COVID-19 Knowledge, Attitudes, and Prevention Practices Among People with Hypertension and Diabetes Mellitus Attending Public Health Facilities in Ambo, Ethiopia

Systematic review and meta-analysis of knowledge, attitudes, and practices regarding COVID-19 among chronic disease patients: A global perspective

Background

Chronic health conditions were significantly correlated with an increased clinical severity of coronavirus 2019 (COVID-19) and a heightened risk of COVID-19 mortality. This study aims to determine global knowledge, attitudes, and practices (Knowledge Abuse Profile) of the patients with chronic diseases toward COVID-19.

Methods

The study was initiated in December 2019 and extended until April 2023, during which an extensive search for relevant English-language literature was conducted as part of this systematic review and meta-analysis. Google Scholar, Scopus, PubMed/MEDLINE, Science Direct, Web of Science, EMBASE, Springer, and ProQuest were utilized for the search. The quality of included studies was assessed using a quality rating checklist created by Joanna Briggs Institute for cross-sectional research. In the STATA software version 14, inverse variance and Cochran Q statistics were used for statistical analysis to assess heterogeneity among the studies. The Dersimonian and Liard random-effects models were applied in cases where heterogeneity existed.

Results

A total of 23 studies involving 14,587 patients contributed to this meta-analysis. These studies comprised 21 studies focused on knowledge, with 6864 participants, 12 studies on attitudes involving 3597 patients, and 12 on practices, encompassing 4126 patients. The pooled estimates for sufficient knowledge, positive attitudes, and COVID-19 preventive behaviors among chronic disease patients were determined as 48.2% (95% confidence interval [95% CI]: 33.9%-62.5%), 60.8% (95% CI: 46.8%-74.8%), and 58.3% (95% CI: 39.5%-77.0%), respectively. Over the years, there was a consistent decrease in adequate knowledge, positive attitudes, and COVID-19 preventive behaviors among the population. Specifically, regarding knowledge, the rates declined from 50.2% in 2020 to 49.7% in 2021 and dropped to 45.1%. Similarly, the percentage of individuals with a positive attitude fell, decreasing from 64.1% in 2020 to 60.3% in 2021 and dropping to 57.9% in 2022. Furthermore, COVID-19 preventive behaviors showed fluctuations, with the rates recorded at 63.7% in 2020, increasing to 75.4% in 2021, and then decreasing to 47% in 2022, in line with the publication dates of included studies.

Conclusion

The findings of meta-analysis show a significant decrease in the levels of knowledge, attitudes, and adherence to preventative interventions for COVID-19 among individuals with chronic diseases. The findings emphasize the need for targeted interventions, and ongoing education to address this trend.

The Level of Knowledge, Attitudes, and Practices in a Caribbean Colombian Population That Recovered from COVID-19 during the Pandemic

This study aimed to assess the knowledge, attitudes, and behaviors related to COVID-19 among Colombians. A cross-sectional descriptive study was carried out during the pandemic between November 2020 and May 2021 using a survey that focused on knowledge, attitudes, and practices regarding COVID-19. The online survey was completed by 1424 participants who had a history of COVID-19 illness, and the study spanned 3 months. Many respondents were male students who demonstrated adequate knowledge of COVID-19 symptoms and prevention measures, although their understanding of its transmission routes was limited. Nevertheless, 65.9% expressed optimism that COVID-19 would ultimately be successfully controlled, and 71.8% had confidence in the Colombian government's handling of the crisis. Additionally, more than half of the participants admitted to visiting crowded places, and this practice was more common among those who were less informed about COVID-19. However, many respondents reported using face masks in public. This highlights a significant gap between theoretical knowledge and actual practices that need to be addressed. To bridge this gap, establishing an interdisciplinary support network is crucial, as is launching mass education campaigns targeting specific population groups, and compiling reports on successful practices implemented during the pandemic. These efforts are essential for enhancing the overall level of knowledge, and the attitudes and practices related to COVID-19, and also for preparing for future health emergencies.

COVID-19-Related Testing, Knowledge and Behaviors among Severe and Chronic Non-Communicable Disease Patients in Neno District, Malawi: A Prospective Cohort Study

COVID-19-related knowledge and behaviors remain essential for controlling the spread of disease, especially among vulnerable patients with advanced, chronic diseases. We prospectively assessed changes over 11 months in COVID-19-related testing, knowledge, and behaviors among patients with non-communicable diseases in rural Malawi using four rounds of telephone interviews between November 2020 to October 2021. The most commonly reported COVID-19-related risks among patients included visiting health facilities (35-49%), attending mass gatherings (33-36%), and travelling outside the district (14-19%). Patients reporting having experienced COVID-like symptoms increased from 30% in December 2020 to 41% in October 2021. However, only 13% of patients had ever received a COVID-19 test by the end of the study period. Respondents answered 67-70% of the COVID-19 knowledge questions correctly, with no significant changes over time. Hand washing, wearing face masks and maintaining a safe distance were the most frequently reported strategies to prevent the spreading of COVID-19. Wearing face masks significantly improved over time (p < 0.001). Although the majority reported accurate knowledge about COVID-19 and enhanced adherence to infection prevention measures over time, patients commonly visited locations where they could be exposed to COVID-19. Government and other stakeholders should increase COVID-19 testing accessibility to primary and secondary facilities.

Health Literacy and Clinic-Epidemiological Profile of Patients with COVID-19-Associated Mucormycosis: A Questionnaire-Based Study

Background The patient partnership is desirable for the optimal management of comorbidities. This became significant more so during the coronavirus disease 2019 (COVID-19) crisis wherein health infrastructure was overburdened.

Objectives The aim of this study was to estimate the clinicoepidemiological profile, health literacy regarding predisposing risk factors, and disease management in patients with COVID-19-associated mucormycosis (CAMCR).

Materials and Methods A structured questionnaire-based study on randomly chosen 100 microbiologically proven patients of CAMCR, consisting of 38 multiple choice questions, was designed with each answer having a patient and assessor response to it.

Results A male predilection was seen (68%) with rhino-orbital (73%) being the commonest anatomic site. Forty-nine percent of the study participants had pre-existing diabetes of which 62% did not carry out regular blood sugar monitoring and in 18%, blood sugars were controlled prior to COVID-19. Thirty-five percent of patients with mild COVID-19 illness were treated with unwarranted steroids and 56% of patients had fluctuating blood sugar levels, during COVID-19 illness.

Seventy-nine percent of patients were not vaccinated against COVID-19, 16% only partially vaccinated. Seventy-one percent of patients were not aware of red flag signs and of mucormycosis with 8% presenting early, on noticing nasal symptoms.

Conclusion This study observed diabetes as the most common comorbidity in patients with CAMCR. A lacuna in the health literacy of diabetics presenting with CAMCR was found. Additionally, knowledge regarding glycemic control during COVID-19 illness with or without the use of steroids and awareness of the “red flag” signs of CAMCR were mostly lacking. Interventions to improve awareness amongst patients with diabetes should help in optimal glycemic control, and avoid potential complications like severe COVID-19 illness, and mucormycosis.

The COVID-19 pandemic: knowledge, attitudes and practices of coronavirus (COVID-19) among patients with type 2 diabetes

BACKGROUND

It is necessary to evaluate COVID-19 data on Knowledge, Attitudes and Practices (KAP) to confirm effective protective practice and to reduce risk in society. Hence, the study was carried out to determine KAP towards COVID-19 and the factors associated with knowledge and practices among patients with type 2 diabetes (T2D).

METHODS

In this cross-sectional (descriptive-analytical) study, 357 patients with diabetes in Izeh participated in the study. The sampling method used was convenience sampling method. Data collection tool was a researcher-made questionnaire of demographic information and KAP of patients with T2D in relation to the new coronavirus. The validity and reliability of the research tool was confirmed using the content validity and test-retest. Data analysis was done in Stata.14.2 and Smartpls 3.2.8 using descriptive and analytical statistical tests.

RESULTS

The mean score of participants' KAP towards Covid-19 was 74.22 (16.30), 72.88 (14.87), and 70.51 (19.70), respectively. The lowest and the highest score of the patients' knowledge was in the field of transmission (56.60 (20.96)) and care and prevention of the COVID-19 (88.58 (21.88)), respectively. Residence was the most important factor predicting the practice of diabetic patients with an explanatory coefficient ([SMD 1.08 (95% CI 0.85 to 1.30), P < 0.001] and R² = 0.87%).

CONCLUSION

Despite the good level of KAP of people towards the COVID-19 disease, there were answers showing poor knowledge, incorrect beliefs and attitudes, and insufficient practice regarding different aspects of the COVID-19 in some cases in our study. Residence was a strong predictor of type 2 diabetes mellitus (T2DM) patients' practice in terms of protective behaviors against Covid-19. Hence, educational needs evaluation based on residence is recommended, especially in rural T2DM patients.

Perceived Knowledge, Attitude, and Practices (KAP) and Fear toward COVID-19 among Patients with Diabetes Attending Primary Healthcare Centers in Kuwait

OBJECTIVES

To assess perceived fear and to evaluate the level of knowledge, attitude, and prevention practices (KAP) regarding COVID-19 infection among patients with diabetes mellitus (DM) attending primary healthcare centers (PHCs) in Kuwait. This will help evaluate gaps and provide appropriate support to limit the spread of COVID-19 infection in high-risk patients.

METHODS

A descriptive cross-sectional study was carried out using a self-administered questionnaire. All patients aged 18 years or older attending for follow-up or newly diagnosed with type 1 or type 2 diabetes were eligible to participate in the study. Patients waiting for their regular follow-up appointments at the PHCs were invited verbally to take part in the study. The study excluded patients under the age of 18 and those with significant cognitive or physical impairment that might interfere with independent self-care behavior. The questionnaire included 57 items. The data were analyzed using descriptive statistics.

RESULTS

A total of 294 questionnaires were distributed to patients at PHCs in three health districts (Hawally, Capital, and Farwaniya) in Kuwait; 251 patients agreed to participate in the study, yielding a response rate of 85.4%. The study showed that most patients had moderate knowledge (71.1%) of COVID-19. The majority of correctly responded questions were about the mode of COVID-19 transmission, the most common clinical presentations, and at-risk people. On the other hand, 83.7% (n = 210) identified common cold symptoms (stuffy nose, runny nose, and sneezing) as COVID-19 symptoms. More than half of the patients (n = 146, 58.2%) were unable to identify uncommon COVID-19 symptoms, such as diarrhea and skin rash or discoloration. Most patients had a positive attitude (90.9%) and good prevention practices (83.6%). The overall fear score of the participating patients was 21.6 ± 6.5 (61.7%).

CONCLUSIONS

Regardless of the positive attitude and good preventive practices of the patients, they had moderate knowledge levels about COVID-19. This indicates that there are significant knowledge gaps that still need to be filled. Different strategies can be used for this purpose, such as social media and public information campaigns. Supporting psychological well-being is vital for at-risk patients during a pandemic.

The Influence of COVID-19 Pandemic on the Health Seeking Behaviors of Adults Living With Chronic Conditions: A View Through the Health Belief Model

The COVID-19 pandemic resulted in disruption in every facet of life including health service delivery. This has threatened the attainment of global targets to improve health and wellbeing of all persons. In particular, for persons living with chronic diseases, who require consistent monitoring by health professionals and medication to enhance their health, understanding how the pandemic has disruption their access to health care delivery is critical for interventions aimed at improving health service delivery for all as well as preparedness for future pandemic. This study applied the constructs of the Health Belief Model, to explore the influences of the COVID-19 pandemic on the health seeking behaviors of persons living with chronic diseases. The design was exploratory descriptive. Semi-structured interviews were conducted to collect data among persons living with chronic diseases in the Cape Coast Metropolis of Ghana. Thematic analysis, both inductive and deductive, was conducted to unearth the findings. Awareness of increased susceptibility and risk of a more severe episode if they contracted COVID-19 as a result of the existing chronic diseases was identified. Lack of access to health professionals during the peak of the pandemic as well as the fear of contracting the virus while accessing their regular chronic disease clinic was the main barriers identified. Information in the media served as cues to action for adopting preventive health strategies. Behavior modifications; dietary and lifestyle, self-medication and adoption of COVID-19 related precautions were practiced. Susceptibility to contracting COVID-19 contributed to missed adherence to treatment appointment. The health belief model was a useful framework in exploring the health seeking behavior of the adults living with chronic conditions during the COVID-19 in this study setting. Intensifying targeted education for persons living with chronic diseases will contribute to the adoption of positive health seeking behaviors during future pandemic.

COVID 19 prevention practice of patients with known chronic illness in Ethiopia: A systemic review and meta-analysis

Introduction

There were different studies done and found a highly variable level of COVID 19 prevention practice; however, there was no summarized evidence on the prevention practice of chronic disease patients in Ethiopia. This systematic review and meta-analysis aims to assess the pooled prevalence of COVID 19 prevention practice and associated factors among chronic disease patients in Ethiopia.

Method

Systematic review and meta-analysis were conducted using PRISMA guidelines. Comprehensive literature was searched in international databases. A weighted inverse variance random effect model was used to estimate pooled prevalence. Cochrane Q-test and I2 statistics were computed to assess heterogeneity among studies. Funnel plot and Eggers test were done to assess publication bias. Review manager software was used to identify determinants of COVID 19 prevention practice.

Result

Overall, 437 articles were retrieved and finally 8 articles were included in this review. The pooled prevalence of good COVID 19 prevention practices was 44.02% (95%CI (35.98%-52.06%). Being rurally reside (AOR = 2.39, 95% CI (1.30-4.41)), having educational status of cannot read and write (AOR = 2.32, 95% CI (1.22-4.40)), and poor knowledge (AOR = 2.43, 95% CI (1.64-3.60)) positively associated with poor practice.

Conclusion

Good COVID 19 prevention practices of chronic disease patients in Ethiopia was low. Rural residence, educational status of cannot read and write and poor knowledge was positively associated with poor practice. Therefore, policymakers and program planners should target those high-risk groups in improving their awareness to enhance their practice specifically focusing on those who are rural reside and with low educational status.

Knowledge, attitude and practices regarding COVID-19 and their associated factors in patients with type 2 diabetes attending Abdullah-Khalil diabetes center, Omdurman: A cross-sectional study

Novel corona virus disease 2019 is the major threat for human life nowadays worldwide. This study aims to assess the knowledge, attitude and practices regarding COVID-19 among patients with type 2 diabetes attending Abdullah Khalil diabetes center (Omdurman Teaching Hospital). A facility-based observational descriptive cross-sectional study was carried out between January and February 2021, using non-probability quota sampling technique in Abdullah-Khalil diabetes center via the use of a structured close-ended interview questionnaire. It consisted of 19, 10, and 10 questions pertaining to knowledge, attitude and practices towards COVID-19 respectively. A total of 249 patients with type 2 diabetes were included. Of them, 132 (53.0%) were females and the majority (53.0%) aged between 41 and 60 years old. Concerning their education and marital status, 70 (28.1%) were primary school level and 208 (83.5%) were married. 89.6% of participants reported mass media as main source of information regarding COVID-19. Patients with type 2 diabetes attending Abdullah-Khalil diabetes center have good knowledge, positive attitude and good prevention practices towards COVID-19. Most respondents had good knowledge, positive attitude and good practices as 78.7%, 97.6%, and 69.9%, respectively. Educational level and source of information showed statistically significant association with the knowledge, attitude. However, the practice showed only statistical association with the mass media as a source of information (P = .006).

Compliance with COVID-19 preventive measures among chronic disease patients in Wolaita and Dawuro zones, Southern Ethiopia: A proportional odds model

Introduction

So far, shreds of evidence have shown that COVID-19 related hospitalization, serious outcomes, and mortality were high among individuals with chronic medical conditions. However, strict compliance with basic public health measures such as hand washing with soap, social distancing, and wearing masks has been recommended and proven effective in preventing transmission of the infection. Therefore, this study aimed to determine the level of compliance with COVID-19 preventive measures and identify its predictors among patients with common chronic diseases in public hospitals of Southern Ethiopia by applying the proportional odds model.

Methods

A facility-based cross-sectional study was employed in public hospitals of Southern Ethiopia between February and March 2021. Using a systematic random sampling technique, 419 patients with common chronic diseases were recruited. Data were collected using an Open Data Kit and then submitted to the online server. The proportional odds model was employed, and the level of significance was declared at a p-value of less than 0.05.

Results

This study revealed that 55.2% (95%CI: 50.4%-59.9%) of the study participants had low compliance levels with COVID-19 preventive measures. The final proportional odds model identified that perceived susceptibility (AOR: 0.91, 95%CI: 0.84, 0.97), cues to action (AOR: 0.89, 95%CI: 0.85, 0.94), having access to drinking water piped into the dwelling (AOR: 0.52, 95%CI: 0.32, 0.84), having no access to any internet (AOR: 0.62, 95%CI: 0.42, 0.92), having no functional refrigerator (AOR: 2.17, 95%CI: 1.26, 3.74), and having poor knowledge (AOR: 1.42, 95%CI: 1.02, 1.98) were the independent predictors of low compliance level with COVID-19 preventive measures.

Conclusion

In the study area, more than half of the participants had low compliance levels with COVID-19 preventive measures. Thus, the identified factors should be considered when designing, planning, and implementing new interventional strategies, so as to improve the participants’ compliance level.

COVID-19 preventive practice and associated factors in Ethiopia: A systematic review and meta-analysis

Objectives

COVID-19 is a global health concern due to its rapid spread and impact on morbidity and mortality. Implementing preventive measures plays an essential role in curbing the spread of COVID-19 infection. This study aimed to assess COVID-19 preventive practice and associated factors in Ethiopia.

Study design

This study was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines.

Methods

Medline, PubMed, Scopus, Cochrane, EMBASE, African Journal Online (AJOL) and Science Direct search engines were used to identify relevant articles published up to early December 2021. The Joana Brigg's Institute (JBI) checklist was used for quality appraisal. A random-effect model was fitted to calculate the pooled estimates. Higgins I² statistics and Egger's test with funnel plots were analysed to check heterogeneity and publication bias, respectively. Due to significant heterogeneity, subgroup analysis by region, study population, study design and publication year, as well as sensitivity analysis, were done to assess the source of heterogeneity.

Results

The pooled level of poor preventive practice for COVID-19 in Ethiopia was 51.60% (95% confidence interval [CI]: 40.30-62.90). Poor COVID-19 preventive practice declined from 61% in studies published in 2020 to 45% in 2021. Lack of knowledge about COVID-19 (adjusted odds ratio [AOR] = 4.61 [95% CI: 2.49-10.73]), a negative attitude towards COVID-19 management (AOR = 2.64 [95% CI: 1.82-3.82]), rural residence (AOR = 2.95 [95% CI: 2.12-4.12]), a low educational level (AOR = 2.93 [95% CI: 2.16-3.98]) and being female (AOR = 1.75 [95% CI: 1.27-2.40]) were significantly associated with a poor level of COVID-19 preventive practice in Ethiopia.

Conclusions

The level of poor COVID-19 preventive practice in Ethiopia was relatively high. Poor COVID-19 prevention practices were significantly correlated with inadequate COVID-19 knowledge, a negative attitude towards COVID-19 management, low educational attainment, living in a rural area and being female. Creating awareness and health education programmes targeting COVID-19 prevention should be strengthened, especially in the target populations identified in this study.

COVID-19 Vaccine Attitude and Its Predictors Among People Living With Chronic Health Conditions in Ibadan, Nigeria

Objective: To assess vaccination attitude and its associated factors among people with chronic health conditions. Methods: In this cross-sectional study, participants were 423 patients with chronic medical conditions. Data were collected on socio-demographic and COVID-19-related characteristics, via Open Data Kit software. A Vaccination Attitudes Examination (VAX) Scale was adopted. The main outcome was vaccine attitude status defined as positive if a VAX sum score was above the median value; otherwise, non-positive. Data were analysed using Chi-square and multivariate logistic regression analyses, at 5% level of significance. Results: Overall proportion of patients with a positive attitude towards COVID-19 vaccination uptake was 46.6%. The most influential factor towards positive attitude was rating the government high in handling the pandemic. Other factors were education, income, COVID-19 knowledge and living room arrangement (p < 0.05). Conclusion: Less than half of people living with a chronic medical condition had a positive attitude towards the COVID-19 vaccine. The attitudes are strongly mediated by confidence in the government. The government could promote a positive vaccine attitude by improving the clarity of health instructions that shows government transparency and effective communication. These are critical tools for maintaining public trust and confidence.

Risky Party and Nightclub Attendance during the COVID-19 Nightlife Shutdown in New York City

From March 2020 through May 2021, nightlife venues were shut down and large gatherings were deemed illegal in New York City (NYC) due to COVID-19. This study sought to determine the extent of risky party attendance during the COVID-19 shutdown among people who attend electronic dance music parties in NYC. During the first four months that venues were permitted to reopen (June through September 2021), time-space sampling was used to survey adults (n = 278) about their party attendance during the first year of the shutdown (March 2020-March 2021). We examined prevalence and correlates of attendance and mask-wearing at such parties. A total of 43.9% attended private parties with more than 10 people, 27.3% attended nightclubs, and 20.5% attended other parties such as raves. Among those who attended any, 32.3% never wore a mask and 19.3% reported attending parties in which no one wore a mask. Past-year ecstasy use was associated with increased risk for attending private (aPR = 1.51, 95% CI: 1.00-2.28) or other parties (aPR = 2.75, 95% CI: 1.48-5.13), and use of 2C series drugs was associated with increased risk for attending nightclubs (aPR = 2.67, 95% CI: 1.24-5.77) or other parties (aPR = 2.50, 95% CI: 1.06-5.87). Attending &gt;10 parties was associated with increased risk for never wearing a mask (aPR = 2.74, 95% CI: 1.11-6.75) and for no other attendees wearing masks (aPR = 4.22, 95% CI: 1.26-14.07). Illegal dance parties continued in NYC during the COVID-19 shutdown. Prevention and harm reduction efforts to mitigate risk of COVID-19 transmission during such shutdowns are sorely needed.

Knowledge, attitude, and practice of Bangladeshi urban slum dwellers towards COVID-19 transmission-prevention: A cross-sectional study

The first COVID-19 case in Bangladesh was detected on March 8, 2020. Since then, efforts are being made across the country to raise awareness among the population for preventing the spread of this virus. We aimed to examine the urban slum dwellers' knowledge, attitude, and practice (KAP) towards COVID-19 transmission-prevention. A phone-based cross-sectional survey was conducted in five slums of Dhaka City. Total 476 adult slum dwellers were interviewed between October 31 to December 1, 2020 using a pre-tested questionnaire. During an interview, information was collected on participants' demographic characteristics and KAP items towards COVID-19. We used quartiles for categorization of knowledge and practice score where the first quartile represents poor, the second and third quartiles represent average while the fourth quartile represents good. Attitude score was standardized using z-score and identified as positive and negative attitude. Multiple linear regression models were used separately to identify the socioeconomic predictors of the KAP scores. The results showed that 25% of the respondents had good knowledge and 25% had poor knowledge, 48% had a positive attitude and 52% had a negative attitude, and 21% maintained good practice and 33% maintained poor practice towards COVID-19 transmission-prevention. About 75% respondents relied on television for COVID-19 related information. Regression results showed that knowledge and attitude scores were significantly higher if respondents had primary or secondary and above level of education compared to the uneducated group. Female respondents maintained significantly good practice compared to their male counterparts (β = 6.841; p<0.01). This study has found that one third of the studied slum dwellers maintained poor practice and one fourth had poor knowledge towards COVID-19 transmission-prevention. As KAP domains are significantly correlated, efforts are needed to raise awareness of COVID-19 particularly targeting individuals with average and lower knowledge to improve attitude and practice for the prevention of COVID-19.

Individual factors in dignified care: a cross-sectional study of critical care nurses

AIM

To determine the level of dignified care provided by critical care nurses and to explore the associated individual factors.

BACKGROUND

Dignity is a fundamental right of human beings. Critically ill patients are dependent on nurses. Their need for respect and dignity is liable to be neglected in intensive care unit settings. Both critically ill survivors and dying patients suffer mental anguish due to loss of dignity.

METHOD

This was a cross-sectional study of 526 critical care nurses working at intensive care units for adults in Zhejiang Province, China. Data were collected from February 2021 to May 2021 using the Intensive Care Unit Dignified Care Questionnaire, Wong and Law Emotional Intelligence Scale, Jefferson Scale of Empathy-Health Professional, Nurses Professional Values Scale-Revised.

RESULTS

The total score of dignified care was 67.37 (8.83), with the standard score as 74.07 (12.99). Participants who performed poorly in absolute and relative dignity accounted for 8.4% and 31.2% of the total sample, respectively. Emotional intelligence (β = 0.379, p < .001), empathy (β = 0.319, p < .001), professional values (β = 0.147, p < .001), age (β = 0.075, p = .003), and training in dignified care (β = 0.074, p = .010) were associated with dignified care, explaining 67.6% of the variance.

CONCLUSION

The average level of participants' behaviors of maintaining patient dignity was medium. Critical care nurses need to improve their ability to maintain relative dignity of patients. Emotional intelligence, empathy, professional values, age level, and training in dignified care were predictors of dignified care.

IMPLICATIONS FOR NURSING MANAGEMENT

Improving emotional intelligence, empathy, and professional values of critical care nurses and training them (especially less experienced nurses) will enhance their ability in dignified care. This study provides a novel perspective to help nursing managers develop interventions to promote humanized care in the intensive care unit.

Evaluation of the Knowledge, Attitude, and Practice of COVID-19 Prevention Methods Among Hypertensive Patients in North Shoa, Ethiopia

Introduction

The occurrence of coronavirus diseases 2019 (COVID-19) has affected more than 247 million populations around the world. People with comorbidities such as hypertension, diabetes mellitus, congestive heart failure, kidney disease, elderly people, and people with weak immunity develop severe types of COVID-19 if exposed to the disease. Therefore, this study aimed to assess knowledge, attitude, and practice of COVID-19 prevention methods among hypertensive patients in North Shoa, Oromia region, Ethiopia.

Methods

An institutional-based cross-sectional study was conducted from May 5/2020 to June 5/2020 in public hospitals in the North Shoa zone, Ethiopia. Data were collected using a structured questionnaire and study participants were recruited using a simple random sampling technique. The data were checked for completeness and entered into the EpiData manager version 4.4.1 and transferred to SPSS version 23 for analysis purposes. Bivariate and multivariate logistic regression were computed and a significant association was declared with a p-value less than 0.05.

Results

A total of 360 (97.0%) hypertension patients responded. This study revealed that 210 (58.3%) study participants had good knowledge of COVID-19 prevention methods, 199 (55.3%) had a favorable attitude towards COVID-19 prevention methods, and 210 (58.3%) hypertension patients at follow-up practiced COVID-19 prevention methods. Respondents who received less than two thousand Ethiopian birrs monthly and respondents who followed electronic news media were significantly associated with the use of sanitizer, respondents who had a favorable attitude towards the COVID-19 prevention method were significantly associated with mask-wearing, and respondents who received less than two thousand Ethiopian birrs monthly were significantly associated with maintaining a physical distance.

Conclusion

Generally, this study finding revealed that the level of knowledge, attitude, and practice towards COVID-19 prevention among hypertension patients was low. Therefore, increasing knowledge, attitude, and practice on COVID-19 among hypertension patients requires a coordinated effort from the government, non-government, and health professionals.

COVID-19 Knowledge, Attitudes, and Practices Among People in Bangladesh: Telephone-Based Cross-sectional Survey

Background

The world has been grappling with the COVID-19 pandemic, a dire public health crisis, since December 2019. Preventive and control measures have been adopted to reduce the spread of COVID-19. To date, the public’s knowledge, attitudes, and practices regarding COVID-19 across Bangladesh have been poorly understood. Therefore, it is important to assess people’s knowledge, attitudes, and practices (KAP) toward the disease and suggest appropriate strategies to combat COVID-19 effectively.

Objective

This study aimed to assess the KAP of Bangladeshi people toward COVID-19 and to identify their determinants.

Methods

We conducted a country-wide cross-sectional telephonic survey from May 7 to 29, 2020. A purposive sampling method was applied, and adult Bangladeshi citizens who have mobile phones were approached to participate in the survey. Interviews were conducted based on verbal consent. Multiple logistic regression analyses and several tests were performed to identify the factors associated with KAP related to COVID-19.

Results

A total of 492 of 576 Bangladeshi adults aged 18 years and above completed the interview, with a response rate of 85.4% (492/576). Of the 492 participants, 321 (65.2%) were male, and 304 (61.8%) lived in a rural area. Mean scores for knowledge, attitudes, and practices were 10.56 (SD 2.86), 1.24 (SD 0.83), and 3.17 (SD 1.5), respectively. Among the 492 respondents, 273 (55.5%) had poor knowledge, and 251 (49%) expressed a negative attitude; 192 out of 359 respondents (53.5%) had poor practices toward COVID-19. Mean scores of knowledge, attitudes, and practices differed significantly across various demographic and socioeconomic groups. Rural residents had lower mean scores of knowledge (mean 9.8, SD 3.1, P<.001) and adherence to appropriate practice measures (mean 4, SD 1.4, P<.001) compared to their urban counterparts. Positive and statistically strong correlations between knowledge and attitudes (r=0.21, P<.001), knowledge and practices (r=0.45, P<.001), and attitudes and practices (r=0.27, P<.001) were observed. Television (53.7%) was identified as the major source of knowledge regarding COVID-19. Almost three-quarters of the respondents (359/492, 73%) went outside the home during the lockdown period. Furthermore, the study found that good knowledge (odds ratio [OR] 3.13, 95% CI 2.03-4.83, and adjusted OR 2.33, 95% CI 1.16-4.68) and a positive attitude (OR 2.43, 95% CI 1.59-3.72, and adjusted OR 3.87, 95% CI 1.95-7.68) are significantly associated with better practice of COVID-19 health measures.

Conclusions

Evidence-informed and context-specific risk communication and community engagement, and a social and behavior change communication strategy against COVID-19 should be developed in Bangladesh based on the findings of this study, targeting different socioeconomic groups.

Perceptions and Feelings of Brazilian Health Care Professionals Regarding the Effects of COVID-19: Cross-sectional Web-Based Survey

BACKGROUND

The importance of health professionals has been recognized in COVID-19 pandemic-affected countries, especially in those such as Brazil, which is one of the top 3 countries that have been affected in the world. However, the workers' perception of the stress and the changes that the pandemic has caused in their lives vary according to the conditions offered by these affected countries, including salaries, individual protection equipment, and psychological support.

OBJECTIVE

The purpose of this study was to identify the perceptions of Brazilian health workers regarding the COVID-19 pandemic impact on their lives, including possible self-contamination and mental health.

METHODS

This cross-sectional web-based survey was conducted in Brazil by applying a 32-item questionnaire, including multiple-choice questions by using the Google Forms electronic assessment. This study was designed to capture spontaneous perceptions from health professionals. All questions were mandatory and divided into 2 blocks with different proposals: personal profile and COVID-19 pandemic impact.

RESULTS

We interviewed Brazilian health professionals from all 5 Brazilian regions (N=1376). Our study revealed that 1 in 5 (23%) complained about inadequate personal protective equipment, including face shields (234/1376, 17.0%), masks (206/1376, 14.9%), and laboratory coats (138/1376, 10.0%), whereas 1 in 4 health professionals did not have enough information to protect themselves from the coronavirus disease. These professionals had anxiety due to COVID-19 (604/1376, 43.9%), difficulties in sleep (593/1376, 43.1%), and concentrating on work (453/1376, 32.9%). Almost one-third experienced traumatic situations at work (385/1376, 28.0%), which may have led to negative feelings of fear of COVID-19 and sadness. Despite this situation, there was hope and empathy among their positive feelings. The survey also showed that 1 in 5 acquired COVID-19 with the most classic and minor symptoms, including headache (274/315, 87.0%), body pain (231/315, 73.3%), tiredness (228/315, 72.4%), and loss of taste and smell (208/315, 66.0%). Some of their negative feelings were higher than those of noninfected professionals (fear of COVID-19, 243/315, 77.1% vs 509/1061, 48.0%; impotence, 142/315, 45.1% vs 297/1061, 28.0%; and fault, 38/315, 12.1% vs 567/1061, 53.4%, respectively). Another worrying outcome was that 61.3% (193/315) reported acquiring an infection while working at a health facility and as expected, most of the respondents felt affected (344/1376, 25.0%) or very affected (619/1376, 45.0%) by the COVID-19.

CONCLUSIONS

In Brazil, the health professionals were exposed to a stressful situation and to the risk of self-contamination-conditions that can spell future psychological problems for these workers. Our survey findings showed that the psychological support for this group should be included in the future health planning of Brazil and of other hugely affected countries to assure a good mental health condition for the medical teams in the near future.

COVID-19 Prevention Practices and Determinant Factors Among Healthcare Professionals Working in Hospitals of South Gondar Zone, Northwestern Ethiopia

BACKGROUND

Coronavirus disease 2019 (COVID-19) has been a global public health crisis since December 2019. Health care professionals (HCP) are highly vulnerable for contracting the disease. Due to the absence of known treatment, prevention is the best option for controlling its transmission.

OBJECTIVE

The study aimed to assess COVID-19 prevention practices and determinant factors among HCP working in hospitals of South Gondar ZoneH, Northwestern Ethiopia.

METHODS

Institution-based cross-sectional study design was used from July 1 to 30, 2020 among 372 HCPs. The participants were selected on random sampling technique basis. Data were entered into Epi data version 3.1 and exported to Statistical Package for Social Science (SPSS V.25) software for data cleaning and analysis. Binary logistic regression analysis was used to assess the association between independent variables and prevention practice of COVID-19.

RESULTS

A total of 372 HCPs participated in the study with a response rate of 94.9%. Less than one-third 112 (30.1%) of the participants were females. About 308 (82.8%), 285 (76.6%), and 224 (60.2%) of the participants had good knowledge, positive attitude, and good prevention practice towards COVID-19, respectively. Being male (AOR =2.68; 95% CI (confidence interval): 1.50,4.81), 2-5 years working experience (AOR= 4.61; 95% CI: 1.70,12.47), greater than five years working experience (AOR= 5.86; 95% CI: 2.01,17.05), age of 31-40 years old (AOR= 2.49; 95% CI; 1.41,4.41), above 40 years (AOR= 6.94; 95% CI: 2.33-20.71), use of COVID-19 guideline (AOR= 4.79; 95% CI: 2.17-10.53), and using peers as sources of information about COVID-19 (AOR= 2.06; 95% CI: 1.07-3.94) were factors of COVID-19 prevention practices.

CONCLUSION

Less than two-thirds of the participants had good COVID-19 prevention practices. Sex, work experience, age, use of COVID-19 guideline, and using peers as sources of information were factors of COVID-19 prevention practices. Hence, continuous information dissemination and experience sharing on COVID-19 prevention should be done continuously.

COVID-19 knowledge, attitude and frequent hand hygiene practices among taxi drivers and associated factors in urban areas of Ethiopia

BACKGROUND

Although several studies have been conducted on COVID-19 knowledge, attitude and prevention practices among healthcare workers and the general population, there has not been any study among taxi drivers in Ethiopia, including Dessie City and Kombolcha Town, the lack of which hinders providing evidence-based interventions to this target group. Thus, this study was designed to contribute to proper planning of COVID-19 intervention measures among taxi drivers in Dessie City and Kombolcha Town, Ethiopia.

METHODS

A cross-sectional study was conducted among 417 taxi drivers in Dessie City and Kombolcha Town during July to August, 2020. The data was collected using a structured questionnaire and an observational checklist. The collected data was checked, coded and entered to EpiData version 4.6 and exported to Statistical Package for the Social Sciences (SPSS) version 25.0 for data cleaning and analysis. The outcome variables of this study were good or poor knowledge, positive or negative attitude and good or poor frequent hand hygiene practices towards COVID-19. Bivariate (Crude Odds Ratio [COR]) and multivariable (Adjusted Odds Ratio [AOR]) logistic regression analysis were employed to identify factors significantly associated with good knowledge, positive attitude and good frequent hand hygiene practices among taxi drivers. Significance level of variables was declared at a p < 0.05 from the adjusted analysis.

MAIN FINDINGS

Out of the total 417 taxi drivers, 69.8% [95% CI: 65.2-73.9], 67.6% [95%CI: 63.1-72.2] and 66.4% [95% CI: 62.1-71.0] of the drivers had good knowledge, positive attitude and good frequent hand hygiene practices, respectively. Educational level (AOR = 7.55, 95% CI = 4.55-12.54), place of residence (AOR = 5.41, 95% CI = 1.4-20.08) and attitude towards COVID-19 prevention (AOR = 1.67, 95% CI = 1.02-2.74) were factors associated with good knowledge about COVID-19. Further, age of taxi drivers greater than 30 years (AOR = 3.01, 95% CI = 1.76-5.13), educational level of secondary or above (AOR = 3.16, 95% CI = 1.88-5.31), income (AOR = 3.36, 95% CI = 1.48-7.61), and knowledge about COVID-19 (AOR = 2.1, 95% CI = 1.21-3.54) were factors associated with positive attitude towards COVID-19 prevention. In addition, attitude towards COVID-19 (AOR = 5.5, 95% CI = 3.40-8.88) and educational level (AOR = 1.84, 95% CI = 1.15-2.95) were the factors associated with good frequent hand hygiene practices.

CONCLUSION

We concluded that the rates of good knowledge, positive attitude and good frequent hand hygiene practices were relatively low among taxi drivers in Dessie City and Kombolcha Town. We strongly recommended providing training about COVID-19 prevention measures for taxi drivers that considers age, education status and attitude areas essential to improve their knowledge, attitude and frequent hand hygiene practices to prevent the spread of COVID-19.

COVID-19 Prevention Practices and Associated Factors among Diabetes and HIV/AIDS Clients in South-Wollo Zone, Ethiopia: A Health Facility-Based Cross-Sectional Study

Background

Coronavirus-2019 (COVID-19) is affecting many people. Chronic patients are highly vulnerable to contracting an infection. Most people recover within a week, but chronic patients can face severe illness or death. The increasing of cases, complications, and mortality demands compulsory preventive measures. Therefore, this study was designed to identify major preventive practices and associated factors.

Methods

A facility-based cross-sectional study was employed from November to December 2020 among diabetics and HIV/AIDS follow-up clients in Dessie referral hospital. Data were entered into EpiData manager 4.6.0 version and exported to Statistical Package for Social Science (SPSS) version 25.0 for data cleaning and analysis. Logistic regression analysis was done and an adjusted odds ratio (AOR) with its 95% confidence interval (CI) was used for determining the strength of association.

Results

Data were collected from 426 participants with a mean age of 46.54 years. The overall poor prevention practice rate of COVID-19 among diabetic and HIV/AIDS follow-up clients was 68.8% 95% CI (64.6–72.8%). Factors significantly associated with poor prevention practice were femaleness (AOR; 1.61; 95% CI; 1.03–2.51), illiterate [AOR; 2.59; 95% CI; 1.33–5.09]), family size greater than four (AOR; 2.06; 95% CI; 1.32–3.23), absence of health professional in the household (AOR; 1.79; 95% CI; 1.13–2.84), not having health insurance (AOR; 1.85; 95% CI; 1.18–2.89) and urban residence (AOR; 0.38; 95% CI; 0.18–0.79).

Conclusion

The overall proportion of prevention practice towards COVID-19 among diabetic and HIV/AIDS follow-up clients was poor. Illiteracy, having a family size greater than four, not having health professionals in the household, not having health insurance and urban residency were associated with poor prevention practices. Therefore, continuous health educations about good preventive behavioral practice should be enhanced by the health professionals.

Perceived Risk of COVID-19 and Related Factors Among University Students in Ethiopia During School Reopening

BACKGROUND

The novel coronavirus disease 2019 (COVID-19) has posed a great threat to the public. University students living in school compound with groups and sharing a common cafeteria are more susceptible to contract and spread the virus. Risk perception multiplies fear and anxiety that triggers precautionary action. However, research is scant in this particular field.

OBJECTIVE

To assess the perceived risk of COVID-19 and its associated factors among University Students in Northeast Ethiopia during school reopening.

METHODS

Institution-based cross-sectional study was conducted among 682 Debre Berhan University students from December 1-15, 2020, when students just get back to school. Data was collected using a structured and pre-tested questionnaire. A multistage sampling technique was used to select study subjects. Data were cleaned and entered into Epi-Data version 4.6 and exported to SPSS version 25 software for analysis. Descriptive statistics, bivariable and multivariable logistic regression analysis were run to summarize the results.

RESULTS

The overall perceived risk of COVID-19 was 296 (43.4%), 95% CI (39.4-47.4). Age (AOR (CI) =3.27 (1.87-5.71), open relationship (AOR (CI) =3.17 (1.73-5.79), fathers' education (AOR (CI) =2.29 (1.31-4.02), having diabetes (AOR (CI) =2.64 (1.15-6.07), and information source from ministry of health (MOH) (AOR (CI) =1.87 (1.27-2.75) had significantly high-risk perception. However, students who use Facebook (AOR (CI) =0.57 (0.39-0.82) and Websites/articles (AOR (CI) =0.14 (0.06-0.34) had significantly low-risk perception. Television (59.8%) and Telegram (66.6%) were the primary sources of information, while the World Health Organization (68.3%) was the most trusted source of information.

CONCLUSION

University students perceived a low risk towards COVID-19 pandemics at the time of school resumption. It was influenced by students' demographic characteristics, co-morbidities, social media, and information sources. The Ministry of Health and Ministry of Education should properly promote risk communication among university students.

Development and Validation of the Knowledge and Attitude Scale Toward COVID-19 Pandemic Breaking Transmission Chain (KA-C) Among Iranian Population

Objectives: We aimed to develop a scale and evaluate this scale's validity and reliability to measure factors affecting people's knowledge and attitudes toward the pandemic breaking transmission chain. Methods: This exploratory mixed-method study was carried out in two phases: (1) item generation using literature reviews and interviews and, (2) item reduction by psychometric assessments of the developed scale. The face, content, construct (exploratory and confirmatory factor analysis), convergent, and discriminant validity of the scale were assessed in the Iranian population (n = 500) from March to June 2020. The Composite Reliability (CR) and the internal consistency correlation coefficient were estimated. Results: The Knowledge and Attitude Scale Toward COVID-19 Pandemic Breaking Transmission Chain (KA-C) among the Iranian population included 18 items. Two factors with a whole variance of 66.05% were identified by exploratory factor analysis. Factors were labeled as "health literacy" and "home health empowerment." The confirmatory factor analysis showed the goodness of fit. The CR of the scale for first and second factors were 0.965 and 0.833 receptively. The scale's internal consistency correlation coefficient was acceptable (Cronbach's alpha = 0.960 and 0.823, average interitem correlation = 0.643 and 0.635, McDonald's omega = 0.963 and 0.829, for the first and second factor, receptively). Conclusion: The KA-C scale can be exerted to screen the people's knowledge and attitude about the COVID-19 pandemic breaking the transmission chain as a valid and reliable scale for further policymaking, health care providers, and for a multi-dimensional psychosocial assessment of the pandemic period.