Patterns of perception toward influenza pandemic among the front-line responsible health personnel in southern Thailand: a Q methodology approach

BACKGROUND Thailand has joined the World Health Organization effort to prepare against a threat of an influenza pandemic. Regular monitoring on preparedness of health facilities and assessment on perception of the front-line responsible health personnel has never been done. This study aimed to document the patterns of perception of health personnel toward the threat of an influenza pandemic. METHODS Q methodology was applied to a set of 385 health personnel in charge of influenza pandemic preparedness in the three southernmost provinces of Thailand. Subjects were asked to rank 33 statements about various issues of influenza pandemic according to a pre-designed score sheet having a quasi-normal distribution on a continuous 9-point bipolar scale ranging from -4 for strongly disagree to +4 for strongly agree. The Q factor analysis method was employed to identify patterns based on the similarity and dissimilarity among health personnel. RESULTS There were three main patterns of perception toward influenza pandemic with moderate correlation coefficients between patterns ranging from 0.37 to 0.55. Pattern I, health personnel, which we labeled pessimistic, perceived themselves as having a low self-efficacy. Pattern II, which we labeled optimistic, perceived the threat to be low severity and low vulnerability. Pattern III, which we labeled mixed, perceived low self-efficacy but low vulnerability. Across the three patterns, almost all the subjects had a high expectancy that execution of recommended measures can mitigate impacts of the threat of an influenza pandemic, particularly on multi-measures with high factor scores of 4 in all patterns. The most conflicting area was vulnerability on the possible impacts of an influenza pandemic, having factor scores of high (3), low (-4), and neutral (0) for patterns I, II, and III, respectively. CONCLUSION Strong consistent perceptions of response efficacy against an influenza pandemic may suggest a low priority to convince health personnel on the efficacy of the recommended measures. Lack of self-efficacy in certain sub-groups indicates the need for program managers to improve self-confidence of health personnel to participate in an emergency response.