key: cord-0978966-tuu6h5zg authors: Olagundoye, Olawunmi; Adewole, Oluremi; Onafeso, Esther Tolulope; Akinwumi, Omobolanle; Amosun, Folasade; Popoola, Olalekan title: Comparing the family characteristics, professional profile, and personality traits of COVID‐19 volunteer and nonvolunteer frontline healthcare workers at the epicenter in Nigeria date: 2021-09-18 journal: Health Sci Rep DOI: 10.1002/hsr2.338 sha: 408fa4b84727a92c81a4457eec39e9791a18e2b0 doc_id: 978966 cord_uid: tuu6h5zg BACKGROUND: Emergency volunteering becomes a necessity in the face of unprecedented disasters like the coronavirus disease 2019 (COVID‐19) pandemic. There is a paucity of empirical data on volunteerism not imported from the developed countries. It became necessary to evaluate the local‐bred volunteerism with its peculiarity, as it emerged within the public health sector of Nigeria's COVID‐19 epicenter. OBJECTIVES: To compare the family characteristics, professional profiles, and personality traits of volunteer and nonvolunteer COVID‐19 frontline healthcare workers (HCWs). To determine the significant predictors of volunteering as well as the deterrents to and motivation for volunteering. METHOD: A comparative cross‐sectional study was conducted between May and August 2020 among COVID‐19 volunteer and nonvolunteer HCWs serving at the six dedicated COVID‐19 isolation/treatment centers and the 27 general hospitals, respectively. Using a stratified sampling technique, three professional categories of HCWs (doctors, nurses, and medical laboratory scientists) were randomly selected from the nonvolunteers while total enumeration of volunteers was done. The survey employed pilot‐tested self‐administered questionnaires. The univariate, bivariate, and multivariate analyses were carried out with IBM Statistical Package for Social Sciences (SPSS) version 23.0. The level of statistical significance was determined by a P‐value of <.05. RESULTS: A total of 244 volunteers and 736 nonvolunteers HCWs participated in this survey. Sex, ethnicity, professional level, income level, number of years of practice, and traits of agreeableness and conscientiousness were significantly different between volunteers and nonvolunteers (P < .05). Inadequate personal protective equipment (PPE), lack of insurance, and inadequate hazard allowance deterred nonvolunteers. After regression analysis, the significant predictors of volunteerism included sex (odds ratio [OR] = 2.644; confidence interval [CI]: 1.725‐4.051), ethnicity (OR = 2.557; CI: 1.551‐4.214), and professional level (matrons: OR = 0.417; CI: 0.254‐0.684, consultants: OR = 0.171; CI: 0.038‐0.757). CONCLUSION: HRH crisis in the face of high‐danger situations such as the COVID‐19 pandemic makes it urgent for health policymakers to address the identified barriers to volunteerism in order to optimize the health outcomes of the population. Indeed, many volunteers in developed countries provide their services in Africa and other developing countries. Unfortunately, there is a paucity of information on local studies on volunteerism not imported from the developed countries. 8 It thus became necessary to evaluate the local-bred volunteerism in the health sector in Lagos, Nigeria, where volunteerism was utilized in the wake of the COVID-19 pandemic. The State's policy on case management resulted in some dichotomy of what is defined as a frontline worker, as COVID-19 cases were to be managed in dedicated isolation/treatment centers by volunteer medical staff from the government hospitals who, having been trained and deployed, will be remunerated with monetary incentives in addition to their regular salaries. Much has been studied as regards the need for volunteerism, useful incentives, and the deterrents to it. [9] [10] [11] [12] [13] [14] [15] [16] However, there is a paucity of peer-reviewed materials on what motivates people to volunteer in high-danger situations such as an epidemic or pandemic. 17 Additionally, more literature focusing on developing countries and low-resource settings is needed. While existing literature details the association between certain socio-demographic characteristics and volunteerism, there is a dearth of research addressing whether and what intrinsic traits, family, and professional characteristics spur medical volunteering. This study aimed to plug the aforementioned gaps, to extend current knowledge, and to provoke further research focusing on the subject matter. Ultimately, it compared the family characteristics, professional profiles, and personality traits of volunteer and nonvolunteer COVID-19 frontline health workers in Lagos and addressed the question of whether these variables impact medical volunteerism in the Nigerian context. To compare the family characteristics, professional profiles, and personality traits of volunteer and nonvolunteer COVID-19 frontline health workers. To determine the deterrents/barriers to volunteering among the nonvolunteers. To identify factors that are significant to volunteering and the sources of motivation among the volunteers. The sample size was calculated using the statistical formula for crosssectional quantitative surveys. Given a standard normal deviate of 1.96, desired level of precision of 0.05, and 50% (0.5) as the proportion that will yield the largest sample size required to draw valid conclusions in the absence of data from previous studies on this subject, a sample size of 384 was calculated for both volunteer and nonvolunteer population groups. Since both populations were finite (<10 000), and the calculated sample size exceeded 5% of population size, application of a correction formula yielded a minimum sample size of 149 for the volunteer group and 340 for the group of nonvolunteers. Total enumeration of all volunteers (244) working at the centers was done. Given the professional stratification of the population groups, samples proportional to the sizes of the professional strata were randomly selected using stratified sampling technique. A sample of 340 nonvolunteering HCWs, when proportionally allocated comprised 98 doctors, 229 nurses, and 13 laboratory scientists. Frontline HCWs who were doctors, nurses, and laboratory scientists currently working at the General Hospitals in Lagos or serving as volunteers at the Lagos State isolation and treatment centers during the study period. Consenting non-volunteer health workers participated in the online survey until the minimum sample size estimated for each stratum of nonvolunteer HCWs was exceeded. The research questionnaire comprised four parts. 19 For each of the items, "I" was added at the beginning so that the items would be easier to read and personalize. The items were grouped into positively and negatively keyed items. Items from the same factor are listed separately to enhance an accurate rating by the respondents. Negatively keyed items are scored in the inverse direction, and the scores for each factor of personality traits are rated in percentages. 19 It takes most people 3 to 8 minutes to complete, and it has been validated and has good internal consistency. 20 4. The items measuring motivation for volunteering elicited the major factors/barriers that may influence volunteerism in non-volunteers and if they would be willing to volunteer if thefactors/conditions T A B L E 1 Comparison of the socio-demographic, professional, and family characteristics of volunteers and nonvolunteers Variable Frequency (%) The survey employed a self-administered questionnaire presented via Google form and a paper version as required by the participants. It was conducted over 11 weeks, between May and August 2020. Each study group had a specific questionnaire similar in composition except for the items assessing motivation for or deterrents to volunteering or not volunteering. The questionnaire captured information about the sociodemographic and family characteristics, professional profile, personality traits, motivations for volunteering, and deterrents to non-volunteering. The personality traits of the participants were measured with the BFFM from the IPIP (BFFM IPIP). 19 The questionnaire was pilot-tested for face validity and reliability. Reliability measurements of internal consistency (Cronbach's alpha reliability coefficient of 0.85) and split-half reliability (Guttman coefficient of 0.89) were good. Items were checked for clarity, and familiar synonyms were included in parentheses for some of the BFFM items identified at the pilot phase: Item 20: "vocabulary"-"a full bank of words." Item 25: "abstract"-"nonphysical/theoretical." Item 30: "vivid"-"clear." Item 34: "seldom"-"rarely." Items 34 and 64: "blue"-"sad." Item 38: "chores"-"tasks." Item 53: "shirk"-"avoid." Item 63: "exacting"-"rigorously demanding." Ethical approval to conduct the study was obtained from the HREC of the authors' institution. Informed consent was granted by the between the groups was significant across professional levels (P < .001), and a decreasing trend in volunteerism was observed with increasing professional ranking as depicted by the Chi-square for trends analysis (P < .001). However, the groups were not significantly different across the occupational categories that were studied (P = .319) and academic qualifications (P = .815). Concerning family characteristics, volunteers and nonvolunteers did not differ significantly with regard to years of marriage (P = .325), family size (P = .68), and family stage (P = .655). As shown in Table 2 , the difference in the average age of the last child between volunteers (48 months) and nonvolunteers (50 months) was not statistically significant (P = .418). The number of dependents between the two groups was also not significantly different (P = .242). The mean number of years of practice in the volunteer group, 11.71 ± 9.19, (median 10 years) was lower than that in the non-volunteer group, 12.59 ± 9.22 (median, 10 years), and the difference in mean was found to be statistically significant (Mann Whitney = 2.238, P = .025). Table 3 shows statistically significant differences in extroversion (P = 0.021),conscientiousness (P < 0.001) and neuroticism (P = 0.024) amongst non-volunteers across the three professional categories. The traits of agreeableness and conscientiousness were also significantly different amongst volunteers (P = 0.005 and P = 0.001 respectively). In Table 4 , agreeableness and conscientiousness were the two traits that were significantly different between volunteers and nonvolunteers in general (P < .05). However, volunteer doctors significantly differed from their non-volunteer counterparts in extroversion, agreeableness, and conscientiousness (P < .05). On the other hand, volunteer and non-volunteer medical laboratory scientists and nurses did not differ significantly in any of the personality traits (P > .05). Sex, ethnicity, and professional levels were significant factors in volunteering to work at COVID-19 isolation centers in Nigeria's epicenter as shown in Table 6 . Male healthcare professionals are two and half times more likely to volunteer than their female counterparts, and the odds ratio (OR) is significant (OR = 2.644; CI: 1.725-4.051). Regarding ethnicity, Igbo healthcare professionals were two and half times more likely to volunteer than their Yoruba counterparts, and the Evidence has also shown that intrinsic factors like functional and physical disability, low self-esteem, and transition into parenthood constitute barriers to volunteering. 21 Our findings lend credence to the demotivating influence of physical health conditions in 13.5% of the nonvolunteers, but family characteristics such as family developmental stage, family size, or the number of years of marriage were not significant factors. While self-esteem was not measured in this study, personality traits of agreeableness and conscientiousness differed significantly between volunteers and nonvolunteers. Some academic schools of thought have postulated that being a volunteer may be intrinsically rooted, and some researchers have found an association between volunteering and personality traits of conscientiousness, agreeableness, and extraversion as well as constructs such as altruism. 22, 23 Comparison is impeded by the dearth of empirical data, more so in the African context, elucidating the roles of personality traits, family characteristics, and professional profile in medical volunteering. This study provides evidence to stimulate and provoke further research on the subject matter as it contributes to one of the earliest empirical data on factors that are associated with medical volunteering in highdanger situations such as an epidemic or pandemic. The study findings may not be generalizable to HCWs in different settings. Other professional categories of HCWs such as pharmacists, physiotherapists, nutritionists, and psychologists were not included in the survey. The authors recommend future cohort studies that will explore the experience of medical volunteering as well as its physical and psychological health benefits. There is increasing awareness of the usefulness of volunteer services, and emergency volunteering has established itself as a necessity and an aid of immense proportions particularly in times of overwhelming disasters like the COVID-19 pandemic. Ultimately, the ability of HCWs to deliver effective services depends on factors such as motivation. The findings from this study suggest that there are important factors to consider in opening the door to local-bred medical volunteerism in the Nigerian context and the evidence it provides supports the introduction of policies to foster it. Olawunmi Olagundoye (corresponding author/manuscript guarantor) had full access to all of the data in this study and takes complete responsibility for the integrity of the data and the accuracy of the data analysis. Olawunmi Olagundoye affirms that this manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned (and, if relevant, registered) have been explained. The data generated from the study are available from the corresponding author upon reasonable request. This research was self-funded. Olawunmi Olagundoye https://orcid.org/0000-0002-1697-1720 The Global Impact of COVID-19 and Strategies for Mitigation and Suppression: Imperial College COVID-19 Response Team WHO Coronavirus disease 2019 (COVID-19) Dashboard https:// covid19.who.int. Accessed Latest update on the covid-19 from Africa CDC https:// africacdc.org/covid-19/s. 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