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Research ArticleORIGINAL RESEARCH

Hospital-Based Health Care Worker Perceptions of Personal Risk Related to COVID-19

Everett Chu, Kyung-Min Lee, Ronnie Stotts, Ivy Benjenk, Geoffrey Ho, David Yamane, Billy Mullins and Eric R. Heinz
The Journal of the American Board of Family Medicine February 2021, 34 (Supplement) S103-S112; DOI: https://doi.org/10.3122/jabfm.2021.S1.200343
Everett Chu
the Department of Anesthesiology and Critical Care Medicine, George Washington School of Medicine & Health Sciences, Washington, DC (EC, RS, IY, GH, IB, DY, ERH); George Washington School of Medicine and Health Sciences, Washington, DC (K-ML); Department of Emergency Medicine, George Washington School of Medicine and Health Sciences, Washington, DC (DY); School of Nursing, George Washington University, Washington, DC (BM).
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Kyung-Min Lee
the Department of Anesthesiology and Critical Care Medicine, George Washington School of Medicine & Health Sciences, Washington, DC (EC, RS, IY, GH, IB, DY, ERH); George Washington School of Medicine and Health Sciences, Washington, DC (K-ML); Department of Emergency Medicine, George Washington School of Medicine and Health Sciences, Washington, DC (DY); School of Nursing, George Washington University, Washington, DC (BM).
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Ronnie Stotts
the Department of Anesthesiology and Critical Care Medicine, George Washington School of Medicine & Health Sciences, Washington, DC (EC, RS, IY, GH, IB, DY, ERH); George Washington School of Medicine and Health Sciences, Washington, DC (K-ML); Department of Emergency Medicine, George Washington School of Medicine and Health Sciences, Washington, DC (DY); School of Nursing, George Washington University, Washington, DC (BM).
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Ivy Benjenk
the Department of Anesthesiology and Critical Care Medicine, George Washington School of Medicine & Health Sciences, Washington, DC (EC, RS, IY, GH, IB, DY, ERH); George Washington School of Medicine and Health Sciences, Washington, DC (K-ML); Department of Emergency Medicine, George Washington School of Medicine and Health Sciences, Washington, DC (DY); School of Nursing, George Washington University, Washington, DC (BM).
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Geoffrey Ho
the Department of Anesthesiology and Critical Care Medicine, George Washington School of Medicine & Health Sciences, Washington, DC (EC, RS, IY, GH, IB, DY, ERH); George Washington School of Medicine and Health Sciences, Washington, DC (K-ML); Department of Emergency Medicine, George Washington School of Medicine and Health Sciences, Washington, DC (DY); School of Nursing, George Washington University, Washington, DC (BM).
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David Yamane
the Department of Anesthesiology and Critical Care Medicine, George Washington School of Medicine & Health Sciences, Washington, DC (EC, RS, IY, GH, IB, DY, ERH); George Washington School of Medicine and Health Sciences, Washington, DC (K-ML); Department of Emergency Medicine, George Washington School of Medicine and Health Sciences, Washington, DC (DY); School of Nursing, George Washington University, Washington, DC (BM).
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Billy Mullins
the Department of Anesthesiology and Critical Care Medicine, George Washington School of Medicine & Health Sciences, Washington, DC (EC, RS, IY, GH, IB, DY, ERH); George Washington School of Medicine and Health Sciences, Washington, DC (K-ML); Department of Emergency Medicine, George Washington School of Medicine and Health Sciences, Washington, DC (DY); School of Nursing, George Washington University, Washington, DC (BM).
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Eric R. Heinz
the Department of Anesthesiology and Critical Care Medicine, George Washington School of Medicine & Health Sciences, Washington, DC (EC, RS, IY, GH, IB, DY, ERH); George Washington School of Medicine and Health Sciences, Washington, DC (K-ML); Department of Emergency Medicine, George Washington School of Medicine and Health Sciences, Washington, DC (DY); School of Nursing, George Washington University, Washington, DC (BM).
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    Figure 1.

    Levels of altruism of health care workers during COVID-19 pandemic based on occupation.

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    Table 1.

    Demographic Characteristics, Occupational Chracteristics, and COVID-19 Exposure of Responders

    CategoriesTotal (n = 402) N (%)Medical Providers (n = 184)N (%)Registered Nurses (n = 218) N (%)P Value
    Sex
     Female308 (76.6%)110 (59.8%)198 (90.8%)<.001
     Male94 (23.4%)74 (40.2%)20 (9.2%)
    Age, y
     <30115 (28.6%)59 (32.1%)56 (25.7%)<.001
     30 to 39173 (43.0%)89 (48.4%)84 (38.5%)
     40 to 4954 (13.4%)24 (13.0%)30 (13.8%)
     50 to 5934 (8.5%)9 (4.9%)25 (11.5%)
    >5926 (6.5%)3 (1.6%)23 (10.5%)
    Ethnicity
     White, non-Hispanic236 (58.7%)116 (63.0%)120 (50.0%)<.001
     Black, non-Hispanic53 (13.2%)8 (4.4%)45 (20.6%)
     Hispanic14 (3.5%)6 (3.3%)8 (3.7%)
     Asian63 (15.7%)38 (20.6%)25 (11.5%)
     Other36 (9.0%)16 (8.7%)20 (9.2%)
    Specialty
     Emergency department44 (11.0%)12 (6.5%)32 (14.7%)<.001
     Intensive care unit61 (15.2%)29 (15.8%)32 (14.7%)
     Perioperative32 (8.0%)8 (4.4%)24 (11.0%)
     Surgery52 (12.9%)28 (15.2%)24 (11.0%)
     Medicine70 (17.4%)45 (24.5%)25 (11.5%)
     Psychiatry11 (2.7%)7 (3.8%)4 (1.8%)
     Women’s services50 (12.4%)13 (7.1%)37 (17.0%)
     Other82 (20.4%)42 (22.8%)40 (18.4%)
    Parent or primary caregiver for a school age child or younger106 (26.4%)44 (23.9%)62 (28.4%).31
    Primary caregiver or live with someone > 80 years old6 (1.4%)0 (0.0%)6 (2.8%).02
    Cared for a patient with diagnosed or suspected COVID-19265 (65.9%)127 (69.0%)138 (63.3%).23
    Has a friend/close relative who contracted COVID-19149 (37.0%)68 (37.0%)81 (37.2%).97
    Has been in quarantine for potential COVID-19 exposure51 (12.7%)22 (12.0%)29 (13.3%).69
    • Although both clinical and non-clinical staff were surveyed, only responses from medical providers (attending physicians, residents, nurse practitioners and physician assistants) and registered nurses were included in analysis.

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    Table 2.

    Stress Factors of Medical Providers Compared to Registered Nurses

    CategoryAll Responses(n = 402) N (%)Medical Providers (n = 184)N (%)Registered Nurses(n = 218)N (%)P Value
    My job is putting me at great risk.284 (70.6%)138 (75.0%)146 (67.0%).08
    I feel extra stress at work.318 (79.1%)142 (77.2%)176 (80.7%).38
    I am afraid of falling ill with COVID-19.290 (72.1%)132 (71.7%)158 (72.5%).87
    I have little control over whether I get infected or not.227 (56.5%)109 (59.2%)118 (54.2%).30
    I am unlikely to survive if I were to get COVID-19.35 (8.7%)6 (3.3%)29 (13.3%)<.001
    I think about resigning because of COVID-19.58 (14.4%)11 (6.0%)47 (21.6 %)<.001
    I am afraid I will pass COVID-19 on to others.342 (95.1%)164 (89.1%)178 (81.6%).04
    My family and friends are worried they might get infected through me.264 (65.7%)117 (63.6%)147 (67.4%).51
    People avoid my family because of my work.134 (33.3%)46 (25.0%)88 (40.4%).001
    Altruism: Because I want to help the COVID-19 patients, I am willing to accept the risks involved.267 (63.4%)147 (79.9%)120 (55.0%)<.001
    • Survey responses were dichotomized to include “agreed” or “strongly agreed” as positive responses. This table shows the frequency of positive responses for each category while also comparing the differences in responses between medical providers and nurses.

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    Table 3.

    Multivariable Linear Regression Model Regressing for Thoughts about Resigning Due to COVID-19 Based on Occupation

    Categories(reference group)Odds Ratio (SE)95% CIP Value
    Occupation (Reference: Medical providers)
     Nurse3.87 (1.63)1.69, 8.84.001
    Age, y (Reference: <30)
     30 to 391.12 (0.48)0.48, 2.59.80
     40 to 490.34 (0.22)0.09, 1.21.10
     50 to 590.88 (0.57)0.25, 3.13.85
     >602.30 (1.41)0.69, 7.68.18
    Gender (Reference: Male)
     Female1.47 (0.77)0.53, 4.09.46
    Race (Reference: White, non-Hispanic)
     Black, non-Hispanic0.76 (0.40)0.27, 2.13.60
     Hispanic4.86 (3.58)1.15, 20.62.032
     Asian1.49 (0.71)0.58, 3.81.41
     Other1.77 (0.89)0.66, 4.72.26
    Specialty (Reference: Emergency department)
     Intensive care unit2.14 (1.38)0.61, 7.58.24
     Perioperative2.78 (2.10)0.63, 12.24.18
     Surgery0.78 (0.64)0.15, 3.93.76
     Medicine1.88 (1.31)0.48, 7.34.36
     Psychiatry0.83 (1.11)0.06, 11.33.89
     Women’s services2.31 (1.59)0.60, 8.89.22
     Other1.78 (1.16)0.50, 6.36.37
    Parent or primary caregiver for a school age child or younger0.55 (0.21)0.26, 1.15.11
    Primary caregiver or live with someone > 80 years old0.34 (0.35)0.05, 2.490.29
    Cared for a patient with diagnosed or suspected COVID-191.35 (0.52)0.63, 2.880.44
    Has a friend/close relative who contracted COVID-190.45 (0.15)0.23, 0.850.015
    Has been in quarantine for potential COVID-19 exposure0.32 (0.13)0.14, 0.730.006
    Constant1.37 (2.44)0.04, 45.480.86
    • SE, standard error; CI, confidence interval.

    • After controlling for demographic and COVID-related characteristics, analysis showed that nursing staff had greater odds of considering resignation, those who had a friend or close relative who contracted COVID-19 and those who had been in quarantine had lower odds of considering resignation with a Pseudo R2 of 0.1809.

  • Please Respond to the Following Set of Questions by Responding Yes or No

    YesNo
    Are you a parent or primary caregiver for school-aged child or younger
    Are you a primary caregiver for or lives with a person over age of 80
    Have you cared for a patient with diagnosed or suspected COVID-19?
    Do you have any friends/close relative that have contracted COVID-19?
    Have you been in quarantine for a potential exposure to COVID-19?
  • Please Select How Much You Agree or Disagree with the Following Statements

    Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
    My job is putting me at great risk.
    I feel extra stress at work.
    I am afraid of falling ill with COVID-19.
    I have little control over whether I get infected or not.
    I am unlikely to survive if I were to get COVID-19.
    I think about resigning because of COVID-19.
    I am afraid I will pass COVID-19 on to others.
    My family and friends are worried they might get infected through me.
    People avoid my family because of my work
    Because I want to help the COVID-19 patients, I am willing to accept the risks involved.
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The Journal of the American Board of Family  Medicine: 34 (Supplement)
The Journal of the American Board of Family Medicine
Vol. 34, Issue Supplement
February 2021
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Hospital-Based Health Care Worker Perceptions of Personal Risk Related to COVID-19
Everett Chu, Kyung-Min Lee, Ronnie Stotts, Ivy Benjenk, Geoffrey Ho, David Yamane, Billy Mullins, Eric R. Heinz
The Journal of the American Board of Family Medicine Feb 2021, 34 (Supplement) S103-S112; DOI: 10.3122/jabfm.2021.S1.200343

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Hospital-Based Health Care Worker Perceptions of Personal Risk Related to COVID-19
Everett Chu, Kyung-Min Lee, Ronnie Stotts, Ivy Benjenk, Geoffrey Ho, David Yamane, Billy Mullins, Eric R. Heinz
The Journal of the American Board of Family Medicine Feb 2021, 34 (Supplement) S103-S112; DOI: 10.3122/jabfm.2021.S1.200343
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