Alice Lee Center for Nursing Studies, National University of Singapore, Singapore School of Population Health, The University of Western Australia, Australia.
Int J Evid Based Healthc. 2011 Dec;9(4):403-19. doi: 10.1111/j.1744-1609.2011.00242.x.
To determine healthcare workers' perceptions of risk from exposure to emerging acute respiratory infectious diseases and the perceived effectiveness of strategies used to facilitate healthy coping in acute hospital and community healthcare settings.
Electronic databases (Cumulative Index to Nursing and Allied Health Literature, Ovid, PubMed, ScienceDirect, Scopus and Wiley InterScience) were searched using a three-step search strategy to identify the relevant quantitative and qualitative studies published in English from 1997 to 2009. The grey literature was not included in the review. The identified studies were evaluated using the Meta-Analysis of Statistics, Assessment and Review Instrument and the Qualitative Assessment and Review Instrument from the Joanna Briggs Institute. Fourteen quantitative studies were included and the findings included in a narrative summary. The findings from the two qualitative studies were categorised into a meta-synthesis that generated two synthesised findings.
Findings indicated that healthcare workers perceived personal and familial health risks and stigmatisation from their exposure to emerging acute respiratory infectious diseases, but the majority were accepting of these risks. Organisational implementation of infection control measures, avoidance of patients and complying with personal protective equipment were identified as risk-mitigating strategies. Demographic, individual and organisational factors were found to influence their risk perceptions and their adoption of strategies to mitigate the risk.
It appears that healthcare workers' risk perceptions can influence their behaviour towards patients with emerging acute respiratory infectious diseases as well as their use of risk-mitigating strategies. Institutions need to ensure that appropriate infection control safeguards are in place to protect workers and their families. Institutions can also offer incentives to encourage healthcare workers to comply with the policies and procedures introduced to mitigate risk.
Institutions and government need to ensure that policies and procedures are communicated and adequate institutional measures (i.e. personal protective equipment; education and training; and personal support) are implemented to safeguard healthcare workers during and after pandemic outbreaks.
Future research needs to examine how perception of risk related to acute emerging respiratory infectious diseases, epidemic or pandemic, and the factors that would influence healthcare workers': decisions to stay within the workforce and provide care or resign from the workforce and compliance with institutional and government policies and procedures, as well as compliance to use of personal protective equipment.
确定医护人员对接触新发急性呼吸道传染病的风险的认知，以及评估在急性医院和社区医疗保健环境中促进健康应对的策略的有效性。
使用三步搜索策略，在电子数据库（综合护理和联合健康文献累积索引、Ovid、PubMed、ScienceDirect、Scopus 和 Wiley InterScience）中进行搜索，以确定 1997 年至 2009 年期间以英文发表的相关定量和定性研究。本综述不包括灰色文献。使用 Joanna Briggs 研究所的 Meta 分析统计评估、评估和审查工具以及定性评估和审查工具对确定的研究进行评估。共纳入 14 项定量研究，研究结果以叙述性总结的形式呈现。从两项定性研究中提取的结果被分类为元综合，生成了两个综合结果。
研究结果表明，医护人员认为他们接触新发急性呼吸道传染病会带来个人和家庭健康风险以及受到污名化，但大多数人接受这些风险。确定了组织实施感染控制措施、避免接触患者和遵守个人防护设备等风险缓解策略。发现人口统计学、个体和组织因素会影响他们的风险认知以及他们采取的降低风险策略。
似乎医护人员的风险认知会影响他们对新发急性呼吸道传染病患者的行为以及他们对降低风险策略的使用。机构需要确保采取适当的感染控制保障措施来保护工作人员及其家属。机构还可以提供激励措施，鼓励医护人员遵守引入的政策和程序以降低风险。
机构和政府需要确保政策和程序得到沟通，并实施适当的机构措施（即个人防护设备；教育和培训；以及个人支持），以在大流行爆发期间和之后保护医护人员。
未来的研究需要探讨急性新发呼吸道传染病、传染病或大流行的风险认知，以及影响医护人员的因素：决定留在劳动力队伍中提供护理或辞去劳动力队伍的工作，以及遵守机构和政府的政策和程序，以及遵守使用个人防护设备。
