Infectious disease emergencies are increasingly becoming part of the health care delivery landscape, having implications to not only individuals and the public, but also on those expected to respond to these emergencies. Health care workers (HCWs) are perhaps the most important asset in an infectious disease emergency, yet these individuals have their own barriers and facilitators to them being willing or able to respond.

The purpose of this review was to identify factors affecting HCW willingness to respond (WTR) to duty during infectious disease outbreaks and/or bioterrorist events.

An integrative literature review methodology was utilized to conduct a structured search of the literature including CINAHL, Medline, Embase, and PubMed databases using key terms and phrases. PRISMA guidelines were used to report the search outcomes and all eligible literature was screened with those included in the final review collated and appraised using a quality assessment tool.

A total of 149 papers were identified from the database search. Forty papers were relevant following screening, which highlighted facilitators of WTR to include: availability of personal protective equipment (PPE)/vaccine, level of training, professional ethics, family and personal safety, and worker support systems. A number of barriers were reported to prevent WTR for HCWs, such as: concern and perceived risk, interpersonal factors, job-level factors, and outbreak characteristics.

By comprehensively identifying the facilitators and barriers to HCWs’ WTR during infectious disease outbreaks and/or bioterrorist events, strategies can be identified and implemented to improve WTR and thus improve HCW and public safety.

Tropical cyclone (TC) Yasi, thought to be the largest and most severe cyclone to cross the Queensland coast since 1918, made landfall on the southern tropical coast near Mission Beach and continued to track westward across Northern Queensland on February 3, 2011. The warning and response model (WRM) suggests that situational factors, personal characteristics, and social contextual variables influence the degree of threat perceived and protective actions taken.

The aim of this study was to examine preparation for this impending natural disaster by residents of the affected regions, and to identify the residents’ resource losses and symptoms of psychological distress following TC Yasi.

A cross-sectional survey was conducted 6-12 months after the cyclone using an adapted tool designed to measure preparedness, loss and psychosocial distress. Four hundred and thirty-three responses were received. Statistical analysis was conducted using Statistical Package for the Social Sciences (SPSS). Categorical characteristics were described using sample size and percentages.

Almost all respondents perceived the cyclone warning as serious or very serious, and more than a third started preparing for the cyclone at least three days before it reached landfall. Overall, 115 (26.7%) respondents reported moderate and 59 (13.7%) reported major property damage; 72 (17.1%) reported a moderate and 49 (11.6%) reported a major change in their feeling of whether they have control over their life; 55 (13.1%) reported a major change in their motivation of getting things done; and 33 (7.9%) reported a major change in their perception of feeling valuable to others. Overall, 142 (34.1%) documented at least one of five symptoms of acute distress.

The findings document the experiences of Australians who have lived through tropical cyclone Yasi. The results support the WRM theory which proposes that people with previous experience take threatened disasters seriously.

UsherK, BuettnerP, WestC, MillisJ, WoodsC, MasonM, BoonH, Chamberlain-SalaunJ. Preparedness for and Impact of Tropical Cyclone Yasi in North Queensland, Australia. Prehosp Disaster Med. 2013;28(3):1-7.