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Anticipated Behaviors of Emergency Prehospital Medical Care Providers during an Influenza Pandemic

Published online by Cambridge University Press:  28 June 2012

Vivienne C. Tippett ,
Kerrianne Watt ,
Steven G. Raven ,
Heath A. Kelly ,
Michael Coory ,
Frank Archer  and
Konrad Jamrozik
Vivienne C. Tippett
Affiliation:
Australian Centre for Prehospital Research, Brisbane, Queensland, Australia; Queensland Ambulance Service, QueenslandAustralia School of Population Health, University of Queensland, Brisbane, QueenslandAustralia
Kerrianne Watt*
Affiliation:
Australian Centre for Prehospital Research, Brisbane, Queensland, Australia; Queensland Ambulance Service, QueenslandAustralia School of Population Health, University of Queensland, Brisbane, QueenslandAustralia
Steven G. Raven
Affiliation:
Australian Centre for Prehospital Research, Brisbane, Queensland, Australia; Queensland Ambulance Service, QueenslandAustralia
Heath A. Kelly
Affiliation:
Victorian Infectious Diseases Reference Laboratory, VictoriaAustralia
Michael Coory
Affiliation:
School of Population Health, University of Queensland, Brisbane, QueenslandAustralia Queensland Health, Brisbane, QueenslandAustralia
Frank Archer
Affiliation:
Monash UniversityDepartment of Community Emergency Health and Paramedic Practice, VictoriaAustralia
Konrad Jamrozik
Affiliation:
Victorian Infectious Diseases Reference Laboratory, VictoriaAustralia
*
Dr. Kerrianne Watt School of Population Health, University of QueenslandHerston RoadBrisbane, Australia4006 E-mail: kwatt@emergency.qld.gov.au
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Abstract

Introduction:

Emergency prehospital medical care providers are frontline health workers during emergencies. However, little is known about their attitudes, perceptions, and likely behaviors during emergency conditions. Understanding these attitudes and behaviors is crucial to mitigating the psychological and operational effects of biohazard events such as pandemic influenza, and will support the business continuity of essential prehospital services.

Problem:

This study was designed to investigate the association between knowledge and attitudes regarding avian influenza on likely behavioral responses of Australian emergency prehospital medical care providers in pandemic conditions.

Methods:

Using a reply-paid postal questionnaire, the knowledge and attitudes of a national, stratified, random sample of the Australian emergency prehospital medical care workforce in relation to pandemic influenza were investigated. In addition to knowledge and attitudes, there were five measures of anticipated behavior during pandemic conditions: (1) preparedness to wear personal protective equipment (PPE); (2) preparedness to change role; (3) willingness to work; and likely refusal to work with colleagues who were exposed to (4) known and (5) suspected influenza. Multiple logistic regression models were constructed to determine the independent predictors of each of the anticipated behaviors, while controlling for other relevant variables.

Results:

Almost half (43%) of the 725 emergency prehospital medical care personnel who responded to the survey indicated that they would be unwilling to work during pandemic conditions; one-quarter indicated that they would not be prepared to work in PPE; and one-third would refuse to work with a colleague exposed to a known case of pandemic human influenza.

Willingness to work during a pandemic (OR = 1.41; 95% CI = 1.0−1.9), and willingness to change roles (OR = 1.44; 95% CI = 1.04−2.0) significantly increased with adequate knowledge about infectious agents generally. Generally, refusal to work with exposed (OR = 0.48; 95% CI = 0.3−0.7) or potentially exposed (OR = 0.43; 95% CI = 0.3−0.6) colleagues significantly decreased with adequate knowledge about infectious agents. Confidence in the employer's capacity to respond appropriately to a pandemic significantly increased employee willingness to work (OR = 2.83; 95% CI = 1.9−4.1); willingness to change roles during a pandemic (OR = 1.52; 95% CI = 1.1−2.1); preparedness to wear PPE (OR = 1.68; 95% CI = 1.1−2.5); and significantly decreased the likelihood of refusing to work with colleagues exposed to (suspected) influenza (OR = 0.59; 95% CI = 0.4−0.9).

Conclusions:

These findings indicate that education and training alone will not adequately prepare the emergency prehospital medical workforce for a pandemic. It is crucial to address the concerns of ambulance personnel and the perceived concerns of their relationship with partners in order to maintain an effective prehospital emergency medical care service during pandemic conditions.

Keywords

attitudesbehavioremergency medical servicesinfection controlinfluenzapandemicprehospitalrisk perceptions
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 25 , Issue 1 , February 2010 , pp. 20 - 25
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2010

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References

1.Gullion, JS: School nurses as volunteers in a bioterrorism event. Biosecur Bioterror 2004;2:112−117.Google Scholar
2.Cowan, A, Clark, SJ, Kemper, AR: Willingness of private physicians to be involved in smallpox preparedness and response activities. Biosecur Bioterror 2005;3:16−22.Google Scholar
3.Alexander, GC, Wynia, MK: Ready and willing? Physicians' sense of preparedness for bioterrorism. Health Aff 2003;22:189−193.Google Scholar
4.Parker MJG: Paediatric emergency department staff perceptions of infection control measures against severe acute respiratory syndrome. Emerg Med J 2006;23:349−353.CrossRefGoogle Scholar
5.Balicer, RD, Omer, SB, Barnett, DJ, EverlyJr, GS: Local public health workers' perceptions toward responding to an influenza pandemic. BMC Public Health 2006;6.CrossRefGoogle Scholar
6.Ehrenstein, B, Hanses, F, Salzberger, B: Influenza pandemic and professional duty: Family or patients first? A survey of hospital employees. BMC Public Health 2006;6.Google Scholar
7.Lemon, SC, Zapka, JG, Clemow, L: Health behaviour change among women with recent familial diagnosis of breast cancer. Prev Med 2004;39.Google Scholar
8.Chaudhary, KN, Solomon, MG, Cosgrove, LA: The relationship between perceived risk of being ticketed and self-reported seat-belt use. J Safety Res 2004;35:383−390.Google Scholar
9.Davis, CG, Macdonald, SL: Threat appraisals, distress and development of positive life changes after September 11 in a Canadian sample. Cogn Behav Ther 2004;33:68−78.Google Scholar
10.Qureshi, K, Gershon, R, Sherman, M, et al. : Health care workers' ability and willingness to report to duty during catastrophic disasters. J Urban Health 2005;82:378−388.CrossRefGoogle ScholarPubMed
11.Syrett, J, Benitez, J, Livingston, W, Davis, A: Will emergency health care providers respond to mass casualty incidents? Prehosp Emerg Care 2007;11:49−54.Google Scholar
12.DiMaggio, C., Markenson, D, Loo, GT, Redlener, I: The willingness of U.S emergency medical technicians to respond to terrorist incidents. Biosecur Bioterror 2005;3:331−337.Google Scholar
13.Mackler, N, Cinti, S: Will first-responders show up for work during a pandemic? Lessons from a smallpox vaccination survey of paramedics. Disaster Manag Response 2007;5:45−48.Google Scholar
14.Watt, K, Tippett, V, Raven, S, et al. : Attitudes to living and working in pandemic conditions among emergency prehospital care personnel. Prehosp Disaster Med 2010;25(1):3−9.CrossRefGoogle Scholar
15.National Health and Medical Research Council, Australian ResearchCouncil, Australian Vice-Chancellors' Committee: National Statement on Ethical Conduct in Human Research. Australian Government, 2007.Google Scholar
16.Tzeng, H: SARS infection control in Taiwan: Investigations of nurses' professional obligation. Outcomes Manag 2003;7:186−193.Google Scholar
17.Imai, T, Takahashi, K, Hoshuyama, T, et al. SARS risk perceptions in healthcare workers, Japan. Emerg Infect Dis 2005;11:404−410.Google Scholar
18.Chan-Yeung, M: Severe acute respiratory syndrome (SARS) and healthcare workers. Int J Occup Environ Health 2004;10:421−427.CrossRefGoogle ScholarPubMed
19.Lau, J, Fung, K, Wong, T, et al. : SARS transmission among hospital workers in Hong Kong. Emerg Infect Dis 2004;10:280−287.CrossRefGoogle ScholarPubMed
20.Moore, D, Gamage, B, Bryce, E, Copes, R, Yassi, A: Protecting health care workers from SARS and other respiratory pathogens: organizational and individual factors that affect adherence to infection control guidelines. Am J Infect Control 2005;33:88−96.Google Scholar
21.Moore, D, Gilbert, M, Saunders, S, et al. : Occupational health and infection control practices related to severe acute respiratory syndrome. American Association of Occupational Health Nurses 2005;53:257−266.Google ScholarPubMed
22.Gershon, RR, Vlahov, D, Felknor, SA, et al. : Compliance with universal safety precautions among health care workers at three regional hospitals. Am J Infect Control 1995;23:225−236.Google Scholar
23.Tam, C., Pang, E, Lam, L, Chiu, H: Severe acute respiratory syndrome (SARS) in Hong Kong in 2003: Stress and psychological impact among frontline healthcare workers. Psychol Med 2004;34:1197−1204.CrossRefGoogle Scholar
24.Maunder, R, Hunter, J, Vincent, L, et al. : The immediate psychological and occupational impact of the 2003 SARS outbreak in a teaching hospital. Can Med Assoc J 2003;168:1245−1251.Google ScholarPubMed
25.Koh, D, Lim, MK, Chia, SE, et al. : Risk perception and impact of severe acute respiratory syndrome (SARS) on work and personal lives of healthcare workers in Singapore: What can we learn? Med Care 2005;43:676−682.Google Scholar
26.Wong, TT, Tam, WW: Handwashing practice and the use of personal protective equipment among medical students after the SARS epidemic in Hong Kong. Am J Infect Control 2005;33:580−586.Google Scholar
27.Chan, S, Leung, G, Tirawi, A, et al. : The Impact of work-related risk on nurses during the SARS outbreak in Hong Kong. Fam Community Health 2005;28:274−287.CrossRefGoogle ScholarPubMed
28.Koh, D, Takahashi, K, Lim, M, et al. : SARS Risk perception and preventative measures, Singapore and Japan. Emerg Infect Dis 2005;11:641−642.CrossRefGoogle ScholarPubMed
29.Verbeek, P, McClelland, I, Silverman, A, Burgess, R: Loss of paramedic availability in an urban emergency medical services system during a severe acute respiratory syndrome outbreak. Acad Emerg Med 2004;11:973−978.Google Scholar