Department of Epidemiology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
BMC Public Health. 2010 Jul 26;10:436. doi: 10.1186/1471-2458-10-436.
Hospital-based providers' willingness to report to work during an influenza pandemic is a critical yet under-studied phenomenon. Witte's Extended Parallel Process Model (EPPM) has been shown to be useful for understanding adaptive behavior of public health workers to an unknown risk, and thus offers a framework for examining scenario-specific willingness to respond among hospital staff.
We administered an anonymous online EPPM-based survey about attitudes/beliefs toward emergency response, to all 18,612 employees of the Johns Hopkins Hospital from January to March 2009. Surveys were completed by 3426 employees (18.4%), approximately one third of whom were health professionals.
Demographic and professional distribution of respondents was similar to all hospital staff. Overall, more than one-in-four (28%) hospital workers indicated they were not willing to respond to an influenza pandemic scenario if asked but not required to do so. Only an additional 10% were willing if required. One-third (32%) of participants reported they would be unwilling to respond in the event of a more severe pandemic influenza scenario. These response rates were consistent across different departments, and were one-third lower among nurses as compared with physicians. Respondents who were hesitant to agree to work additional hours when required were 17 times less likely to respond during a pandemic if asked. Sixty percent of the workers perceived their peers as likely to report to work in such an emergency, and were ten times more likely than others to do so themselves. Hospital employees with a perception of high efficacy had 5.8 times higher declared rates of willingness to respond to an influenza pandemic.
Significant gaps exist in hospital workers' willingness to respond, and the EPPM is a useful framework to assess these gaps. Several attitudinal indicators can help to identify hospital employees unlikely to respond. The findings point to certain hospital-based communication and training strategies to boost employees' response willingness, including promoting pre-event plans for home-based dependents; ensuring adequate supplies of personal protective equipment, vaccines and antiviral drugs for all hospital employees; and establishing a subjective norm of awareness and preparedness.
医院工作人员在流感大流行期间是否愿意上班是一个至关重要但尚未得到充分研究的现象。威特的扩展平行过程模型（EPPM）已被证明可用于了解公共卫生工作者对未知风险的适应性行为，因此为检查医院工作人员对特定情况的应对意愿提供了一个框架。
我们在 2009 年 1 月至 3 月期间向约翰霍普金斯医院的 18612 名员工在线匿名进行了一项基于 EPPM 的关于对紧急应对态度/信念的调查。有 3426 名员工（18.4%）完成了调查，其中约有三分之一是卫生专业人员。
受访者的人口统计学和专业分布与所有医院工作人员相似。总体而言，超过四分之一（28%）的医院工作人员表示，如果被要求但不被要求应对流感大流行情景，他们不愿意做出回应。只有另外 10%的人愿意在被要求的情况下做出回应。三分之一（32%）的参与者报告说，在发生更严重的大流行性流感情景时，他们将不愿意做出回应。这些回应率在不同部门之间是一致的，与医生相比，护士的比例低三分之一。当被要求额外工作时间时犹豫不决的受访者，如果被要求，在大流行期间做出回应的可能性要低 17 倍。60%的工作人员认为他们的同事在这种紧急情况下可能会报告上班，而他们自己这样做的可能性要高出 10 倍。认为自己效能高的医院员工表示愿意应对流感大流行的比例要高出 5.8 倍。
医院工作人员的应对意愿存在明显差距，EPPM 是评估这些差距的有用框架。一些态度指标可以帮助识别不太可能做出回应的医院员工。调查结果指出了某些基于医院的沟通和培训策略，以提高员工的应对意愿，包括为有家属的员工制定在家办公的预案；确保为所有医院员工提供充足的个人防护设备、疫苗和抗病毒药物；并建立一个对意识和准备情况的主观规范。
