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Anticipated Behaviors of Emergency Prehospital Medical Care Providers during an Influenza Pandemic

Published online by Cambridge University Press:  28 June 2012

Vivienne C. Tippett ,
Kerrianne Watt ,
Steven G. Raven ,
Heath A. Kelly ,
Michael Coory ,
Frank Archer  and
Konrad Jamrozik
Vivienne C. Tippett
Affiliation:
Australian Centre for Prehospital Research, Brisbane, Queensland, Australia; Queensland Ambulance Service, QueenslandAustralia School of Population Health, University of Queensland, Brisbane, QueenslandAustralia
Kerrianne Watt*
Affiliation:
Australian Centre for Prehospital Research, Brisbane, Queensland, Australia; Queensland Ambulance Service, QueenslandAustralia School of Population Health, University of Queensland, Brisbane, QueenslandAustralia
Steven G. Raven
Affiliation:
Australian Centre for Prehospital Research, Brisbane, Queensland, Australia; Queensland Ambulance Service, QueenslandAustralia
Heath A. Kelly
Affiliation:
Victorian Infectious Diseases Reference Laboratory, VictoriaAustralia
Michael Coory
Affiliation:
School of Population Health, University of Queensland, Brisbane, QueenslandAustralia Queensland Health, Brisbane, QueenslandAustralia
Frank Archer
Affiliation:
Monash UniversityDepartment of Community Emergency Health and Paramedic Practice, VictoriaAustralia
Konrad Jamrozik
Affiliation:
Victorian Infectious Diseases Reference Laboratory, VictoriaAustralia
*
Dr. Kerrianne Watt School of Population Health, University of QueenslandHerston RoadBrisbane, Australia4006 E-mail: kwatt@emergency.qld.gov.au
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Abstract

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.

Keywords

attitudesbehavioremergency medical servicesinfection controlinfluenzapandemicprehospitalrisk perceptions
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 25 , Issue 1 , February 2010 , pp. 20 - 25
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2010

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