Anxiety and Work Avoidance among Intensive Care Workers during an Influenza A/H1N1 Outbreak

Abstract

Background: Healthcare workers in intensive care units are particularly vulnerable to contracting influenza infection. This study explored the anxiety levels and work avoidance behaviors of healthcare workers in intensive care units within 2 weeks of admission of a patient with influenza A/H1N1 infection. Methods: A cross-sectional questionnaire-based study was conducted between December 2, 2015 and December 12, 2015. Linear and logistic regression analyses were used to determine associations between levels of worry and relevant independent variables. Results: Out of 238 healthcare workers (physicians, nurses, and allied health professionals) in pediatric and adult intensive care units, 169 responded. The mean worry level of respondents about contracting the disease or transmitting it to family members was 4.65 (standard deviation [SD] 1.8) out of 10. The level of worry about being assigned to care for an H1N1-infected patient was moderate (mean 4.8 [SD 2.6]) Higher levels of anxiety were associated with a higher general anxiety disorder 7-point score, lack of previous exposure to H1N1-infected patients, fear of vaccination side effects, working in units where patients had died of the disease, and younger age. Thirty (18%) respondents were willing to change their work shift, and 10 considered going off duty to avoid contact with infected patients. Over one-third reported a reduction in their interaction with H1N1-infected patients. This was lower in respondents who had previously cared for H1N1-infected patients (β=-1.186; odds ratio, 0.31; P=0.009) and those who perceived infection control measures to be adequate (β=-0.233; odds ratio, 0.79; P=0.019). Conclusion: Healthcare workers in intensive care units reported moderate levels of anxiety and perception of threat during the recent influenza A/H1N1 epidemic, and some demonstrated work avoidance behavior. This highlights the need to address occupational stress among intensive care unit staff during viral outbreaks.