In The Face of a Pandemic: Work Habits, Attitude, and Productivity of Health Care Frontliners

In The Face of a Pandemic: Work Habits, Attitude, and Productivity of Health Care Frontliners

Alex T. Braganza Jr; Aldrin I. Casilian; Micolle Jhaenakinne C. Dela Cruz; Zshareena Faye Contillo; Ma. Angelica L. Malazzab; Maria Soleil Presquito

Bachelor of Science in Psychology, Cagayan State University- Carig Campus

DOI: https://dx.doi.org/10.47772/IJRISS.2025.905000277

Received: 07 May 2025; Accepted: 09 May 2025; Published: 11 June 2025

ABSTRACT

The COVID-19 pandemic raised multiple crises especially with the healthcare sector in the Philippines. Medical frontliners have become more vulnerably susceptible to health risks and other associated factors amidst the situation. Consequently, this study intended to determine the frontliners’ level of work habits, attitude and productivity (WHAP) specifically, in terms of the respondents’ age, sex, occupation, type of sector affiliation, length of service, salary and employment status. The study constituted 100 medical frontliners within Cagayan and utilized Work Habits, Attitude and Productivity Scale (WHAPS) by Vicentia M. Cervera, Ed. D which is a standard tool for measuring the level of manifestation of workers in different work-related behaviors. T-test and Analysis of Variance (ANOVA) were the statistical tools used to know if there is a significant difference in the level of the respondents’ WHAP when grouped according to their profile. Findings have revealed that these workers have high level in concentration, job satisfaction and productivity. The results have also shown a significant difference on the following: age according to level of work orientation; type of sector affiliation according to level of motivation; employment status according to level of productivity; and length of service and salary according to level of concentration, significant at p-value <0.05. Overall, the study concludes that the respondents have high level of WHAP in all five dimensions namely: concentration, motivation, job satisfaction, productivity and work orientation.

Keywords: Covid-19 Pandemic, Frontliners, Health Care, Work Habits, Attitude, and Productivity

INTRODUCTION

The COVID-19 pandemic overwhelmed the healthcare workforce in frontline serving infected patients and working in emergence due to high rates of infected cases especially those who had severe symptoms of COVID-19 infection as they were required for hospitalization. They are the primary in-demand workers amidst the pandemic and are convened now as frontline health workers or medical frontliners.

Early evidence suggests that healthcare workers are one of the most vulnerable groups when it comes to positive COVID-19 infection, mortality and mental illness (Yaghoubi et al., 2021). This study highlights the level of work habits, attitude and productivity of medical frontliners amidst COVID-19 pandemic along with how the Work Habits, Attitude and Productivity (WHAP) dimensions are mirrored on the variables related to their WHAP. With the mere fact that they are on high exposure with the virus and other viral illnesses on their working environment, the researchers implored to investigate on this matter hypothetically asserting that there is no significant difference in the respondents’ level of work habits, attitude and productivity when grouped according to age, sex, occupation, type of sector affiliation, length of service, salary and employment status.

Moreover, medical frontliners have irrefutably become more susceptible to high levels of physical and psychological risks due to extreme exposure with the virus. Even before the rise of pandemic, several studies focusing on the health care sector have shown that health care professionals are exposed to a variety of severe occupational stressors. Although the level of stress that develop are not the same with all health care professionals, health care professions are among the most stressful ones (Cooper & Cooper, 1988). Especially with the COVID-19 situation, it is undeniable that being on the frontline along with being in a stressful working environment, can quite have an effect in their work habits, attitude and productivity level.

Healthcare workers practice is directly correlated with their attitude and the increasing age is seen as having positive attitude towards COVID-19 (Limbu et al., 2020). A positive attitude that is cultivated within a workplace result in having lesser levels of stress and being more productive (Fallah, 2017). Fallah (2017) also suggested that organizations must strive to cultivate good workplace attitudes among employees as to motivate because highly motivated employees perform and serve well. (Pothoff et al., 2018), in their systematic review and meta-analyses on the relationship between habit and healthcare professional behavior [in clinical practice] suggested that habit plays a significant role in healthcare professional behavior. Moreover, the productivity and performance of healthcare workers can decrease due to poorly planned workplace environment (Edem et al., 2017). Edem and company (2017) have shown the effect of workplace environmental factor on healthcare performance and productivity. According to them, an unsafe health facility environment such as poor supervisor support, poor work space, lack of personal protective equipment among other things can adversely affect employees’ productivity.

COVID-19 paused the economic aspect of almost the entire world. Establishments were forcibly closed making people unemployed, and leaving them with no choice but to stay at homes and secure their safety not to acquire the virus. The rapid spread of the disease created challenges for healthcare systems and forced healthcare workers to grapple with clinical and nonclinical stressors, including shortages of personal protective equipment, mortality and morbidity associated with COVID-19, fear of bringing the virus home to family members, and the reality of losing colleagues to the disease (H. Heather, 2020).

With the sudden change in the working environment, many resigned from their jobs to possibly protect themselves and their family members as well. Some stayed committed into serving and some are even more motivated to work during the pandemic. During the conduct of this study, the researchers aimed to correlate the difference between the two sexes, and as well as the age brackets in terms of their work habits, attitude, and productivity.

Given the foregoing context, the researchers studied the level of their work habits, attitude and productivity using the WHAP Scale towards their health profession and being out in the open as frontliners during the COVID-19 pandemic. There are factors other than the aforementioned which can be among the many possible and realistic agents [but not all, and not singlehandedly experienced] that consequently affect the work habits, attitude and productivity of health care workers.

Concentration has placed extreme demands on healthcare frontliners. The concept of concentration is related to that of focused attention, but they are not equivalent (Heitz and Engle, 2007). In this study, concentration will be explored in context of the pandemic. On how health care frontliners gain and regain forcus or concentration in the workplace with the threat of the covid-19 virus. In this trying times, health care frontliners need adequate support to increase their productivity and keep them motivated (Pathania et. al., 2020). Motivation is widely believed to be a key factor for the performance of individual and organization and serves to be a significant predictor of intention to quit the workplace. On the other hand, job satisfaction is associated with personal and job-related factors. Productivity refers to how individuals generate outputs with reference to attitude toward work (Edem et. al., 2017) and work orientation is a person’s orientation toward work such as cool, oriented or hyper-oriented work orientation. In this study, areas such as the correlation of these five dimensions to the profile variables with significant impact to the overall work habits, attitude, and productivity was explored.

Heaps of challenges were passed to the medical frontliners during the onset of pandemic. And amongst these challenges were anxiety and fear amongst professionals, challenges in enforcing social distancing, challenges in fulfilling social shielding responsibility, and delay in testing (M. Nyasahu, et al., 2020).

The dynamics of the disease overwhelms the capacity of National Health Care system in which the frontliners are not given a significant spotlight. Some underlying reasons behind the unstable work habits, and tendency to be productive of frontliners are Risk of Infection, Sense of Helplessness, Moral Injury, and Lack of Social Support (Nisha Cooch 2020). Frontline health care workers needed to navigate a range of exceptional challenges ranging from increased exposure to death in health care and home settings, increased hours and pressure at work, dealing with challenging situations brought on from contact with members of the public and social isolation from colleagues and loved ones. (Lai et al., 2020; Stuijfzand et al., 2020; The Lancet 2020)

The increasing number of cases of COVID-19, and the uncontrollable community transmission greatly affects the frontliners’ work habits, attitude, and productivity. The study will measure the frontliners’ Concentration, Job Satisfaction, Motivation, Productivity, and Work Orientation. With these dimensions, and with the current onset of the pandemic, what is the level of their work habits, attitude, and productivity, despite of having a minimal support from the government? Health care workers lack adequate social protection. Out of the more than 60,000 cases of health care workers infected by COVID-19 by February 2021, only a small percentage have been recognized by the authorities as work-related, impeding the workers’ right to compensation (UN HRC, March 2021).

Furthermore, the study mainly assessed the correlation between the profile of the respondents and the overall work habits, attitude, and productivity of heath care frontliners in five dimensions namely Concentration, Motivation, Job Satisfaction, Productivity, and Work Orientation.

METHODS

Research Design

The researchers used the descriptive-correlational research design to describe the variables and the relationships that occur naturally between and among them. It is used to determine the relationship between the variables whether it is positive, negative, or neutral.

The descriptive-correlational research design is utilized to assess and describe the relationship between the profile of the respondent in terms of age, sex, occupation, type of sector affiliation, length of service, salary and employment status to the different dimensions of the Work Habits, Attitude, and Productivity Scale which are Concentration, Job Satisfaction, Motivation, Productivity, and Work Orientation.

Locale of the Study

The study was conducted in various medical institutions that include either public or private clinics, hospitals, isolation units, and the like within Cagayan. These institutions are selected through the availability of the respondents who took part in the study. These are the ones catering most of the health care services in their respective areas may it be of check-ups, Covid-19 vaccination, Isolation, confinement, and other medical-related services.

Respondents and Sampling Procedure

The respondents of the study constituted 100 workers in the frontline service from the different medical institutions whether public or private in Cagayan, following the age requirement of the standardized test used which is 18-61 years old.

The respondents have been chosen through Convenience Sampling Technique wherein only those available and willing to participate took part to the conduct of the study.

Research Instrument

The instrument employed in collecting the data for the study is the Work Habits, Attitude and Productivity Scale (WHAPS) by Vicentita M. Cervera, Ed.D. This is a standard tool for determining a person’s work habits, attitudes and tendency to be productive. This instrument was used in the research to measure the level of manifestation of the respondents along the different work-related behaviors namely concentration, motivation, job satisfaction, productivity and work orientation. The WHAPS exhibited evidences of validity and reliability as a measure of work habits, attitudes and productivity. Reliability coefficient of the whole scale is 0.86.

Level of Work Habits, Attitudes, and Productivity

Data Gathering Procedure

The researchers provided a consent form to the respondents to ask permission for the conduct of the study. Once the respondents agreed to take part with the research, the researcher immediately proceeded to the floating and administration of the WHAP Scale starting with giving the instructions with respect to the nature of the study which is during the covid-19 pandemic. It only took them 10-15 minutes to complete the scale. After answering the scale, the data is tallied on a Microsoft Excel format for the scoring, norming, analysis, and treatment.

Analysis of Data

Descriptive statistics is employed to analyze the level of Work Habits, Attitude, and Productivity of respondents in terms of the five given dimensions. The descriptive values for each dimension are Low, Average, and High that varied depending on the obtained raw scores and stanine scores.

The researchers both utilized T-test and ANOVA to know if there is a significant difference between the variables.

RESULTS AND DISCUSSION

Table 1. Frequency and Percentage Distribution of Respondents According to Profile

Table 1 shows the distribution of respondents according to profile. The profile of the respondents is divided according to sex, age, occupation (clustered into three namely: admin, medical, and utility), type of sector affiliation, employment status, length of service and salary. This table constituted 100 respondents. In terms of sex, 75 are female respondents and 25 are male. Female respondents comprise a larger percentage (75%) compared to male (25%). This implies that majority of the respondents are female.

In terms of age, 64 of the respondents are from ages 21-30 which also have the highest percentage (64%), 23 are 31-40 (23%), 10 are ages 41-50 (10%) and 3 are ages 51-60 (3%). Majority of the respondents were on the age bracket of 21-30. In terms of occupation, 27 works in administrative area (27%) 70 are medical workers consists of nurses, doctors, radiologists etc. (70%) and 3 were utility workers (3%). Majority of the respondents are medical workers. In terms of type of sector affiliation, 36 of the respondents work in a private establishment (36%) and 64 were working in public (64%). This shows that majority of the respondents were from a public establishment. In terms of length of service, 6 are working below 6 months (6%), there are 12 who work for 6 months to 1 year (12%), 18 are working for 1 year to 2 years (18%), for 2 years to 4 years, there are 29 (29%).

There are 14 who are working 4 years to 6 years (14%). For 6 years to 10 years there are 9 (9%) and for more than 10 years there are 12 (12%). This shows that majority of the respondents are working for 2 years to 4 years. In terms of salary, 24 have below 10,000 pesos salary (24%) 43 have the salary of 10,000-20,000 (43%). 15 have the salary of 20,000-30,000 (15%). 14 have the salary of 30,000-40,000 (14%). This shows that majority of the respondents have the salary of 10,000-20,000.

Table 2. Frequency and Percentage Distribution of Respondents’ level of Work Habits, Attitude, and Productivity

Table 2 shows the frequency distribution of the level of work habits, attitude and productivity of the respondents through its five dimensions namely concentration, motivation, job satisfaction, productivity and work orientation. According to the manual, a higher score in Concentration means that the person has high concentration on the job while a lower C means that the person lacks concentration. A high motivation means that the person is intrinsically motivated, while a lower one means that he/she is extrinsically motivated to work. A higher P means that the person is a productive worker while a lower one, an unproductive worker. A high score in work orientation means that the person is a cool, organized worker while a lower score means that he/she is a hyper, other-organized worker.

Under concentration, 50 out of 100 respondents scored high and 12 scored low. This implied that half of the 100 respondents have high concentration at work. In relation to this study’s result, previous findings relative to this research was found out that medical frontliners, or health care workers as they have been called as well, have had difficulty concentrating at work due to rampant stress from the COVID-19 virus itself and the risks marked by getting infected. Aside from stress, previous findings have also revealed that the pandemic situation have led to poor mental health acquiring disorders from the significant psychological distress they have experienced from work.

Out of 100 respondents, 53% scored average and 29% scored high in motivation which implied that the respondents have average motivation at work. Previous researches explored from the developed countries have been done regarding motivation of medical frontliners but there is very little evidence about what actually motivates them in the Philippines. A study from Indonesia, an Asian country like ours, revealed that family support is the main factor that motivates healthcare workers.

In the dimension of job satisfaction, 45% of the respondents scored high and 39% scored average inferring that the respondents have good job satisfaction. Previous studies have shown that factors linked with job satisfaction are both personal and job-related including sociodemographic characteristics such as age, gender and [education]. Moreover, in another past study, [sex, [age], profession, service year (length of service), position and monthly salary were identified as factors, as well, affecting job satisfaction.

In productivity, the respondents scored high at 47% and 43% scored average supposing that the respondents have also quite good productivity at work. Medical frontliners, although faced with a lot of stressors from work and personal factors as had been mentioned from a related article which can be seen from Chapter 2, are still highly productive despite of relatively poor working environments before and since the worsening of the pandemic situation happened.

Lastly, in work orientation, the respondents scored average at 43% and 41% scored high. This suggested that the respondents have good or average work orientation. In a study by Missel, et al. (2020), healthcare workers who have participated appeared to have been highly oriented towards their work, preparing long ahead of time especially the ones working in critical task of caring for COVID-19 patients. This said finding had been conducted at Denmark and did not quite reflect the current finding of this paper.

Overall, the high and average scores in all of the dimensions obtained good percentages which implicates that generally, medical frontliners maintain a good level of work habits, attitude and productivity at work. Out of the five dimensions, motivation has the highest percentage of low scores at 18%. Job satisfaction and work orientation both scored low at 16% and 12% in concentration while their productivity level scored low at 8% obtaining the lowest percentage among the five dimensions.

Table 3.1. T-test result of Respondents’ Work Habits, Attitude, and Productivity by Profile Variables

Table 3.1 shows the test of difference of the level of work habits, attitude and productivity of the respondents by sex, type of sector affiliation, and employment status. The five dimensions: concentration, motivation, job satisfaction, productivity and work orientation all have no significant difference according to sex.

Meanwhile, motivation is the only dimension among the five that obtained a significant difference with a p-value of 0.0249 according to type of sector affiliation. As cited on the article of Torres, working environments around the world changed drastically due to the pandemic and this had caused various adjustments around each sector, whether it may be private or public. The main driving force that has a huge significance on their sector affiliation is their level of motivation which is defined as “the willingness to exert different level of efforts towards achieving organizational goals and satisfying existing needs” (Franco, 2002). This is reflected on the research findings.

In terms of employment status, the only dimension with a significant difference is productivity with a p-value of 0.02182 which according to Lofland, is the product of having irregularities at work. Work productivity is defined by presenteeism and it could greatly affect performance, measured using work disability, work loss, and work limitation (Drenowski). And lastly, there is no significant difference among the occupations. We can note that a p-value greater than 0.05 means that the null hypothesis should not be rejected, and a p-value lower than 0.05 means that the null hypothesis should be rejected.

Table 3.2. Anova and LSD result of Respondents’ Work Habits, Attitude, and Productivity by Profile Variables

Table 3.2 shows the differences between variables in specific dimensions under WHAPs.

In terms of age, there is a significant difference between 40-49 years old and 22-29 years old with a p-value of 0.0169 on work orientation. Another age bracket with a significant difference is between 40-49 years old and 30-39 years old with a p-value of 0.0118. Given the health risks faced by older employees as well as early retirement incentives that they anticipate with the organization with budget shortfalls to offer, it is possible that the post-covid workplace is less diverse with respect to age. This is signified by the difference between ages 22-29 and 40-49, and as well as 30-39 and 40-49. On the other hand, the degree that COVID-related losses in employees’ defined contribution retirement plans prompt older workers to delay retirement, according to the study conducted by Solinge and Henkens (2014). Hence, on the study by Missel, Bernild & Dagyaran (2020), due to undetermined pandemic health protocols and response and the constant changing of quarantine protocols as well leave them hanging which in turn affect their overall work performance and effectiveness and give them work stress, which we can infer that younger age is associated with an intrinsic orientation to work. To incorporate, is a strong sense of professional identity and were highly oriented towards their work.

In terms of Length of Service, a significant difference is seen under concentration between 2-4 years and 6-10 years with p-value of 0.0034 and between below 6 months and 6-10 years with a p-value of 0.0129. There is little evidence with regards to length of service on the level of work habits, attitude and productivity or even consequently on the dimension of concentration.

In terms of Monthly Salary, there is a significant difference under concentration, between 20,001-30,000 and below 10,000 with a p-value of 0.0234. Another monthly salary with a significant difference is between 30,001-40,000 with a p-value of 0.0052 and between 10,001-20,000 and 30,001-40,000 with a p-value of 0.0123. The difference in monthly salary is seen in the dimension concentration. Covid-19 has highlighted the extent to which society depends upon the frontline workers who are often employed in low-paid jobs whose quality matches neither the importance of the work, nor the skills involved. Wage or Salary is one of the most important things when people work. One motivation to increase productivity is to pay wages of employees above the market rate. Which we can see that monthly salary impacts productivity; which we can note is one dimension that’s being measured by the WHAP scale. In contrary to this study made by the Harvard Business Review, the study revealed that there is a significant difference in monthly salary of frontliners under concentration. Which we can note that health care frontliners’ concentration from the onset of the covid-19 pandemic has decreased. But with good compensation, and in-time issuing of the government-promised SRA and hazard pay, it can be a good factor for the increase in concentration of frontline workers, given and notable that those who receive higher salary have pre-dominantly manifested a significant difference from those who receive below 10,000 pesos.

We can note that a p-value greater than 0.05 means that the null hypothesis should not be rejected, and a p-value lower than 0.05 means that the null hypothesis should be rejected. In table 3.2, other dimensions have no significant difference under different respective variables.

SUMMARY OF FINDINGS

Majority of the respondents are female and most of them are between the age bracket 21-30 years old. Doctors, nurses, radiologists, and other medical professionals make up the largest portion of the population. Workers who had been working for 2-4 years had the highest percentage and frequency and majority of the respondents earn between Php10,001 up to Php20,000 in a month as a salary.

Based on the result of the respondents’ Work Habits, Attitude and Productivity (WHAPS), half (50) of the respondents scored high in concentration, job satisfaction and productivity at work. In terms of motivation and work orientation, majority of them scored average. This implies that overall, medical frontliners maintain a good level of work habits attitude and productivity at work during the onset of COVID-19.

On the T-test employed when respondents are grouped according to their demographic profile namely: type of sector affiliation and employment status, there is a significant difference under specific dimensions. For type of sector affiliation, there is a significant difference on motivation with a p-value of 0.0249. For the employment status, there is a significant difference on productivity with a p-value of 0.0218.

On the LSD result when respondents are grouped according to Age, Length of Service, and Monthly salary, there are different brackets under these variables that have a significant difference under a specific dimension of WHAP. For the variable age, there is a significant difference under the age brackets 40-49 y/o and 22-29 y/o and 40-49 y/o and 30-39 y/o both under the dimension work orientation. For Length of Service, there is a significant difference between the brackets 2-4 years and 6-10 years, and below 6 months and 6-10 years, both under concentration. For monthly salary, there are three brackets with significant difference namely 20,000-30,000 and below 10,000, 30,001-40,000 and below 10,000, and lastly, 10,001-20,000 and 30,001-40,000 all under concentration.

CONCLUSION

According to age, ages between 21-30 constitute most of the medical frontliners in Cagayan implying that as workers’ age increase, the number of workers by age bracket decreases. Also, majority of the respondents only earn between Php10,001 up to Php20,000 per month. Salary has a significant difference with the medical frontliners’ level of concentration but has been one of the motivating forces of workers to become more motivated and productive at work.

Consequently, most of the respondents have high concentration, high job satisfaction and high productivity at work. In the other two dimensions, the respondents have average level of motivation and work orientation at work with motivation having the highest percentage of low scores which means that some of the respondents are extrinsically motivated to work conferring to the definition of extrinsic motivation as being driven to perform or engage in an activity in an expectation to earn a reward or avoid punishment. Productivity has the lowest percentage of low scores implying that only few are nonproductive to work. Overall, the medical frontliners has observed very well the habit, attitude and productivity tendency at work. Having been said, medical frontliners within Cagayan, regardless of the rampant situation of the COVID-19 pandemic are concluded to have a good level of work habits, attitude and productivity.

According to the statistical data, there is no significant difference in respondents’ Work Habits, Attitude, and Productivity when grouped according to sex and occupation. This implies that regardless of their sex or occupation, their level of Work Habits, Attitude, and Productivity remain the same.

The significant difference however is evident on the following: respondents’ level of Work orientation when grouped according to their age; their level of Motivation when grouped according to their Type of Sector Affiliation; their level of Productivity when grouped according to Employment status; and their level of Concentration when grouped according to Length of Service and Monthly Salary.  This implies that the significant difference on the levels of the five dimensions of Work Habits, Attitude, and Productivity varies on the respondents’ Age, Type of sector Affiliation, Length of Service, Salary, and Employment Status but not on the respondents’ Sex and Occupation.

RECOMMENDATIONS

1. Although the study has concluded that the respondents have a good habit, attitude and productivity tendency at work, medical facilities should still focus more on improving their employees’ morale to further boost their level of work habits, attitude and productivity especially with the changing course in the medical field like the present COVID-19 pandemic situation.

2. Both public and private sectors should offer better work compensations and increased benefits to help further their intrinsic motivation to work. These medical facilities should provide amenable workload and work shift to give more family time to these medical frontliners.

3. Medical frontliners should be supported with self-regulation drills from the sector they are working for and as well as from the government, to help them reduce anxiety driven from work-related situations and to relieve them from psychological distress.

4. Medical Frontliners should be able to assess themselves and through introspection, use this research as guide to improve their Work Habits, Attitude, and Productivity at work.

5. Future similar studies should expand the population that will participate in the research investigation to discern the validity of the findings of this research.

6. Hospital Administrators and Institution Heads should develop a program plan to increase their employees’ motivation and work orientation such as providing the necessities of their employees’ in terms of work materials and paraphernalia as well as to conduct activities that can improve the above-mentioned dimensions.

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