Objective To systematically evaluate the evidence of healthcare workers' willingness to report to work during a pandemic influenza.
Design Systematic review of published articles.
Data Survey Cinahl, CSA Illumina, Healthcare Reference Center, Health Sciences, Health Source: Nursing /Academic Edition, Nursing and Allied Health, Medline, ProQuest, PubMed Central, Google Scholar and Citation Lists.
Review Method Articles describing healthcare workers' willingness to report to work during an influenza pandemic and associated outcomes were selected for review. Only scholarly journals were accepted. Group contrasts were analyzed using identical measurements and numerical scales.
Results Of the 206 studies reviewed, 28 studies met inclusion criteria. Of these, 18 studies, split into two methodologically homogenous groups, were included in the quantitative analysis. In 10 studies researchers elicited responses using a scale with a midpoint, unsure or an undecided option, which were coded as "not willing to report to work." In these studies, mean willingness to report to work was 56.12% (SD = 21.36, range = 59.20). In 8 studies researchers elicited responses using a forced choice scale without a midpoint, coding the top half of the scale as "willing to report to work". In these studies, mean willingness to report to work was 75.26%, (SD = 10.81, range = 33.10). Means differed significantly by study group, as indicated by Mann-Whitney nonparametric U test, U =17.00, p = 0.043. A detailed meta-analysis could not be performed due to vast variation in study design, such as use of scale points, dichotomization methods and coding of HCW groups.
Conclusion There is little consistency in findings that summarize percent of healthcare workers willing to report to work. A large proportion of them (up to 40%) may fall into the "unsure" group, which needs to be carefully studied. Scales without a midpoint systematically overestimated willingness to report to work and the magnitude of this overestimation was high (about 20%). To enable generalization, we recommend ways to standardize the design and reporting of future studies. Specifically, we recommend scales with the option of unsure or not applicable, inclusion of tables that show willingness to report to work by HCW type, gender, and scale point.
|Commitee:||Fales, William, Fulton, Lawrence|
|School:||Central Michigan University|
|Department:||DHA - Health Administration/School of Health Sciences|
|School Location:||United States -- Michigan|
|Source:||DAI-B 74/07(E), Dissertation Abstracts International|
|Subjects:||Public health, Health care management|
|Keywords:||Emergency management, Healthcare workers, Influenza pandemic, Scale design, Willingness to report to work|
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