Study On Core Emergency Response Competences For Epidemics Of Infectious Diseases And Its Influencing Factors Among Primary Medical Workers In Shandong Province

BackgroundPrimary medical workers refer to the health technicians,including practicing physicians or assistant physicians,nurses and medical technicians in primary healthcare institutions,and are the human resources guarantee for primary healthcare institutions to play the fundamental role in responding to public health emergencies.The COVID19 pandemic has exposed the flaw in the emergency response competences to public health emergencies among the primary medical workers in China.They still have weaknesses in the early monitoring of and the knowledge and skills relevant to public health emergencies.The epidemics of infectious diseases is not only the main type of public health emergencies in China,but also has the characteristics of rapid transmission,wide range of infection,and great difficulty in prevention and control.Improving the emergency response competences to the epidemic of infectious diseases is the key to improve the response capacity to public health emergencies.Therefore,it is of great significance to carry out research on the core response capacity and influencing factors of the infectious disease epidemic among primary medical workers during the normalization period of the pandemic for building high-quality primary health emergency teams and promoting the fundamental role of primary healthcare institutions.ObjectiveThis study aimed to explore the current situation and influencing factors of the core emergency response competences for epidemics of infectious diseases among the primary medical workers during the normalization period of pandemic,found out the deficiencies of the core emergency response capacity,and thus provide policy recommendations for the training and construction of grassroots primary health emergency teams in Shandong Province.MethodsThis survey was conducted between July and August in 2022.Study participants included the primary medical workers in community healthcare centers and township hospitals in Shandong Province.Using a multi-stage stratified sampling method,a total of 458 primary medical workers was selected from 20 primary healthcare institutions in 10 districts and counties.Literature research method was used to summarize and sort out the relevant studies on the emergency response capacity at home and abroad and questionnaire survey was conducted to understand the current situation of the core emergency response capacity of the participants.Demographic characteristics,occupational features,as well as training and drilling experience were collected through self-designed questionnaires.The core emergency response competences for epidemics of infectious diseases was evaluated by "the core response competence index system for infectious disease emergencies" designed by Kan et al.Work engagement was rated by the short version of Utrecht Work Engagement Scale(UWES-9).Psychological resilience was assessed by the short version of Connor Davidson Resilience Scale(CDRISC-10).One-way Analysis of Variation(ANOVA)and chi square test were used to compare the difference in emergency response capability among different participants.Multinomial logistic regression analysis was conducted to examine the influencing factors of emergency response capability.All the data analysis was completed with Stata 15.0 and the statistical significance was set at p≤0.05.ResultsA total of 460 electronic questionnaires were distributed in this study,including 458 valid ones,with an effective rate of 99.5%.Participants were predominantly female(69.0%),with the average age of 35.99±9.01 years.The average score of the core emergency response competence was 150.88±32.40,with a mean scoring rate of 79.41%.The scoring rate of emergency prevention competence was the highest,reaching 79.81%,and the scoring rate of emergency preparedness competence was the lowest,reaching 78.16%.As for the score of each item,the score of "knowledge related to the transmission process of infectious diseases" is the highest,while the score of"knowledge related to the infection spectrum of infectious diseases" is the lowest in the emergency prevention competence.In the emergency preparedness competence,"the knowledge of National Contingency Planningfor Public Health Emergencies" and "the knowledge of National Contingency Planning for Medical Rescue in Public Health Emergencies" scored higher,while "the knowledge of Law of the People’s Republic of China on the Prevention and Treatment of Infectious Diseases" and "the knowledge of Regulation on Responses to Public Health Emergencies" scored lower.In the emergency rescue competence,the skills of hand hygiene,medical waste disposal,wearing and taking off protective equipment scored higher,while the scores of participating in international rescue and responding to biological terrorist attacks were lower.The result of the univariate analysis showed that there were statistically significant differences in the core emergency response ability among the participants with different gender,age,educational level,major,self-assessment health status,social insurance,weekly working hours,emergency rescue experience on infectious diseases,training on infectious diseases,drilling on infectious diseases,and psychological resilience.The result of the multinomial logistic regression analysis showed that the gender(OR=0.29,95%CI:0.09-0.93 for the high level of emergency response capacity),age(OR=0.14,95%CI:0.03-0.59 for the medium level;OR=0.05,95CI:0.01-0.25 for the high level),educational level(OR=4.68,95%CI:1.70-12.88 for the medium level;OR=4.89,95%CI:1.69-14.13 for the high level),major(OR=0.31,95%CI:0.11-0.90 for the medium level;OR= 0.19,95%CI:0.06-0.58 for the high level),health status(OR=4.68,95%CI:1.36-16.08 for the medium level),weekly working hours(OR=6.58,95%CI:1.16-37.34 for the medium level),training on infectious diseases(OR=3.44,95%CI:1.03-11.49 for the high level),and psychological resilience(OR=1.12,95%CI:1.04-1.21 for the medium level;OR=1.36,95%CI:1.26-1.48 for the high level)were significantly associated with the core emergency response competence among the primary medical workers.Conclusions and SuggestionsThe core emergency response competences for epidemics of infectious diseases was at a medium level among the primary medical workers in Shandong Province,but the emergency preparedness competence needed to be improved,especially in the knowledge of laws and regulations for public health emergencies.Female,aging between 26 and 34 years old,low educational level,non-clinical medicine majors,poor health,weekly working hours between 51 and 59,no infectious disease training experience,and poor psychological resilience exerted negative effects on the core emergency response competences for epidemics of infectious diseases.Based on the above conclusions,the following suggestions were put forward.Firstly,focusing on the weakness of the emergency response capacities for epidemics of infectious diseases among primary medical workers.Secondly,emphasizing the improvement of emergency response capacities among female primary medical workers and those in the age group of marriage and childrearing.Thirdly,improving the educational level of primary medical workers and optimizing the professional composition of primary health emergency teams.Fourthly,enhancing the training on infectious diseases and improving its effect.Fifthly,paying attention to the health status and improving the psychological resilience of primary medical workers.