Mixed Method Study to Explore Ethical Dilemmas and Health Care Workers' Willingness to Work Amid COVID-19 Pandemic in Palestine

Abstract

Background: The high potential risks involved in working in a healthcare setting during a pandemic and the associated fear that may affect health care workers' (HCWs') willingness to work are important to understand to eliminate potential barriers to working. This study aimed to assess Palestinian HCWs' willingness to work and the related factors as well as to explore their ethical dilemmas during the coronavirus disease 2019 (COVID-19) pandemic.Materials and Methods: Quantitative (survey questionnaire) and qualitative (semi-structured interviews) data were collected. Frontline HCWs (n = 550) received an online survey link via closed institutional networks. Frequencies summarized the data, and chi-square compared variables and outcomes. Odds ratios (ORs) and multivariable analysis examined predictors for willingness to work. Fifteen HCWs (physicians, nurses, and lab and radiology technicians) were purposefully sampled and agreed to interviews to explore their thoughts, motivations, and worries. Thematic analysis focused on ethical dilemmas to enhance the breadth and the depth of the study.Results: Almost 25% of surveyed HCWs were not willing to work during the pandemic. Logistic model results showed that physicians and nurses had higher willingness to work than others (p = 0.004, Adj. OR = 3.5). Lower stress levels and longer professional experience were predictors of more willing to work (p = 0.03, Adj. OR = 2.5; p = 0.03, Adj. OR = 2.6, respectively). Interviews showed that willingness to work did not preclude HCWs from fulfilling their duties despite grueling workloads and grave fears about safety and security. HCWs felt poorly prepared, unappreciated, and frustrated by unfair work distribution. The occupation presented additional safety issues.Conclusion: Physicians and nurses were more likely to comply with a commitment to their professional ethics and the duty or obligation to work. Stress levels could be mitigated in the future with better leadership, adding supports to address mental health and psychosocial challenges to enhance HCWs' well-being and improve quality of care. The realities of the occupation added additional threats and uncertainty.

Prevalence of SARS-CoV-2 antibodies in the Palestinian population: A primary health center-based cross-sectional study

“…Moreover, due to the political situation in Palestine, many young men are employed in Israel. This plays an essential role in the initial spread surge within the population [33].…”

Work Stress Hampering Employee Performance During COVID-19: Is Safety Culture Needed?

“…As the service providers, the employees working in the banks have more vulnerability toward prevailing hazards of COVID-19 due to the frequent human-to-human interactions. Similarly, we do find literature focusing on the stress and mental health of healthcare workers and its impact on their burnout ( Luceño-Moreno et al, 2020 ; Yıldırım and Solmaz, 2020 ), work life balance ( Magnavita et al, 2020 ), psychological wellbeing and anxiety ( Denning et al, 2021 ; Galbraith et al, 2021 ; Mo et al, 2021 ), and their willingness to work ( Maraqa et al, 2020 ) during the COVID-19 pandemic. However, very little is known about the impact of stress due to COVID-19 (COVID-19 STR) on the performance of banking staff who had to be available on duty during these tough times.…”

COVID-19-related anxieties: Impact on duty to care among nurses

“…Finally, a survey of 550 frontline hospital workers in multiple disciplines in Palestine found that 25% of survey respondents were not willing to work during a pandemic, though physicians and nurses expressed this feeling less often than other healthcare workers. 33 Those with more longevity and lower stress levels were less likely to consider abandoning the workplace. Healthcare workers felt poorly prepared for COVID-19 care, unappreciated, and frustrated by unfair work distribution.…”