Connor Susan B
Prehosp Disaster Med. 2014 Dec;29(6):555-60. doi: 10.1017/S1049023X14001186. Epub 2014 Nov 11.
Over the past decade, numerous groups of researchers have studied the willingness of health care personnel (HCP) to respond when a disaster threatens the health of a community. Not one of those studies reported that 100% of HCP were willing to work during a public-health event (PHE).
The objective of this study was to explore factors associated with the intent of HCP to respond to a future PHE.
The theory of planned behavior (TPB) framed this cross-sectional study. Data were obtained via a web-based survey from 305 HCP. Linear associations between the TPB-based predictor and outcome variables were examined using Pearson's correlations. Differences between two groups of HCP were calculated using independent t tests. A model-generating approach was used to develop and assess a series of TBP-based observed variable structural equation models for prediction of intent to respond to a future PHE and to explore moderating and mediating effects.
The beginning patterns of relationships identified by the correlation matrix and t tests were evident in the final structural equation model, even though the patterns of prediction differed from those posited by the theory. Outcome beliefs had both a significant, direct effect on intention and an indirect effect on intention that was mediated by perceived behavioral control. Control beliefs appeared to influence intention through perceived behavioral control, as posited by the TPB, and unexpectedly through subjective norm. Subjective norm not only mediated the relationship between control beliefs and intention, but also the relationship between referent beliefs and intention. Additionally, professional affiliation seemed to have a moderating effect on intention.
The intention to respond was influenced primarily by normative and control factors. The intent of nurses to respond to a future PHE was influenced most by the control factors, whereas the intent of other HCP was shaped more by the normative factors. Health care educators can bolster the normative and control factors through education by focusing on team building and knowledge related to accessing supplies and support needed to respond when a disaster occurs.
在过去十年中，众多研究团队对灾难威胁社区健康时医护人员（HCP）的响应意愿进行了研究。这些研究均未报告称100%的医护人员愿意在公共卫生事件（PHE）期间工作。
本研究的目的是探讨与医护人员对未来公共卫生事件响应意图相关的因素。
本横断面研究采用计划行为理论（TPB）。通过基于网络的调查从305名医护人员处获取数据。使用Pearson相关性检验来检验基于TPB的预测变量与结果变量之间的线性关联。使用独立t检验计算两组医护人员之间的差异。采用模型生成方法来开发和评估一系列基于TPB的观测变量结构方程模型，以预测对未来公共卫生事件的响应意图，并探讨调节和中介效应。
尽管预测模式与理论假设不同，但相关矩阵和t检验所确定的初始关系模式在最终的结构方程模型中依然明显。结果信念对意图既有显著的直接影响，也有通过感知行为控制介导的间接影响。如TPB所假设的那样，控制信念似乎通过感知行为控制影响意图，并且意外地通过主观规范产生影响。主观规范不仅介导了控制信念与意图之间的关系，还介导了参照信念与意图之间的关系。此外，专业隶属关系似乎对意图有调节作用。
响应意图主要受规范和控制因素影响。护士对未来公共卫生事件的响应意图受控制因素影响最大，而其他医护人员的意图则更多地受规范因素影响。医护教育工作者可以通过专注于团队建设以及与灾难发生时响应所需物资获取和支持相关的知识教育，来强化规范和控制因素。
