ICN confirms 1,500 nurses have died from COVID 19 in 44 countries and estimates that healthcare worker COVID 19 fatalities worldwide could be more than 20,000(33). Papoutsi et al., Citing the WHO, 52 countries had reported a total of 22,073 health care workers that had contracted COVID-19(34, 35). In Iran, more than 6,000 health care workers have contracted Covid-19 disease and 150 have died(36).
This study was undertaken with the aim of determining the risk perception status of the healthcare personnel concerning the Covid-19 disease and the relevant effective factors afterwards about 1 month past the prevalence of the disease in Iran. Results indicated that the average score of risk perception of the healthcare workers (66.43 ± 8.17) was at higher level compared with the risk perception of other Iranian groups (9). In the meantime, this could be attributed probably to the time gap of 1 month relative to the previous research during which the stresses may have been eased and the workers' awareness of the emergent Covid-19 disease may have been increased. In any case, it is expected that the risk perception of the healthcare workers about the Covid-19 disease must rest at the excellent and desirable level so that they could provide the best efficiency towards the prevention and treatment of the disease, hence the education and taking measures as to heightening the risk perception level of the healthcare workers seems necessary. The results of studies in other countries are consistent with the fact that health workers, despite having high knowledge, had low risk perception and performance in the prevention of Covid-19 disease. Various reasons for this action have been stated, high workload, lack of protective equipment and lack of access to the guidelines(37, 38).
In comparison to the other risk areas like the environmental risks, the individuals perception status of the related risks arising from the emergent infectious diseases is relatively limited (39). Since the observation of the health predictive measures is directly effective in prevention of the disease expansion. Therefore, the best part of the programming of the instructions is performed at the society level from the top to the bottom and has a strong focus on the observation of the governments' instructions, all based on the risk perception principles and preparation for countering the epidemic(1).
In examining the factors effective on risk perception of the healthcare works about the Covid-19 it was determined that: Among the demographic factors, only the level of education was effective on the risk perception. The inverse relationship between education level and risk perception score is a significant finding. Although risk perception score is expected to increase with the increase of education level, but as was mentioned in the definition, the risk perception is a complex and subjective construct, and it is necessarily different from awareness. Studies showing that the increase in knowledge and awareness is associated with a reduction in risk perception often attributed it to a reduction in the risk concerns (24, 40, 41). Also there are reports of increasing the risk perception related to the increased vulnerability(42). This finding seems to indicate the unknown aspects of the relationship between knowledge, understanding and perception which is consistent with the results of the study conducted by Rolison and Hanoch (2015) in the US, confirming that more knowledge was associated with lower risk perception (43).
This study did not reveal any relationship between risk perception on the one hand and age or gender on the other hand, -although some studies have reported a relationship between the older ages or female gender and higher risk perception།that seems to be related with the type of risk and the understudy population, for which further studies are recommended (18, 41, 42)
Political factors showed the greatest correlation (r = 0.787) with the personnel risk perception. This relationship may be due to the nature of Covid-19 epidemic and the necessary top-down management of the risk based on which the healthcare workers must act within certain principles and regulations' framework. Policy guidelines are essential for managing all aspects of risk perception and performance of healthcare professionals, especially at the primary health care level (44). When knowledge is limited, trust plays an important role in judging and perceiving the emerging diseases (45, 46).
Also, the medical staff risk perception was directly and significantly related to cultural-religious component (r = 0.758). Since more than 98% of Iranians are Muslims, this relationship is not far-fetched. The majority of participants (86.2%) agreed that preventive measures complied with the Islamic religious precepts. But only 42.6% agreed that the cultural affairs authorities' views were complied with the scientists’ views. The inconsistency between the political and cultural affairs' authorities is a noteworthy point which was consistent with Chester (2008) study results (47). This component provides new horizon of promoting public perception of the risks threatening society, However, more research is needed.
In this study, the social, cognitive and emotional factors were effective with less correlation in medical staffs' risk perception of the Covid-19 disease. Due to the emergent nature of the disease and the lack of necessary knowledge about it, the cognitive factors low scores are justifiable, but probably because the epidemic has overshadowed all social and professional relationships of the health care workers, social and emotional factors had limited effect on the risk perception scores.