Attitudes to Living and Working in Pandemic Conditions among Emergency Prehospital Medical Care Personnel

2010 ◽  
Vol 25 (1) ◽  
pp. 13-19 ◽  
Author(s):  
Kerrianne Watt ◽  
Vivienne C. Tippett ◽  
Steven G. Raven ◽  
Konrad Jamrozik ◽  
Michael Coory ◽  
...  

AbstractIntroduction: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.

2010 ◽  
Vol 25 (1) ◽  
pp. 20-25 ◽  
Author(s):  
Vivienne C. Tippett ◽  
Kerrianne Watt ◽  
Steven G. Raven ◽  
Heath A. Kelly ◽  
Michael Coory ◽  
...  

AbstractIntroduction: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.


2021 ◽  
Author(s):  
Nadia A. Charania ◽  
Ian D. Martin ◽  
Eric N. Liberda ◽  
Richard Meldrum ◽  
Leonard J. S. Tsuji

Background There is concern of avian influenza virus (AIV) infections in humans. Subsistence hunters may be a potential risk group for AIV infections as they frequently come into close contact with wild birds and the aquatic habitats of birds while harvesting. This study aimed to examine if knowledge and risk perception of avian influenza influenced the use of protective measures and attitudes about hunting influenza-infected birds among subsistence hunters. Methods Using a community-based participatory research approach, a cross-sectional survey was conducted with current subsistence hunters (n = 106) residing in a remote and isolated First Nations community in northern Ontario, Canada from November 10–25, 2013. Simple descriptive statistics, cross-tabulations, and analysis of variance (ANOVA) were used to examine the distributions and relationships between variables. Written responses were deductively analyzed. Results ANOVA showed that males hunted significantly more birds per year than did females (F1,96 = 12.1; p = 0.001) and that those who hunted significantly more days per year did not perceive a risk of AIV infection (F1,94 = 4.4; p = 0.040). Hunters engaged in bird harvesting practices that could expose them to AIVs, namely by cleaning, plucking, and gutting birds and having direct contact with water. It was reported that 18 (17.0%) hunters wore gloves and 2 (1.9%) hunters wore goggles while processing birds. The majority of hunters washed their hands (n = 105; 99.1%) and sanitized their equipment (n = 69; 65.1%) after processing birds. More than half of the participants reported being aware of avian influenza, while almost one third perceived a risk of AIV infection while harvesting birds. Participants aware of avian influenza were more likely to perceive a risk of AIV infection while harvesting birds. Our results suggest that knowledge positively influenced the use of a recommended protective measure. Regarding attitudes, the frequency of participants who would cease harvesting birds was highest if avian influenza was detected in regional birds (n = 55; 51.9%). Conclusions Our study indicated a need for more education about avian influenza and precautionary behaviours that are culturally-appropriate. First Nations subsistence hunters should be considered an avian influenza risk group and have associated special considerations included in future influenza pandemic plans.


2021 ◽  
Author(s):  
Nadia A. Charania ◽  
Ian D. Martin ◽  
Eric N. Liberda ◽  
Richard Meldrum ◽  
Leonard J. S. Tsuji

Background There is concern of avian influenza virus (AIV) infections in humans. Subsistence hunters may be a potential risk group for AIV infections as they frequently come into close contact with wild birds and the aquatic habitats of birds while harvesting. This study aimed to examine if knowledge and risk perception of avian influenza influenced the use of protective measures and attitudes about hunting influenza-infected birds among subsistence hunters. Methods Using a community-based participatory research approach, a cross-sectional survey was conducted with current subsistence hunters (n = 106) residing in a remote and isolated First Nations community in northern Ontario, Canada from November 10–25, 2013. Simple descriptive statistics, cross-tabulations, and analysis of variance (ANOVA) were used to examine the distributions and relationships between variables. Written responses were deductively analyzed. Results ANOVA showed that males hunted significantly more birds per year than did females (F1,96 = 12.1; p = 0.001) and that those who hunted significantly more days per year did not perceive a risk of AIV infection (F1,94 = 4.4; p = 0.040). Hunters engaged in bird harvesting practices that could expose them to AIVs, namely by cleaning, plucking, and gutting birds and having direct contact with water. It was reported that 18 (17.0%) hunters wore gloves and 2 (1.9%) hunters wore goggles while processing birds. The majority of hunters washed their hands (n = 105; 99.1%) and sanitized their equipment (n = 69; 65.1%) after processing birds. More than half of the participants reported being aware of avian influenza, while almost one third perceived a risk of AIV infection while harvesting birds. Participants aware of avian influenza were more likely to perceive a risk of AIV infection while harvesting birds. Our results suggest that knowledge positively influenced the use of a recommended protective measure. Regarding attitudes, the frequency of participants who would cease harvesting birds was highest if avian influenza was detected in regional birds (n = 55; 51.9%). Conclusions Our study indicated a need for more education about avian influenza and precautionary behaviours that are culturally-appropriate. First Nations subsistence hunters should be considered an avian influenza risk group and have associated special considerations included in future influenza pandemic plans.


2020 ◽  
Vol 32 (5) ◽  
pp. 276-284
Author(s):  
William J. Jefferson

The United States Supreme Court declared in 1976 that deliberate indifference to the serious medical needs of prisoners constitutes the unnecessary and wanton infliction of pain…proscribed by the Eighth Amendment. It matters not whether the indifference is manifested by prison doctors in their response to the prisoner’s needs or by prison guards intentionally denying or delaying access to medical care or intentionally interfering with treatment once prescribed—adequate prisoner medical care is required by the United States Constitution. My incarceration for four years at the Oakdale Satellite Prison Camp, a chronic health care level camp, gives me the perspective to challenge the generally promoted claim of the Bureau of Federal Prisons that it provides decent medical care by competent and caring medical practitioners to chronically unhealthy elderly prisoners. The same observation, to a slightly lesser extent, could be made with respect to deficiencies in the delivery of health care to prisoners of all ages, as it is all significantly deficient in access, competencies, courtesies and treatments extended by prison health care providers at every level of care, without regard to age. However, the frailer the prisoner, the more dangerous these health care deficiencies are to his health and, therefore, I believe, warrant separate attention. This paper uses first-hand experiences of elderly prisoners to dismantle the tale that prisoner healthcare meets constitutional standards.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Jiae Shin ◽  
Dongwoo Ham ◽  
Seoeun Ahn ◽  
Hee-Young Paik ◽  
Hyojee Joung

Abstract Objectives This study aimed to investigate sex differences in the medical utilization for ischemic heart disease (IHD) among newly diagnosed hypertensive patients using a cohort data of South Korea. Methods We analyzed the National Sample Cohort version 2.0 of the National Health Insurance Service. Newly diagnosed hypertensive patients aged 40–84 were extracted from the baseline population, who received health examinations during 2003–2006 without pre-existing type 2 diabetes or circulatory diseases. Propensity score was applied to match men to women with the same ratio of body mass index (BMI) and fasting blood glucose (FBG) among the patients. Men and women (each 10, 110) were selected for analyses and followed until the end of 2015. Person-year was defined as the period from the diagnosis of hypertension to the incidence of IHD. Associations between IHD and the medical care utilization such as the mean of medical care visit, the mean medical cost, and the type and the location of medical care providers were investigated using Cox proportional hazard model. Hazard ratios (HR) of IHD according to medical care utilization were adjusted for age, income, BMI, FBG, smoking, and alcohol consumption. Results Incidence rates (per 1000 person-years) of IHD were 43.1 in men and 43.0 in women. The mean follow-up period was 5.2 person-years. The HRs of IHD were significantly higher in the subjects with a high mean medical cost (T3) (men, HR = 1.39, 95% CI 1.25–1.54; women, HR = 1.33, 95% CI 1.20–1.48) than in those with a low mean medical cost (T1). However, the subjects visiting medical care providers more (T3) had lower HRs than those visiting less (T1) (men, HR = 0.80, 95% CI 0.72–0.89; women, HR = 0.79, 95% CI 0.71–0.88). Conclusions Hypertensive patients in Korea showed an increased risk of IHD when they paid medical cost more and visited medical care less per person-year in both men and women. Funding Sources This research was supported by Support Program for Women in Science, Engineering and Technology through the National Research Foundation of Korea funded by the Korea government (MSIT). (No.2016H1C3A1903202). Supporting Tables, Images and/or Graphs


2016 ◽  
Vol 35 (8) ◽  
pp. 1404-1409 ◽  
Author(s):  
Nengliang Yao ◽  
Christine Ritchie ◽  
Fabian Camacho ◽  
Bruce Leff

2021 ◽  
Vol 12 (1) ◽  
pp. 73-85
Author(s):  
Leonie Elliott-Graves

For adults with learning disabilities, touch is a necessary element of their everyday care. Yet touch delivered by care providers is a contentious and marginal practice, which is often avoided due to fears of abuse allegations, and the effects of touch avoidance can be significantly detrimental to the quality of care provided. The Safe Touch pilot project, developed with a London-based organization providing care to adults with learning disabilities, including those with profound and multiple learning disabilities (PMLD), used performing arts practices and massage to help the staff develop and utilize ‘positive’ touch – touch for communication, interaction and well-being – when working with service users. Fifteen service users with learning disabilities and PMLD along with the organization’s staff participated in the project. Drawing on the project’s processes and findings, some successes and limitations in employing performing arts activities with care staff to increase the use of positive touch with people with PMLD were identified.


Author(s):  
Hui Ye ◽  
Juan Ma ◽  
Yang Wu ◽  
Ying Zhang

Limited research focuses on risk perceptions of hot weather among ethnic minority groups in remote mountain areas of China. Adopting a multi-stage sampling method, this study received completed questionnaires from 643 participates in Enshi Tujia and Miao Autonomous Prefecture of China in 2017 and 2018. We used multivariate logistic regression models to explore the factors affecting risk perceptions and coping behaviors with regards to hot weather. Results showed that despite a relatively high level of risk perception, the study population in the mountain areas of China had a very low level of preparedness in responding to the risks from heat, and a lack of professional health knowledge in general. In particular, 61.3% (95% CI: 57.1%−5.6%) of the participants felt increasing temperatures in recent years, 73.2% (95% CI: 69.3%−7.0%) thought extreme high temperatures would be a health threat, and 61.3% (95% CI: 57.1%−5.4%) reported physical discomfort during hot weather. However, only 12% (95% CI: 9.5%−4.5%) had the information or knowledge to stay healthy during the extreme high temperatures, and only 24.2% had (95% CI: 20.8%−7.6%) preparation. The logistic regression models suggested that ethnic group, health status, marital status, gender, and employment could affect their perceptions, which could significantly affect the adoption of coping behaviors. In conclusion, our findings have significant implications for developing policies and health education and promotion programs for ethnic minorities in remote regions to maintain good health during hot weather.


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