Perception and attitude of healthcare workers in Saudi Arabia with regard to Covid-19 pandemic and potential associated predictors

COVID-19 and COVID-19 vaccination experiences and perceptions among health workers during the pandemic in Ebonyi state, Nigeria: An analytical cross-sectional study

BACKGROUND

COVID-19 continues to be a disease of global public health importance and requires long-term management and control. Health workers' (previous) experiences and perceptions regarding the COVID-19 pandemic and COVID-19 vaccination/vaccination process will influence not only their subsequent use of control measures but also public experiences/perceptions. We explored the COVID-19 and COVID-19 vaccination and the vaccination process experiences and perceptions, and their predictors, among the health workers in Ebonyi state, Nigeria.

METHODS

We conducted an online-offline analytical cross-sectional survey between March 12 and May 9, 2022 among all categories of health workers (clinical/non-clinical, public/private) working/living in Ebonyi state who consented to participate and were selected by convenience/snowballing techniques. A structured electronic questionnaire was used to collect data: self-administered via WhatsApp and interviewer-administered via KoBoCollect for participants who did not have WhatsApp. Data was analysed using descriptive statistics and bivariate/multivariate generalized linear models.

RESULTS

Of the 1276 health workers surveyed: 55.8% had strong COVID-19 experience and perception, 80.7% had good COVID-19 vaccination expectation and perception, and 87.7% had positive COVID-19 vaccination process experience and perception. The most important predictors of the extent and level of COVID-19 and COVID-19 vaccination and the vaccination process experiences and perceptions were level of place of work (primary-secondary/tertiary), level of attitude towards COVID-19 (vaccination), and level of knowledge about COVID-19. Another important predictor was place of work (public/private).

CONCLUSIONS

The evidence indicate the factors that should guide subsequent policy actions in the strategies to enhance the COVID-19 and COVID-19 vaccination and the vaccination process experiences and perceptions of health workers (and their use of control measures) in Ebonyi state, Nigeria, and other similar contexts. It also indicate factors to be considered by future policy actions regarding similar diseases.

Influences of healthcare workers' behaviours towards infection prevention and control practices in the clinical setting: A systematic review

AIM

To systematically evaluate empirical studies investigating the influences of healthcare workers' behaviours towards infection prevention and control practices in the Coronavirus clinical space, and to appraise and synthesise these findings.

DESIGN

A systematic review of the literature.

METHODS

The review used a five-step framework described by Khan et al. (Journal of the Royal Society of Medicine, 2003, 96 and 118) of Framing questions for a review; Identifying relevant work; Assessing the quality of studies; Summarising the evidence; and Interpreting the findings. Searches were conducted in CINHAL, MEDLINE, PsychINFO, Scopus, and Google Scholar databases to retrieve relevant peer-reviewed literature published in English between 2019 and 2023. Covidence and Joanna Briggs Quality appraisal tools were used for critical assessment. To improve transparent reporting, this review used a Synthesis Without Meta-analysis (SWiM) in systematic review guidelines, as informed by Campbell et al. (BMJ, 2020, 368).

RESULTS

Twenty studies were included in this review, identifying nine themes describing factors influencing HCWs' behaviours towards IPC practices in the coronavirus environment. The overarching influences emerged as knowledge-oriented, person-oriented, and environment-oriented.

CONCLUSION

Healthcare workers' responsibilities at point-of-care involve providing direct care to patients with highly transmissible infections and working in clinical settings that may be ill-designed for IPC practices, increasing the risk of transmission. Given the lack of a definitive solution to eradicate new mutant viruses and that IPC practices are the mainstay of prevention and control of transmissible, measures to improve are imperative. The identified HCWs' domains on behaviours towards IPC are critical in strategies to mitigate risks and further set an opportunity for developing an IPC model congruent with the rapid response required for HCWs during emerging or re-merging mutant virus outbreaks. This is significant, given that HCWs' preparedness with IPC practices at point-of-care is central to patient care, the workforce and community safety.

Disparities in the level of COVID-19 health literacy and the associated factors among employees in long-term care facilities in Taiwan

BACKGROUND

Coronavirus disease 2019 (COVID-19) poses a significant threat to the safety of residents in long-term care facilities, and the staff of long-term care facilities are essential in the care and prevention of major infectious diseases and therefore require good health literacy to ensure the health of residents. The main objective of this study was to examine the health literacy of staff in long-term care facilities and analyze the factors associated with their COVID-19 health literacy in Taiwan to provide a basis for the response mechanism to emerging infectious diseases.

METHODS

A cross-sectional survey with a structured questionnaire by a convenience sample method and to assess the COVID-19 health literacy of caregivers working in long-term care facilities in this study. The COVID-19 health literacy scale was a self-administered scale designed to combine the concept of "health literacy" with the 3 levels and 5 stages of preventive medicine. A total of 385 workers from 10 long-term care facilities were surveyed as the study sample, and the validated questionnaires were statistically analyzed using SPSS version 22.0 statistical software. A multivariate logistic regression model was used to establish the associated factors of the COVID-19 health literacy level.

RESULTS

Overall, the mean COVID-19 health literacy score was 88.7 ± 10.4 (range: 58-105). Using a quartile scale, 92 (23.9%) of the study participants had low health literacy (health literacy score < 82), 190 (49.3%) had average health literacy (health literacy score 82-98), and the remaining 103 (26.8%) had good health literacy (health literacy score 99-105). Statistical analysis revealed significant differences (p < 0.05) in the COVID-19 health literacy score by demographic variables (education, job category, number of daily service users, and training related to infectious disease prevention and control) of the study population. The logistic regression analysis of the COVID-19 health literacy level (> 82 vs. ≤82) showed a significant difference in the study sample by gender (male vs. female, OR = 2.46, 95% CI = 1.15-5.26), job category (nurse practitioner vs. caregiver, OR = 7.25, 95% CI = 2.46-21.44), monthly service hours (> 160 h vs. 40-79 h, OR = 0.044, 95% CI = 0.07-0.97), experience caring for confirmed COVID-19 patients (yes vs. no, OR = 0.13, 95% CI = 0.02-0.98), and training related to infectious disease prevention and control (yes vs. no, OR = 2.8, 95% CI = 1.52-5.15).

CONCLUSIONS

This study recommends that facilities provide immediate updated COVID-19 information to staff, especially frontline caregivers, and specifically enhance COVID-19 infection control education training for all facility staff to eliminate health literacy disparities.

Ethical uncertainty and COVID-19: exploring the lived experiences of senior physicians at a major medical centre

Given the wide-reaching and detrimental impact of COVID-19, its strain on healthcare resources, and the urgent need for-sometimes forced-public health interventions, thorough examination of the ethical issues brought to light by the pandemic is especially warranted. This paper aims to identify some of the complex moral dilemmas faced by senior physicians at a major medical centre in Saudi Arabia, in an effort to gain a better understanding of how they navigated ethical uncertainty during a time of crisis. This qualitative study uses a semistructured interview approach and reports the findings of 16 interviews. The study finds that participants were motivated by a profession-based moral obligation to provide care during the toughest and most uncertain times of the pandemic. Although participants described significant moral dilemmas during their practice, very few identified challenges as ethical in nature, and in turn, none sought formal ethics support. Rather, participants took on the burden of resolving ethical challenges themselves-whenever possible-rationalising oft fraught decisions by likening their experiences to wartime action or by minimising attention to the moral. In capturing these accounts, this paper ultimately contemplates what moral lessons can, and must be, learnt from this experience.

Impact of a Video-Based Educational Intervention on the Levels of Knowledge and Concerns about COVID-19 Vaccination

Background. The hesitancy to receive the COVID-19 vaccine plays a role in delaying the current global and national COVID-19 management strategies. Evidence has highlighted the importance of examining the public’s concerns and knowledge about COVID-19 vaccines in sustaining public prevention of the further spread of the virus worldwide. This study aimed to assess the impact of a video-based educational session on the Saudi public’s levels of knowledge and concerns about the COVID-19 vaccination. Methods. In a double-blind, randomized posttest-only control group study design, 508 Saudis were randomized to an experimental group (n = 253) and a control group (n = 255). The experimental group was exposed to a video-based educational session, while the control group was not. Then both groups were subjected to a validated questionnaire to assess their level of knowledge and concerns about the vaccine. Results. In comparison to the control group, the experimental group showed a significantly lower proportion of overall high concern (0.4% vs. 5.5%, p < 0.001) and a higher proportion of overall good knowledge (74.2% vs. 55.7%, p < 0.001). After adjustment for possible confounders, the experimental group showed a significantly lower percent mean score of overall concern (45.0% vs. 65.0%, p < 0.001) and a higher percent mean score of overall knowledge (74.2% vs. 55.7%, p < 0.001) than the control group. Conclusions. The video-based educational intervention positively impacted the levels of knowledge and concerns about COVID-19 vaccination among the experimental group. These interventions safeguard against the rumors and misconceptions about COVID-19 vaccinations. Further studies on the impacts of such interventions on vaccine uptake are recommended.

Knowledge- and Experience-Based Perceptions of Radiation Therapists during the COVID-19 Outbreak

Objective: To assess the perceived risks and impact of the COVID-19 outbreak on radiation therapists in Saudi Arabia. Methods: A questionnaire was distributed to all radiation therapists in the country. The questionnaire contained questions about demographic characteristics, the extent of the pandemic's impact on hospital resources, risk perception, work-life, leadership, and immediate supervision. The questionnaire's reliability was assessed using Cronbach's alpha; >0.7 was considered adequate. Results: Out of the 127 registered radiation therapists, 77 (60.6%) responded; 49 (63.6%) females; and 28 (36.4%) males. The mean age was 36.8 ± 12.5 years. Nine (12%) of the participants had a past experience with pandemics or epidemics. Further, 46 (59.7%) respondents correctly identified the mode of transmission of COVID-19. Approximately, 69% of the respondents perceived COVID-19 as more than a minor risk to their families and 63% to themselves. COVID-19 had an overall negative impact on work at the personal and organizational levels. However, there was a positive attitude toward organizational management during the pandemic in general; positive responses ranged from 66.2% to 82.4%. Ninety-two percent considered protective resources and 70% considered the availability of supportive staff to be adequate. Demographic characteristics were not significantly associated with the perceived risk. Conclusions: Despite the high perception of risk and negative impact on their work, radiation therapists conveyed a positive overall perception regarding resource availability, supervision, and leadership. Efforts should be made to improve their knowledge and appreciate their efforts.

Clinical characteristics and outcome of Covid-19 illness and predictors of in-hospital mortality in Saudi Arabia

BACKGROUND

Patients' race and ethnicity may play a role in mortality from Covid-19. Studies in China, the US, and Europe have been conducted on the predictors of Covid-19 mortality, yet in the EMR countries, such studies are scarce. Therefore, we aimed to describe the hospitalization rate, ICU-admission, and in-hospital mortality of Covid-19 and predictors of in-hospital mortality in Saudi Arabia.

METHODS

E-medical records were examined for all Covid-19 patients diagnosed in five tertiary hospitals affiliated with the Saudi-National Guard-Health Affairs during March 21, 2020, and September 12, 2021, based on a positive SARS-CoV-2 RT-PCR test, (n = 35,284). Data were collected on patients' characteristics, comorbidities, laboratory findings, hospitalization, ICU admission, and in-hospital and overall mortality. Logestic regressions were used to identify the independent predictors of in-hospital mortality. The best laboratory parameters cut-off values to predict in-hospital mortality were identified using the area under the receiver operating characteristic curve (AUC). Significance was considered at p < 0.05.

RESULTS

Of all 35,284 Covid-19 patients, 81.8% were adults and 21.7% were hospitalized. Compared to non-hospitalized patients, hospitalized patients were more of female gender (52.1% versus 47.3%, p < 0.001) and had higher mean age (p < 0.001), higher mean BMI (p < 0.001), and higher rates of: diabetes (p < 0.001), hypertension (p < 0.001), ischemic heart disease (p < 0.001), cancer (p < 0.001), COPD (p < 0.001) and asthma (p = 0.011). The study showed 3.1% overall case-fatality, 20.3% ICU admission rate, and 9.7% in-hospital mortality. Predictors of in-hospital mortality among adult patients were; patients' age ≥ 70 years (OR = 6.93, 95% CI 1.94-24.79), ischemic heart disease (OR = 1.80, 95% CI 1.05-3.09), ICU admission (OR = 24.38, 95% CI 15.64-38.01), abnormal C-reactive protein "CRP" (OR = 1.85, 95% CI 1.08-3.16), abnormal D-dimer (OR = 1.96, 95% CI 1.15-3.36), lymphopenia (OR = 2.76, 95% CI 2.03-3.3.76), high neutrophil count (OR = 2.10, 95% CI 1.54-2.87), and abnormal procalcitonin (OR = 3.33, 95% CI 1.88-5.90). The best laboratory parameters cut-off values to predict in-hospital mortality were CRP > 72.25 mg/L (AUC = 0.64), D-dimer > 1125 µg/L (AUC = 0.75), neutrophils count > 5,745 × 10^9/L (AUC = 0.70), lymphocytic count < 1.10 × 10^9/L (AUC = 0.72), and procalcitonin > 0.18 ng/mL (AUC = 0.76).

CONCLUSIONS

Rates of hospitalization, ICU-admission, in-hospital mortality and overall case fatality were nearly comparable to the rates in western countries. Early interventions are necessary for high-risk Covid-19 patients, especially elderly patients and those with cardiac diseases.

The impact of COVID-19 pandemic on anxiety and depression among physical therapists in Saudi Arabia: a cross-sectional study

BACKGROUNDS

A physical therapist may become infected while treating a patient since they are in direct contact with them or within a two-meter radius. In addition, physical therapists may feel that they are more susceptible to COVID-19 infection when applying rehabilitation practices, which often involve direct contact with patients. The physical therapist were surveyed on their level of anxiety and depression due to the Coronavirus disease pandemic (COVID-19).

METHODS

The physical therapists were asked to complete two reliable and validated scales, the Generalized Anxiety Disorder scale (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9), to identify the presence of anxiety and depression in the participants. In addition, logistic regression models were used to determine the general characteristics of anxiety or depression.

RESULTS

Among the 117 physical therapists who completed and participated in the study, 74 (63%) and 65 (55.5%) physical therapists reported having symptoms of anxiety and depression, respectively. The prevalence of overall anxiety levels was higher; mild (OR = 2.09; P = 0.08), moderate (OR = 2.26; P = 0.15), and severe levels six times as high (OR = 6.28; P = 0.1) in females compared to male physical therapists. Females, younger age, unmarried individuals, not having children, and not living with family showed a higher prevalence of anxiety and depression. Binary logistic regression analysis also revealed that the female gender, a single individual, and having no children were associated with anxiety and depression.

CONCLUSIONS

A significant percentage of physical therapists reported symptoms of anxiety and depression, especially among females, younger age, single individuals, not having children, and not living with family. Thus, the mental health of physical therapists is suggested to be constantly and cautiously monitored, especially for those at high risk of developing psychological symptoms.

Risk perception and affective state on work exhaustion in obstetrics during the COVID-19 pandemic

A multicenter cross-sectional survey study involving four Italian University Hospitals was performed to test the hypothesis that negative affect and positive affect (affective dimensions) mediate the association between risk perception (perceived risk of infection and death; cognitive dimensions) and the feeling of work exhaustion (WE) among obstetrics healthcare providers (HCPs) during the Coronavirus Disease 2019 (COVID-19) pandemic. Totally, 570 obstetrics HCPs were invited to complete the 104-item IPSICO survey in May 2020. A theoretical model built on the tested hypothesis was investigated by structural equation modelling. The model explained 32.2% of the WE variance. Only negative affect mediated the association between cognitive dimensions and WE and also the association between WE and psychological well-being before the pandemic, experiences of stressful events, female gender, and dysfunctional coping. Non-mediated associations with WE were observed for work perceived as a duty, experience of stressful events, support received by colleagues, and the shift strategy. Only previous psychological well-being, support by colleagues, and shift strategies were inversely associated with WE. Based on study results, monitoring negative than positive affect appears superior in predicting WE, with practical implications for planning psychological interventions in HCPs at the individual, interpersonal, and organizational levels.

COVID-19 and Saudi medical students: A cross-sectional study on knowledge, preventive behaviors, and risk perception

Background

The knowledge, preventive behaviors, and risk perception of the COVID-19 pandemic among health care workers can affect virus transmission and control. As the primary individuals in contact with infected patients, health care workers risk infection. There are a few studies on the knowledge and self-practice prevention for COVID-19 among medical students.

Objectives

This study evaluated the COVID-19-related knowledge, preventive behaviors, and risk perceptions among medical students and interns.

Methods

This study used a quantitative cross-sectional evaluation of the Saudi Arabian medical students utilizing a previously published online survey in 2020.

Results

The study questionnaire was completed by 474 respondents. The average knowledge and preventive behavior score was significantly lower in males. The reported source of information showed a statistically significant association with knowledge and was higher in the respondents who reported world health organization (WHO)/centers for disease control and prevention (CDC)/UpToDate as their main source of information. The National Guidelines of the Ministry of Health was the second source to be reported for seeking information. A statistically significant positive correlation was observed between the knowledge and preventive measures scores. The respondents who did not follow any information regarding COVID-19 had significantly lower knowledge and preventive behavior scores than those obtaining knowledge from sources. The preventive behavior score was not significantly different between clinical and pre-clinical students.

Conclusion

This study assessed the knowledge, perceptions, and practices of COVID-19 following the onset of the pandemic in Saudi Arabia, indicating an acceptable level of undergraduate students' knowledge regarding the epidemic and its control measures.

Religion, politics and COVID-19 risk perception among urban residents in Malawi

INTRODUCTION

Majority of Malawians have not yet adopted COVID-19 mitigation measures despite having knowledge about its infectivity, morbidity, and fatality. Understanding drivers of hesitancy to adoption of COVID-19 mitigation measures is critical as it can inform prevention programs. This study explores Malawians' COVID-19 risk perception, and the associated constraints in the adoption of mitigation efforts. A Health Belief Model (HBM) approach was used to understand perceived factors that undermine public health COVID-19 messages to reduce the spread of the pandemic in Malawi.

METHODS

The study applied rapid appraisal and photovoice qualitative inquiry to comprehend risk perception regarding COVID-19. We purposively selected 52 participants from three major cities in Malawi. Audio and video interviews were transcribed verbatim, and transcripts were coded manually to derive key themes and concepts.

RESULTS

The study identified that social factors particularly religious and political beliefs influenced COVID-19 risk perception. Specific religious beliefs pertaining to individuals recognizing signs of the 'Christian apocalypse' were particularly associated with lower risk perceptions. Politically, participants believed COVID-19 lockdown measures were a ploy by the then-ruling party to remain in power.

CONCLUSION

The study suggests that religious beliefs and political environment undermine self -perceived risk of contracting COVID-19 among urban dwellers in Malawi. We recommend that diverse actors in Malawi should collaborate to promote the dissemination of accurate COVID-19 discourses and reduce the severity of the pandemic's impact in Malawi.

COVID-19 and Saudi Arabia: Awareness, Attitude, and Practice

The Severe Acute Respiratory Syndrome-CoronaVirus-2 (SARS-CoV-2) pandemic has transformed our appreciation of healthcare awareness worldwide. The amount of related data accumulated during this time has surpassed any other outbreak of a viral pathogen. Healthcare awareness is related to one of the nine pillars of the “World health organization (WHO) operational planning guidelines to support country preparedness and response”. This review is structured around the awareness/knowledge, attitudes, and practices (KAP)-related publications in Saudi Arabia up to date to understand the impact of COVID-19 on these domains. The excellent communication effort response from governments, international, and individuals to keep the public informed about the outbreak is highlighted. Unraveling such impacts on the Saudi communities, including healthcare workers (HCWs)/professionals (HCPs), students, patients with different diseases, and non-professional individuals, is essential in containing the outbreak and planning preventive measures in case of future outbreaks.

Awareness, Knowledge, and Perceptions of COVID-19 Precautions Among Employees of Al-Imam Abdulrahman Al Faisal Hospital in Riyadh, KSA

Background

The global pandemic of coronavirus disease-19 (COVID-19) was announced by the World Health Organization (WHO) in early 2020. The consequences of the pandemic were vast, where healthcare systems, education, and the economy of many countries were greatly affected. As such, extraordinary precautions and measures were implemented to the public as well as to the healthcare systems in order to counter the spread of the disease. However, the success of these measures depends largely on the individual's adherence to them as well as their awareness about COVID-19. Indeed, healthcare workers and their non-medical co-workers play a crucial role in that, as they are considered the front line in fighting the infection.

Objectives

To assess the knowledge, awareness and perceptions of the healthcare workers (HCWs) regarding COVID-19 in Al-Imam Abdulrahman Al Faisal Hospital in Riyadh, Saudi Arabia.

Methods

Using a cross-sectional study design, a previously validated questionnaire was used as an online survey to assess the knowledge, awareness and perceptions (KAP) of HCWs regarding COVID-19. The targeted population of this study was all the healthcare workers in Al-Imam Abdulrahman Al Faisal Hospital, including their non-medical co-workers.

Results

The study included 274 respondents consisting of 53.65% males and 46.45% females with an average age between 30-39 years. The majority of the respondents were paramedics with a percentage of 30.66%. The governmental references were the main source of information regarding COVID-19 for 69% of the respondents. Questions with accurate responses that exceeded 90% were about the COVID-19 complications, transmission, and measures to reduce its transmission. In this study, overall knowledge was significantly associated with the gender of the participants (P=0.01).

Conclusion

There was a good level of knowledge and perception in health care professionals and co-workers regarding SARS-CoV-2.

Hospitals early challenges and interventions combatting COVID-19 in the Eastern Mediterranean Region

BACKGROUND

During rapidly evolving outbreaks, health services and essential medical care are interrupted as facilities have become overwhelmed responding to COVID-19. In the Eastern Mediterranean Region (EMR), more than half of countries are affected by emergencies, hospitals face complex challenges as they respond to humanitarian crises, maintain essential services, and fight the pandemic. While hospitals in the EMR have adapted to combat COVID-19, evidence-based and context-specific recommendations are needed to guide policymakers and hospital managers on best practices to strengthen hospitals' readiness, limit the impact of the pandemic, and create lasting hospital sector improvements towards recovery and resilience.

AIM

Guided by the WHO/EMR's "Hospital readiness checklist for COVID-19", this study presents the experiences of EMR hospitals in combatting COVID-19 across the 22 EMR countries, including their challenges and interventions across the checklist domains, to inform improvements to pandemic preparedness, response, policy, and practice.

METHODS

To collect in-depth and comprehensive information on hospital experiences, qualitative and descriptive quantitative data was collected between May-October 2020. To increase breadth of responses, this comprehensive qualitative study triangulated findings from a regional literature review with the findings of an open-ended online survey (n = 139), and virtual in-depth key informant interviews with 46 policymakers and hospital managers from 18 out of 22 EMR countries. Purposeful sampling supported by snowballing was used and continued until reaching data saturation, measures were taken to increase the trustworthiness of the results. Led by the checklist domains, qualitative data was thematically analyzed using MAXQDA.

FINDINGS

Hospitals faced continuously changing challenges and needed to adapt to maintain operations and provide essential services. This thematic analysis revealed major themes for the challenges and interventions utilized by hospitals for each of hospital readiness domains: Preparedness, Leadership, Operational support, logistics, supply management, Communications and Information, Human Resources, Continuity of Essential Services and Surge Capacity, Rapid Identification and Diagnosis, Isolation and Case Management, and Infection, Prevention and Control.

CONCLUSION

Hospitals are the backbone of COVID-19 response, and their resilience is essential for achieving universal health coverage. Multi-pronged (across each of the hospitals readiness domains) and multi-level policies are required to strengthen hospitals resilience and prepare health systems for future outbreaks and shocks.

Psychological distress reported by healthcare workers in Saudi Arabia during the COVID-19 pandemic: A cross-sectional study

INTRODUCTION

Few studies have considered the impact of COVID-19 on the mental health of healthcare workers (HCWs) in the Kingdom of Saudi Arabia (KSA). We estimated the prevalence and severity of psychological distress and characterized predisposing risk factors among HCWs in KSA during the COVID-19 pandemic.

METHODS

We conducted a cross-sectional online survey of 1,985 HCWs from 6 hospitals across the country designated with caring for COVID-19 patients between April 16 and June 21, 2020. Our data analysis was performed using logistic regressions. Ordered logistic regressions were also performed using forward stepwise model selection to explore the effects of risk factors on psychological distress.

RESULTS

The prevalence of psychological distress reported by HCWs in KSA was high, ranging from mild-moderate to severe in severity. Younger HCWs, women, those in contact with COVID-19 patients, and those who either had loved ones affected or who were themselves affected by COVID-19 were the most at-risk of psychological distress. Risk factors such as insomnia, loneliness, fear of transmission, and separation from loved ones most significantly predicted elevated levels of distress among HCWs.

CONCLUSIONS

Increasing psychological distress was commonly reported by HCWs during the early months of COVID-19 pandemic in KSA. Public health policy makers and mental health professionals must give special attention to risk factors that predispose HCWs in KSA to psychological distress.

Stress, Depression, Anxiety, and Burnout among Healthcare Workers during the COVID-19 Pandemic: A Cross-sectional Study in a Tertiary Centre

Background:

Healthcare workers have been known to suffer from depression, anxiety, and other mental health issues as a result of their profession. Healthcare professionals were already vulnerable to mental health issues prior to the COVID-19 pandemic, but now they are even more prone to stress and frustration.

Objective:

The study aimed to assess stress, depression, anxiety, and burnout among healthcare workers during the COVID-19 pandemic. Moreover, it assessed the relationship between stress, depression, anxiety, burnout, and COVID-19 related stress.

Methods:

A cross-sectional, descriptive, and correlative design was adopted to assess stress, depression, anxiety, and burnout among healthcare workers and determine the relationship among these variables during the COVID-19 pandemic.

Results:

The response rate was 87.6% (831 out of 949), the majority of the participants were nurses (87.4%), and 38.4% were working in inpatient settings. The means of COVID-19 related anxiety (17.38 ± 4.95) and burnout (20.16 ± 6.33) were high and tended to be in the upper portion of the total scores. Participants reported moderate to extremely severe levels of stress (26.5%), anxiety (55.8%), and depression (37.2%). Males reported a higher level of stress (16.59 ± 10.21 vs. 13.42 ± 9.98, p = 0.002) and depression (14.97 ± 10.98 vs. 11.42 ± 10.56, p = 0.001). COVID-19 related anxiety was significantly correlated with participants’ professions (p = 0.004). Burnout (p = 0.003) and depression (p = 0.044) were significantly correlated with the participants’ working area. Significant positive correlations were found between stress, depression, anxiety, burnout, and COVID-19 related stress.

Conclusion:

Healthcare workers may experience considerable psychologic distress as a result of the COVID-19 pandemic due to providing direct patient care, quarantine, or self-isolation. Healthcare workers who were at high risk of contracting COVID-19 appeared to have psychological distress, burnout, and probably, chronic psychopathology. Frontline staff, especially nurses, were at higher risk of showing higher levels of psychological and mental health issues in the long term.

A national survey evaluating the knowledge and attitude of health-care workers of Saudi Arabia about Coronavirus infection

Background and Objectives:

Health-care workers (HCWs) are playing an instrumental role in combating coronavirus infection (COVID-19). While rendering their services, they also run the risk of cross-contamination. Hence, it is important to evaluate and correlate the knowledge and attitude of HCWs of Saudi Arabia about COVID-19.

Materials and Methods:

A prospective, nationwide, questionnaire-based survey was conducted after getting the approval from the institutional ethical board. A validated and reliable questionnaire was constructed, developed on the Qualtrics software, and circulated through an electronic medium across the country. The questionnaire had a total of 29 questions regarding knowledge and attitude about COVID-19. Through convenience sampling, the data were collected from a total sample of 1553 HCWs. Based on the primary area of expertise, the sample was categorized into three study groups with 1040 medical health-care professionals (MHCPs) (Group I), 318 dental health-care professionals (DHCPs) (Group II), and 195 allied health-care professionals (AHCPs) (Group III). Univariate and multivariate logistic regression analysis was done using SPSS v. 21, where P < 0.05 was considered statistically significant.

Results:

Female HCWs (P = 0.003) were shown to have a higher (adjusted odds ratio [aOR]: 1.46; confidence interval [CI]: 1.19–1.79) risk of inadequate knowledge in comparison to male HCWs. With respect to qualification, HCWs with doctorate qualification (P = 0.005) (aOR: 0.39; CI: 0.2–0.75) had shown to have adequate knowledge compared to their counterparts. AHCPs were shown inadequate knowledge (P < 0.001; aOR: 2.36; CI: 1.65–3.38), but adequate attitude (P < 0.001; aOR: 0.13; CI: 0.09–0.2) compared to MHCPs and DHCPs.

Conclusion:

MHCPs were shown to have the most appropriate level of knowledge, whereas AHCPs outscore other counterparts of HCWs with respect to attitude toward COVID-19. Emphasis should be directed to the whole community of HCWs in enhancing their awareness and practice attitude toward the novel infection of COVID-19.

Impact of COVID-19 pandemic quarantine on physical, nutritional, psychosocial life and work aspects in the Kingdom of Saudi Arabia

Background:

The coronavirus disease-2019 (COVID-19) is a global public health disaster imposing a nationwide lockdown. This study was undertaken to determine the impact of COVID-19 quarantine on physical, nutritional, psychosocial life, and work aspects on the population of Saudi Arabia.

Methods:

Data collection was based on the fear of COVID-19 Scale (FCV-19S) and was analyzed by the Likert-type scale. A total of 2828 individuals participated during their COVID-19 quarantine. The data were collected during June 10–17, 2020 using the psychosocial FCV-19S.

Results:

COVID-19 quarantine was negatively correlated with the physical, nutritional, psychosocial life and work aspects of the Saudi Arabia’s population (P < 0.05). As a result of the correlation analysis, gender, sociodemographic status and having a family member dying of COVID-19, marital status (single), monthly income (<3000) and occupation (student), and lost a job or businesses were significantly associated with fear of COVID-19 (P < 0.05). Furthermore, the participants reported a reduction in their physical activity by 59%, whereas 26.5% of participants showed an increase of body weight. Moreover, 23% of participants lost their jobs during the pandemic.

Conclusions:

The lockdown period was associated with an increase in the COVID-19 fear score. The degree FCV-19S was varied in different categories in several aspects. Low levels of physical activity and weight gained were observed during the lockdown period.

Knowledge, attitude, practices and perceived job stress among physical therapists in the Kingdom of Saudi Arabia during the COVID-19 pandemic: a cross-sectional study

AIM

The objective of this study was to assess the level of knowledge, attitude and practice (KAP) and perceived job stress among physical therapists (PTs) during the COVID-19 pandemic in the Kingdom of Saudi Arabia (KSA).

METHODS

A cross-sectional study design was adopted; 300 PTs working within the KSA were randomly selected, and the KAP questionnaire was distributed through email using a Google form during the first quarter of 2022. The questionnaire consisted of demographic information, KAP, and perceived stress level at the job. Data analysis was carried out using SPSS 20.0.

RESULTS

Most PTs are knowledgeable about the management of COVID-19 patients, where their overall correct response to the items of the knowledge-related questionnaire was 87%. Most PTs had positive attitudes toward successful control of COVID-19 (83%) and took necessary precautions, such as frequent handwashing (97.2%) and adherence to the Centers for Disease Control & Prevention (CDC) guidelines (91.5%) during practice. The overall job stress level of the PTs was 'Moderate' (76.5%). This study showed a significant association between the level of job stress experienced by the PTs and selected demographic variables.

CONCLUSION

PTs have adequate knowledge, exhibit a positive attitude and adhere to CDC guidelines while managing patients during the COVID-19 pandemic. Most PTs are prone to moderate job stress while managing patients during the COVID-19 pandemic, and appropriate strategies must be devised to alleviate their job stress and improve their efficiency.

A qualitative study to explore primary health care practitioners' perceptions and understanding regarding the COVID-19 pandemic in KwaZulu-Natal, South Africa

BACKGROUND

The coronavirus disease 2019 (COVID-19) is a novel virus that has rapidly spread across countries globally, and has been declared a pandemic by the World Health Organization (WHO). In South Africa, more that 1 million cases have been confirmed since case zero was detected in March 2020. South Africa is currently leading in the sub-Saharan African region in terms of COVID-19-related mortality and morbidity rates.

AIM

The aim of this study was to explore primary health care practitioners' perceptions and understanding regarding the COVID-19 pandemic in KwaZulu-Natal, South Africa.

SETTING

The study was conducted at two selected primary health care facilities (a community health centre and satellite clinic) within a low-income rural context in KwaZulu-Natal, South Africa.

METHODS

A qualitative study was conducted to explore and describe perceptions and understanding of primary health care practitioners regarding the COVID-19 pandemic in KwaZulu-Natal (KZN), South Africa. Data were collected from a purposive sample of 15 participants at two different clinics situated in rural KZN, South Africa. Participants comprised of nurses, physiotherapists, pharmacists, community care givers, social workers and clinical associates. The participants were both men and women who were all above the age of 20. Data were collected through individual, in-depth face-to-face interviews using a semi-structured interview guide. An audiotape was used to collect data, which were transcribed verbatim. Data were analysed manually by thematic analysis following Tech's steps of data analysis.

RESULTS

Participants reported pre-pandemic and pandemic perceptions of fear, denial, expectancy and a perceived poor preparation for the COVID-19 outbreak. The findings also revealed participants' misperceptions regarding the nature of the COVID-19 pandemic and unrealistic expectations of occupational compensations for working during the outbreak.

CONCLUSION

The findings of this study suggest that primary health care practitioners generally have negative perceptions and understanding regarding the pandemic because of misinformation obtained from social media. Interventions to support health care practitioners are necessary to mitigate the potentially negative implications of health practitioners' misconceptions on service delivery and their mental health.

Psychological Distress and Anxiety Levels Among Health Care Workers at the Height of the COVID-19 Pandemic in the United Arab Emirates

Objectives: Providing medical care during a global pandemic exposes healthcare workers (HCW) to a high level of risk, causing anxiety and stress. This study aimed to assess the prevalence of anxiety and psychological distress among HCWs during COVID-19. Methods: We invited HCWs from 3 hospitals across the United Arab Emirates (UAE) to participate in an anonymous online survey between April 19-May 3, 2020. The GAD-7 and K10 measures were used to assess anxiety and psychological distress. Logistic regression models assessed associations between knowledge, attitude, worry, and levels of anxiety and psychological distress. Results: A total of 481 HCWs participated in this study. The majority of HCWs were female (73.6%) and aged 25-34 years (52.6%). More than half were nurses (55.7%) and had good knowledge of COVID-19 (86.3%). Over a third (37%) of HCWs reported moderate/severe psychological distress in the K10 measure and moderate/severe anxiety (32.3%) in the GAD-7, with frontline workers significantly reporting higher levels of anxiety (36%). Knowledge of COVID-19 did not predict anxiety and psychological distress, however, HCWs who believed COVID-19 was difficult to treat and those who perceived they were at high risk of infection had worse mental health outcomes. Worry about spreading COVID-19 to family, being isolated, contracting COVID-19 and feeling stigmatized had 1.8- to 2.5-fold increased odds of symptoms of mental health problems. Additionally, HCWs who felt the need for psychological support through their workplace showed increased odds of psychological distress. Conclusion: HCWs in the UAE reported a high prevalence of psychological distress and anxiety while responding to the challenges of COVID-19. The findings from this study emphasize the public, emotional and mental health burden of COVID-19 and highlight the importance for health systems to implement, monitor, and update preventive policies to protect HCWs from contracting the virus while also providing psychological support in the workplace.

Multilevel Factors Affecting Healthcare Workers' Perceived Stress and Risk of Infection During COVID-19 Pandemic

Objectives: This study aimed to identify key factors affecting Healthcare workers (HCWs) perceived stress and risk of contracting COVID-19 among themselves and their family members during the pandemic. Methods: A cross-sectional online questionnaire study was conducted between 19 March and April 5, 2020 in Hong Kong. HCWs from public hospitals and private dentists, and their family members participated. Results: A total of 747 HCWs and 245 family members participated. Higher perceived stress in HCWs was associated with more negative changes in family relationship (p = 0.025). The HCWs' perceived stress, however, was positively associated with family cohesion (p = 0.033) and stress levels of family members (p < 0.001). The level of HCWs' satisfaction toward the hospital policies in response to the COVID-19 outbreak was associated with lower levels of perceived stress and risk of themselves or their family members contracting COVID-19. HCWs' previous frontline experience of SARS was significantly associated with less perceived risk of themselves or their family members contracting COVID-19. Conclusion: Hospital policies addressing HCWs' needs, frontline experience of SARS, and family relationship influenced psychological wellbeing of HCWs during the COVID-19 outbreak.

Noninvasive Detection of Respiratory Disorder Due to COVID-19 at the Early Stages in Saudi Arabia

The Kingdom of Saudi Arabia has suffered from COVID-19 disease as part of the global pandemic due to severe acute respiratory syndrome coronavirus 2. The economy of Saudi Arabia also suffered a heavy impact. Several measures were taken to help mitigate its impact and stimulate the economy. In this context, we present a safe and secure WiFi-sensing-based COVID-19 monitoring system exploiting commercially available low-cost wireless devices that can be deployed in different indoor settings within Saudi Arabia. We extracted different activities of daily living and respiratory rates from ubiquitous WiFi signals in terms of channel state information (CSI) and secured them from unauthorized access through permutation and diffusion with multiple substitution boxes using chaos theory. The experiments were performed on healthy participants. We used the variances of the amplitude information of the CSI data and evaluated their security using several security parameters such as the correlation coefficient, mean-squared error (MSE), peak-signal-to-noise ratio (PSNR), entropy, number of pixel change rate (NPCR), and unified average change intensity (UACI). These security metrics, for example, lower correlation and higher entropy, indicate stronger security of the proposed encryption method. Moreover, the NPCR and UACI values were higher than 99% and 30, respectively, which also confirmed the security strength of the encrypted information.

COVID-19: Risk Stratification of Healthcare Workers in the Eastern Province of Saudi Arabia and Their Knowledge, Attitude, and Fears

Introduction With the expeditious spread of coronavirus disease 2019 (COVID-19), healthcare workers have undoubtedly faced a higher risk of contracting the disease compared to the general public. This study aimed to stratify the risk of coronavirus disease 2019 infection among healthcare workers in the Eastern province of Saudi Arabia and shed light on their level of knowledge, attitude, and fear towards the disease. Methods A quantitative cross-sectional study, involving 978 Arabic and English-speaking healthcare workers, was conducted using a self-administered online questionnaire. The knowledge, attitude, and fear scales were developed by researchers using the most updated information regarding coronavirus disease 2019. The Objective Risk Stratification tool developed in the United Kingdom was used to measure the risk level of contracting coronavirus disease 2019. Collected data were analyzed and interpreted using the Statistical Package for Social Sciences software. Results Out of the 978 participants, 63.1% were female, 74.6% were 20-39 years old, 86.9% were Saudis, and 31.3% worked as physicians. The most common health-related risk factors for severe coronavirus disease 2019 among the study participants were smoking (23.4%), sickle cell trait (22.8%), and asthma (21.2%). The risk of contracting coronavirus disease 2019 was found to be low in 87.2% of participants, with those significantly at higher risk being male, non-Saudis, black Africans, and 70-79 years old. The knowledge level was found to be high among 54.7% of participants, with significantly higher levels being reported among females, non-Saudis, and participants who were either physicians or pharmacists. The most commonly cited source of knowledge was the Saudi Ministry of Health (82%). Participants largely demonstrated a positive attitude towards the disease (53.9%), particularly those working as physicians and in the governmental sector. The majority of participants (54.4%) were found to have a high level of fear toward the disease, with significantly higher levels being reported among females, 30-39 years old, and those who were either nurses or pharmacists. Conclusion The present study demonstrated significant sociodemographic variability among healthcare workers in the Eastern province, with respect to their risk of contracting coronavirus disease 2019 and their levels of knowledge, attitude, and fear toward the disease.

Exploring health impact and safety measures against transmission of COVID-19 pandemic in Saudi Arabia

The pandemic of Covid-19 at the global level cannot be underestimated. Arab world including Saudi Arabia is affected with the pandemic of Covid-19. More importantly, the surge of the numbers of infected individuals in Iran has brought fear and anxiety in the whole region in general and Saudi Arabia in particular. Several studies have investigated the prevalence of the virus in different countries from various perspectives. Nonetheless, little focus is given to academic research on health challenge of the virus resulting to fear and anxiety in the recent time in the context of Saudi Arabia. This study primarily aims at exploring the health effect of Covid-19 in Saudi Arabia despite the fact that, the World Health Organization (WHO) has clamored for preventive measures in addressing global health effect of the virus. The methodology of the study is systematic literature review (SLR) and content analysis of the secondary data on health impact of Covid-19 and preventive measures against its transmission in the country are critically analyzed. The results of secondary data of the study indicated that a number of confirmed cases, active cases and deaths in Saudi Arabia manifested negative impact of Covid-19 on citizens' health especially fear and anxiety despite the fact that records have showed steady recovered cases in the country. More specifically, the findings indicated that, health impact of Covid-19 are as follows namely: fear or anxiety, negative attitude among health workers and women in health workforce. Similarly, Saudi Arabia has put in place various preventive measures such as: preventive measures against transmission of Covid-19 which are as follows: institutional preparedness and strengthening mechanism, curfews and lockdowns and suspension of activities and order of social distancing. In conclusion, this paper has lucidly highlighted the health effect of Covid-19 and safety measures against the transmission of Covid-19 have been elaborated in the context of Saudi Arabia. It is thereby suggested that, the outcome of this study can be helpful to the health workers and policymakers in the country to be acquainted with the magnanimity of the novel coronavirus as well as putting effective safety mechanisms in place in curtailing the spread of Covid-19 in Saudi Arabia.

Depression, Suicidal Thoughts, and Burnout Among Physicians During the COVID-19 Pandemic: a Survey-Based Cross-Sectional Study

OBJECTIVES

Frontline workers have been a bulwark in the fight against COVID-19, while being subject to major unexpected stressors. These include conflicting news, evolving guidelines, perceived inadequate personal protective equipment, overflow of patients with rising death counts, absence of disaster training, and limitations in the implementation of social distancing. This study investigates the incidence and associated factors of depression, suicidal thoughts, and burnout among physicians during the COVID-19 pandemic.

METHODS

In a cross-sectional survey-based study of resident, fellow, and attending physicians from a tertiary university hospital during the height of the COVID-19 pandemic in New York from April 24 to May 15, 2020, demographics and practice specialty, attending vs. resident/fellow status, call frequency, emotional exhaustion, depersonalization, and depression severity were examined.

RESULTS

Two hundred twenty-five subjects completed the survey (response rate of 16.3%), with rates of 6.2% depression, 6.6% suicidal ideation, and 19.6% burnout. Depression, suicidal ideation, and burnout were all associated with history of prior depression/anxiety and frequency of on call. Suicidal ideation and burnout were also associated with younger age. There was no difference in rates of depression, suicidal ideation, or burnout between attending and resident physicians. Female physicians reported less work-life balance and more burnout.

CONCLUSIONS

These findings highlight the importance of considering physician mental health during times of peak stress, such as natural or man-made disasters. The prominence of premorbid depression/anxiety as a relevant factor underscores the need to further understand physician mental health and provide early screening and treatment.

Assessment of quality of work life (QWL) among healthcare staff of intensive care unit (ICU) and emergency unit during COVID-19 outbreak using WHOQoL-BREF

Objective

The study aimed to document the quality of work life (QWL) among healthcare staff of intensive care units (ICUs) and emergency units during COVID-19 outbreak using the WHOQoL-BREF.

Methods

A multicenter cross-sectional study was conducted for two months (May – June 2020) among healthcare staff working in intensive care units (ICUs) and emergency units of the hospitals under the National Guard Health Authority (NGHA) across five cities of Saudi Arabia. The study used the WHOQoL-BREF instrument to document the QWL through an electronic institutional survey. The data was analyzed through IBM SPSS version 23. The study was approved by an ethics committee.

Results

A total of 290 healthcare professionals responded to the survey. The mean overall quality of life score was 3.37 ± 0.97, general health = 3.66 ± 0.88, domains, i.e., physical = 11.67 ± 2.16, psychological = 13.08 ± 2.14, social = 13.22 ± 3.31 and environment = 12.38 ± 2.59. Respondents aged > 40 years, male gender, married status, being a physician and, having a work experience > 15 years and no extra working hours, had higher mean scores for several domains of Quality of life (QoL), overall QoL and general health (p < 0.05).

Conclusion

The QWL among healthcare staff during COVID-19 pandemic was low. Demographic factors were mainly the determinants for a higher QWL while the variable of extra working hours was a determinant of lower QWL. Despite the pandemic, no COVID-19 related variables affected the work life of healthcare staff.

Knowledge, attitude, and use of protective measures against COVID-19 among nurses: a questionnaire-based multicenter cross-sectional study

Background

During this pandemic, nurses have always been on the frontline and are probably the first healthcare providers to interact with patients presenting with symptoms of COVID-19. The main aim of this multicenter study was to assess knowledge, attitude, and use of protective measures against COVID-19 among nurses across the Occupied Palestinian Territory (oPt) during the ongoing pandemic.

Methods

This was a questionnaire-based multicenter cross-sectional study that was conducted in the period between October 2020 to December 2020. The study tool tested knowledge (8-item), attitude (2-item), and use of protective measures against COVID-19 (3-item) among nurses. Associations between nurses’ characteristics and their knowledge, attitude, and use of protective measures were investigated using Student’s t-test, Analysis of Variance, and Pearson’s correlations. To control potentially confounding variables, predictors of higher knowledge, attitude, and use of protective measures were identified using multiple regression analyses.

Results

The study tool was complete by 455 nurses. The mean of knowledge, attitude, and use of protective measures scores were 75.7% (SD:12.4%), 75.1% (SD: 17.7%), and 91.6% (SD: 18.2%), respectively. Multiple linear regression models showed that high knowledge was predicted by being female (p-value = 0.004) and self-rating social status as high (p-value = 0.005). Higher attitude was predicted by being female (p-value = 0.005), self-rating academic achievements as high (p-value = 0.007), and having contracted COVID-19 (p-value = 0.001). Higher use of protective measures was predicted by self-rating academic achievements as high (p-value = 0.010).

Conclusion

Findings of this study suggested that nurses in the oPt had high knowledge, relatively optimistic attitude, and appropriately used protective measures against COVID-19 during the ongoing pandemic. Knowledge, attitude, and use of protective measures among nurses should continuously be updated as information unfold during the ongoing pandemic. More efforts are still needed to ensure protection of healthcare providers including nurses from contracting COVID-19.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00689-x.

The Economic and Psychological Impacts of COVID-19 Pandemic on Indian Migrant Workers in the Kingdom of Saudi Arabia

The ongoing Coronavirus disease 2019 (COVID-19) pandemic has changed the working environment, occupation, and living style of billions of people around the world. The severest impact of the coronavirus is on migrant communities; hence, it is relevant to assess the economic impact and mental status of the Indian migrants. This study is quantitative in nature and based on a sample survey of 180 migrant workers. Descriptive statistics, chi-square test, dependent sample t-test, and Pearson’s correlation coefficient were utilized to analyze the surveyed data. The findings of the study reveal, through the working experience of the migrants, that new international migration has reduced due to lockdown and international travel restrictions. It was also reported that the majority of the migrants worked less than the normal working hours during the lockdown, causing a reduction of salary and remittances. Chi-square test confirms that the perceptions of migrants towards the COVID-19 management by the government were significantly different in opinion by different occupation/profession. Majority of the sampled migrants reported the problem of nervousness, anxiety, and depression; however, they were also hopeful about the future. The psychological problem was severe for the migrants above the age of 40, not educated, and with a higher number of family members. Subsequently, the policy implications from the findings of the research can draw attention of the policy makers towards protective measures which need to be implemented to support migrants during the ongoing pandemic. The government should take some necessary steps, such as a financial benefit scheme, to overcome the problems in the reduction of migrant earnings and remittances. The government should not focus only on vaccination and physical fitness of the migrants but also need to find out the cure of the psychological impact arising during the pandemic.

Knowledge, Attitude, and Perceived Risks Towards COVID-19 Pandemic and the Impact of Risk Communication Messages on Healthcare Workers in Saudi Arabia

Purpose

To investigate knowledge, attitude, and perceived risks towards COVID-19 pandemic among healthcare workers (HCWs) in Saudi Arabia. Besides, the impact of risk communication strategy on the attitude and practice of HCWs was investigated.

Patients and Methods

We conducted a cross-sectional study that targeted HCWs from various Saudi health facilities. We utilized a self-administrated, online-based questionnaire designed to assess basic knowledge of COVID-19, attitude and disease perception, and the impact of risk communication messages among HCWs.

Results

A total of 1691 responses were received in the study. The HCWs exhibited good levels of knowledge (total maximum score is 1) of COVID-19 concerning the modes of transportation of COVID-19 (0.82±0.16), sample collection method for COVID-19 diagnosis (0.98±0.08), transmission of infection from asymptomatic individuals (0.99±0.11), and that antibiotics are not effective against the new COVID-19 (0.83±0.38). Nearly one-third of the participants considered a high/very high possibility of acquiring COVID-19 infection. HCWs had good attitude scores concerning their willingness to deal with new COVID-19 patients (0.87±0.33) and their beliefs in being educated on COVID-19 (0.99±0.11). Almost all participants strongly agree/agree that it is important to take action to prevent the spread of COVID-19 within healthcare facilities and received health information messages. Notably, 93.4% of the participants stated that the received messages changed their attitude towards COVID-19 and its preventive measures. Good knowledge scores were significantly associated with age > 49 years old, higher educational level, and physician occupation. Similarly, good attitude scores were higher among males, HCWs aged 40–49 years old, non-Saudi nationals, and physician and nurse occupations.

Conclusion

HCWs have fair knowledge and attitude towards the COVID-19 pandemic. The risk communication is an effective strategy to improve the attitude and practice of HCWs towards COVID-19 in Saudi Arabia.

COVID-19 Community Transmission among Healthcare Workers at a Tertiary Care Cardiac Center

Aim: To determine the frequency, mode of transmission, and outcome of Coronavirus Disease 2019 (COVID-19) among healthcare workers (HCWs) in a tertiary care cardiac center in the Kingdom of Saudi Arabia (KSA). Methods: This is a retrospective study of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infected HCWs and was conducted from 2 March to 31 December 2020. Data related to the presence of COVID-19 symptoms, mode of transmission, hospitalization, and mortality were collected from the patients’ medical records. Results: Of the 4462 patients tested for COVID-19 by real-time reverse transcriptase polymerase chain reaction (RT-PCR), 203 (4.5%) HCWs were positive; of these, 125 (61.6%) were males, and the most common age group was <40 years. The most commonly encountered health professionals were nurses (74, 36.4%), followed by therapists/technicians (48, 23.6%), housekeepers (25, 12.3%), and physicians (21, 10.4%). The majority (184, 90.6%) of the HCWs contracted COVID-19 in the community, and only 19 (9.4%) were healthcare-associated infections. Of the infected HCWs, 169 (83.3%) had mild symptoms and were managed in home isolation. The most common symptoms were fever (128, 63.1%), body ache (124, 61.8%), headache (113, 55.7%), dry cough (123, 60.6%), sore throat (97, 47.8%), body weakness (97, 47.8%), and fatigue (94, 46.3%). Comparing males and females, there was a significantly higher number of female nurses; in contrast, there was a higher number of male physicians, housekeepers, therapists/technicians, and other specialty HCWs. A significantly lower number of nurses, therapists/technicians were infected in the ≥40 years age group compared to <40 years. Furthermore, a significantly higher difference was observed among non-Saudi nurses compared to Saudi nurses. No mortality was documented among the included HCWs. Conclusions: In the largest tertiary cardiac center in KSA, most HCWs who contracted COVID-19 developed mild symptoms; nurses and those aged <40 years were most commonly infected, and most infections were acquired in the community. HCWs’ adherence to mitigation measures outside of the workplace is vital to curb the current pandemic and decrease nosocomial transmission risk.

Psychological Determinants of COVID-19 Vaccine Acceptance among Healthcare Workers in Kuwait: A Cross-Sectional Study Using the 5C and Vaccine Conspiracy Beliefs Scales

Acceptance of coronavirus disease 2019 (COVID-19) vaccination appears as a decisive factor necessary to control the ongoing pandemic. Healthcare workers (HCWs) are among the highest risk groups for infection. The current study aimed to evaluate COVID-19 vaccine acceptance among HCWs in Kuwait, with identification of the psychological determinants of COVID-19 vaccine hesitancy. The study was conducted using an online anonymous survey distributed between 18 March 2021 and 29 March 2021. The sampling strategy was convenience-based depending on chain-referral sampling. Psychological determinants of COVID-19 vaccine acceptance were assessed using the 5C subscales and the Vaccine Conspiracy Beliefs Scale (VCBS). The total number of study participants was 1019, with the largest group being physicians (28.7%), pharmacists (20.2%), dentists (16.7%), and nurses (12.5%). The overall rate for COVID-19 vaccine acceptance was 83.3%, with 9.0% who were not willing to accept vaccination and 7.7% who were unsure. The highest rate for COVID-19 vaccine acceptance was seen among dentists (91.2%) and physicians (90.4%), while the lowest rate was seen among nurses (70.1%; p < 0.001). A higher level of COVID-19 vaccine hesitancy was found among females, participants with a lower educational level, and HCWs in the private sector. A preference for mRNA vaccine technology and Pfizer-BioNTech COVID-19 vaccine was found among the majority of participants (62.6% and 69.7%, respectively). COVID-19 vaccine hesitancy was significantly linked to the embrace of vaccine conspiracy beliefs. The highest 5C psychological predictors of COVID-19 vaccine acceptance were high levels of collective responsibility and confidence, and lower levels of constraints and calculation. The VCBS and 5C subscales (except the calculation subscale) showed acceptable levels of predicting COVID-19 vaccine acceptance based on receiver operating characteristic analyses. The participants who depended on social media platforms, TV programs, and news releases as their main sources of knowledge about COVID-19 vaccines showed higher rates of COVID-19 vaccine hesitancy. An overall satisfactory level of COVID-19 vaccine acceptance was seen among HCWs in Kuwait, which was among the highest rates reported globally. However; higher levels of vaccine hesitancy were observed among certain groups (females, nurses and laboratory workers, HCWs in the private sector), which should be targeted with more focused awareness programs. HCWs in Kuwait can play a central role in educating their patients and the general public about the benefits of COVID-19 vaccination to halt the spread of SARS-CoV-2, considering the high rates of vaccine hesitancy observed among the general public in Kuwait and the Middle East.

SARS-CoV-2 B.1.1.7 UK Variant of Concern Lineage-Related Perceptions, COVID-19 Vaccine Acceptance and Travel Worry Among Healthcare Workers

Background: Healthcare workers' (HCWs') travel-related anxiety needs to be assessed in light of the emergence of SARS-CoV-2 mutations. Methods: An online, cross-sectional questionnaire among HCWs between December 21, 2020 to January 7, 2021. The outcome variables were HCWs' knowledge and awareness of the SARS-CoV-2 B.1.1.7 lineage that was recently reported as the UK variant of concern, and its associated travel worry and Generalized Anxiety Disorder (GAD-7) score. Results: A total of 1,058 HCWs completed the survey; 66.5% were female, 59.0% were nurses. 9.0% indicated they had been previously diagnosed with COVID-19. Regarding the B.1.1.7 lineage, almost all (97.3%) were aware of its emergence, 73.8% were aware that it is more infectious, 78.0% thought it causes more severe disease, and only 50.0% knew that current COVID-19 vaccines are effective in preventing it. Despite this, 66.7% of HCWs were not registered to receive the vaccine. HCWs' most common source of information about the new variant was social media platforms (67.0%), and this subgroup was significantly more worried about traveling. Nurses were more worried than physicians (P = 0.001). Conclusions: Most HCWs were aware of the emergence of the SARS-CoV-2 B.1.1.7 variant and expressed substantial travel worries. Increased worry levels were found among HCWs who used social media as their main source of information, those with lower levels of COVID-19 vaccine uptake, and those with higher GAD-7 scores. The utilization of official social media platforms could improve accurate information dissemination among HCWs regarding the Pandemic's evolving mutations. Targeted vaccine campaigns are warranted to assure HCWs about the efficacy of COVID-19 vaccines toward SARS-CoV-2 variants.

Medical Staff Work Burnout and Willingness to Work during COVID-19 Pandemic Situation in Pakistan

Medical staff is vital for helping society through a health crisis, human-made or natural disaster, and pandemic. This study aims to investigate the medical staff's work-related burnout during Covid-19 and their willingness to work when they are most needed. The cross-sectional design was used, and an online survey was conducted through snowball sampling. Sample comprised on 250 participants (male = 89 & female= 161). The study's inclusion criteria were that only those medical staff of different hospitals was approached to collect data performed inwards isolated for Covid-19 treatment corona isolation wards. Maslach burnout inventory (MBI-HSS) and willingness to work (WTW) tools were used to collect data. Descriptive and Partial least square analysis was utilized to evaluate the relationships. The Coefficient of determination or R-Square value was 0.299, which means 29.9% or 30% of the work burnout variation was due to the impact of emotional exhaustion and personal accomplishment. Perceived danger, Role Competence, Self-Efficacy, and Sense of duty significantly impacted the willingness to work. Despite the workload and perceived risk, 42.6% of participants agreed to work if their department had to need their services, while 55.2% of participants agreed to work whether their department asked them or not. Government and hospital management should adopt a proactive and positive response during the pandemic to eradicate the employee stress and adopt adequate steps to improve the willingness to work with medical staff.

Behavior Responses and Attitude of the Public to COVID-19 Pandemic During Movement Restrictions in Saudi Arabia

BACKGROUND

The behavior of the general public and the adoption of precautionary measures during a pandemic determine the fate of the country in the absence of any specific cure. This study aimed to determine the public attitude and behavior responses to the COVID-19 pandemic in Saudi Arabia during movement restrictions, and the predictors of behavioral responses.

METHODS

A community-based cross-sectional study of 2470 adult individuals in Saudi Arabia, 17-29 April 2020 was conducted via Survey Monkey, using an anonymous validated e-questionnaire. Data were collected on demographic characteristics, COVID-19-related attitudes, and behavioral responses in terms of; precautionary measures, preparedness, and self-quarantine activities, to be responded to by 4-point Likert scales. Multiple linear regression analyses were performed to identify the significant predictors of compliance with different behaviors. Significance was considered at p<0.05.

RESULTS

Participants reported positive attitudes towards governmental actions (95%), self-hygiene (93.2%), social distancing (97.1%) and choice of healthy food (89.6%), and negative attitudes towards the current worldwide situation of the pandemic (81.0%) and hearing someone tested positive (77.8%) or died from COVID-19 (83.7%). High rates of compliance to behavior were reported by only 55.8% of participants in terms of precautionary measures (71.3%), preparedness (38.4%), and self-quarantine activities (46.1%). After adjusting for all possible confounders, the total attitude score was a significant predictor of the total scores of precautionary measures (t=12.01, p<0.001), preparedness (t=9.29, p<0.001), self-quarantine activities (t=12.05, p<0.001), and overall behavior response (t=14.09, p<0.001). Other significant predictors of higher overall behavior response scores were female gender (t=7.22, p<0.001) and non-Saudi nationality (t=3.40, p<0.001).

CONCLUSION

This study provides baseline data on the behavioral response to the national COVID-19 pandemic in Saudi Arabia. The levels of compliance to behavior response and attitude to COVID-19 pandemic were less than satisfactory. Socio-demographics influence public behavior and protective health measures. COVID-19 awareness programs are recommended.

Lessons From the First Wave of COVID-19: Work-Related Consequences, Clinical Knowledge, Emotional Distress, and Safety-Conscious Behavior in Healthcare Workers in Switzerland

The coronavirus disease (COVID-19) imposes an unusual risk to the physical and mental health of healthcare workers and thereby to the functioning of healthcare systems during the crisis. This study investigates the clinical knowledge of healthcare workers about COVID-19, their ways of acquiring information, their emotional distress and risk perception, their adherence to preventive guidelines, their changed work situation due to the pandemic, and their perception of how the healthcare system has coped with the pandemic. It is based on a quantitative cross-sectional survey of 185 Swiss healthcare workers directly attending to patients during the pandemic, with 22% (n = 40) of them being assigned to COVID-19-infected patients. The participants answered between 16th June and 15th July 2020, shortly after the first wave of COVID-19 had been overcome and the national government had relaxed its preventive regulations to a great extent. The questionnaire incorporated parts of the "Standard questionnaire on risk perception of an infectious disease outbreak" (version 2015), which were adapted to the case of COVID-19. Clinical knowledge was lowest regarding the effectiveness of standard hygiene (p < 0.05). Knowledge of infectiousness, incubation time, and life-threatening disease progression was higher, however still significantly lower than regarding asymptomatic cases and transmission without physical contact (p < 0.001). 70% (95%-confidence interval: 64-77%) of the healthcare workers reported considerable emotional distress on at least one of the measured dimensions. They worried significantly more strongly about patients, elderly people, and family members, than about their own health (p < 0.001). Adherence to (not legally binding) preventive guidelines by the government displayed patterns such that not all guidelines were followed equally. Most of the participants were faced with a lack of protective materials, personnel, structures, processes, and contingency plans. An increase in stress level was the most prevalent among the diverse effects the pandemic had on their work situation. Better medical equipment (including drugs), better protection for their own mental and physical health, more (assigned) personnel, more comprehensive information about the symptoms of the disease, and a system of earlier warning were the primary lessons to be learned in view of upcoming waves of the pandemic.

'Senior Nursing Students and Interns' Concerns and Willingness to Treat Patients with COVID-19: A Strategy to Expand National Nursing Workforce during the COVID-19 Pandemic

Background

The coronavirus disease of 2019 (COVID-19) pandemic has challenged the existing healthcare delivery systems worldwide and overwhelmed the globally short healthcare workforce, particularly nurses. Nurses are recognized as front-line responders to the COVID-19 pandemic and are crucial healthcare members to win the fight against the evolving COVID-19. Considering the long-lasting shortage of national nurses, and turnover of the current nursing workforce, it is essential to consider unconventional strategies aiming at expanding the national nursing workforce in order to embrace the impact of COVID-19.

Objective

This study aimed to measure senior nursing students and intern's willingness to treat patients with COVID-19. Further, this study investigated their feelings, knowledge, and concerns regarding treating patients with COVID-19.

Methods

This quantitative, cross-sectional study utilized self-reported survey gathered from a convenience sample of 178 senior nursing students and interns. A 7-item scale was used to measure the participants' willingness to treat patients with COVID-19. The data were collected between March 2020 and April 2020.

Results

Out of 178 participants, 50.56% were at Level 8, 89.33% were single, and 53.37% had a very satisfactory grade point average. The highest proportion of the respondents (38.20%) felt neutral about treating patient with COVID-19, while 53.93% had good knowledge about COVID-19. The perceived willingness to treat of participants had an overall mean score of 20.19, which indicated neutral willingness to treat patients with COVID-19. Participants' feelings about treating patients with COVID-19 predicted their willingness to treat patients with COVID-19 (P<0.001).

Conclusion/Recommendation

There is a clear need for educational and training programs both in clinical practice and academia for the improvement among nursing students and interns who reported paucity of knowledge about COVID-19. Furthermore, hospital institutions should provide additional incentives or hazard protections to maintain and even increase the number of staff at the frontline who are willing to care for patients amid the deadly pandemic of COVID-19.

Psychological Distress, Early Behavioral Response, and Perception Toward the COVID-19 Pandemic Among Health Care Workers in North Shoa Zone, Oromiya Region

Background: The coronavirus disease 2019 (COVID-19) pandemic has had a significant psychological impact on health care workers (HCWs). Therefore, this study inspects the mental health status, behavioral response, and perception among HCWs (nurses, physicians, and medical laboratory workers) during the COVID-19 pandemic in public health care facilities. Methods: A facilities-based cross-sectional study was conducted in July 2020. A simple random sampling technique was used to select study participants. Data were collected by self-report administered questionnaires using Patient Health Questionnaire-9 (PHQ-9) for depression, General Anxiety Disorder-7 (GAD-7) for anxiety, Insomnia Severity Index (ISI) for insomnia, Impact of Event Scale-Revised (IES-R) for psychological distress, Perceived Threat Scale for perception, and Behavioral Response Inquiry for the behavioral response. Moreover, bivariable and multivariable logistic regressions analysis was used to identify the association between dependent and independent variables at p-value <0.05. Results: A total of 417 (98.6%) HCWs responded to a self-administered questionnaire. The proportion of HCWs who had moderate to severe symptoms of psychological distress, depression, anxiety, and insomnia during the COVID-19 pandemic were 58, 16.3, 30.7, and 15.9%, respectively. Three-fifth of the nurses, medical laboratory professionals (62.2%), and physicians (59.2%) had reported good behavioral responses toward the COVID-19 pandemic. More than three-fifths of the nurses had reported poor perception toward the COVID-19 pandemic. Conversely, 61.2% of physicians and three-fourths (75.5%) of medical laboratory professionals had reported good perception toward the COVID-19 pandemic. Female and married participants, those working in the emergency unit, those with poor behavioral responses, and those with poor perception toward the COVID-19 pandemic were significantly associated with symptoms of psychological distress, depression, anxiety, and insomnia. Conclusions: Psychological impacts among physicians, nurses, and medical laboratory professionals are high during the COVID-19 pandemic. The Ethiopian Federal Ministry of Health should aim to protect all HCWs' psychological well-being during the COVID-19 pandemic with appropriate interventions and accurate information response.

Investigating healthcare practitioners' attitudes towards the COVID-19 outbreak in Saudi Arabia: A general qualitative framework for managing the pandemic

BACKGROUND

Some previous studies have investigated the attitudes of healthcare professionals towards certain aspects of the COVID-19 outbreak. In addition, some general frameworks have been proposed to manage the pandemic.

OBJECTIVE

The purpose of this article was to analyze the attitudes of healthcare practitioners in Saudi Arabia towards the treatment of patients with COVID-19, work planning of practitioners, leadership approaches to manage the pandemic, sharing information strategies, medical errors, compliance with procedures, and challenges faced by the practitioners. Furthermore, another objective was to propose a general framework for managing the COVID-19 outbreak in Saudi Arabia.

METHODS

To achieve these purposes, a survey was designed based on an online questionnaire that was initially sent via WhatsApp, Twitter, Facebook, and email to 336 healthcare practitioners working in 7 hospitals in Saudi Arabia. The response rate was 30.4%.

RESULTS

The outcomes indicated that healthcare practitioners in Saudi Arabia had positive attitudes towards effective communication and interaction between health professionals and patients, leadership and maintenance of team coordination, work planning, communication and cooperation between team members, training and skills development of healthcare professionals, implementing strict procedures to avoid errors and control the spread of the COVID-19 pandemic, maintaining an adequate supply of medicines and medical equipment, and obtaining the support of the government, the community, and the people.

CONCLUSION

Based on the findings, it was possible to suggest that the management of health care operations related to the COVID-19 outbreak in Saudi Arabia requires effective collaboration and information sharing among various stakeholders. In this sense, communication, effective leadership, coordination and work planning, adequate treatment for patients, strict compliance with hospital rules and procedures, preventive and regulatory measures, and training and support for health professionals, were parameters considered in the general qualitative framework suggested in this study for managing the COVID-19 pandemic in Saudi Arabia. The propositions presented in this study can help the Saudi Arabian government implement an effective plan to control the spread of the COVID-19 pandemic in this country.