Medical residents’ attitudes and emotions related to Middle East respiratory syndrome in Saudi Arabia: A cross-sectional study

Aldrees, Turki; Al Ghobain, Mohammed; Alenezi, Abdullah; Alqaryan, Saleh; Aldabeeb, Dana; Alotaibi, Najed; Alzahrani, Kamal; Alharethy, Sami

Discussion. We examined the attitudes and emotions related to an MERS outbreak of the medical =0.10 P=0.126 MERS -Middle Eastern Respiratory Syndrome, -Spearman's rank correlation coefficient, P -probability value residents serving as frontline physicians in 4 tertiary care hospitals in Riyadh, KSA. Overall, our results indicated that most of medical residents believed their job put them at considerable risk of exposure and were afraid of contracting MERS; however, they also believed that it was part of their professional duty to care for MERS patients and accepted this risk of infection. Participants were also not willing to change their jobs due to the risk of exposure to MERS and they were confident that the hospitals would look after them if they were infected. These results generally accord with 2 recently published studies conducted in KSA among health care workers (HCWs), which sought to examine their attitudes and concerns regarding the emerging outbreak of MERS-CoV. In particular, in both studies, HCWs reported that their job put them at a high risk of contracting the infection. 9,10 For example, Abolfotouh et al 9 reported that around 70% of surveyed participants felt at risk of contracting a MERS-CoV infection at work, although around 61% felt obligated to provide medical care for patients infected with MERS-CoV. These findings are also consistent with studies conducted in other countries dealing with different viral outbreaks that had major emotional impacts on healthcare workers. [5] [6] [7] For instance, during the SARS outbreak in 2003, approximately two-thirds of healthcare workers in Toronto experienced concern for their own or their family's health. 6 In Hong Kong, 68% of participants reported a high level of stress and 57% were found to have experienced psychological distress; high stress was much more common among nurses and younger workers. 6 Unsurprisingly, most medical residents at the 4 centers recognized their professional obligation to look after patients with MERS despite the potential risk to themselves. This contrasts with the findings of a previous study in Australia during the avian influenza outbreak of 2006, wherein a hospital staff absentee rate of 38% was found. 11 Similar findings to the Australian study were reported in Hong Kong and Mainland China during the SARS outbreak, wherein a large number of HCWs were absent or refused to look after the infected patients. 6 By contrast, in Germany, only 28% of surveyed healthcare workers agreed that it would be professionally acceptable for healthcare workers to abandon their workplace during an influenza pandemic to protect themselves and their families, whereas 52% disagreed with this statement. 12 We found that older residents were more likely to report being afraid of infection than were younger residents. This is in contrast to Nickell et al 5 study, wherein 73% of staff who were younger than 30 years of age reported being concerned about infection, compared with only 65.6% of staff who were older than 50 years Tam et al 6 reported a similar finding to Nickell et al 5 younger staff members were more prone to job stress during a SARS outbreak than were older staff. However, in both Tam et al 6 and Nickle et al 5 studies, medical doctors were a minority of participants, making up only 9% and 3% of their cohort. In contrast, Wong et al 8 report no significant differences in distress among the age groups 8 In line with our study, Abolfotouh et al 9 reported