University of Wisconsin Health, University of Wisconsin-Madison, Madison, Wisconsin.
Division of Infection Disease, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Infect Control Hosp Epidemiol. 2021 Oct;42(10):1198-1205. doi: 10.1017/ice.2020.1396. Epub 2021 Mar 2.
Influenza can be introduced and propagated in healthcare settings by healthcare workers (HCWs) working while ill with influenza. However, reasons driving this behavior are unclear. In this study, we examined barriers to and facilitators of absenteeism during the influenza season.
Cross-sectional mixed methods study.
Ambulatory and inpatient settings in a large, tertiary-care healthcare system.
An anonymous electronic survey was sent to HCWs between June 11 and July 13, 2018, asking participants to self-report influenza-like illness (ie, ILI symptoms of fever, chills, cough, or sore throat) during the 2017-2018 influenza season. We conducted a logistical regression analysis to identify factors associated with absenteeism.
Of 14,250 HCWs, 17% responded to the survey. Although 1,180 respondents (51%) reported symptoms of ILI, 575 (43%) did not stay home while ill. The most commonly perceived barriers to ILI absenteeism included being understaffed (odds ratio [OR], 1.78; P = .04), unable to find a replacement for work (OR, 2.26; P = .03), desiring not to use time off (OR, 2.25; P = .003), and paid by the hour or unable to afford being absent (OR, 2.05; P = .02). Common perceived facilitators of absenteeism included support from coworkers and management, clearer policy, better sick days availability, and lower perceived threat of disciplinary action.
Reporting to work with ILI symptoms is common among HCWs. Most barriers and facilitators are related to systems. Addressing system factors, such as policies regarding sick days and sick leave and ensuring adequate backup staffing, is likely to facilitate absenteeism among ill HCWs.
流感患者的医护人员（HCWs）在患病期间工作可导致流感在医疗机构内传播。然而，导致这种行为的原因尚不清楚。本研究旨在调查流感季节缺勤的障碍因素和促进因素。
横断面混合方法研究。
大型三级保健系统的门诊和住院环境。
2018 年 6 月 11 日至 7 月 13 日，我们向 HCWs 发送了一份匿名电子调查，要求参与者报告 2017-2018 流感季节的流感样疾病（即发热、寒战、咳嗽或喉咙痛等 ILI 症状）。我们进行了逻辑回归分析，以确定与缺勤相关的因素。
在 14250 名 HCWs 中，有 17%的人对调查做出了回应。尽管 1180 名受访者（51%）报告有 ILI 症状，但仍有 575 名（43%）患病时未留在家中。缺勤的最常见感知障碍因素包括人手不足（比值比 [OR]，1.78；P =.04）、找不到工作替代者（OR，2.26；P =.03）、不想休假（OR，2.25；P =.003）和按小时付费或无法承受缺勤（OR，2.05；P =.02）。缺勤的常见感知促进因素包括同事和管理层的支持、更明确的政策、更好的病假可用性以及对纪律处分的感知威胁较低。
报告有 ILI 症状仍坚持工作在 HCWs 中很常见。大多数障碍因素和促进因素都与系统有关。解决与病假和病假相关的政策等系统因素，并确保有足够的后备人员，可能会促进患病 HCWs 缺勤。
