Healthcare providers’ perspectives on factors influencing their critical care decision-making during the COVID-19 pandemic: An international pilot survey

Table 1 Rotated structure matrix for principal axis analysis with varimax rotation of six component questionnaire

	Rotated component coefficients for components
	1	2	3	4	5	6
Obtain informed consent	0.785
Accurately inform patient’s family regarding patient’s condition	0.711
Age influence on treatment		0.883
Give priority to patient’s interests over other interests in the treatment plan		0.410
Age influence on decision to access ventilator		0.407
Sex influence on treatment		0.302
Family member presence influence on treatment plan			0.624
Patient’s financial status influence on treatment plan			0.568
Time of arrival influence on treatment plan			0.415
Maintain privacy of patient’s information				0.538
Clinical research data collection influence on patient treatment				0.500
Give accurate information about risk/ benefit of treatment plan				0.416
Hospital policies and decisions helpful in treatment plan					0.652
Hindrance of hospital policies and decisions on treatment plan					0.427
Language influence treatment						0.466
Social media information influence on treatment plan						-0.385

Only items that were loaded in each component are presented.

Table 2 Demographic information of study participants

	Frequency	Percentage
Sex
Male	72	70.6
Female	30	29.4
Age (years)
31-35	7	6.9
36-40	13	12.7
41-45	32	31.4
46-50	20	19.6
> 50	30	29.4
Hospital department
Emergency room	3	2.9
COVID ICU	57	55.9
Non-COVID ICU	13	12.7
Ward/floor	29	28.4

ICU: Intensive care unit; COVID: Coronavirus disease.

Table 3 Factors influencing clinical decision making (personal, family, financial, hospital administration and communication)

	No influence	Very little influence	Moderate influence	One of the important factors	Most important factor
Patient-related factors
Age influence on treatment	14 (13.7)	21 (20.6)	33 (32.4)	30 (29.4)	4 (3.9)
Age influence on decision to access ventilator	24 (23.5)	16 (15.7)	36 (35.3)	23 (22.5)	3 (2.9)
Sex influence on treatment	90 (88.2)	8 (7.8)	2 (2)	1 (1)	1 (1)
Patient’s family and financial status-related factors
Patient’s financial status influence on treatment plan	60 (58.8)	15 (14.7)	23 (22.5)	3 (2.9)	1 (1)
Family member presence influence on treatment plan	47 (46.1)	39 (38.2)	9 (8.8)	5 (4.9)	2 (2)
Hospital administration-related factors
Time of arrival influence on treatment plan	39 (38.2)	18 (17.6)	19 (18.6)	21 (20.6)	5 (4.9)
Hospital policies and decisions helpful in treatment plan	20 (19.6)	31 (30.4)	29 (28.4)	16 (15.7)	6 (5.9)
Hindrance of hospital policies and decisions in treatment plan	41 (40.2)	39 (38.2)	16 (15.7)	4 (3.9)	2 (2)
Clinical research data collection influence on patient treatment	43 (42.2)	30 (29.4)	13 (12.7)	8 (7.8)	8 (7.8)
Communication-related factors
Social media information influence on treatment plan	59 (57.8)	33 (32.4)	9 (8.8)	0 (0)	1 (1)
Language influence on treatment	98 (96.1)	3 (2.9)	0 (0)	0 (0)	1 (1)

Data presented as frequency (percentage).

Table 4 Patient privacy and informed consent influence on clinical decision-making

	Never	Mostly not	Sometimes	Mostly	Always
Accurately inform patient’s family regarding patient’s condition	1 (1)	0 (0)	5 (4.9)	44 (43.1)	52 (51)
Obtain informed consent	0 (0)	1 (1)	10 (9.8)	45 (44.1)	46 (45.1)
Give accurate information about risk/benefit of treatment plan	0 (0)	1 (1)	8 (7.8)	38 (37.3)	55 (53.9)
Maintain privacy of patient’s information	0 (0)	0 (0)	0 (0)	18 (17.6)	84 (82.4)
Give priority to patient’s interests over other interests in the treatment plan	2 (2)	3 (2.9)	6 (5.9)	27 (26.5)	66 (64.7)

Data presented as frequency (percentage).

Table 5 Influence of clinical work on health-care providers

	Never	Mostly not	Sometimes	Mostly	Always
Clinical work affects professional relationships	24 (23.5)	36 (35.3)	28 (27.5)	13 (12.7)	1 (1)
Clinical work affects family relationships	19 (18.6)	28 (27.5)	27 (26.5)	23 (22.5)	5 (4.9)
Clinical work affects health	18 (17.6)	33 (32.4)	33 (32.4)	12 (11.8)	6 (5.9)

Data presented as frequency (percentage).

Table 6 Differences in factors influencing critical decision-making and the impact of coronavirus disease 2019 on clinicians’ health and interpersonal relations when classified based on current place of residence

	Developing country (n = 64)	Developed country (n = 38)	P value
Patient-related factors
Age influence on treatment	2.75 ± 1.11	3.13 ± 1.04	0.063
Age influence on decision to access ventilator	2.45 ± 1.17	3.00 ± 1.07	0.017
Sex influence on treatment	1.13 ± 0.42	1.29 ± 0.84	0.320
Patient’s family and financial status-related factors
Patient’s financial status influence on treatment plan	1.95 ± 0.97	1.50 ± 0.83	0.001
Family member presence influence on treatment plan	2.08 ± 0.97	1.13 ± 0.67	0.007
Hospital administration-related factors
Time of arrival influence on treatment plan	2.53 ± 1.27	2.08 ± 1.34	0.076
Hospital policies and decisions helpful in treatment plan	2.73 ± 1.14	2.32 ± 1.12	0.064
Hindrance of hospital policies and decisions in treatment plan	1.83 ± 0.95	2.00 ± 0.93	0.247
Clinical research data collection influence on patient treatment	2.13 ± 1.25	2.05 ± 1.27	0.770
Communication-related factors
Social media information influence on treatment plan	1.53 ± 0.69	1.55 ± 0.83	0.918
Language influence on treatment	1.02 ± 0.13	1.16 ± 0.68	0.110
Patient privacy and informed consent
Accurately inform patient’s family regarding patient’s condition	3.55 ± 0.62	3.26 ± 0.64	0.018
Obtain informed consent	3.48 ± 0.71	3.08 ± 0.59	0.001
Give accurate information about risk/benefit of treatment plan	3.53 ± 0.67	3.29 ± 0.69	0.057
Maintain privacy of patient’s information	1.78 ± 0.42	1.89 ± 0.31	0.148
Give priority to patient’s interest over other interests in the treatment plan	4.56 ± 0.79	4.45 ± 0.76	0.286
Effect on health and interpersonal relationships
Clinical work affects professional relationships	2.13 ± 0.92	2.66 ± 1.07	0.014
Clinical work affects family relationships	2.56 ± 1.15	2.87 ± 1.17	0.196
Clinical work affects health	2.69 ± 1.05	2.34 ± 1.15	0.092

Data presented as mean ± SD.