Infection Prevention Performance among In-Flight Cabin Crew in South Korea
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Participants and Data Collection
2.3. Measurement Variables
2.3.1. General Participant Characteristics
2.3.2. IP Performance
2.3.3. IP Awareness
2.3.4. Organizational Culture
2.3.5. Simulation-Based PPE Training
2.4. Statistical Analysis
3. Results
3.1. Participant Characteristics
3.2. IP Performance and Awareness
3.3. Factors Related to IP Performance
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Kemenesi, G.; Zeghbib, S.; Somogyi, B.A.; Tóth, G.E.; Bányai, K.; Solymosi, N.; Szabo, P.M.; Szabó, I.; Bálint, Á.; Urbán, P.; et al. Multiple SARS-CoV-2 Introductions Shaped the Early Outbreak in Central Eastern Europe: Comparing Hungarian Data to a Worldwide Sequence Data-Matrix. Viruses. 2020, 12, 1401. [Google Scholar] [CrossRef]
- Weekly Epidemiological Update 29 December 2020. Available online: https://www.who.int/publications/m/item/weekly-epidemiological-update---29-december-2020 (accessed on 10 January 2021).
- Tarro, G. The New Coronavirus from the Chinese City of Wuhan. Int. J. Recent. Sci. Res. 2020, 11, 36901–36902. [Google Scholar]
- Liu, J.Y.; Chen, T.J.; Hwang, S.J. Analysis of Imported Cases of COVID-19 in Taiwan: A Nationwide Study. Int. J. Environ. Res. Public. Health. 2020, 17, 3311. [Google Scholar] [CrossRef]
- Killeen, G.F.; Kiware, S.S. Why Lockdown? Why National Unity? Why Global Solidarity? Simplified Arithmetic Tools for Decision-Makers, Health Professionals, Journalists and the General Public to Explore Containment Options for the 2019 Novel Coronavirus. Infect. Dis. Model. 2020, 5, 442–458. [Google Scholar] [CrossRef]
- Bae, S.H.; Shin, H.; Koo, H.Y.; Lee, S.W.; Yang, J.M.; Yon, D.K. Asymptomatic Transmission of SARS-CoV-2 on Evacuation Flight. Emerg. Infect. Dis. 2020, 26, 2705–2708. [Google Scholar] [CrossRef] [PubMed]
- Kamata, K.; Jindai, K.; Ide, K.; Funaki, T.; Saito, H.; Takeshita, N.; Ohmagari, N.; Hinoshita, E.; Asanuma, K. The Flight Evacuation Mission for COVID-19 from Wuhan, China to Tokyo, Japan from 28 January to 17 February 2020. Jpn. J. Infect. Dis. 2020. In press. [Google Scholar] [CrossRef]
- Browne, A.; Ahmad, S.S.; Beck, C.R.; Nguyen-Van-Tam, J.S. The Roles of Transportation and Transportation Hubs in the Propagation of Influenza and Coronaviruses: A Systematic Review. J. Travel. Med. 2016, 23, tav002. [Google Scholar] [CrossRef] [Green Version]
- Grout, A.; Howard, N.; Coker, R.; Speakman, E.M. Guideline, Law, and Governance: Disconnects in the Control of Airline-associated Infectious Disease. Lancet Infect. Dis. 2017, 17, e118–e122. [Google Scholar] [CrossRef]
- Choi, E.M.; Chu, D.K.W.; Cheng, P.K.C.; Tsang, D.N.C.; Peiris, M.; Bausch, D.G.; Poon, L.L.M.; Watson-Jones, D. In-Flight Transmission of SARS-CoV-2. Emerg. Infect. Dis. 2020, 26, 2713–2716. [Google Scholar] [CrossRef] [PubMed]
- Yang, N.; Shen, Y.; Shi, C.; Ma, A.H.Y.; Zhang, X.; Jian, X.; Wang, L.; Shi, J.; Wu, C.; Li, G.; et al. In-Flight Transmission Cluster of COVID-19: A Retrospective Case Series. Infect. Dis. 2020, 52, 891–901. [Google Scholar] [CrossRef] [PubMed]
- Han, Z.; To, G.N.; Fu, S.C.; Chao, C.Y.; Weng, W.; Huang, Q. Effect of Human Movement on Airborne Disease Transmission in an Airplane Cabin: Study Using Numerical Modeling and Quantitative Risk Analysis. BMC Infect. Dis. 2014, 14, 434. [Google Scholar] [CrossRef] [Green Version]
- Hertzberg, V.S.; Weiss, H.; Elon, L.; Si, W.; Norris, S.L.; FlyHealthy Research Team. Behaviors, Movements, and Transmission of Droplet-Mediated Respiratory Diseases During Transcontinental Airline Flights. Proc. Natl. Acad. Sci. USA 2018, 115, 3623–3627. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Peddle, M.B.; Smith, J.A. Hazard Control for Communicable Disease Transport at Ornge. Can. J. Emerg. Med. 2020, 22, S79–S83. [Google Scholar] [CrossRef]
- World Health Organization. Management of Ill Travellers at Points of Entry–International Airports, Seaports and Ground Crossings–In the Context of COVID-19 Outbreak: Interim Guidance; World Health Organization: Geneva, Switzerland, 16 February 2020. [Google Scholar]
- Gupta, J.K.; Lin, C.H.; Chen, Q. Risk Assessment of Airborne Infectious Diseases in Aircraft Cabins. Indoor. Air. 2012, 22, 388–395. [Google Scholar] [CrossRef] [PubMed]
- Freedman, D.O.; Wilder-Smith, A. In-Flight Transmission of SARS-CoV-2: A Review of the Attack Rates and Available Data on the Efficacy of Face Masks. J. Travel. Med. 2020, 27, taaa178. [Google Scholar] [CrossRef]
- Oh, J.E.; Park, J.Y. Influencing Factors on Performance for Standard Precaution of Healthcare Workers of General Hospital for Infection Control. J. Digit. Converg. 2018, 16, 231–249. [Google Scholar]
- Park, Y.M.; Park, H.-S.; Park, K.-Y. Factors Influencing Level of Awareness and Compliance with Vancomycin-resistant Enterococcus Infection Control Among Nurses in Intensive Care Units. J. Korean Acad. Fundam. Nurs. 2008, 15, 531–538. [Google Scholar]
- Moore, D.; Gamage, B.; Bryce, E.; Copes, R.; Yassi, A.; BC Interdisciplinary Respiratory Protection Study Group. Protecting Health Care Workers from SARS and Other Respiratory Pathogens: Organizational and Individual Factors that Affect Adherence to Infection Control Guidelines. Am. J. Infect. Control 2005, 33, 88–96. [Google Scholar] [CrossRef]
- Al-Dossary, R.; Alamri, M.; Albaqawi, H.; Al Hosis, K.; Aljeldah, M.; Aljohan, M.; Aljohani, K.; Almadani, N.; Alrasheadi, B.; Falatah, R.; et al. Awareness, Attitudes, Prevention, and Perceptions of COVID-19 Outbreak Among Nurses in Saudi Arabia. Int. J. Environ. Res. Public. Health. 2020, 17, 8269. [Google Scholar] [CrossRef]
- Kim, Y. Nurses’ Experiences of Care for Patients with Middle East Respiratory Syndrome-Coronavirus in South Korea. Am. J. Infect. Control. 2018, 46, 781–787. [Google Scholar] [CrossRef] [Green Version]
- Tan, W.; Ye, Y.; Yang, Y.; Chen, Z.; Yang, X.; Zhu, C.; Chen, D.; Tan, J.; Zhen, C. Whole-Process Emergency Training of Personal Protective Equipment Helps Healthcare Workers Against COVID-19: Design and Effect. J. Occup. Environ. Med. 2020, 62, 420–423. [Google Scholar] [CrossRef]
- Cho, S.S.; Kim, K.M.; Lee, B.Y.; Park, S.A. The Effects of Simulation-based Infection Control Training on the Intensive Care Unit Nurses’ Perception, Clinical Performance, and Self-Efficacy of Infection Control. J. Korean. Clin. Nurs. Res. 2012, 18, 381–390. [Google Scholar]
- Suess, T.; Remschmidt, C.; Schink, S.B.; Schweiger, B.; Nitsche, A.; Schroeder, K.; Doellinger, J.; Milde, J.; Haas, W.; Koehler, I.; et al. The Role of Facemasks and Hand Hygiene in the Prevention of Influenza Transmission in Households: Results from a Cluster Randomised Trial; Berlin, Germany, 2009–2011. BMC. Infect. Dis. 2012, 12, 26. [Google Scholar] [CrossRef] [Green Version]
- Chung, K.I. A Comparative Study of the Organizational Culture of the Hotels Between Korea and United States. Korean. Hosp. Tourism. Acad. 2001, 10, 185–200. [Google Scholar]
- Taylor, I.; Brotheridge, C.M. Cultural Differences in Emotional Labor in Flight Attendants. In Individual and Organizational Perspectives on Emotion Management and Display; Härtel, C.E.J., Zerbe, W.J., Ashkanasy, N.M., Eds.; Emerald Group Publishing Limited: Bingley, UK, 2006; pp. 167–191. [Google Scholar]
- Ha, A.-N.; Lee, H.-S. The Effects of Organizational Culture Within Airline’s Crew Team on Organizational Commitment the Team and Customer Orientation. Tour. Res. 2017, 42, 193–220. [Google Scholar]
- van Buijtene, A.; Foster, D. Does a Hospital Culture Influence Adherence to Infection Prevention and Control and Rates of Healthcare Associated Infection? A Literature Review. J. Infect. Prev. 2019, 20, 5–17. [Google Scholar] [CrossRef]
- Bielecki, M.; Patel, D.; Hinkelbein, J.; Komorowski, M.; Kester, J.; Ebrahim, S. Air Travel and COVID-19 Prevention in the Pandemic and Peri-pandemic Period: A Narrative Review. Travel. Med. Infect. Dis. 2021, 39, 101915. [Google Scholar] [CrossRef]
- Hong, S.; Kwon, Y.-S.; Park, H. Nursing Students’ Awareness and Performance on Standard Precautions of Infection Control in the Hospital. J. Korean. Acad. Soc. Nurs. Edu. 2012, 18, 293–302. [Google Scholar] [CrossRef] [Green Version]
- Polit, D.F.; Beck, C.T. The Content Validity Index: Are You Sure You Know What’s Being Reported? Critique and Recommendations. Res. Nurs. Health 2006, 29, 489–497. [Google Scholar] [CrossRef] [Green Version]
- Kim, H.; Park, H.-R. The Effects of Organizational Culture for Infection Control and Self-Efficacy on Compliance with Standard Precautions of Emergency Room Nurses. J. Korean. Biol. Nurs. Sci. 2019, 21, 46–53. [Google Scholar] [CrossRef]
- Zhu, J.; Jing, P. The Analysis of Bootstrap Method in Linear Regression Effect. J. Math. Res. 2010, 2, 64. [Google Scholar] [CrossRef] [Green Version]
- Cohen, J. Statistical Power Analysis. Curr. Dir. Psychol. Sci. 1992, 1, 98–101. [Google Scholar] [CrossRef]
- Nahm, F.S. Understanding Effect Sizes. Hanyang. Med. Rev. 2015, 35, 40–43. [Google Scholar] [CrossRef] [Green Version]
- Huang, C.-C.L.; Jou, Y.-J.; Cho, H.-J. VIF-Based Adaptive Matrix Perturbation Method for Heteroskedasticity-Robust Covariance Estimators in the Presence of Multicollinearity. Commun. Stat. Theor. Methods. 2017, 46, 3255–3263. [Google Scholar] [CrossRef]
- Jung, H.S.J.; Yoon, H.H. Why Is Supervisor Leadership Important? The Effects of Leadership Styles on Work Engagement and Innovative Behavior Among Flight Attendant. Int. J. Tourism. Hosp. Res. 2020, 34, 75–90. [Google Scholar] [CrossRef]
- Bazaid, A.S.; Aldarhami, A.; Binsaleh, N.K.; Sherwani, S.; Althomali, O.W. Knowledge and Practice of Personal Protective Measures During the COVID-19 Pandemic: A Cross-Sectional Study in Saudi Arabia. PLoS ONE 2020, 15, e0243695. [Google Scholar] [CrossRef]
- Parker, M.J.; Goldman, R.D. Paediatric Emergency Department Staff Perceptions of Infection Control Measures Against Severe Acute Respiratory Syndrome. Emerg. Med. J. 2006, 23, 349–353. [Google Scholar] [CrossRef] [Green Version]
- Jeong, G.; Lee, T.R.; Hwang, S.Y.; Cha, W.C.; Shin, T.G.; Sim, M.S.; Jo, I.J.; Song, K.J.; Rhee, J.E.; Jeong, Y.K. Emergency of Department Workers’ Perceptions of Effectiveness and Reported Compliance of Infection Control Measures After Middle East Respiratory Syndrome Outbreaks. J. Korean. Soc. Emerg. Med. 2016, 27, 328–335. [Google Scholar]
- Tso, R.V.; Cowling, B.J. Importance of Face Masks for COVID-19: A Call for Effective Public Education. Clin. Infect. Dis. 2020, 71, 2195–2198. [Google Scholar] [CrossRef]
- Liang, M.; Gao, L.; Cheng, C.; Zhou, Q.; Uy, J.P.; Heiner, K.; Sun, C. Efficacy of Face Mask in Preventing Respiratory Virus Transmission: A Systematic Review and Meta-Analysis. Travel. Med. Infect. Dis. 2020, 36, 101751. [Google Scholar] [CrossRef]
- Assefa, D.; Melaku, T.; Bayisa, B.; Alemu, S. Knowledge, Attitude and Self-Reported Performance and Challenges of Hand Hygiene Using Alcohol-Based Hand Sanitizers Among Healthcare Workers During COVID-19 Pandemic at a Tertiary Hospital: A Cross-Sectional Study. Infect. Drug. Resist. 2021, 14, 303–313. [Google Scholar] [CrossRef]
- Gautret, P.; Soula, G.; Parola, P.; Brouqui, P. Hajj Pilgrims’ Knowledge About Acute Respiratory Infections. Emerg. Infect. Dis. 2009, 15, 1861–1862. [Google Scholar] [CrossRef]
- Deyneko, A.; Cordeiro, F.; Berlin, L.; Ben-David, D.; Perna, S.; Longtin, Y. Impact of Sink Location on Hand Hygiene Compliance After Care of Patients with Clostridium difficile Infection: A Cross-Sectional Study. BMC. Infect. Dis. 2016, 16, 203. [Google Scholar] [CrossRef] [Green Version]
- Beiu, C.; Mihai, M.; Popa, L.; Cima, L.; Popescu, M.N. Frequent Hand Washing for COVID-19 Prevention Can Cause Hand Dermatitis: Management Tips. Cureus 2020, 12, e7506. [Google Scholar] [CrossRef] [Green Version]
- Leggat, P.A.; Smith, D.R. Dermatitis and Aircrew. Contact. Dermatitis. 2006, 54, 1–4. [Google Scholar] [CrossRef]
- Pittet, D.; Simon, A.; Hugonnet, S.; Pessoa-Silva, C.L.; Sauvan, V.; Perneger, T.V. Hand Hygiene Among Physicians: Performance, Beliefs, and Perceptions. Ann. Intern. Med. 2004, 141, 1–8. [Google Scholar] [CrossRef] [Green Version]
- Díaz-Guio, D.A.; Ricardo-Zapata, A.; Ospina-Velez, J.; Gómez-Candamil, G.; Mora-Martinez, S.; Rodriguez-Morales, A.J. Cognitive Load and Performance of Health Care Professionals in Donning and Doffing PPE Before and After a Simulation-Based Educational Intervention and Its Implications During the COVID-19 Pandemic for Biosafety. Infez. Med. 2020, 28, 111–117. [Google Scholar]
- Okamoto, K.; Rhee, Y.; Schoeny, M.; Lolans, K.; Cheng, J.; Reddy, S.; Weinstein, R.A.; Hayden, M.K.; Popovich, K.J.; Centers for Disease Control and Prevention Epicenters Program. Impact of Doffing Errors on Healthcare Worker Self-Contamination When Caring for Patients on Contact Precautions. Infect. Control. Hosp. Epidemiol. 2019, 40, 559–565. [Google Scholar] [CrossRef]
- Poller, B.; Hall, S.; Bailey, C.; Gregory, S.; Clark, R.; Roberts, P.; Tunbridge, A.; Poran, V.; Crook, B.; Evans, C. “VIOLET”: A Fluorescence-Based Simulation Exercise for Training Healthcare Workers in the Use of Personal Protective Equipment. J. Hosp. Infect. 2018, 99, 229–235. [Google Scholar] [CrossRef] [Green Version]
- Agarwal, N.; Agarwal, P.; Querry, A.; Mazurkiewicz, A.; Tempel, Z.J.; Friedlander, R.M.; Gerszten, P.C.; Hamilton, D.K.; Okonkwo, D.O.; Kanter, A.S. Implementation of an Infection Prevention Bundle and Increased Physician Awareness Improves Surgical Outcomes and Reduces Costs Associated with Spine Surgery. J. Neurosurg. Spine. 2018, 29, 108–114. [Google Scholar] [CrossRef] [Green Version]
- Rhoden, S.; Ralston, R.; Ineson, E.M. Cabin Crew Training to Control Disruptive Airline Passenger Behavior: A Cause for Tourism Concern? Tour. Manag. 2008, 29, 538–547. [Google Scholar] [CrossRef]
- Albayat, S.; Bansal, D.; Kokku, S.B.; Al-Romaihi, H.; Khogali, H.; Farag, E. Assessment of Cabin Crew Awareness About Malaria in a Major Airline. Mediterr. J. Hematol. Infect. Dis. 2019, 11, e2019049. [Google Scholar] [CrossRef] [PubMed]
- Kim, J.H.; Choi-Kwon, S.; Park, Y.H. Comparison of Inflight First Aid Performed by Cabin Crew Members and Medical Volunteers. J. Travel. Med. 2017, 24, taw091. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Paethrangsi, N. Competency Training of Initial Crew Resource Management Course for Cabin Crew. IOP Conf. Ser. Mater. Sci. Eng. 2020, 918, 012179. [Google Scholar] [CrossRef]
(N = 177) | ||
---|---|---|
Variables | Categories | M ± SD or n (%) |
Gender | Female | 133 (75.1) |
Male | 44 (24.9) | |
Age (years) | 37.58 ± 8.46 | |
20~29 | 45 (25.4) | |
30~39 | 57 (32.2) | |
40~49 | 69 (39.0) | |
50~59 | 6 (3.4) | |
Marriage | Married | 67 (49.2) |
Living with | Alone | 35 (19.8) |
Education | College | 27 (15.3) |
University | 131 (74.0) | |
Graduate or above | 19 (10.7) | |
Position | Team leader | 72 (50.7) |
Staff | 105 (59.3) | |
Working period (years) | 6.26 ± 3.38 | |
Experience handling passengers with | MERS 1 | 14 (7.9) |
COVID-19 2 | 25 (14.1) | |
Quarantined due to contact with | MERS 1 | 3 (1.7) |
COVID-19 2 | 19 (10.7) | |
Simulation-based PPE 3 training | 23 (13.0) |
(N = 177) | ||||
---|---|---|---|---|
Categories | M ± SD | t | p | |
Awareness | Performance | |||
Hand hygiene | 4.61 ± 0.45 | 4.47 ± 0.56 | 3.86 | <0.05 |
Wearing a mask | 4.78 ± 0.35 | 4.73 ± 0.35 | 1.72 | 0.088 |
Handling passengers with confirmed or suspected COVID-19 1 | 4.97 ± 0.08 | 4.90 ± 0.41 | 0.96 | 0.347 |
Average | 4.75 ± 0.28 | 4.56 ± 0.44 | 6.54 | <0.05 |
(N = 177) | |||||
---|---|---|---|---|---|
Variables | Categories | Performance 5 | |||
M ± SD or Median (Range) | t, F, Z, or r | p | |||
Gender | Female | 4.55 ± 0.47 | −0.86 | 0.393 | |
Male | 4.61 ± 0.33 | ||||
Age (years) | 20~29 | 4.55 ± 0.44 | 0.60 | 0.616 | |
30~39 | 4.52 ± 0.42 | ||||
40~49 | 4.58 ± 0.45 | ||||
50~59 | 4.76 ± 0.33 | ||||
Marriage | Single | 4.58 ± 0.42 | 0.54 | 0.592 | |
Married | 4.55 ± 0.45 | ||||
Education | College | 4.56 ± 0.49 | 0.04 | 0.965 | |
University | 4.57 ± 0.43 | ||||
Graduate or above | 4.54 ± 0.38 | ||||
Position | Team leader | 4.57 ± 0.43 | −0.09 | 0.928 | |
Staff | 4.56 ± 0.44 | ||||
Experience handling passengers with | MERS 1 | Yes | 4.87 (4.19, 5.00) | −1.76 | 0.078 |
No | 4.67 (2.79, 5.00) | ||||
COVID-19 2 | Yes | 4.76 (3.33, 5.00) | −1.21 | 0.227 | |
No | 4.65 (2.79, 5.00) | ||||
Quarantined due to contact with | MERS 1 | Yes | 4.73 (3.53, 5.00) | −0.03 | 0.979 |
No | 4.67 (2.79, 5.00) | ||||
COVID-19 2 | Yes | 4.76 (3.33, 5.00) | −0.92 | 0.361 | |
No | 4.67 (2.79, 5.00) | ||||
Simulation-based PPE 3 training | Yes | 4.76 (3.33, 5.00) | −1.99 | < 0.05 | |
No | 4.64 (2.79, 5.00) | ||||
IP awareness (range 1–5) 4 | 4.75 ± 0.28 | 0.50 | < 0.05 | ||
Organizational culture (range 1–7) 4 | 5.96 ± 0.77 | 0.26 | < 0.05 |
(N = 177) | ||||||
---|---|---|---|---|---|---|
Variables 1 | B | Bootstrap | Clearance | VIF 4 | ||
SE | 95% CI 3 | p | ||||
Constant | 0.40 | 0.54 | −0.75–1.41 | 0.475 | ||
Awareness | 0.77 | 0.11 | 0.54–1.03 | <0.05 | 0.84 | 1.19 |
Simulation-based PPE training 2 | 0.25 | 0.07 | 0.11–0.39 | <0.05 | 0.97 | 1.03 |
Organizational culture | 0.04 | 0.05 | −0.40–0.13 | 0.347 | 0.79 | 1.27 |
Adj R2= 0.29, F = 12.84 (p < 0.05), Durbin-Watson’s d = 1.97 | ||||||
Kolmogorov-Smirnov normality test Z = 1.95 (p = <0.05), Breusch Pegan test χ2 = 16.80 (p = <0.05) |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Ryu, J.; Kim, J.; Choi-Kwon, S. Infection Prevention Performance among In-Flight Cabin Crew in South Korea. Int. J. Environ. Res. Public Health 2021, 18, 6468. https://doi.org/10.3390/ijerph18126468
Ryu J, Kim J, Choi-Kwon S. Infection Prevention Performance among In-Flight Cabin Crew in South Korea. International Journal of Environmental Research and Public Health. 2021; 18(12):6468. https://doi.org/10.3390/ijerph18126468
Chicago/Turabian StyleRyu, Jaegeum, Jungha Kim, and Smi Choi-Kwon. 2021. "Infection Prevention Performance among In-Flight Cabin Crew in South Korea" International Journal of Environmental Research and Public Health 18, no. 12: 6468. https://doi.org/10.3390/ijerph18126468