As the results showed above, willingness to volunteer increased with age. The literatures also support this(10, 11). Although the respondents were all undergraduates with a relatively small age span, compared with freshmen, senior students had a richer reserve of professional knowledge, had been more influenced by medical humanities, and had a stronger sense of social responsibility as they were about to step into the society which support their more willingness to participate in voluntary activities.
Being female was positively associated with willingness to volunteer. Previous studies both support and contradict this finding. Most of the studies supporting this finding focused on nurses' or nursing students' willingness to work(12), among which female respondents accounted for an overwhelming proportion. It was possible that the ethic of care can be attributed to a gendered socialization and the type of person who chose to enter the nursing profession(10, 12). Meanwhile, in the inconsistent studies, Aoyagi and Ives(13, 14) both mentioned that childcare obligation was a consistent barrier to female’s willingness as female always took primary responsibility for childcare which might be related to the less willingness of female to volunteer. However, in our study, the respondents were undergraduates with no children and little responsibility for childcare which should have made the result closer to the true willingness of different gender.
The undergraduates from school of clinical medicine, nursing and public health were more likely to participate the voluntary activities of COVID-19. This was also consistent finding across most studies, especially the clinical medical and nursing students(12-14). In contrast, few studies had mentioned students of public health. In our study, undergraduates majoring in public health had a very strong desire (OR 3.81, 95%CI 2.26-6.40) to participate in voluntary activities of COVID-19. This might because the epidemic had strengthened students' sense of professional identity and social responsibility, and they considered COVID-19, a public health emergency of international concern issued by WHO, might have something to do with their profession. However, gaps in previous research may be related to the neglect of public health around the world, as evidenced by the pandemic of COVID-19. Therefore, it is necessary to popularize public health training in medical undergraduates can improve their vision and responsibility of global health.
Admission to the first choice, not being the single child and born in the rural area were all positive factors associated with willingness to participate voluntary activities. These factors are essentially non-modifiable and statistically proven influencers of willingness to work, which is important information for both policy makers and medical education managers. Even though they are difficult factors to influence, we can strengthen the opposite students’ medical humanities and social responsibility education to influence them to become more willing to volunteer.
Past volunteerism experience was an important effect factor. Comparing with non-participation, whether the frequency of participation was frequent but irregular, regular or occasional, there was a significant positive correlation with willingness to volunteer. This was an important inspiration for medical education administrators, who should emphasize voluntary activities in undergraduate medical education, incorporate vacation voluntary activities into practical assessment and various awards evaluation, which could directly and positively encourage medical undergraduates to actively participate in voluntary activities.
Among the students who were willing to volunteer, most chose public service which did not require medical skills, while only less than one third chose professional health-care. When asked what was most needed for participating in COVID-19 related voluntary activities, more than 80% of the students answered that professional guidance was needed. These indicated that students were lack of training so that they were not confident in their medical professional skills, and previous study had also pointed out that well professional skills directly affected their willingness and ability to participate in voluntary activities(15). This proved once again the necessity of organized and regular voluntary activities in undergraduate education in medical colleges.
The average time and extent of understanding COVID-19 also had a significant impact on willingness to volunteer. The most access to learn about voluntary activities was through internet media, followed by mainstream media. Less than one fifth got the information from university or class. Medical colleges can keep in touch with relevant medical institutions and send volunteers there who have been uniformly trained and selected by the colleges as soon as necessary.
During this outbreak, countless health workers were called or volunteered to work on the front lines, while regrettably seeing health workers in some countries and regions go on strike. The ethics of volunteering during a pandemic lead necessarily to a debate regarding an ethical duty to care(10). Daniel(16) stated the erosion of this sense of duty. While Huber(17) thought the duty of care was much more explicit during infectious disease outbreaks. Even previous studies had been asserted that immediate action is required to make such a duty explicit to healthcare workers and set it out(10). However, duty of care could be used to restrain medical workers, but not medical students. In our study, more than half of the students in each major were willing to volunteer, which clearly support Huber’s(17) view. The motivation for choosing the most is to make a contribution to society, followed by the affection for the country and the compassion for the people’s suffering. These were the reaching consequence of adhering to medical humanities education. In the global fight against COVID-19, the importance of medical humanities education shouldn’t have been ignored.
Table 4 Univariate analysis of willingness to volunteer for fighting COVID-19
Variables
|
Group
|
Willingness to volunteer
n (%)
|
c2
|
P
|
Gender
|
Male
|
1123(62.5)
|
23.670
|
<0.001
|
School
|
Clinical Medicine
|
1278(67.2)
|
60.493
|
<0.001
|
|
Nursing
|
395(69.5)
|
|
|
|
Pharmacy
|
538(62.6)
|
|
|
|
Laboratory Medicine
|
518(65.3)
|
|
|
|
Public Health
|
280(78.0)
|
|
|
|
Psychology
|
57(67.1)
|
|
|
|
Biological Sciences and Technology
|
144(63.4)
|
|
|
|
Big Health and Intelligence Engineering
|
343(58.7)
|
|
|
Whether be admitted to the first choice
|
Yes
|
2475(67.8)
|
21.296
|
<0.001
|
Single Child
|
Yes
|
1291(63.8)
|
9.742
|
0.008
|
Participation of voluntary activities before
|
Never
|
976(57.2)
|
148.293
|
<0.001
|
Occasionally
|
2192(68.4)
|
|
|
Regularly
|
70(82.4)
|
|
|
Often but not regularly
|
315(82.0)
|
|
|
The average time per day to understand the outbreak of COVID-19
|
Take no time
|
29(39.7)
|
147.458
|
<0.001
|
|
Time<30min
|
1965(61.6)
|
|
|
|
30min≤Time<60min
|
1103(31.1)
|
|
|
|
60min≤Time<90min
Time≥90min
|
250(72.3)
206(76.3)
|
|
|
Knowledge of route of COVID-19
|
Very well understood
|
594(76.5)
|
147.000
|
<0.001
|
|
Basically understood
|
2785(65.8)
|
|
|
|
Uncertain
|
163(48.7)
|
|
|
|
Basically not understood
|
10(27.0)
|
|
|
|
Very little understood
|
1(16.7)
|
|
|
Knowledge of population of COVID-19
|
Very well understood
|
536(78.5)
|
182.458
|
<0.001
|
|
Basically understood
|
2663(66.8)
|
|
|
|
Uncertain
|
33751.9)
|
|
|
|
Basically not understood
|
16(30.2)
|
|
|
|
Very little understood
|
1(14.3)
|
|
|
Whether to know voluntary activities of COVID-19
|
Yes
|
1538(79.0)
|
235.290
|
<0.001
|
Table 5 Multivariate logistic regression of willingness to volunteer for fighting COVID-19
Variables
|
Group
|
OR
|
95%CI
|
P
|
Age
|
|
0.92
|
0.87-0.98
|
0.009
|
Gender
|
Male
|
0.68
|
0.56-0.81
|
<0.001
|
School
|
Clinical Medicine
|
1.43
|
1.06-1.92
|
0.018
|
|
Nursing
|
1.07
|
0.71-1.61
|
0.129
|
|
Pharmacy
|
1.12
|
0.82-1.54
|
0.476
|
|
Laboratory Medicine
|
1.13
|
0.82-1.56
|
0.470
|
|
Public Health
|
3.81
|
2.26-6.40
|
<0.001
|
|
Psychology
|
0.63
|
0.33-1.21
|
0.168
|
|
Biological Sciences and Technology
|
1.51
|
0.93-2.46
|
0.098
|
|
Great Health and Intelligence Engineering
|
|
|
|
Whether be admitted to the first choice
|
Yes
|
1.41
|
1.16-1.71
|
0.001
|
Birth Place
|
Urban
|
0.75
|
0.62-0.91
|
0.004
|
|
Rural
|
|
|
|
Single Child
|
Yes
|
0.72
|
0.60-0.87
|
0.001
|
Participation of voluntary activities before
|
Often but not regularly
|
3.23
|
2.03-5.16
|
<0.001
|
|
Regularly
|
1.51
|
0.72-3.17
|
0.278
|
|
Occasionally
|
1.80
|
1.50-2.16
|
<0.001
|
|
Never
|
|
|
|
The average time per day to understand the outbreak of COVID-19
|
Time≥90min
|
4.31
|
2.04-9.13
|
<0.001
|
|
60min≤Time<90min
|
5.55
|
2.63-11.70
|
<0.001
|
|
30min≤Time<60min
|
3.58
|
1.97-6.51
|
<0.001
|
|
Time<30min
|
2.12
|
1.20-3.76
|
0.010
|
|
Take no time
|
|
|
|
Knowledge of population of COVID-19
|
Very well understood
|
22.02
|
2.30-210.53
|
0.007
|
|
Basically understood
|
17.264
|
1.83-162.56
|
0.013
|
|
Uncertain
|
11.32
|
1.19-107.35
|
0.034
|
|
Basically not understood
|
3.46
|
0.33-35.98
|
0.299
|
|
Very little understood
|
|
|
|
Whether to know voluntary activities of COVID-19
|
Yes
|
2.54
|
2.05-3.16
|
<0.001
|