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Abstract ---To investigate the preparedness in avian influenza and its relation with psychological stress, we assessed the staffs in a university-teaching hospital in January 2004. The study population included medical physicians, nursing staffs, administrative staffs, and medical technicians. The questionnaire for avian influenza preparedness was modified form ASTHO checklist. There were 53 items to be investigated. The main categories include (1) legal and policy issues; (2) authority; (3) vaccination/antivirals; (4) surge capacity; (5) communications and education; (6) laboratory and surveillance. In addition, the emotional stress was assessed by a stress test that ranges from 0 points to 110 points. The psychological background was set if the avian influenza is coming in the near future. The overall average scoring for ASTHO checklist was 19+6 points (95%CI 13-24). The scoring was 20+7 points (95%CI 13-26) for nursing staffs, 19+7 points (95%CI 12-26) for medical physicians, and 21+6 points (95%CI 14-27) for administrative staffs. There was no significant difference among three groups. The correlation between emotional stress and preparedness is moderate (r²=0.59, P<0.0001). For each group, the similar findings were confirmed (data not shown). This study demonstrated that a substantial portion of health care staffs still did not know well the pandemic plans and thus had psychological barrier in management of avian influenza pandemics.