COVID-19 is a recent phenomenon globally manifested compelling healthcare workers to face and rapidly adapt to forceful changes. Pandemics' impact is often intense; reports that provide radiographers feedback about their work experience can be an excellent source for required pandemic data. Moreover, Kuwait's radiographic population is a diverse environment; it consists of a wide range of ethnicities, varying genders, and physical abilities; thus, the generated results from this report could be of great help to other healthcare workers in formulating recovery plans and for future preparedness.
This study is the first conducted in Kuwait that measure pandemic experiences and perceptions for radiographers to the best of our knowledge. This study started in the early to middle stages of the COVID-19 outbreak in areas that were non-pandemic but critically affected, and during a full lockdown of the country. First, the extent of the work-flow disruption for radiographers measures, 80% of radiographers agreed that COVID-19 affects their work as an organization, unit, and on them. When dealing with an epidemic, forced changes must be applied to overcome several factors (e.g., spread/infection). Recent publications suggest some of the most effective ways to control the spread of the virus are by changing the dynamics of the working environment like segregating radiographers into teams, reducing the number of working staff (e.g., secretaries, administrators), continuously having to disinfect equipment, using additional isolation rooms, and increasing the use of mobile radiography units (Food and Drug Administration Staff, 2020, (Kooraki, Hosseiny, Myers and Gholamrezanezhad, 2020, (Stogiannos, Fotopoulos, Woznitza and Malamateniou, 2020). Also, having to daily wear heavy protective gear such as gloves, head cap, disposable gown, shoe covers, and protective goggles can be exhausting and time-consuming (Occupational Safety and Health Administration (OSHA), 2020, Kooraki, Hosseiny, Myers and Gholamrezanezhad, 2020, Mohakud, Ranjan, Naik and Deep, 2020). Consequently, radiographers rated these precautions in the second PEPS tool. In this section, management, resources, and control scores show, 4.9% found that management's information was completely inadequate, and 47.1% felt that they had some form of adequate information, while 48% agree to complete adequate information from their management in dealing with this crises. Conversely, most radiographers (74.5 %) agreed that their protective equipment, staff availability, and support staff competence were not adequate. Consequently, this would affect their risk perception, which is the third Item in the PEP survey. Participants scored risk perception (e.g., contact, virulence, and control), underestimating risk can prompt unnecessary incidents (e.g., carelessness, negligence); lack of awareness often leads to an unconcerned attitude, which may adversely affect the preparedness to meet these challenges, also, overestimating risk can undermine organizational effectiveness (e.g., panic, chaos, fear). 62% of the participants reported that they feared the virus and felt underprepared in dealing with it, and they scored 54% risk perception of their colleges. However, less than half of the participants believe that the virus would not be of great risk to the public (45%) or their families (49%). Significant demographics that affect this tool include participants nationalities (P 0.009 < 0.05 ), health condition (P 0.050 < 0.05) and radiographic working level (P 0.004 <0.005). Moreover, more than half of the participating radiographers in this study had more than ten years of working experience (52%), and an education level of bachelor (71.5%) or higher (23.5%) (Table 2). However, these factors, surprisingly, showed no significance in any PEPS tools. Radiography is a skill-based practice where it requires a certain amount of knowledge; however, it also needs continuous forms of ongoing education, and updates (Elshami, Elamrdi, Alyafie and Abuzaid, 2016). Like most healthcare workers, radiographers have to be familiar with frequent job training, specifically during a pandemic; ongoing training provides new, critical information regardless of previous knowledge (Kooraki, Hosseiny, Myers and Gholamrezanezhad, 2020). having training and knowledge enables workers to feel confident to do their work, thus providing some measure of stress reduction (Bhagavathula et al., 2020). All epidemics and pandemics have their unique characteristics in terms of causality, progression, and control measures (Roy et al., 2020). It is crucial to provide health education and create awareness during such situations to effectively prevent disease spread (Johnson and Hariharan, 2017). Also, in a previous study, health professionals often have better awareness, positive attitudes towards epidemics/pandemics, and often experience low anxiety (Mishra et al., 2016). Nevertheless, studies from Ethiopia reported poor knowledge and erroneous healthcare professionals' beliefs during the two outbreak in 2015, and 2020, both studies urged for intense training of the healthcare professionals (Abebe et al., 2016, Jemal et al., 2020). In a study conducted in Trinidad and Tobago in 2016, following the H1N1 epidemic, it was seen that a significant proportion of the general public was unaware of the seriousness and measures of prevention of the epidemic (Johnson and Hariharan, 2017). Research suggests that although radiographers perform a similar technical occupation, the impact of the country culture on radiography manifests through the scope of practice and level of recognition within the healthcare spectrum (Cowling and Lawson, 2020). This study showed radiographers performing a similar technical occupation; however, the departments were in a wide variety of cultural and socio-economic environments, which significantly affected the radiographer. Finally, the work-life and leadership sections (PEPS 4 - 5) identify management areas that employees perceive as going well and where they would appreciate the improvement. More than 70 % agreed to flexible working hours, workload being within their capabilities, felt supported, had a good sense of community, fairness, and no conflict between priorities and values. Similarly, almost half of the participants agree that leadership, whether it be management or immediate supervisors, provided hope, confidence, honest assessment, and a safe environment. It is the manager's and supervisors' responsibility to provide training about the outbreak in a formal setting to ensure that all workers understand details about disease transmission, screening, use of personal protection equipment. Radiographer's working-level showed significance in reporting PEPS tool five, which is understanding that the radiographer level indicates work responsibilities and supervision duties as their level increases obligations and responsibilities increase. The majority of radiographers explained fear and risk of working with COVID-19; however, they had a positive attitude toward their leadership and management. Most radiographers explained that regardless of their faith in management, additional education interventions and campaigns were required to improve their sense of safety and confidence. Working with an insensitive working environment of COVID-19, any organization will experience some burnout, depending on both the quality of the management system and how leaders react in real-time. This PEPS tool can help to contain future burnouts and conflicts.
Limitations
Despite the findings introduced here, It is important to stress that this survey showed some limitations; the number of radiographers and participation was deficient; it was challenging to urge people to complete the survey regardless of all the rigorous methods of engorgements. Also, another factor could be the short period of data collection that could have led to that. Nevertheless, this is considered a moderate sample size. Moreover, this pandemic caused many to be busy watching the news and taking care of personal affairs. Thus, participation revolved around radiographers who were active on the internet or social media during the short period of data collection, which might have led to selection bias and sampling error, which prevents the ability to generalize our results.