Understanding Factors Contributing to Nurses’ Intention to Care for COVID-19 Patients Using the Theory of Planned Behavior

Abstract

Background: Globally, the nursing community has lost several colleagues during the Coronavirus Disease 2019 (COVID-19) battle. One of the negative consequences of the disease is the pressure on healthcare services and demands that exceed the system's capacity to provide sufficient resources. Similarly, the experiences of care providers might trigger emotional and physical stress, which could affect the healthcare system's readiness to manage infectious outbreaks. This study was aimed at investigating nurses’ intention to care for COVID-19 patients and determining factors contributing to their intentions to care at the Ministry of Health facilities in Saudi Arabia.
 Methods: This descriptive cross-sectional survey design was used to recruit 336 nurses working in Al Madinah Ministry of Health hospitals where COVID-19 patients received medical and nursing care. The instrument was created following the framework of the Theory of Planned Behavior.
 Results: Nurses’ intention to care for COVID-19 patients was significantly correlated with their education level, nationality, knowledge about COVID-19, and nurses’ exposure during their earlier education for emerging infectious diseases. Factors related to social pressure from friends, colleagues, and workplace administration support needed improvement. Examining the model fits through multiple regression revealed that the combination of six subscales – “attitude, subjective norms, perceived behavioral control, behavioral beliefs, normative beliefs, and control beliefs” – accounted for a significant (89%) variability of intention to care, R2 = 0.892, adjusted R2 = 0.793, F (6-329) = 201, p ≤ 0.000.
 Conclusion: Providing nursing education is the main predictor of higher nurses' intention to care for COVID-19 patients, it is imperative that nursing education courses should continue investing in enhancing nurses' capabilities in caring for COVID-19 patients.

Factors influencing nurses' intent to provide care involved in coronavirus disease 2019: Theory of planned behaviour perspectives

“…This trend can be attributed to the two factors. A previous study (Aljohani et al, 2021) In terms of general characteristics, nurses who live with their parents showed a lower intent to provide COVID-19 care. Similarly, Chung et al (2015) also reported that intent to provide care was lower among nurses who live with their families compared with those who live alone.…”

“…This trend can be attributed to the two factors. A previous study (Aljohani et al, 2021 ) reported that continuous nursing education that focuses on imparting knowledge about and fostering clinical competency for COVID‐19 care improves nurses' intent to provide care in Saudi Arabia. Considering these results, it can be inferred that nurses' intent to provide care increased owing to the improved COVID‐19 care competency through continuous education and training for infectious disease care.…”

“…The studies that examined nurses' intent to provide care amid outbreaks of EIDs, from SARS in 2003 to COVID‐19 in 2019 (Aljohani et al, 2021 ; Kyung & Shin, 2021 ; Lee & Kang, 2020 ), show that intent to provide care increased with a more positive attitude towards the behaviour. Further, study findings show that nurses' attitude towards providing care for infectious diseases is more positive with organisation's reward and compensation system and manager's recognition (Lee & Kang, 2020 ), and a supportive work environment that provides more opportunities for education and training about the disease and situations and ensures an adequate supply of PPE (Aljohani et al, 2021 ; Kyung & Shin, 2021 ; Lee & Kang, 2020 ). A US study by Garrett et al ( 2009 ) after the SARS outbreak reported that all healthcare providers must be paid bonuses and given additional vacation leaves for their work.…”

“…• Through this study, recommendations can be made for increasing the ability to care for patients with infectious diseases in the field of nursing practice education that are necessary to cope with the ongoing COVID-19 pandemic as well as future infectious disease crises. a theoretical framework for factors influencing nurses' intent to provide care for patients with SARS (Kim et al, 2006), novel influenza A (H1N1, H5N1; Chung et al, 2015), EIDs (Lee & Kang, 2020) and COVID-19 (Aljohani et al, 2021;Cheng et al, 2021;Kyung & Shin, 2021;Park & Park, 2021). Most existing studies on nurses' intent to provide COVID-19 care have been limited to specific regions (Aljohani et al, 2021;Cheng et al, 2021;Kyung & Shin, 2021;Park & Park, 2021) or included nurses not directly involved in COVID-19 care (Cheng et al, 2021;Kyung & Shin, 2021;Park & Park, 2021).…”

Psychometric validation of the nursing care behavior questionnaire during emerging disease epidemics: A theory of planned behavior approach

“…Occupational pressure, stress, and anxiety may drive certain nurses to leave their positions, creating adverse consequences for the healthcare system as a whole. Pressures stemming from emerging infectious diseases prompt nurses in hospital settings to experience fear and apprehension towards their care responsibilities, sometimes causing them to neglect this crucial role [ 6 ].…”