Risk communication with nurses during infectious disease outbreaks: Learning from SARS


  • Eileen O’Connor, PhD
  • Tracey O’Sullivan, PhD
  • Carol Amaratunga, PhD
  • Patricia Thille BSc (PT), PhD (Student)
  • Karen P. Phillips, PhD
  • Michelle Carter, MSc
  • Louise Lemyre, PhD, FRSC




risk communication, occupational support, SARS, nurses, infectious disease, emergency management, pandemic planning, disaster medicine


Objective: To identify gaps in risk communication during public health emergencies as identified by nurses who worked in critical and emergency care hospital units during the Severe Acute Respiratory Syndrome (SARS) outbreak in Canada.
Design: This research is part of a larger multimethod study of the psychosocial impacts of the SARS outbreak in Canada for healthcare workers. For this qualitative analysis of risk communication, focus groups were conducted in four Canadian cities using purposive sampling to study perspectives of frontline critical care and emergency department nurses. Covello’s (2003) model of best practices in risk communication is applied to assess specific areas in which risk communication gaps were identified by nurses interviewed in the focus groups.
Setting: Five focus groups held in four Canadian cities: Halifax, Ottawa, Toronto, Vancouver.
Participant/Data: n _ 100 participated in focus groups in four urban communities.
Results: During the SARS outbreak in 2003, high levels of uncertainty, lack of trust, and questions about leadership credibility emerged as important risk communication challenges. Communication problems were compounded by a lack of reliable information, frequent changes in infection control guidelines and risk avoidance messages, as well as contradictory actions of management and senior leaders.
Conclusions: Risk communication constitutes an important component of any emergency protocol. This study of nurses working in emergency and critical care hospital settings during the 2003 SARS outbreak indicates key areas in which risk communication could be more efficient to address nurses’ concerns related to managing uncertainty, occupational health and safety, and employee quality of life. Recommendations useful for planning of any pandemics including H1N1 are derived.

Author Biographies

Eileen O’Connor, PhD

Assistant Professor, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada; Affiliate Scientist, Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada.

Tracey O’Sullivan, PhD

Assistant Professor, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada; Research Associate, Elizabeth Bruyere Research Institute, Ottawa, Ontario, Canada.

Carol Amaratunga, PhD

Dean, Justice Institute of British Columbia, British Columbia, Canada; Project Principal Investigator.

Patricia Thille BSc (PT), PhD (Student)

Faculty of Communication and Culture, University of Calgary, Calgary, Alberta, Canada.

Karen P. Phillips, PhD

Assistant Professor, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada; Principal Scientist, Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada.

Michelle Carter, MSc

Research Assistant, Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada.

Louise Lemyre, PhD, FRSC

Professor, Faculty of Social Sciences, University of Ottawa, Ottawa, Ontario, Canada; McLaughlin Research Chair on Psychosocial Aspects of Risk and Health, Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada.


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How to Cite

O’Connor, PhD, E., T. O’Sullivan, PhD, C. Amaratunga, PhD, P. Thille BSc (PT), PhD (Student), K. P. Phillips, PhD, M. Carter, MSc, and L. Lemyre, PhD, FRSC. “Risk Communication With Nurses During Infectious Disease Outbreaks: Learning from SARS”. Journal of Emergency Management, vol. 7, no. 5, Sept. 2009, pp. 48-56, doi:10.5055/jem.2009.0021.