Introduction:Emergency prehospital medical care providers are frontline health workers during emergencies. However, little is known about their attitudes, perceptions, and likely behaviors during emergency conditions. Understanding these attitudes and behaviors is crucial to mitigating the psychological and operational effects of biohazard events such as pandemic influenza, and will support the business continuity of essential prehospital services.Problem:This study was designed to investigate the association between knowledge and attitudes regarding avian influenza on likely behavioral responses of Australian emergency prehospital medical care providers in pandemic conditions.Methods:Using a reply-paid postal questionnaire, the knowledge and attitudes of a national, stratified, random sample of the Australian emergency prehospital medical care workforce in relation to pandemic influenza were investigated. In addition to knowledge and attitudes, there were five measures of anticipated behavior during pandemic conditions: (1) preparedness to wear personal protective equipment (PPE); (2) preparedness to change role; (3) willingness to work; and likely refusal to work with colleagues who were exposed to (4) known and (5) suspected influenza. Multiple logistic regression models were constructed to determine the independent predictors of each of the anticipated behaviors, while controlling for other relevant variables.Results:Almost half (43%) of the 725 emergency prehospital medical care personnel who responded to the survey indicated that they would be unwilling to work during pandemic conditions; one-quarter indicated that they would not be prepared to work in PPE; and one-third would refuse to work with a colleague exposed to a known case of pandemic human influenza.Willingness to work during a pandemic (OR = 1.41; 95% CI = 1.0−1.9), and willingness to change roles (OR = 1.44; 95% CI = 1.04−2.0) significantly increased with adequate knowledge about infectious agents generally. Generally, refusal to work with exposed (OR = 0.48; 95% CI = 0.3−0.7) or potentially exposed (OR = 0.43; 95% CI = 0.3−0.6) colleagues significantly decreased with adequate knowledge about infectious agents. Confidence in the employer's capacity to respond appropriately to a pandemic significantly increased employee willingness to work (OR = 2.83; 95% CI = 1.9−4.1); willingness to change roles during a pandemic (OR = 1.52; 95% CI = 1.1−2.1); preparedness to wear PPE (OR = 1.68; 95% CI = 1.1−2.5); and significantly decreased the likelihood of refusing to work with colleagues exposed to (suspected) influenza (OR = 0.59; 95% CI = 0.4−0.9).Conclusions:These findings indicate that education and training alone will not adequately prepare the emergency prehospital medical workforce for a pandemic. It is crucial to address the concerns of ambulance personnel and the perceived concerns of their relationship with partners in order to maintain an effective prehospital emergency medical care service during pandemic conditions.
Introduction:Little is known about the risk perceptions and attitudes of healthcare personnel, especially of emergency prehospital medical care personnel, regarding the possibility of an outbreak or epidemic event.Problem:This study was designed to investigate pre-event knowledge and attitudes of a national sample of the emergency prehospital medical care providers in relation to a potential human influenza pandemic, and to determine predictors of these attitudes.Methods:Surveys were distributed to a random, cross-sectional sample of 20% of the Australian emergency prehospital medical care workforce (n = 2,929), stratified by the nine services operating in Australia, as well as by gender and location. The surveys included: (1) demographic information; (2) knowledge of influenza; and (3) attitudes and perceptions related to working during influenza pandemic conditions. Multiple logistic regression models were constructed to identify predictors of pandemic-related risk perceptions.Results:Among the 725 Australian emergency prehospital medical care personnel who responded, 89% were very anxious about working during pandemic conditions, and 85% perceived a high personal risk associated with working in such conditions. In general, respondents demonstrated poor knowledge in relation to avian influenza, influenza generally, and infection transmission methods. Less than 5% of respondents perceived that they had adequate education/training about avian influenza. Logistic regression analyses indicate that, in managing the attitudes and risk perceptions of emergency prehospital medical care staff, particular attention should be directed toward the paid, male workforce (as opposed to volunteers), and on personnel whose relationship partners do not work in the health industry.Conclusions:These results highlight the potentially crucial role of education and training in pandemic preparedness. Organizations that provide emergency prehospital medical care must address this apparent lack of knowledge regarding infection transmission, and procedures for protection and decontamination. Careful management of the perceptions of emergency prehospital medical care personnel during a pandemic is likely to be critical in achieving an effective response to a widespread outbreak of infectious disease.
As front-line health professionals, paramedics will be among the first members of the health community to face exposure during a pandemic event. In Australia, the prehospital workforce has had little experience in working in infectious environments such as an influenza pandemic. Currently, there are limited published studies on the perceptions of the prehospital workforce on pre-event risk, in particular, of paramedics and their partners. A collaborative national and international team led by the Australian Centre for Pre-hospital Research commenced a national study of paramedics and their partners to examine these perceptions. The results of this research will be directed toward the development of responsive health and infection control messages for paramedics and their families. Preliminary analyses highlight some important messages for the prehospital community These messages include that among paramedics, high risk perception is associated with less confidence in the provision of adequate strategies by employers to protect them from exposure, and higher likelihood of being unwilling to work during pandemic conditions. However, knowledge about avian influenza and/or human pandemic influenza does not appear to be associated with employer confidence, levels of concern, or willingness to work in pandemic conditions (OR = 1.91; 95% CI = 1.1-3.3). Paramedics report that the information most likely to mitigate their level of perceived risk relates to the confidence in their Personal Protective Equipment and intra/inter-organization communications and alert systems. The results of this study will be described in detail and an analysis will be provided of the strategies that are in place in the Australian emergency prehospital services to respond to these messages.
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