inadequate interface between primary and secondary care and valuable health care resources were thus inappropriately matched to community needs. There are various ways for GPs to contribute in combating the influenza pandemic. They are prompt in detecting and monitoring epidemics and mini-epidemics of viral illnesses in the community. They can empower and raise the health literacy of the community such as advocating personal hygiene and other precautious measures. GPs could also assist in the development of protocols for primary care management of patients with flu-like illnesses and conduct clinical audits on the standards of preventive and treatment measures. GPs with adequate liaison with public health agencies would facilitate early diagnosis of patients with influenza. In this article, we summarise the primary care actions for phases 4-6 of the pandemic. We shall discuss the novel roles of GPs as alternative source of health care for patients who would otherwise be cared for in the secondary care level. The health care system would thus remain sustainable during the public health crisis.
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Tebruegge M, Pantazidou A, Ritz N, Connell T, Bryant P, Donath S, Curtis N. Perception, attitudes and knowledge regarding the 2009 swine-origin influenza A (H1N1) virus pandemic among health-care workers in Australia. J Paediatr Child Health 2010; 46:673-9. [PMID: 20796180 DOI: 10.1111/j.1440-1754.2010.01820.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To determine the perceptions, attitudes and knowledge of Australian health-care workers (HCWs) regarding the novel, swine-origin influenza A (H1N1) virus (S-OIV) outbreak that reached the country in early May 2009. METHODS Self-administered, anonymous Web-based survey conducted during the early stages of the S-OIV pandemic. Participants comprised hospital- and community-based medical and nursing staff, medical students, allied health professionals, laboratory staff and administrative personnel. RESULTS Of the 947 participants surveyed, 59.4% were not convinced that Australia was sufficiently prepared for an influenza pandemic. Only 17.6% of the participants stated they were prepared to work unconditionally during a pandemic; 36.5% stated they would work if they had access to antiviral treatment; 27.9% would if provided with antiviral prophylaxis; and 7.5% would refuse to work. In addition, 37.5% of the participants responded they would refuse or avoid being involved in screening suspected cases. A total of 47.7% admitted to possessing a personal supply of antivirals or having considered this option. Only 48.0% provided a realistic estimate of the mortality associated with an influenza pandemic at a population level. HCWs overestimating the mortality risk and HCWs believing the efficacy of antiviral prophylaxis to be low were significantly less likely to be prepared to work (P= 0.04 and P= 0.0004, respectively). CONCLUSIONS To ensure adequate staffing during an influenza pandemic, preparedness plans should anticipate significant levels of absenteeism by choice. Interventions aimed at increasing staff retention during a pandemic require further evaluation.
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Affiliation(s)
- Marc Tebruegge
- Infectious Diseases Unit, Department of General Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.
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Poland GA. The 2009-2010 influenza pandemic: effects on pandemic and seasonal vaccine uptake and lessons learned for seasonal vaccination campaigns. Vaccine 2010; 28 Suppl 4:D3-13. [PMID: 20713258 DOI: 10.1016/j.vaccine.2010.08.024] [Citation(s) in RCA: 119] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Individual and national/cultural differences were apparent in response to the 2009-2010 influenza pandemic. Overall pandemic influenza immunization rates were low across all nations, including among healthcare workers. Among the reasons for the low coverage rates may have been a lack of concern about the individual risk of influenza, which may translate into a lack of willingness or urgency to be vaccinated, particularly if there is mistrust of information provided by public health or governmental authorities. Intuitively, a link between willingness to be vaccinated against seasonal influenza and against pandemic influenza exists, given the similarities in decision-making for this infection. As such, the public is likely to share common concerns regarding pandemic and seasonal influenza vaccination, particularly in the areas of vaccine safety and side effects, and personal risk. Given the public's perception of the low level of virulence of the recent pandemic influenza virus, there is concern that the perception of a lack of personal risk of infection and risk of vaccine side effects could adversely affect seasonal vaccine uptake. While governments are more often concerned about public anxiety and panic, as well as absenteeism of healthcare and other essential workers during a pandemic, convincing the public of the threat posed by pandemic or seasonal influenza is often the more difficult, and underappreciated task. Thus, appropriate, timely, and data-driven health information are very important issues in increasing influenza vaccine coverage, perhaps even more so in western societies where trust in government and public health reports may be lower than in other countries. This article explores what has been learned about cross-cultural responses to pandemic influenza, and seeks to apply those lessons to seasonal influenza immunization programs.
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Wong ELY, Wong SYS, Kung K, Cheung AWL, Gao TT, Griffiths S. Will the community nurse continue to function during H1N1 influenza pandemic: a cross-sectional study of Hong Kong community nurses? BMC Health Serv Res 2010; 10:107. [PMID: 20433691 PMCID: PMC2907760 DOI: 10.1186/1472-6963-10-107] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2009] [Accepted: 04/30/2010] [Indexed: 12/03/2022] Open
Abstract
Background Healthcare workers have been identified as one of the high risk groups for being infected with influenza during influenza pandemic. Potential levels of absenteeism among healthcare workers in hospital settings are high. However, there was no study to explore the attitudes of healthcare workers in community setting towards the preparedness to the novel H1N1 influenza pandemic. The aim of this study was to explore the willingness of community nurses in Hong Kong to work during H1N1 influenza pandemic. Methods A cross-sectional survey was conducted among all 401 community nurses employed by the Hospital Authority in Hong Kong when the WHO pandemic alert level was 6. Results The response rate of this study was 66.6%. 76.9% participants reported being "not willing" (33.3%) or "not sure" (43.6%) to take care of patients during H1N1 influenza pandemic. The self-reported reasons for being unwilling to report to duty during H1N1 influenza pandemic were psychological stress (55.0%) and fear of being infected H1N1 influenza (29.2%). The reported unwillingness to report to duty was marginally significantly associated with the request for further training of using infection control clinical guideline (OR: 0.057; CI: 0.25-1.02). Those who reported unwillingness or not being sure about taking care of the patients during H1N1 influenza pandemic were more depressed (p < 0.001) and found work more emotionally stressful (p < 0.001). Conclusions Interventions to provide infection control training and address community nurses' psychological needs might increase their willingness to provide care to patients in the community during H1N1 influenza pandemic. This would help to ensure an effective and appropriate health system response during the H1N1 influenza pandemic.
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Affiliation(s)
- Eliza L Y Wong
- School of Public Health & Primary Care, The Chinese University of Hong Kong, Hong Kong, School of Public Health Building, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China
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Barnett DJ, Levine R, Thompson CB, Wijetunge GU, Oliver AL, Bentley MA, Neubert PD, Pirrallo RG, Links JM, Balicer RD. Gauging U.S. Emergency Medical Services workers' willingness to respond to pandemic influenza using a threat- and efficacy-based assessment framework. PLoS One 2010; 5:e9856. [PMID: 20352050 PMCID: PMC2844432 DOI: 10.1371/journal.pone.0009856] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2009] [Accepted: 03/05/2010] [Indexed: 11/19/2022] Open
Abstract
Background Emergency Medical Services workers' willingness to report to duty in an influenza pandemic is essential to healthcare system surge amidst a global threat. Application of Witte's Extended Parallel Process Model (EPPM) has shown utility for revealing influences of perceived threat and efficacy on non-EMS public health providers' willingness to respond in an influenza pandemic. We thus propose using an EPPM-informed assessment of EMS workers' perspectives toward fulfilling their influenza pandemic response roles. Methodology/Principal Findings We administered an EPPM-informed snapshot survey about attitudes and beliefs toward pandemic influenza response, to a nationally representative, stratified random sample of 1,537 U.S. EMS workers from May–June 2009 (overall response rate: 49%). Of the 586 respondents who met inclusion criteria (currently active EMS providers in primarily EMS response roles), 12% indicated they would not voluntarily report to duty in a pandemic influenza emergency if asked, 7% if required. A majority (52%) indicated their unwillingness to report to work if risk of disease transmission to family existed. Confidence in personal safety at work (OR = 3.3) and a high threat/high efficacy (“concerned and confident”) EPPM profile (OR = 4.7) distinguished those who were more likely to voluntarily report to duty. Although 96% of EMS workers indicated that they would probably or definitely report to work if they were guaranteed a pandemic influenza vaccine, only 59% had received an influenza immunization in the preceding 12 months. Conclusions/Significance EMS workers' response willingness gaps pose a substantial challenge to prehospital surge capacity in an influenza pandemic. “Concerned and confident” EMS workers are more than four times as likely to fulfill pandemic influenza response expectations. Confidence in workplace safety is a positively influential modifier of their response willingness. These findings can inform insights into interventions for enhancing EMS workers' willingness to respond in the face of a global infectious disease threat.
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Affiliation(s)
- Daniel J Barnett
- Johns Hopkins Preparedness and Emergency Response Research Center, Baltimore, Maryland, United States of America.
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Editorial Comments–Anticipated Behaviors of Emergency Prehospital Medical Care Providers during an Influenza Pandemic. Prehosp Disaster Med 2010; 25:26-7. [DOI: 10.1017/s1049023x00007615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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