Safety attitudes, burnout and well-being among healthcare workers during the COVID-19 pandemic: an Indo-Pacific regional cross-sectional study

INTRODUCTION@#The coronavirus disease 2019 (COVID-19) pandemic has had an unprecedented impact in Asia and has placed significant burden on already stretched healthcare systems. We examined the impact of COVID-19 on the safety attitudes among healthcare workers (HCWs), as well as their associated demographic and occupational factors, and measures of burnout, depression and anxiety.@*METHODS@#A cross-sectional survey study utilising snowball sampling was performed involving doctors, nurses and allied health professions from 23 hospitals in Singapore, Malaysia, India and Indonesia between 29 May 2020 and 13 July 2020. This survey collated demographic data and workplace conditions and included three validated questionnaires: the Safety Attitudes Questionnaire (SAQ), Oldenburg Burnout Inventory and Hospital Anxiety and Depression Scale. We performed multivariate mixed-model regression to assess independent associations with the SAQ total percentage agree rate (PAR).@*RESULTS@#We obtained 3,163 responses. The SAQ total PARs were found to be 35.7%, 15.0%, 51.0% and 3.3% among the respondents from Singapore, Malaysia, India and Indonesia, respectively. Burnout scores were highest among respondents from Indonesia and lowest among respondents from India (70.9%-85.4% vs. 56.3%-63.6%, respectively). Multivariate analyses revealed that meeting burnout and depression thresholds and shifts lasting ≥12 h were significantly associated with lower SAQ total PAR.@*CONCLUSION@#Addressing the factors contributing to high burnout and depression and placing strict limits on work hours per shift may contribute significantly towards improving safety culture among HCWs and should remain priorities during the pandemic.

The Positive Effect Of An Integrated Medical Response Protocol On The Knowledge, Attitude And Practice Of Medical Response During Flood Disaster Among Healthcare Providers In Kelantan: A Simulation-Based Randomized Controlled Trial

@#The Integrated Medical Response protocol (IMP) is a new protocol of medical response during the response phase of a flood disaster in Kelantan, Malaysia. It integrates response workflows of various rescue agencies involved in patient care during response phase of flood disaster. Traditionally, health care services in this region used either an all-hazard protocol or those not specific to Kelantan. The present study is aimed to test the effectiveness of IMP on knowledge, attitude and practice of healthcare providers (HCP) involved in managing patients during flood disaster in Kelantan. This study was a prospective parallel group, single blinded, randomized controlled trial. The unit of randomization was the district within Kelantan on a 1:1 basis into either the control or intervention group using cluster randomized method. The hospitals within the district were subsequently assigned to the allocated group. Investigators were blinded to the assignments. The knowledge, attitude and practice scores of HCP were assessed by FloodDMQ-BM© and was evaluated 2 weeks before and immediately after a flood disaster table-top exercise. Data was analyzed using two-way repeated measure ANOVA. Our findings showed that intervention was essential to improve the knowledge [F (1,100) = 6.947, p-value 0.010 (<0.05)] and attitude scores [F (1,100) = 31.56, p-value 0.001]. Meanwhile, practice score was improved in both control and intervention group with time [F (1,100) = 226.56, p-value 0.001]. Thus, our localized IMP specific to response phase of flood disaster was crucial to further enhance the knowledge and attitude levels among HCP while practice level showed similar improvement in both control and intervention group post table-top exercise.