Facemasks in the emergency room: What do patients think?

Background: Patient acceptance of routine use of facemasks in the emergency department (ED) has not been well established. Concerns exist about the impact of facemasks on the patient-physician relationship. Purpose: To examine patient attitudes and knowledge about routine use of facemasks in the ED. Methods: Original 26-item survey with a convenience sample of 162 patients in the ED of a large Midwestern teaching hospital during the 2009 H1N1 pandemic. Factor analysis revealed 3 factors: positive mask attitudes (6 items); negative mask attitudes (4 items), and fear of infection (3 items). Results: Positive mask attitudes were significantly more likely among non-white and less educated patients. Fear of infection was significantly lower among men and the elderly. While there was a high level of facemask acceptance, a meaningful minority (28.5%) did not want their doctor to wear a mask; or felt afraid when a doctor was wearing a mask (9.4%). A majority of patients (56.5%) felt that the air in the ED was unsafe to breathe. While 89.7% of patients with positive attitudes towards facemasks felt it was important for ED staff to wear them, 71.2% with negative attitudes did too. Patients with infection fear were more likely to believe that facemasks provided adequate protection (90.3% vs. 80.2%). Even patients with negative attitudes about facemasks believed them to be effective in preventing infection. Conclusions: Patients generally view masks in a positive manner and perceive them to be important personal protective equipment in preventing the spread and acquiring of infection during an epidemic.