Perception and attitude of COVID-19 health workers and their family members

INTRODUCTION

Novel corona virus disease (COVID-19) which originated from China rapidly became pandemic and infected people across the continents including India.^1,2

This disease has crippled health, welfare and economy of the countries and has caused confusion, anxiety and fear among the general public.³ It has also caused changes in humanitarian perception and attitudes. Social stigma has also resulted in targeting health workers, their families and other venerable groups of people as being the reason for spreading this disease.^4-6

This pandemic has strained and exhausted healthcare infrastructure, work force and resources. There is unprecedented situation which demand increase in healthcare facilities including manpower to operate effectively.^7,8 Front line workers are important pillars to combat against COVID-19 and their perception should be well understood so that they are able to deliver their services efficiently.⁹ When these workers are involved in providing services to potentially infectious patients there is possibility of considerable stigmatization.⁴ The contagion brings out a wide spectrum of attitudes, perceptions and stigmas. Moreover, work and family environment play important role in coping with stressful conditions. It is therefore essential to understand the effects of stigma, related to the perception of front-line workers and their family members in this unprecedented time. Though there are paucity of studies in this context but various literatures suggest that it is important to know perception of health workers and their family members to understand their coping skills with stressful conditions. As COVID-19 is a highly infectious disease, health worker engaged in management of COVID-19 are at risk and this might have impact on their various life dimensions. Spillover effects of COVID-19 duties on health workers and their family members of can be substantial.¹⁰ Therefore, this study was conducted with an objective to identify the perception and attitude of health workers engaged in management of COVID-19 along with the family members.

METHODS

A cross-sectional study was conducted among health workers engaged in the management of COVID-19 at a tertiary care center of Jodhpur city along with their family members, through a self-administered online survey. After the due permission from the Institutional Ethical Committee of AIIMS Jodhpur, questionnaire in form of google forms were circulated to include all healthcare workers and family members of the healthcare workers in the months of March to May 2020.

Inclusion criteria

All the people who consented and filled the google forms, and were directly involved in COVID-19 patient related duties were included in the study.

The questionnaire was framed after extensive literature search and piloting was done to check feasibility of the questionnaire. Questionnaire consisted of basic demographic details, knowledge, perception and attitude towards COVID-19 duties of health workers. The study guaranteed anonymity and consent was sought from participant prior to participation. The data was presented as mean, standard deviation, numbers and percentages. Difference in characteristics was evaluated using t-test. The statistical analysis was performed using SPSS (version 23) and the p value less than 0.05 was considered significant.

RESULTS

Out of the total 150 participants surveyed, 75 were healthcare workers and 75 were family members of health workers. Out of all health workers, 42 (56.2%) were female with mean age of 35.3±13.20 years and 33 (43.8%) were males with mean age of 34.9±11.01 years. Table 1 illustrates the socio-demographic characteristics of healthcare workers engaged in management of COVID-19.

Out of 75 family members of healthcare workers 38 (50.7%) were female with mean age of 37.4±12.78 years and 37 (49.3%) were male with mean age of 37.9±11.63 years. Most of the respondents (53.3%) were below 39 years of age. Table 2 shows the socio-demographic characteristics of family members of healthcare workers engaged in management of COVID-19.

Order of best strategy for preventing COVID-19 infection perceived by 49.3% (n=75) health workers was: hand hygiene, social distancing, use of masks, drug prophylaxis. Order for effectiveness for preventing COVID-19 infection perceived by 64% (n=75) family members was: social distancing, use of masks, hand sanitization and drug prophylaxis. Figure 1 illustrates the perception of healthcare workers and their family members towards preventing COVID-19 infection.

Table 5 illustrate comparative mean perception of healthcare workers engaged in COVID-19 duties and their family members. There was a non-significant difference (t=0.0739; p=0.4714) between mean Likert values of perception of healthcare workers and their family members.

Around 50% of healthcare workers agreed that they were facing interference in daily routine as a result of involvement in COVID-19 related duties. Around 31% were afraid that they might get COVID-19 infection as result of current postings and duties. Table 3 illustrate the perception of healthcare workers regarding engagement in management of COVID-19.

Around 45% of family members of healthcare workers engaged in COVID-19 management agreed that they are comfortable with COVID-19 posting of their family member. Around 35% agreed that their other family members will also get COVID-19 infection because COVID-19 posting. Table 4 illustrate the perception of family members regarding engagement in management of COVID-19.

DISCUSSION

Knowledge about perception of healthcare workers in context to pandemics is of upmost importance because fear, stigma and home environment largely play role in determining work outcomes.¹¹ Stigma and poor family environment are one of the underline determinant of compromised psychological and physical health.¹² Several studies have been conducted on whether stigma, work and home environment can affect healthcare worker’s behaviour and quality of life.^4,13,14 Jodhpur is an unceasing hotspot for COVID-19 in Rajasthan and is solely depended on efforts of healthcare workers deployed at various levels to mitigate and prevent the pandemic. Considering the fact that psychological well-being of healthcare workers is an important aspect for delivering efficient job outcomes, this study was conducted to provide an overview of the domains of health workers and family member perception and attitude in context to COVID-19 duty.

It was observed that around 40% family member agreed that they or their family person could get infection due to their family member involved in COVID-19 duties. They seem to be neutral (mean =2.9) when they were asked whether COVID related duties have hampered their family relationship. This might be due to their hesitation to speak about their personal relationship or they were actually unsure about how their relationship will be maintained. It was interesting to note that only 25% family members relationship reported suffering because of posting of family member engaged in management of COVID-19. Healthcare workers also felt that their relationship with family member (53%) and society (55%) has suffered. These finding suggest that this unprecedented pandemic has impacted the life of healthcare workers in one or another way, similar findings were also demonstrated study done by various studies that stigma and distress are important predictors of reduce work efficiency and pose a threat to well-being quality of healthcare workers.^4,11-14

As the data was self-reported a potential limitation of the study is the probability of the participants’ responses getting influence by “social desirability.

CONCLUSION

This study illustrated the concerns of health workers and their family members engaged in COVID-19 management. Strategies for providing health education and necessary support for plummeting perception of the fear of infection can be planned for improving psychological and social wellbeing of healthcare workers and their family members.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: Not required

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