Health workers’ perception vs medically approved COVID-19 infection risk: the risk communication gap

Abstract Background This study analyses how healthcare workers (HCWs) perceived risks, protection and preventive measures during the COVID-19 pandemic in relation to medically approved risks and organisational measures. We aim to explore ‘blind spots’ of pandemic protection and identify mental health needs. Methods A German multi-method hospital study at Hannover Medical School serves as an ‘optimal-case’ scenario of a high-income country, well-resourced hospital sector and an organisation with low HCW infection rate serves to explore governance gaps in HCW protection. Document analysis, expert information and survey data (n = 1163) were collected as part of a clinical study into SARS-CoV-2 serology testing during the second wave of the pandemic (November 2020-February 2021). Selected survey items included perceptions of risks, protection and preventive measures. Descriptive statistical analysis and regression were undertaken for gender, profession and COVID-19 patient care. Results Our study reveals a low risk of 1% medically approved infections among participants, but a much higher mean personal risk estimate of 15%. The majority (68.4%) expressed ‘some’ to ‘very strong’ fear of acquiring infection at the workplace. Individual protective behaviour and compliance with protective workplace measures were estimated as very high. Yet only about half of the respondents felt strongly protected by the employer; 12% even perceived ‘no’ or ‘little’ protection. Gender and contact with COVID-19 patients had no significant effect on the estimations of infection risks and protective workplace behaviour, but nursing was correlated with higher levels of personal risk estimations and fear of infection. Conclusions A strong mismatch between low medically approved risk and personal risk perceptions of HCWs brings stressors and threats into view, that may be preventable through improved information, risk communication and inclusion of mental health support in pandemic preparedness. Key messages • Healthcare workers’ perceptions of COVID-19 infection risks are much higher than medically approved infection risk. • Pandemic preparedness and protection plans must pay greater attention to information, risk communication and mental health needs.


Background:
This study analyses how healthcare workers (HCWs) perceived risks, protection and preventive measures during the COVID-19 pandemic in relation to medically approved risks and organisational measures. We aim to explore 'blind spots' of pandemic protection and identify mental health needs.

Methods:
A German multi-method hospital study at Hannover Medical School serves as an 'optimal-case' scenario of a high-income country, well-resourced hospital sector and an organisation with low HCW infection rate serves to explore governance gaps in HCW protection. Document analysis, expert information and survey data (n = 1163) were collected as part of a clinical study into SARS-CoV-2 serology testing during the second wave of the pandemic (November 2020-February 2021). Selected survey items included perceptions of risks, protection and preventive measures. Descriptive statistical analysis and regression were undertaken for gender, profession and COVID-19 patient care.

Results:
Our study reveals a low risk of 1% medically approved infections among participants, but a much higher mean personal risk estimate of 15%. The majority (68.4%) expressed 'some' to 'very strong' fear of acquiring infection at the workplace. Individual protective behaviour and compliance with protective workplace measures were estimated as very high. Yet only about half of the respondents felt strongly protected by the employer; 12% even perceived 'no' or 'little' protection. Gender and contact with COVID-19 patients had no significant effect on the estimations of infection risks and protective workplace behaviour, but nursing was correlated with higher levels of personal risk estimations and fear of infection.

Conclusions:
A strong mismatch between low medically approved risk and personal risk perceptions of HCWs brings stressors and threats into view, that may be preventable through improved information, risk communication and inclusion of mental health support in pandemic preparedness. Key messages: Healthcare workers' perceptions of COVID-19 infection risks are much higher than medically approved infection risk. Pandemic preparedness and protection plans must pay greater attention to information, risk communication and mental health needs.

Background:
Conflictual interactions with patients' relatives are prevalent in the work of hospital nurses. These situations may increase burnout and result in intentions to leave the nursing profession and high rates of turnover. It is important to understand the coping mechanisms and behaviours that nurses employ in such conflicts, to help them develop more adequate strategies that could prevent these outcomes. This study aimed at revealing how nurses' attachment styles colour their behavioural coping mechanisms when dealing with such interactions with patients' relatives, and how they are related to burnout and intentions to leave the profession.

Methods:
An online survey was completed by 140 hospital nurses that included three scenarios of typical conflicts with patients' relatives. Each scenario was followed by questions that assess stress and inadequacy when handling such situations, and behaviours: problem-solving responses, emotional support seeking, avoidance, and escalating responses. The survey also included self-reports of attachment styles, burnout, and intentions to leave nursing. Data were analysed using SEM (Amos 23).

Results:
The model shows an acceptable fit (2(24) = 39.33, p = .025; CFI = .963; RMSEA = .068). Higher anxious attachment was associated with higher stress and feelings of inadequacy in handling the situation, which in turn were associated with more emotional support seeking, avoidance, and escalating responses. Escalating responses were indirectly associated with intentions to leave the nursing profession via higher burnout. Higher avoidant attachment was associated with fewer problem-solving responses.

Conclusions:
Evaluating nurses' attachment style, cognitions, and behaviours in conflicts with patients' relatives is imperative for iii74 European Journal of Public Health, Volume 32 Supplement 3, 2022