School of Population Health, The University of Adelaide, Adelaide, South Australia 5005, Australia.
BMC Public Health. 2013 Apr 15;13:344. doi: 10.1186/1471-2458-13-344.
During the 2009 H1N1 influenza pandemic, Australian public health officials closed schools as a strategy to mitigate the spread of the infection. This article examines school communities' understanding of, and participation in, school closures and the beliefs and values which underpinned school responses to the closures.
We interviewed four school principals, 25 staff, 14 parents and 13 students in five schools in one Australian city which were either fully or partially closed during the 2009 H1N1 pandemic.
Drawing on Thompson et al's ethical framework for pandemic planning, we show that considerable variation existed between and within schools in their attention to ethical processes and values. In all schools, health officials and school leaders were strongly committed to providing high quality care for members of the school community. There was variation in the extent to which information was shared openly and transparently, the degree to which school community members considered themselves participants in decision-making, and the responsiveness of decision-makers to the changing situation. Reservations were expressed about the need for closures and quarantine and there was a lack of understanding of the rationale for the closures. All schools displayed a strong duty of care toward those in need, although school communities had a broader view of care than that of the public health officials. Similarly, there was a clear understanding of and commitment to protect the public from harm and to demonstrate responsible stewardship.
We conclude that school closures during an influenza pandemic represent both a challenge for public health officials and a litmus test for the level of trust in public officials, government and the school as institution. In our study, trust was the foundation upon which effective responses to the school closure were built. Trust relations within the school were the basis on which different values and beliefs were used to develop and justify the practices and strategies in response to the pandemic.
在 2009 年 H1N1 流感大流行期间，澳大利亚公共卫生官员关闭学校作为减轻感染传播的策略。本文考察了学校社区对学校关闭的理解和参与程度，以及支撑学校对关闭做出反应的信念和价值观。
我们采访了澳大利亚一个城市的五所学校的四位校长、25 名教职员工、14 名家长和 13 名学生，这些学校在 2009 年 H1N1 流感大流行期间全部或部分关闭。
借鉴汤普森等人的大流行规划伦理框架，我们表明，在关注伦理流程和价值观方面，各所学校之间以及同一所学校内部都存在很大差异。在所有学校中，卫生官员和学校领导都坚定地致力于为学校社区成员提供高质量的护理。在信息是否公开透明地共享、学校社区成员是否认为自己是决策制定的参与者，以及决策者对不断变化的情况的反应程度方面，存在差异。对关闭和隔离的必要性表示保留，并且对关闭的理由缺乏理解。所有学校都对有需要的人表现出强烈的关怀义务，尽管学校社区对关怀的看法比公共卫生官员更广泛。同样，对保护公众免受伤害和展示负责任的管理有明确的理解和承诺。
我们的结论是，在流感大流行期间关闭学校既是对公共卫生官员的挑战，也是对公众对公共官员、政府和学校作为机构的信任程度的考验。在我们的研究中，信任是建立有效应对学校关闭的基础。学校内部的信任关系是利用不同的价值观和信念来制定和证明应对大流行的实践和策略的基础。
