ABSTRACT
This study aimed to analyze stressors to which medical staff is vulnerable due to the coronavirus disease 2019 (COVID-19) pandemic. It also imposes a hierarchy on complex relations among stressors for excavating underlying structure and builds a model of interrelationships contrasting reality. The design of this study comprises a literature survey, data collection from primary sources, and analysis. Stressors have been explored from within current published/unpublished literature and validated by experts through approval vote. Data were collected from the focus group (panel of experts), and interpretive structural modeling (ISM) was used as the research methodology. Findings of ISM are avowed through "cross-impact matrix multiplication applied to classification" (MICMAC) analysis. As a result of the literature survey, a list of stressors was generated, and a total of 19 stressors qualified as representative of the phenomenon. The results of ISM show that two stressors (i.e., "unavailability of proper personal protective equipment (PPE)" and "lack of proper communication") emerged as the most critical stressors since they occupy the bottom of the model, whereas, four stressors (i.e., "anxious about isolation/quarantine," "subject to violent crimes," "feeling frustrated and powerless," and "exhausting shifts/hours without clear end") are relatively less critical since they occupy the top of the model. The rest of the stressors occupy the middle of the model and therefore, have moderate-severe effects on frontline soldiers. The results of MICMAC show that the stressor "subject to violent crimes" is classified in the dependent cluster and the remaining fall in the linkage cluster but no stressor falls in independent and autonomous. Overall results indicate that all stressors are relevant to the phenomenon under this study, but they are currently not settled. This study is invaluable for policymakers, frontline soldiers, researchers, the international community, and society since it provides a lot of new information that is helpful in refining strategies and combating influential stressors.
ABSTRACT
The study is aimed to analyze the determinants of the effectiveness of SOPs in mass gatherings for containing COVID-19. The overall design of the study involves a literature review, data collection by field survey, structural modeling, and analysis. The study is built on the experts' opinion of a focus group (representing people who recently participated in and are responsible for mass gatherings). The study uses the discussion of the literature review to identify the determinants, interpretive structural modeling (ISM) for developing and analyzing a structural model, and Matrice d'Impacts Croises Multiplication Appliquée a un Classement (MICMAC) for corroboration of results of the ISM/classification of determinants. From the literature review, a list of determinants is generated and verified by a panel of experts. The results of the ISM revealed that the determinants "legal environment of the country," "practicability of SOPs," "perceived benefit of adapting SOPs," and "possibilities of avoiding gathering" occupied the top of the model, therefore, they are less critical determinants, whereas "nature of gathering" occupied the bottom of the model, and is thus the most critical determinant. The remaining determinants form the middle of the model, and are therefore moderately severe. The results of MICMAC show that the determinant "perceived benefit of adapting SOPs" is dependent, "nature of gathering" is independent, and all others are linked. The results of MICMAC implicitly substantiate the findings of the ISM. The overall results of the study show that "nature of gathering" is the key determinant. This research does not require a priori theory since it is a theory-building study that uses an inductive approach. It is based on real data and it is useful for local authorities, organizers, participants (attendees/visitors) of mass gatherings, health officials/regulators, researchers, and the community at large. This study has fundamental importance for planning and preparing for such events while ensuring the minimum risk of COVID-19 transmission.