Factors associated with motivation and hesitation to work among health professionals during a public crisis: a cross sectional study of hospital workers in Japan during the pandemic (H1N1) 2009

Abstract

BackgroundThe professionalism of hospital workers in Japan was challenged by the pandemic (H1N1) 2009. To maintain hospital function under critical situations such as a pandemic, it is important to understand the factors that increase and decrease the willingness to work. Previous hospital-based studies have examined this question using hypothetical events, but so far it has not been examined in an actual pandemic. Here, we surveyed the factors that influenced the motivation and hesitation of hospital workers to work in Japan soon after the pandemic (H1N1) 2009.MethodsSelf-administered anonymous questionnaires about demographic character and stress factors were distributed to all 3635 employees at three core hospitals in Kobe city, Japan and were collected from June to July, 2009, about one month after the pandemic (H1N1) in Japan.ResultsOf a total of 3635 questionnaires distributed, 1693 (46.7%) valid questionnaires were received. 28.4% (N = 481) of workers had strong motivation and 14.7% (N = 249) had strong hesitation to work. Demographic characters and stress-related questions were categorised into four types according to the odds ratios (OR) of motivation and hesitation to work: some factors increased motivation and lowered hesitation; others increased motivation only; others increased hesitation only and others increased both motivation and hesitation. The strong feeling of being supported by the national and local governments (Multivariate OR: motivation; 3.5; CI 2.2-5.4, hesitation; 0.2; CI 0.1-0.6) and being protected by hospital (Multivariate OR: motivation; 2.8; CI 2.2-3.7, hesitation; 0.5; CI 0.3-0.7) were related to higher motivation and lower hesitation. Here, protection included taking precautions to prevent illness among workers and their families, providing for the care of those who do become ill, reducing malpractice threats, and financial support for families of workers who die on duty. But 94.1% of the respondents answered protection by the national and local government was weak and 79.7% answered protection by the hospital was weak.ConclusionsSome factors have conflicting effects because they increase both motivation and hesitation. Giving workers the feeling that they are being protected by the national and local government and hospital is especially valuable because it increases their motivation and lowers their hesitation to work.

Exploring staff willingness to attend work during a disaster: A study of nurses employed in four Australian emergency departments

“…2,7,[9][10][11][12][15][16][17]19 This study further identified a number of lesser-known factors that influence decisions to attend work during a disaster such as leadership in the workplace and the influence of positive collegial relationships.…”

“…[6][7][8][9][10] Healthcare personnel who fear for their own safety in terms of illness, injury or death are reluctant to attend work during a disaster. [11][12][13][14] The availability of appropriate treatment, prophylaxis and infection control measures may increase the likelihood to respond.…”

“…Some studies reported that health care personnel felt obligated to work during disasters, stating that they have no choice in the matter. 7,11 This raises questions related to the legal, ethical and moral issues that health care personnel may face when they consider whether to work during a disaster.…”

Anxiety and Work Avoidance among Intensive Care Workers during an Influenza A/H1N1 Outbreak

“…HCW's hesitation and avoidance to work during viral pandemics has been reported before [8,10,16,17]. A survey of randomly selected HCWs across 3 health care trusts in West Midlands in the UK suggested that absenteeism can reach up to 85%, especially among nurses and ancillary healthcare workers during influenza pandemics [16].…”

“…A survey of randomly selected HCWs across 3 health care trusts in West Midlands in the UK suggested that absenteeism can reach up to 85%, especially among nurses and ancillary healthcare workers during influenza pandemics [16]. Imai et al reported that 14.7% of hospital employees in 3 core hospitals in Japan were very hesitant to work during the H1N1 pandemic [17]. This unwillingness was even higher among community nurses.…”