INTRODUCTION:

Problem statement:

A descriptive study to assess the concerns regarding COVID-19 outbreak among healthcare workers working in a secondary hospital.

OBJECTIVE OF THE STUDY:

To assess the concerns regarding COVID-19 outbreak among healthcare workers.

NEED FOR THE STUDY:

The novel Corona virus species named SARS CoV-2 emerged from the city of Wuhan, China has led to fast spreading outbreak of COVID-19¹¹. The disease which started in China has now affected almost every country in a ruthless manner¹³.

The World Health Organization (WHO) has declared the occurrence of Corona as pandemic within a month of its inception. Since the emergence of COVID-19 virus in December 2019, the virus has affected around 210 countries across the globe with a global mortality of over a million¹². The major epidemic or pandemic outbreaks pose an increasing demand of HCWs. This has been so overwhelming for the individual HCWs and the hospital as a whole. It is of utmost public health concern to address to these issues and act at the earliest to ensure safety and security to the HCWs which will help in productive work and thus the quality patient outcome (8).

REVIEW OF LITERATURE:

In an infection outbreak, the tedious, outstretched and overstretched burden on the healthcare system likely to impart a substantial emotional overdrive onto the HCWs⁹. The regular increasing number of infected cases, the uncertainity of any specific medicine or vaccine, massive workload, has been bounding up every day¹⁰. There are many concerns about the lives of the people and their daily living. HCWs are at utmost risk of being infected when caring for such patients⁵. Scholars have predicted this rapidly progressing COVID-19 to be the end of the world. This state of hopelessness and uncertainity puts the HCWs to work under severe pressure⁷. Based on the results acquired from studies on previous global outbreaks; early assessment of HCWs’ concerns and apt intervention to resolve it is very vital. The recent views and interviews of Health care professionals have highlighted that COVID-19 has laid extreme levels of psychological stress on them due to long hours of work, working in constant fear of exposure to the disease and facing social discrimination and stigmatization^7,6.

There is paucity of scientific data regarding the concerns of the HCWs on COVID-19 in India (9). In lieu of the rapid emergence of the pandemic, the investigator conducted a study regarding the concerns of the HCWs working in a 120 bedded secondary hospital of Eastern India.

METHODOLOGY:

A descriptive research design was adopted in this study to assess the concerns of the HCWs regarding COVID-19. The study was conducted among the health care workers in Christian Hospital Berhampur (CHB). CHB is a secondary level Christian mission hospital located in Ganjam district of State Odisha, India.

The study population comprised of all hospital employees in CHB during the study period. The sample of the study included all hospital staff working in the clinical area contributing to patient care.

A consecutive sampling technique was used to select the samples for the study and the subjects recruited had fulfilled the inclusion criteria.

A self-administered questionnaire was designed on the basis of survey used in previous studies. The tool was modified and had two sections. The first section comprised of the socio demographic data of the subjects. This included age, gender, marital status, years of work experience, qualification, designation.

The second section consisted of the concerns regarding COVID-19. The items were divided under three domains namely, work related (8 items), non-work related (4 items) and perceived impact of COVID-19 on personal life and work (7 items). These items were measured on a 6point likert scale as strongly agree, agree, unsure but agree, unsure but disagree, disagree, strongly disagree. During the statistical analyses, the responses were dichotomized into two possible responses as Agree and Disagree. The response ‘Agree’ includes the responses of Strongly agree, Agree and Unsure but agree, while the response ‘Disagree’ included responses of Strongly Disagree, Disagree and Unsure but Disagree.

RESULTS:

The data collected was analysed using descriptive statistics.

Socio-demographic data:

A total of 152 samples were recruited for the study. The mean age of the sample was 37.43 years. Majority (43.42%) of the subjects belonged to the age group of 20-34 years followed by 38.15% in the age group of 35-49 years. Of the 152 subjects, most of them (78.9%) were females and married (60.5%). Almost equal percentage of Nursing personnel (42.1%) and non-professionals (46%) participated in the study. Many subjects (33.6%) had the work experience between 1-5 years.

Work related concerns (Table-1)

Table 1: Work related concerns of Health care workers regarding COVID-19 outbreak

S. No.	Concerns regarding COVID-19 pandemic	Agree %	Disagree %
1.	My job would put me at great exposure risk	64	36
2.	I am afraid of falling ill with COVID-19	50	50
3.	I should not be looking after COVID-19 patients.	46	55
4.	I accept that risk is part of my job.	66	34
5.	I might look for another job because of my job.	5	95
6.	Risk is not acceptable.	40	60
7.	Acceptable if colleagues resign because of their fear.	11	89
8.	Confident that the employer would look after my needs if I fall ill with COVID-19.	88	12

Inference:

Though majority of the sample (88%) expressed that they have confident that the employer would look after their needs if they fall ill with COVID-19, 64% HCWs had expressed that their job would put them at great risk of exposure and 95% would like to look for another job. However, many of them (89%) disagreed to the concern of accepting their colleagues resigning because of their fear related to COVID-19 infection.

Non-work related concerns (Table-2)

Table -2: Non-work related concerns of health care workers regarding COVID-19 pandemic

S. No.	Concerns regarding COVID-19 pandemic	Agree %	Disagree %
1.	Person close to me would be at high risk of getting COVID-19 because of my job.	57	43
2.	I would be MOST concerned for
	a) Spouse	91	9
	b) Parents	93	7
	c) Children	92	8
	d) Close friends	92	8
	e) Work Colleagues	95	5
	f) Others	90	10
3.	People close to me would be worried for my health.	93	7
4.	People close to me would be worried as they may get infected by me.	48	52

Inference:

This table reveals that though 57% of the subjects only had the concern of the person close to them getting infected due to their occupation, majority (>90%) of the subjects expressed their concerns for their family members, friends, colleagues and others. Majority (93%) of them told that people close to them will be worried for their health. The subjects involved in the study did not express much concern of their closed ones being worried about them getting infected by me (48%).

Perceived impact on personal life and work (Table-3)

Table -3: Health care workers perceived impact regarding COVID 19 pandemic on personal life and work.

S. No.	Concerns regarding COVID 19 pandemic	Agree %	Disagree %
1.	I would be afraid of my family about the risk I am exposed to	28	72
2.	People would avoid me because of my job.	18	82
3.	People would avoid my family members because of my job.	9	91
4.	I would avoid telling other people the nature of my job.	6	94
5.	There would be adequate staff at my workplace to handle the increased demand.	71	29
6.	There would be more conflict among colleagues at work.	50	50
7.	I would have an increase in workload.	83	14

Inference:

A high proportion of the sample (72%) disagreed to the concern of their family members afraid for the risk of me being exposed to the disease. Majority (91%) of them disagreed that their family will avoid them due to the nature of their job while 83% of them accepted that there will be an increase in the amount of workload due to the pandemic. This study result revealed an equal portion (50%) of the study population agreed and disagreed that there would be more conflict among colleagues at work and many subjects (94%) expressed that they would avoid telling others the nature of their job. Most of the subjects (83%) felt there would be increase in workload.

DISCUSSION:

The present study reflected the mean age of subjects was 37.43+12.06 years. This was at par with a study done by Jacob et al which also reflected similar findings in the study. The study revealed mean age of 34.43+9.95 years and 87% of the study population were females which were similar to the population of this study (78.9%).

Majority (64%) expressed a high concern of being exposed to COVID 19 due to their job. This was similar to the findings of Jacob et al where 76% of the nursing personnel were concerned of the exposure risk.

This study highlighted that only 55% of the subjects would not prefer taking care of COVID 19 patient. This was in contrast to the finding of the study by Abolfotouh et al (1) where a majority (92%) preferred avoidance of taking care of patient with Middle East Respiratory Syndrome Corona virus (MERS-CoV).

Many (95%) subjects did not prefer to leave their job in-spite of the pandemic which sounded similar to the findings of the study by Cheong where majority HCWs did not prefer to leave their job due to Avian Influenza outbreak.

This study findings showed that 88% of the subjects believed that their employer will look after their needs if they are infected with COVID 19 which was consistent with study finding by Jacob et al where 95% of the subjects agreed for the same.

The current study highlighted that only 43% of the HCWs were concerned that their family members may get infected with COVID 19 due to their job which was consistent to study findings of Jacob et al where only 35 % of the subjects agreed for the same with respect to Sever Acute Respiratory syndrome (SARS)(3).

The current study revealed that majority of the subjects (84%) disagreed with the fact that they or their family members (91%) will be avoided by others due to their nature of job. This was similar to the study conducted by Jacob et al where 90% of the subjects agreed that their family members would be avoided due to their job.

Jacob et al(3) highlighted that only 27% of the subjects felt concerned that there will be conflict among the colleagues at work due to SARS while the findings of the present study was inconsistent with it where half of the subjects (49%) agreed of a conflict among the colleagues. Majority (83%) of them believed that there will be increase in workload in lieu of the pandemic which was consistent to the study findings of other similar studies.

There are many studies done on various aspects regard to COVID 19 pandemic, but there is paucity of scientific evidence related to the concerns regarding COVID 19 outbreak among healthcare workers.

Though many of the results of this study is consistent with the results of other studies done in the past, very less studies are done in Indian settings. This study result brings the hidden and least considered aspect to the light that needs extra care and importance as the health care workers are the key to alleviate and mange this acute COVID 19 pandemic in India. This also would help the world of health care to build on with further studies as India is in active phase of COVID 19 pandemic.

NURSING IMPLICATIONS:

· This study reflected on the dire urgency to monitor the effects of the unsaid concerns among the HCWs which can massively affect their work effectiveness .

· Nurses, being the frontline warriors should be provided adequate support and counselling which aid in boosting their morale, mental health and maintain the integrity of the health care systems.

CONCLUSION AND RECOMMENDATIONS:

As truly stated, “No country or hospital or clinic can keep up patients safe unless it keeps it’s health workers safe (4).

COVID 19 pandemic has reminded all of us the vital role HCWs play to relieve suffering and safe lives. It is very important for all healthcare institutions to ensure that HCWs have safe working environment, the necessary training, regular counselling or debriefing sessions, the respect and incentives that they deserve to promote good patient care for their loved ones.

The researcher recognizes the limitations of the study and acknowledges that further additional studies are necessary to determine how best to protect HCWs from these natural calamities as they render their selfless services for the betterment of mankind.

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Received on 21.09.2021 Modified on 06.04.2022

Asian J. Nursing Education and Research. 2022; 12(3):325-329.

DOI: 10.52711/2349-2996.2022.00067