1 Division of Risk Management and Societal Safety, Lund University, Sweden.
2 Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.
Scand J Public Health. 2019 Mar;47(2):99-104. doi: 10.1177/1403494817753450. Epub 2018 Jan 23.
Exposure to infection is a risk for all healthcare workers. This risk acquires another dimension in an outbreak of highly contagious, lethal disease, such as the Ebola epidemic in West Africa in 2014. Healthcare workers are usually well and correctly informed about the risks from such diseases, but family, neighbours, friends, or colleagues may react strongly to the risk that staff might bring infection home from an epidemic overseas. Research around such stigmatization is scarce. We wanted to investigate how common it is, which expressions it assumes and how it is influenced by dissemination of information.
We interviewed a sample of Swedish healthcare workers who had worked in West Africa during the 2014 outbreak of Ebola, as well as one close contact for each of them, about reactions before leaving and after returning, and also about information received.
The majority of contact persons reported no or little concern, neither when the healthcare worker revealed the plan to leave, nor on the healthcare worker's return. The prevailing reason was trust in the judgement of 'their' healthcare worker, mainly using information received from the healthcare worker to assess risks, and relying little on other information channels. This means that the person assessing the risk was at the same time the hazard. There were indications that instructions regarding quarantine and self-isolation were less stringently followed by healthcare workers than by other aid workers in the outbreak, which could give confusing signals to the public. Simple, clear and non-negotiable rules should be preferred - also from an information perspective.
感染暴露是所有医护人员面临的风险。在高传染性、致命疾病（如 2014 年西非的埃博拉疫情）爆发时，这种风险会增加另一维度。医护人员通常对这些疾病的风险有很好的了解和正确的认识，但家人、邻居、朋友或同事可能会对员工从海外疫情地区带回感染的风险做出强烈反应。针对这种污名化的研究很少。我们想调查它有多普遍，它表现出哪些形式，以及信息传播如何影响它。
我们采访了一组曾在 2014 年西非埃博拉疫情期间在西非工作的瑞典医护人员，以及他们每个人的一位密切接触者，了解他们在出发前和返回后的反应，以及他们收到的信息。
大多数接触者报告说，无论是在医护人员透露离开计划时，还是在医护人员返回时，他们都没有或几乎没有担心。主要原因是对“他们”的医护人员的判断的信任，主要是根据医护人员提供的信息来评估风险，而很少依赖其他信息渠道。这意味着评估风险的人同时也是危险的。有迹象表明，与其他援助人员相比，医护人员对隔离和自我隔离的指示遵守得不够严格，这可能会给公众发出混乱的信号。简单、明确和不可协商的规则应该是首选的——从信息的角度来看也是如此。
