COVID-19 Risk Perceptions Among Healthcare Workers During Early "New Behavior Norms" Phase
COVID-19 Risk Perceptions Among Healthcare Workers During Early "New Behavior Norms" Phase
COVID-19 Risk Perceptions Among Healthcare Workers During Early "New Behavior Norms" Phase
Corresponding Author:
Lolita Lolita
Faculty of Pharmacy, Universitas Ahmad Dahlan
Prof Dr Soepomo Warungboto Umbulharjo, Yogyakarta, Indonesia
Email: [email protected]; [email protected]
1. INTRODUCTION
The novel coronavirus of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing
coronavirus diseases 2019 (COVID-19) has been established as a global health crisis that affected 216
countries of the globe. This virus has rapidly spread to almost all nations, including Indonesia [1]. Indonesia
first announced the COVID-19 infection in early March 2020. Within one month, the number of infected
people had surpassed nearly 3,000 with an 8% of case fatality rate. Based on data compiled by Indonesian
Health Authorities, there are more than 3.5 million confirmed cases of COVID-19 in the 34 provinces. The
significant jump in the number of confirmed COVID-19 positive cases has been followed by a substantial
death rate risk [2]. As of June 2020, the Indonesian government presented a “new behavior norms” by
liberalized several large scale social restrictions policy to encourage economic, social dan public activities
recovery. The implementation of “new behavior norms” provides high public awareness to implement the
health protocols when carrying out their normal activities [3].
Many healthcare professionals are at the forefront of an ongoing struggle against the pandemic. They face
enormous challenges in providing emergency health care services under extreme pressure [4]. Therefore, they have
become at a much greater risk of COVID-19 exposure and might be exposed to significant worsening mental
health [5]. A previous study found that depression among health workers was relatively high [6]. Similarly, a study
of healthcare workers in Portugal also noted that almost 50% of them are highly vulnerable to getting COVID-19
infection [7]. Most of them expressed fear of contracting COVID-19 while working in health services.
According to the Indonesian Medical Association, there has been an increase in the number of
COVID-19-related deaths among Indonesian health workers. As of June 2020, 974 health care workers had died
as a result of COVID-19; the majority (374 cases) were physicians and nurses (311 cases) [8]. The lack of
supply of personal protective equipment (PPE) and inadequate basic training regarding infection control are
taking healthcare personnel at greater risk of acquiring the COVID-19 [6]. In addition, dishonest patients in
providing healthcare professionals information could be deemed a great challenge in dealing with the pandemic
[9]. According to reported cases, many healthcare workers were at high risk of infection during the ongoing
COVID-19 pandemic, owing to their close contact with patients and/or potentially infectious co-workers [10].
Risk perception is a major driving factor to elicit individual health behavior in response to the
pandemic. Notably, the effectiveness of COVID-19 response strategies will depend upon personal behavior and
adherence to COVID-19 preventive measures [11]. Inadequate related knowledge and risk perception among
healthcare workers could increase the infection rates caused by delayed therapeutic management of COVID-19
[12]. Understanding the critical factors that influence healthcare workers' risk perception is vital for helping
navigate their response in the face of a pandemic [13]. To the best of our knowledge, this is the first study
investigating risk perception and its associated factor among Indonesian healthcare workers during the early
phase of the new normal-era. Therefore, understanding their COVID-19 risk perception might provide valuable
insights to develop more effective risk communications strategies in pandemic prevention and control.
2. RESEARCH METHOD
2.1. Study design and data collection
This study has been approved by the Research Ethics Committee of Aisyiyah University (reference
number: 1305/KEP-UNISA/IV/2020). All participants have been informed about the study purpose and the
confidential data detailed on the first page of the online survey. The study was proceeded after obtaining the
informed consent and agreement from each participant. A cross-sectional analysis study was designed to
examine the risk perception of COVID-19 and its associated factor among Indonesian healthcare
professionals. We conducted an online survey questionnaire shared through the social media platforms during
the early phase of “new behavior norms” implementation from April to July 2020. The sampling technique was
used with non-probability sampling technique, namely convenience sampling. The respondents were identified
and chosen from the population based on the relative ease of access to the researchers. The eligibility criteria
included healthcare professionals over the age of 17 years and residing in Indonesia. We excluded the
participants who did not fill the whole questionnaire and foreign healthcare workers living in Indonesia.
COVID-19 risk perceptions among healthcare workers during early … (Lolita Lolita)
354 ISSN: 2252-8806
health status, quarantine condition, chronic illness history, smoking history, supplement use, and availability
of personal protective equipment (PPE) during the pandemic. In comparison, the dependent variable was risk
perception of COVID-19 in three categories: perceived severity, perceived vulnerability, and perceived
threat. The data was tested using the Kolmogorov-Smirnov to examine the normal distribution between
variables. The Kruskal-Wallis/Mann Whitney U bivariate analysis was performed to determine the
relationship between sociodemographic characteristics towards risk perception dimensions and efficacy
beliefs. The Spearman correlation test was carried out to identify the association of sociodemographic factors
with risk perception of COVID-19. A significance level of 5% was considered statistically significant.
3.1. Demographic
Table 1 describes that majority of respondents were female (75.8%), adult (72.6%), and had a higher
education (96.8%). Most of the participants in this study were health workers who had a healthy condition
(83.9%), consumed supplements routinely (82.3%), and still worked in health services every day (58.5%).
Int J Public Health Sci, Vol. 11, No. 1, March 2022: 352-358
Int J Public Health Sci ISSN: 2252-8806 355
Risk perception has long been recognized as a critical concept in encouraging healthy behaviors.
Managing public health risks during the COVID-19 pandemic depended on the public's ability to assess their
potential risks [29]. COVID-19 pandemic awareness was processed according to each individual's risk
Int J Public Health Sci, Vol. 11, No. 1, March 2022: 352-358
Int J Public Health Sci ISSN: 2252-8806 357
perception [30]. Therefore, it is important to understand the impact of numerous factors on COVID-19 risk
perception. A high level of risk perception among healthcare workers will increase their awareness in
implementing protective behaviors to contribute significantly to COVID-19 prevention and control [31].
4. CONCLUSION
Healthcare workers are at disproportionate risk of contracting COVID-19. Evaluating the risk perception
and its associated factors is vital in identifying healthcare workers' protective action in handling the pandemic.
This study identified healthcare workers with a high level of COVID-19 risk perception during the early phase
of new normal behavior. Age and health status are significantly correlated with the COVID-19 risk perception.
Therefore, comprehensive risk communication, professional training, and great support should be implemented
to strengthen the pandemic management strategies in the healthcare workforce setting.
This study has several limitations, including the sample being less representative of the Indonesian
healthcare workers population. It is more likely that better results will be obtained from a larger sample size.
Moreover, the cross-sectional study methodology could only illustrate relationships between patterns and
social-demographic factors; no causal relationship exists. A further cohort-based study design should be
proposed to measure changes in COVID-19 risk perception across time. Therefore, this study should be
considered a preliminary study as such, and the findings can be used to help improve risk communication and
epidemic control education in the future pandemic.
Despite these limitations, our present findings might be expected to enhance risk perception, promote
preventive actions, and initiate online sessions to assist healthcare professionals in comprehending existing
standards and protecting themselves from COVID-19 infection. Targeted risk communication with relevant
channels should be considered for these frontline groups to improve their risk awareness and safety actions.
REFERENCES
[1] Z. Xu et al., “Pathological findings of COVID-19 associated with acute respiratory distress syndrome,” The Lancet. Respiratory
medicine, vol. 8, no. 4. pp. 420–422, Apr. 2020, doi: 10.1016/S2213-2600(20)30076-X.
[2] WHO Indonesia, “Coronavirus disease 2019 (COVID-19) situation report-18,” World Heal. Organ, 2020.
[3] H. Andriani, S.Si, Apt, M.Sc, Ph.D, “Effectiveness of large-scale social restrictions (PSBB) toward the New Normal Era during
COVID-19 outbreak: a mini policy review,” J. Indones. Heal. Policy Adm., vol. 5, no. 2, pp. 61–65, 2020, doi:
10.7454/ihpa.v5i2.4001.
[4] Q. Liu et al., “The experiences of health-care providers during the COVID-19 crisis in China: a qualitative study,” Lancet Glob.
Heal., vol. 8, no. 6, pp. e790–e798, 2020, doi: 10.1016/S2214-109X(20)30204-7.
[5] L. Kang et al., “The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus.,” The lancet.
Psychiatry, vol. 7, no. 3. p. e14, Mar. 2020, doi: 10.1016/S2215-0366(20)30047-X.
[6] S. C. Lam et al., “Perceived risk and protection from infection and depressive symptoms among healthcare workers in Mainland
China and Hong Kong During COVID-19,” Frontiers in Psychiatry, vol. 11. p. 686, 2020.
[7] D. Peres, J. Monteiro, M. Almeida, and R. Ladeira, “Risk perception of COVID-19 among the portuguese healthcare
professionals and general population,” J. Hosp. Infect., vol. 105, no. 3, pp. 434–437, May 2020, doi: 10.1016/j.jhin.2020.05.038.
[8] WHO Indonesia, “Coronavirus disease 2019 (COVID-19) situation report-60,” World Heal. Organ, 2020. .
[9] Y. Zolkefli, “Be honest: individuals’ moral responsibility within the COVID-19 context,” Malaysian J. Med. Sci., vol. 27, no. 6,
pp. 144–147, 2020, doi: 10.21315/mjms2020.27.6.13.
[10] A. Soebandrio et al., “COVID-19 prevalence among healthcare workers in Jakarta and neighbouring areas in Indonesia during
early 2020 pandemic,” Ann. Med., vol. 53, no. 1, pp. 1896–1904, Jan. 2021, doi: 10.1080/07853890.2021.1975309.
[11] S. Girma, L. Agenagnew, G. Beressa, Y. Tesfaye, and A. Alenko, “Risk perception and precautionary health behavior toward
COVID-19 among health professionals working in selected public university hospitals in Ethiopia,” PLoS One, vol. 15, no. 10, p.
e0241101, 2020, doi: 10.1371/journal.pone.0241101.
[12] A. S. Bhagavathula, W. A. Aldhaleei, J. Rahmani, M. A. Mahabadi, and D. K. Bandari, “Knowledge and Perceptions of
COVID-19 Among Health Care Workers: Cross-Sectional Study,” JMIR Public Heal. Surveill., vol. 6, no. 2, p. e19160, Apr.
2020, doi: 10.2196/19160.
[13] J. Jacobs, M. Taylor, K. Agho, G. Stevens, M. Barr, and B. Raphael, “Factors associated with increased risk perception of
pandemic influenza in australia,” Influenza Res. Treat., vol. 2010, p. 947906, 2010, doi: 10.1155/2010/947906.
[14] R. O. Nanda et al., “COVID-19 risk perception among Indonesians in early stage of the outbreak,” Int. J. Public Heal. Sci., vol.
10, no. 2, pp. 249–257, 2021, doi: 10.11591/ijphs.v10i2.20678.
[15] R. O. Nanda, L. Lolita, W. Indayati, I. Rusdiyanti, A. Ikhsanudin, and S. Mareti, “Knowledge, precautionary actions, and
perceived risk of COVID-19 among indonesian people,” International Journal Public Health Science (IJPHS), vol. 10, no. 1, pp.
COVID-19 risk perceptions among healthcare workers during early … (Lolita Lolita)
358 ISSN: 2252-8806
BIOGRAPHIES OF AUTHORS
Int J Public Health Sci, Vol. 11, No. 1, March 2022: 352-358