title: Hospital Employee Willingness to Work during Earthquakes Versus Pandemics.
abstract: BACKGROUND
  Research indicates that licensed health care workers are less willing to work during a pandemic and that the willingness of nonlicensed staff to work has had limited assessment.
  
  
  OBJECTIVE
  We sought to assess and compare the willingness to work in all hospital workers during pandemics and earthquakes.
  
  
  METHODS
  An online survey was distributed to Missouri hospital employees. Participants were presented with 2 disaster scenarios (pandemic influenza and earthquake); willingness, ability, and barriers to work were measured. T tests compared willingness to work during a pandemic vs. an earthquake. Multivariate linear regression analyses were conducted to describe factors associated with a higher willingness to work.
  
  
  RESULTS
  One thousand eight hundred twenty-two employees participated (15% response rate). More willingness to work was reported for an earthquake than a pandemic (93.3% vs. 84.8%; t = 17.1; p < 0.001). Significantly fewer respondents reported the ability to work during a pandemic (83.5%; t = 17.1; p < 0.001) or an earthquake (89.8%; t = 13.3; p < 0.001) compared to their willingness to work. From multivariate linear regression, factors associated with pandemic willingness to work were as follows: 1) no children ≤3 years of age; 2) older children; 3) working full-time; 4) less concern for family; 5) less fear of job loss; and 6) vaccine availability. Earthquake willingness factors included: 1) not having children with special needs and 2) not working a different role.
  
  
  CONCLUSIONS
  Improving care for dependent family members, worker protection, cross training, and job importance education may increase willingness to work during disasters.
authors.affiliation: Division of Emergency Medicine, Department of Pediatrics, Saint Louis University, Saint Louis, Missouri.
authors.forename: Rachel L
authors.initials: RL
authors.lastname: Charney
authors.affiliation: Institute for Biosecurity, College for Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri.
authors.forename: Terri
authors.initials: T
authors.lastname: Rebmann
authors.affiliation: Division of Emergency Medicine, Department of Pediatrics, Saint Louis University, Saint Louis, Missouri.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Flood
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D055866:Earthquakes; D004651:Employment; D005191:Family Characteristics; D005260:Female; D006761:Hospitals; D006801:Humans; D007251:Influenza, Human / Q000453:epidemiology* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D008923:Missouri; D016272:Occupational Health; D058873:Pandemics / Q000517:prevention & control; D010561:Personnel Staffing and Scheduling; D010564:Personnel, Hospital / Q000523:psychology*; D024382:Professional Role; D012424:Rural Population / Q000706:statistics & numerical data; D012449:Safety; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data; D014612:Vaccines / Q000600:supply & distribution; D014836:Volition; D000078329:Workforce; D055815:Young Adult
chemical_list: D014612:Vaccines
keywords: disaster; earthquake; pandemic; preparedness; willingness to work