Astudy by the Instituto de Saúde Pública da Universidade do Porto (ISPUP) found that, in a public health emergency situation, such as the COVID-19 pandemic, the perceived organisation of institutions and the existence of adequate infrastructures and personal protective equipment (PPE) are essential for a greater readiness to respond among health professionals.
It was also observed that health professionals who perceived their actions as relevant in response to a public health emergency, in this case, the COVID-19 pandemic, were also more willing to act. These aspects, as well as attention to the risk worker burnout, should be taken into consideration by hospital and primary health care organisations in future public health emergencies.
The study, entitled Preparedness in a public health emergency: determinants of willingness and readiness to respond in the onset of the COVID-19 pandemic, was conducted with the aim of understanding which factors influence the preparedness of health professionals in the face of a new public health emergency.
As Teresa Leão, first author of the study, researcher at ISPUP, and coordinator of the Policies and Health Laboratory, part of the associate Laboratory for Integrative and Translational Research in Population Health (ITR), explains, “this study was conducted at the very beginning of the pandemic, when health services were dealing with cases of infection by a new virus, about which we knew very little. We were then facing a new public health emergency, which was putting healthcare systems under strain”.
To try to understand which factors were associated with a greater preparedness of professionals in the face of this new public health emergency, the researchers decided to conduct an online questionnaire among the workers of the Local Health Unit – Unidade Local de Saúde (ULS) of Matosinhos, during the first wave of COVID-19.
“We considered this ULS a good sample because we would be able to question different professionals, from operational assistants to doctors and nurses, working in primary and hospital care, in an environment which includes specialties such as infectious diseases, internal medicine, intensive care medicine, pediatrics, general and family medicine, and public health services, among others, involved in the first-line response since the beginning of the pandemic,” says Teresa Leão.
Between May and June of 2020, the period corresponding to the end of the first wave of the COVID-19 pandemic in Portugal, 252 workers were questioned.
The online questionnaire sought to assess the willingness, readiness, and ability of the professionals at the ULS of Matosinhos in responding to this new public health emergency. Willingness is understood as the individual factors and the context outside the individual that provide an emotional and psychological burden to respond; whereas ability has to do with the technical knowledge needed to respond appropriately; and readiness has to do with the available resources, be it human resources, adequate equipment or organizational infrastructures that allow for a quick response.
About 60% of the responses to the questionnaires were given by professionals working in the so-called front line.
It was concluded that most workers considered themselves ready to respond to the pandemic, and that this readiness was higher among people who were on the front line of care.
The factors that most influenced workers’ readiness were related to the perceived existence of adequate infrastructures, access to PPE and good organisation within the institution. Most participants in the study considered that the ULS of Matosinhos met their expectations in these aspects. In addition, most employees were aware of the institution’s contingency plan.
Another aspect to be highlighted is the fact that more than a quarter of the respondents presented a high or severe risk of burnout, and that this proportion was higher among those who were not in the frontline.
According to Teresa Leão, “we found that a higher risk of burnout was associated with a greater willingness to act. This could mean that the people who were more willing to act were the ones who were working with greater intensity, and therefore, presented a higher risk of burnout”.
The researchers highlight the importance of effective communication by healthcare organisations to ensure an adequate response to a public health emergency, prioritising a clear distribution of roles and adequate psychological support for workers, especially those on the frontline.
“When we are faced with a new public health emergency, namely a new virus, it is important that institutions think about whether they have adequate infrastructures, but that they also ask themselves how workers perceive the level of organisation in the institution, and if they know how to act”, indicates Teresa Leão.
“It is also important that professionals clearly understand their role in an emerging public health emergency scenario and understand the importance of their actions in solving the problem. A final fundamental point has to do with the risk of burnout among health professionals. It is necessary to guarantee that the mental health teams that are available in these units are also looking out for the risk in their own employees”, she concludes.
The study also had the participation of Gustavo Duarte, member of the Local Health Unit of Matosinhos, and Gonçalo Gonçalves, from INESC-TEC.
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