Putzer Gavin J, Koro-Ljungberg Mirka, Duncan R Paul, Dobalian Aram
College of Public Health, University of Georgia, Athens, GA 30602, USA.
South Med J. 2013 Jan;106(1):21-6. doi: 10.1097/SMJ.0b013e31827caed2.
Human-induced public health emergencies such as the anthrax bioterrorism event and the terrorism events of September 11, 2001 in the United States have increased awareness of the nation's vulnerability to large-scale emergencies. Scant attention has been given to preparing physicians in sparsely populated areas for public health emergencies. This study introduces a conceptual model developed from participants' responses that can be used to improve our understanding of rural physicians' preparedness regarding public health emergencies such as a bioterrorism event. The conceptual model is valuable because it illustrates some areas of question, concern, and future inquiry regarding bioterrorism preparedness.
This study used a qualitative research approach and grounded theory methods for data analysis. Semistructured interviews were conducted among six rural physicians in Florida. Florida was considered a particularly appropriate location given that the state was an initial site of the 2001 anthrax attacks. In addition, approximately half of Florida's counties are considered rural.
The findings of this study suggest that not all rural physicians in Florida believe that they are adequately prepared for a bioterrorism event. The conceptual model elements--cognitive, clinical, expectation, and simulation--emerged from an analysis of participant responses.
According to participant responses and the formulation of the conceptual model it may be postulated that preparedness may be effectively achieved if physicians are aware of the possibility of bioterrorism through education and seminars, able to suspect and recognize an event when it occurs, and institute appropriate medical management.
诸如炭疽生物恐怖主义事件以及2001年美国“9·11”恐怖主义事件等人为引发的公共卫生突发事件,提高了美国对国家在应对大规模突发事件时脆弱性的认识。对于让人口稀少地区的医生做好应对公共卫生突发事件的准备,关注甚少。本研究介绍了一个基于参与者回答而开发的概念模型,该模型可用于增进我们对农村医生在应对诸如生物恐怖主义事件等公共卫生突发事件时准备情况的理解。这个概念模型很有价值,因为它阐明了有关生物恐怖主义防范方面一些存在疑问、令人关切以及未来需要探究的领域。
本研究采用定性研究方法和扎根理论方法进行数据分析。对佛罗里达州的六位农村医生进行了半结构化访谈。鉴于佛罗里达州是2001年炭疽袭击的最初发生地,所以该州被认为是一个特别合适的地点。此外,佛罗里达州大约一半的县被视为农村地区。
本研究结果表明,并非佛罗里达州所有的农村医生都认为他们已为生物恐怖主义事件做好了充分准备。概念模型的要素——认知、临床、预期和模拟——是通过对参与者回答的分析得出的。
根据参与者的回答以及概念模型的构建,可以假定,如果医生通过教育和研讨会了解生物恐怖主义的可能性,在事件发生时能够怀疑并识别该事件,并采取适当的医疗管理措施,那么就可以有效地实现防范。