Abstract
Background
Federal, provincial and municipal leaders in Canada have adopted a culture of preparedness with the development and update of emergency plans in anticipation of different types of disasters. As evident during the 2003 global outbreak of Severe Acute Respiratory Syndrome (SARS), it is important to provide support for health care workers (HCWs) who are vulnerable during infectious outbreak scenarios. Here we focus on the identification and evaluation of existing support mechanisms incorporated within emergency plans across various jurisdictional levels.
Methods
Qualitative content analysis of 12 emergency plans from national, provincial and municipal levels were conducted using NVIVOTM software. The plans were scanned and coded according to 1) informational, 2) instrumental, and 3) emotional support mechanisms for HCWs and other first responders.
Results
Emergency plans were comprised of a predominance of informational and instrumental supports, yet few emotional or social support mechanisms. All the plans lacked gender-based analysis of how infectious disease outbreaks impact male and female HCWs differently. Acknowledgement of the need for emotional supports was evident at higher jurisdictional levels, but recommended for implementation locally.
Conclusions
While support mechanisms for HCWs are included in this sample of emergency plans, content analysis revealed few emotional or social supports planned for critical personnel; particularly for those who will be required to work in extremely stressful conditions under significant personal risk. The implications of transferring responsibilities for support to local and institutional jurisdictions are discussed.
Résumé
Contexte
Les dirigeants fédéraux, provinciaux et municipaux du Canada ont adopté une culture de préparation à diverses catastrophes en élaborant et en actualisant des plans d’urgence. Comme on l’a constaté en 2003 pendant la flambée mondiale de syndrome respiratoire aigu sévère (SRAS), il est important d’offrir de l’aide aux travailleurs de la santé qui seraient vulnérables en cas d’épidémie. Le présent article porte sur le repérage et l’évaluation des mécanismes de soutien déjà intégrés dans les plans d’urgence aux trois ordres de gouvernement.
Méthode
Nous avons procédé à l’analyse qualitative du contenu de 12 plans d’urgence nationaux, provinciaux et municipaux à l’aide du logiciel NVIVOMD. Les plans ont été numérisés par balayage et codés en fonction de leurs mécanismes de soutien 1) informationnel, 2) instrumental et 3) affectif aux travailleurs de la santé et autres secouristes opérationnels.
Résultats
Les plans d’urgence comprenaient surtout des mécanismes de soutien informationnel et instrumental, mais peu de mécanismes de soutien affectif ou social. Aucun plan ne comportait d’analyse sexospécifique de l’incidence des flambées de maladies infectieuses sur le personnel masculin et féminin. Le besoin de mesures de soutien affectif était pris en compte par les administrations fédérale et provinciales, mais on en recommandait l’instauration à l’échelle locale.
Conclusion
Des mécanismes de soutien des travailleurs de la santé figurent dans l’échantillon de plans d’urgence étudié, mais l’analyse de leur contenu montre que l’on ne prévoit pas assez de mesures de soutien affectif ou social pour le personnel essentiel, particulièrement les employés qui devront travailler dans des situations extrêmement tendues et prendre des risques considérables pour leur propre santé. Nous présentons aussi les conséquences d’un transfert des responsabilités de soutien aux administrations municipales et à celles des établissements.
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Acknowledgements: The authors gratefully acknowledge the funding support of the Canadian Chemical, Biological, Radiological and Nuclear Research Technology Initiative (CRTI), Defence Research and Development Canada. Special thanks to our colleagues Lynn McCrann, Heather Smith Fowler, Bob Clarke, Daniel Krewski, Louise Lemyre, and Eileen O’Connor, from the research team for the project titled: Caring About Healthcare Workers As First Responders. Thank you also to several project partners, including the Bureau for Women’s Health and Gender Analysis, Health Canada; the Canadian Federation of Nurses Unions; Victorian Order of Nurses; and the Canadian Women’s Health Network.
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O’sullivan, T.L., Amaratunga, C.A., Hardt, J. et al. Are We Ready? Evidence of Support Mechanisms for Canadian Health Care Workers in Multi-jurisdictional Emergency Planning. Can J Public Health 98, 358–363 (2007). https://doi.org/10.1007/BF03405419
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DOI: https://doi.org/10.1007/BF03405419