Attitudes, Anxiety, and Behavioral Practices Regarding COVID-19 among University Students in Jordan: A Cross-Sectional Study

Hand hygiene knowledge, attitude, and practice before, during and post COVID-19: a cross-sectional study among university students in the United Arab Emirates

Aims

Hand hygiene (HH) is an essential practice to evade the transmission of germs and minimize community-acquired infections. This study assesses the knowledge, attitude and practice (KAP) of HH and other health and safety measures before, during, and after the COVID-19 pandemic. in university students in the United Arab Emirates (UAE).

Methods

A cross-sectional questionnaire study was conducted between December 2022 and March 2023, targeting university students from all disciplines and study levels. A 44-item questionnaire was used which included student demographics, knowledge, attitude, and practice of HH, as well as the anticipated risk of COVID-19 morbidity and mortality. Participants consented before commencing the questionnaire, and the collected data were analysed using the student's t-test and ANOVA test, as required.

Results

A total of 378 responses were received nationwide, with a valid response rate of 98%. The HH knowledge revealed an average score of 62%, which was significantly higher in students with moderate family income. Additionally, the average attitude score was 74.7%, as measured on the Likert scale, and the score lacked any correlation with the other variables. HH practice showed an average score of 86.8%, which was correlated with the students' gender and field of study.

Conclusions

This study showed a moderate level of knowledge, a good attitude, and good practice around HH and other safety measures among the UAE's university students. Socioeconomic status, gender, and field of study influenced the study outcomes. This study highlights the need for effective awareness campaigns to reinforce students' health and safety, especially for male and non-health science students, in order to protect against communicable diseases.

Knowledge, attitudes, and behaviour of college students in disposing used masks during the COVID-19 pandemic in DKI Jakarta Province

Background

The COVID-19 pandemic has increased the need for mask production which has caused the problem of mask waste generating in the environment without being managed. This research was conducted to determine the relationship between knowledge, attitudes, and sociodemographic factors with college student behaviours in managing household mask waste in Daerah Khusus Ibukota (DKI) Jakarta Province.

Methods

This study used a quantitative approach and cross-sectional study design. Data collection was carried out using an online questionnaire consisting of the respondents' sociodemographic, knowledge, attitudes, and behaviours.

Results

The majority of students had high knowledge (63.3%), positive attitudes (52.5%), and good behaviours (50.6%). Statistically, there was a significant relationship between knowledge and behaviours (p = 0.022), but there was no significant relationship between attitudes and behaviours (p = 0.269). In addition, the sociodemographic factor variables showed a significant relationship between place of residence and behaviours (p = 0.008). However, there was no significant relationship between age, gender, education, and study program groups and behaviours (p > 0.05). Multivariate analysis showed that living with family was a dominant factor for bad behaviours (OR 1.664, 95% CI=1.124-2.464), and the second risk factor was the low level of knowledge has a significant relationship with the behaviours of mask waste management at home (OR=1.559, 95% CI=1.044-2.330).

Conclusions

Students who live alone also show better behaviour compared to students who live with their families. The place of residence variable has the greatest influence on the behaviour of mask waste management at the household, followed by the knowledge variable.

Beyond COVID-19: the impact of recent pandemics on medical students and their education: a scoping review

INTRODUCTION

Over the past two years, coronavirus disease (COVID-19) has greatly altered medical student education as well as daily life. Medical schools across the world were disrupted and had to immediately adapt the educational experience to the online environment in order to continue the delivery of quality medical education. However, COVID-19 was not the only recent pandemic. This posed the question, were similar disruptions and adaptations also seen in recent past pandemics such as Severe Acute Respiratory Syndrome (SARS) or Middle East Respiratory Syndrome (MERS) that could have prepared medical educators for COVID-19? This scoping review investigated the educational and personal impact of recent pandemics on medical students.

METHODS

This review followed the PRISMA-ScR guidelines for scoping reviews. Nine databases including PubMed, ERIC, and EMBASE were systematically searched using keywords and subject headings related to medical students and SARS, H1N1, MERS, Ebola, Zika, and COVID-19. Studies were limited to research studies published between 2000 and 2020 and in English. Based on exclusion and inclusion criteria, all studies were independently screened by two reviewers first by the title/abstract and then via full text. Data were extracted from the included studies and analyzed qualitatively using thematic analysis.

RESULTS

A total of 174 studies fit the criteria. Seven major themes emerged from those studies: educational adaptations and online modifications, knowledge and attitudes of students, mental wellness of students, student involvement and use of telehealth, student vaccination, physical wellness of students, and stigma.

CONCLUSION

This review provided insights into how medical students were affected by recent pandemics and their perceptions of pivoting to online education, mental health, and knowledge of the diseases. Additionally, this review showcases the various educational adaptations that emerged uniquely during the COVID-19 pandemic, such as telehealth services or video conferencing tools, that can be utilized in a post-pandemic environment.

The mental health impact of pandemic COVID-19 crisis on university students in Saudi Arabia and associated factors

INTRODUCTION

New Coronavirus (COVID-19) pandemic has multiple effects. We aimed in this study to assess anxiety, depression, and stress levels among university students in Saudi Arabia and associated factors.

METHOD

We collected 5,140 participations from universities for our cross-sectional study, responders completed the demographic questions, patient health questionnaire 9 (PHQ9) for depression, generalized anxiety disorder 7 (GAD7) for anxiety, and perceived stress scale (PSS) between 24th and 30th of April 2020.

RESULT

80.99% were females and mean age was 21.85 years. 40.8% had significant symptoms of anxiety, 48.8% had significant symptoms of depression, and 86.7% had moderate to high perceived stress. Being Female, younger age, living in eastern region, had a relative or acquaintances with COVID-19, and had chronic medical or mental illness are associated factors with high levels of depression, anxiety, and stress.

DISCUSSION

COVID-19 pandemic negatively affected the mental health of university students. Quick and effective interventions are mandatory.

Impact of COVID-19 Pandemic on Mental Health among the Population in Jordan

BACKGROUND

Mental health is a key indicator for public health measures. Jordan is one of the countries that has a high prevalence of mental illness and disorders. The COVID-19 pandemic has affected all health services in the country with a high refugee population. The aim of this review is to assess the impact of the pandemic on mental health in Jordan and identify key factors affecting it, in addition to addressing lessons learned from the pandemic.

METHODS

A systematic search was conducted on Medline Plus, Embase, Web of Science, EBSCOHost Psycinfo and Cinhal, following the PRISMA guidelines. Articles were selected based on predefined inclusion and exclusion criteria. Data were extracted and synthesized using narrative descriptive analysis.

RESULTS

The pandemic had a significant impact on PTSD, psychological distress, anxiety, depression and stress. Predictors of a higher impact on mental health were related to gender, socio-economic status and comorbidities. The healthcare workers group was the most affected by mental disorders.

CONCLUSIONS

The COVID-19 pandemic's impact on mental health was associated with high levels of PTSD, anxiety, depression and stress. In a country with a high prevalence of mental disorders, prompt and quick measures are needed to support the health system to absorb the effect of the pandemic and be responsive to dealing with the existing high prevalence.

Factors motivating lebanese youth to adopt COVID-19 good practices: a cross-sectional study

Background

It is now widely acknowledged that young people can be asymptomatic carriers of the COVID-19 virus. While vaccines are successful, COVID-19 good practices continue to be useful in controlling the virus transmission. This study aimed to investigate the associated risk factors impacting the youths' adoption of COVID-19 good practices in Lebanon.

Methods

Data were collected through an online survey. The analyzed sample included 602 young people.

Results

Our results indicate that around half the youth sample in our study adhere to COVID-19 good practices. COVID-19 good practices are more likely to be adopted by individuals who are more worried about their health and those who live with their partners. Furthermore, media trust was a significant predictor of COVID-19 good practices.

Conclusion

Media can play a larger role in promoting good practices through youth-targeted programs. By identifying community influencers and encouraging peer-to-peer communication, it is possible to engage youth who distrust the media and persuade them to adopt COVID-19 good practices.

Undergraduate health sciences students' response regarding COVID-19 pandemic in Saudi Arabia: an observational study

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic represents a major health problem, and its influences may persist with emerging viral variants. The current work was to evaluate the knowledge, attitude, and learning satisfaction of health sciences students (HSS) regarding the COVID-19 pandemic.

METHODS

A questionnaire-based cross-sectional study was conducted from 20 February 2021 to 20 March 2021. Participants were undergraduate HSS at Prince Sattam bin Abdulaziz University in Al Kharj, Saudi Arabia. The questionnaire has been generated and distributed via online form. The questionnaire used was based on previous studies and included demographic information and knowledge, attitudes, perception, and learning satisfaction related to the COVID-19 pandemic.

RESULTS

Out of the 400 questionnaires distributed to eligible students, the current study included a total of 330 HSS (82.5% response rate) from colleges of medicine (25.5%), dentistry (11.8%), pharmacy (33.6%), and Applied Medical Sciences (29.1%) of participants. The mean scores of knowledge, attitude, and learning satisfaction attained by students were 5.63 ± 0.65 out of 6, 4.22 ± 1.01 out of 5, and 11.28 ± 2.9 out of 19, respectively. Results show an association between the knowledge score of students and their age-group and specialty-college. Students with chronic diseases reported lower attitude scores and rate of COVID-19 vaccine-willingness. Younger HSS had a higher learning satisfaction score than the older participants.

CONCLUSION

Overall, participants show high knowledge level and positive attitude toward COVID-19 but fair learning satisfaction during the pandemic. Further studies are needed to improve the learning satisfaction and attitude of HSS in the future.

COVID-19 pandemic: perception, attitude, and practices of university students from health sector faculties

Background

Adherence to preventive control measures is influenced by perception, attitudes, and practices toward the disease prevention.

Aim

To assess the perceptions, attitude, and practices of university students in three health sector faculties (Medicine, Nursing, and Pharmacy) from six Egyptian universities towards COVID-19 pandemic prevention.

Methods

An electronic online survey was distributed to students of 3 faculties (Medicine, Pharmacy, and Nursing) in six Egyptian universities from March to July 2021. The questionnaire consists of the following parts: socio-demographic data of participants, student perception and attitude towards the COVID-19 pandemic and its consequences, as well as practices of preventive measures in the community.

Results

The study included 1990 participants. Most respondents perceived the seriousness of the COVID-19 pandemic (88.2%). The rates of practicing precautionary measures were mostly high (approximately 90% or above). Significantly high attitude scores toward the pandemic were detected in people with quite-to-extremely concerned, very good/excellent status, aware of infection risk, willing to report positive cases and avoiding contact with them, and seeking medical advice regarding infection. The attitude to protective measures followed a similar pattern along with average health status, female students, and avoidance of contact when experiencing flu symptoms. Significantly higher practice scores were observed in those with bad health status, rural areas, perceiving the risk of infection, willing to report positive cases, and avoiding contact with positive cases.

Conclusion

The effectiveness of precautionary measures should be stressed to promote positive student practices.

Individual hygiene behaviors during the COVID-19 pandemic

OBJECTIVE

To investigate the hygiene behaviors of individuals during the Coronavirus Disease-2019 (COVID-19) pandemic.

METHOD

During the pandemic (April 2021-September 2021), 439 adults were surveyed online via Google Forms, which assessed the individuals' introductory information and hygiene behaviors as determined by the COVID-19 Hygiene Scale.

RESULTS

Out of the participants, 71.3% were female and 68.3% were 18-33 years old. The mean COVID-19 Hygiene Scale score of the participants was 94.62 ± 26.56. Individuals belonging to the 18-33 years age group had significantly higher hand hygiene scores than the other age groups (p < 0.05). Women showed a higher mean total and subdomain scores in the COVID-19 Hygiene Scale than men. A significant difference between the social distance and mask use and hand hygiene subdomains was observed (p < 0.05).

CONCLUSION

The hand hygiene scores of the individuals varied by age and gender, whereas the social distance and mask use scores varied by only gender. Based on the above mentioned results, the nurses should focus on the individuals' development of effective hygiene behaviors, and schedule and implement trainings according to the sociodemographic differences among the individuals.

Fear, Risk Perception, and Engagement in Preventive Behaviors for COVID-19 during Nationwide Lockdown in Nepal

The world has faced huge negative effects from the COVID-19 pandemic between early 2020 and late 2021. Each country has implemented a range of preventive measures to minimize the risk during the COVID-19 pandemic. This study assessed the COVID-19-related fear, risk perception, and preventative behavior during the nationwide lockdown due to COVID-19 in Nepal. In a cross-sectional study, conducted in mid-2021 during the nationwide lockdown in Nepal, a total of 1484 individuals completed measures on fear of COVID-19, COVID-19 risk perception, and preventive behavior. A multiple linear regression analysis was used to identify factors associated with COVID-19 fear. The results revealed significant differences in the fear of COVID-19 in association with the perceived risk of COVID-19 and preventive behaviors. Age, risk perception, preventive behavior, and poor health status were significantly positively related to fear of COVID-19. Perceived risk and preventive behaviors uniquely predicted fear of COVID-19 over and above the effects of socio-demographic variables. Being female and unmarried were the significant factors associated with fear of COVID-19 among study respondents. Higher risk perception, poor health status, and being female were strong factors of increased fear of COVID-19. Targeted interventions are essential to integrate community-level mental health care for COVID-19 resilience.

COVID-19 preventive practices and associated factors among high school and preparatory school students in Dessie City, Ethiopia

Background

As the COVID-19 pandemic continues to ravage the world, the most pretentious sector besides the economy is the education system. Ethiopia is not equipped with the infrastructure and facilities to provide online classes for students at all levels. Hence, all institutions were re-opened with mandatory infection prevention and control (IPC) protocols such as the use of face masks, physical distancing, shifts in classes, and routine hand washing practices with soap and water to restrict the spread of the virus. Nevertheless, there has been no monitoring and follow- up and there is no data on IPC compliance among school children in the country. The purpose of this study was to examine the COVID-19 preventive practices and their associated factors among high and preparatory school students in Dessie City, Ethiopia.

Methods

A cross-sectional study was carried out by using a pre-tested face-to-face applied structured questionnaire and direct observations from March 8 to March 20, 2021, in five high and preparatory schools in Dessie City. The sample size was proportionally allocated in each school based on the students' total number registered in the first academic semester, then stratified by grade level, and proportionally allocated to each grade and section. Finally, a simple random sampling method was used to select study participants. Variables with p-values < 0.25 in the bivariate logistic regression analysis were entered into the multivariate logistic regression model.

Results

This study involved 422 students with a response rate of 98.8%. The level of good preventive practices was 43.7%. After adjusting for covariates, female, positive attitudes, received IPC training and clear accessible sharing of information and feedback with parents, students and teachers were identified as predictors of good precaution practices.

Conclusion

The prevalence of good prevention practices for COVID-19 among students was relatively very low. Therefore, the Department of Health and Education of Dessie City and each school should implement environmental health programs and promote prevention practices in high schools and preparatory schools.

Self-reported adherence to preventive practices during the third wave of COVID-19 in Afghanistan

Objective:

The study objectives were aimed to highlight the areas where public awareness is needed to enhance preventive practices among the public. Hence, to avoid the spread of virus in public settings. In addition, the study has provided compelling data and evidence on the coronavirus disease-2019 trend for health policymakers to make strategic decisions.

Introduction:

The coronavirus disease-2019 is a highly contagious respiratory disease caused by severe acute respiratory syndrome coronavirus type-2. The disease has spread across the globe. In Afghanistan, thousands of confirmed cases with hundreds of deaths have been reported. In addition, due to insufficient healthcare workforce, insecurity, fragile healthcare infrastructure, low coronavirus disease-2019 vaccination and low testing capacity, the true nature of the pandemic is unlcear.

Method:

An online survey of the general population in Afghanistan was conducted from April-May 2021. Convenience sampling technique was used to recruit the respondents. Social media platforms were used (WhatsApp, Twitter and Facebook Messenger) to disseminate the electronic survey instrument. Written informed consent was taken from the participants before the filling questionnaires. Data collection was guided through a self-administered questionnaire developed by the researchers according to the World Health Organization guidelines. The sample size was calculated using EPI software. The inclusion criteria were being 18 years or older and having access to the Internet to fill out the online questionnaire. IBM SPSS Statistics version 25.0 was used for analysis. Descriptive statistics (frequencies, percentages) and bi-variable (chi-square) analyses were done. A p value of <0.05 was considered significant at a 95% confidence interval.

Results:

From 1094 respondents, 78% were male. The majority of respondents were aged ⩽30 years and had an undergraduate education. Nearly 1 in 3 participants were healthcare workers, and 70% lived in households with five or more family members. Overall, 70% of the respondents reported good preventive practices. The majority of the participants reported covering their mouth and nose while coughing and sneezing and cleaning their hands regularly and using alcohol. Meanwhile, 80% of the participants wore a mask when going outside. Moreover, people with post-graduate education had a higher level of preventive practices than those with an undergraduate education.

The results of logistic regression revealed participants residence in Kabul, healthcare workers, family size less than 5, avoid meeting people outside, gender, and avoiding 3Cs, were the significant determinants of adhering to good preventive practices.

Conclusion:

Generally, the public in Afghanistan followed infection prevention rules. However, certain areas require further improvement, such as observing social distance and avoiding shaking hands when meeting others. Negligence of these prevention practices can lead to an increase in infection transmission among people. Public awareness should be continued to keep the people supportive of the government policies.

Time in Service and Resilience in Active Military Personnel during the COVID-19 Pandemic: A Cross-Sectional Study in Northern Peru

Greater occupational exposure may have a positive effect on the development of resilience. We aimed to determine the association between working time and resilience in Peruvian military personnel during the COVID-19 pandemic. A secondary data analysis was performed including 586 records of military personnel who supported the health emergency during the second epidemic wave in Lambayeque, Peru. Resilience was measured with the short form of the Connor-Davidson Resilience Scale (CD-RISC). Working time and other relevant covariates were collected by self-report. Generalized linear models were used. The mean resilience score was 22.18 and 43.2% scored high for resilience. Participants reported that they are strong individuals when facing difficulties (42.3%), are able to handle unpleasant feelings (40.3%), and achieve their goals despite obstacles (40.4%). Working more than 18 months was associated with a 35% higher prevalence of high resilience (PR: 1.35; 95% CI: 1.05-1.75). In conclusion, a notable number of military personnel experienced high levels of resilience during the pandemic. Working time may have played an important role in the development of this ability. Our findings could help guide the deployment and organization of the military in health emergency support missions.

Prevalence and influencing factors of anxiety in medical students during the COVID-19 pandemic

Background and objective

The novel coronavirus disease (COVID-19) pandemic has caused a traumatic impact on the whole world in all aspects including physical health, economic condition, and mental health. Psychological problems are commonly neglected for their inconspicuous symptoms. Little is known about the medical students' psychological status during the COVID-19 pandemic. Our study aimed to investigate the prevalence and influencing factors of anxiety among medical students during the COVID-19 pandemic.

Methods

Two thousand and two medical students were investigated in this cross-sectional study. Zung's self-rating anxiety scale was used to evaluate their anxiety symptoms. A total of 1917 questionnaires were collected, and the response rate was 95.8%.

Results

There were 1735 (90.5%) complete and valid questionnaires. The average SAS standard score was 42.8 ± 11.0. The results indicated that the prevalence of anxiety in medical students was 25.9%. Less social support (OR = 1.4, 95%CI 1.2-1.7) is an independent risk factor of anxiety syndrome, while the female (OR = 0.6, 95%CI 0.5-0.8) is less likely to have anxiety syndrome.

Conclusion

The prevalence of anxiety in medical students is higher during the COVID-19 pandemic. Male students and students with less social support are more likely to have anxiety syndrome. Medical educators and students themselves should take serious steps to prevent, recognize and deal with the anxiety prevalence.

University Students' Risk Perception, Protective Measures, and General Health During the COVID-19 Pandemic in Turkey

OBJECTIVE

This study aimed to investigate university students' risk perception, protective measures, and general health during the coronavirus disease 2019 (COVID-19) pandemic in Turkey.

METHODS

The research sample consisted of 1920 university students. The data were collected through an online questionnaire.

RESULTS

A total of 56.6% of the students considered their risk of being infected with the COVID-19. The number of measures taken by students was lower than expected. Students' increased anxiety perceived individual risk level, insufficient social support perceptions, and their perceptions of the current pandemic more serious than previous epidemics affect the number of measures they take. Students had sleep and study problems, and suicidal thoughts in the social isolation period. Sex, studying in medicine, anxiety related to COVID-19, feeling unconfident in coping with the pandemic, social support, were determined to be risk factors regarding general health, sleep and study problems, and suicidal thoughts.

CONCLUSIONS

The results of the study showed that the measures taken by university students were insufficient and the precautions were affected by many factors. It was determined that their health was adversely affected by the pandemic. University administrations and decision-makers should consider the risk factors to improve the students' experiences in such pandemics and emergencies.

Highly educated patients have lower dental compliance during the COVID-19 pandemic: an observational study

BACKGROUND

The outbreak of coronavirus disease 2019 (COVID-19) is rapidly changed medical habits, and dental clinics have been forced to adapt. This study explored the pandemic-induced changes in patient utilization of dental services to assist practitioners in responding efficiently to similar public crises as references in the future.

METHODS

We retrospectively analyzed the correlation between patient profiles and dental visits attendance within 2 months before and during the outbreak.

RESULTS

A total of 332 patients, 210 women and 122 men (total number of visits: 1068) were enrolled in this study. A significantly lower attendance rate was noted during the COVID-19 period (70.3%) than prior to the pandemic (83.4%). The rate of return visits for patients with a high education level during the COVID-19 period was significantly reduced from 96.5 to 93.1%. In addition, the number of days between two visits significantly increased during the pandemic.

CONCLUSIONS

Our results indicate that, during the pandemic period, the attendance rates of return dental appointments decreased, and the rate of missed appointments for patients with a high educational levels was higher than that of patients with a low educational level.

CLINICAL RELEVANCE

Preventive management of these patients who are easy to miss dental appointments may enable more effective use of medical resources.

The Effect of the Knowledge, Attitude, and Behavior of Workers Regarding COVID-19 Precautionary Measures on Food Safety at Foodservice Establishments in Jordan

The novel coronavirus (COVID-19) pandemic has caused sequential ripples of public health concern worldwide. Restaurant owners and workers have been significantly affected by safety regulations which have governed the activities of both employees and consumers. The objective of this study was to investigate the knowledge, attitude, and practices (KAP) of restaurant owners and workers in the context of COVID-19 and assess the effect of COVID-19 precautions on the implementation of food safety measures at foodservice establishments in Jordan. A cross-sectional survey was conducted that involved 605 participants from 91 restaurants and catering establishments in Jordan. The questionnaire was filled out during a face-to-face interview or via online platforms. Most (77%) of the respondents were male and under 35 years old (79%), with 42% of them having a high educational level (bachelor’s degree or postgraduate studies) and 46% having 1–5 years of work experience. It was found that only 20% of workers possessed good knowledge (scores above 75%), 56% had positive attitudes, and 55% had good practices, with a mean of 47% being compliant with the KAP levels expected. In total, 19 to 34% of participants observed that the precautions and preventive measures put in place during the pandemic improved the application of key food safety regulations within their workplaces. It is evident that more training is required for both employees and employers to ensure the effective implementation of the regulations required to prevent the spread of COVID-19 and food-borne pathogens via the application of good hygienic practices that improve food safety, reducing illnesses and food waste while maintaining food security and economic sustainability.

Practice Level and Associated Factors Towards the Preventive Measures of COVID-19 Among the General Population; A Systematic Review and Meta-Analysis

Background

Studies conducted on the practice of COVID-19 preventive methods across the world are highly inconsistent and inconclusive. Hence, this study intended to estimate the pooled preventive practice and its determinants among the general population.

Methods

This study was conducted using online databases (PubMed, HINARI, Scopus, EMBASE, Science Direct, and Cochrane library database), African Journals online, Google Scholar, open gray and online repository accessed studies. The quality of the included studies was assessed using Newcastle-Ottawa Quality Assessment Scale (NOS). STATA 14.0 software for analysis. The existence of heterogeneity between studies was checked using Cochran Q test and I2 test statistics and then, the presence of publication bias was detected using both funnel plot and Egger's test.

Results

51 studies were included and the pooled level of practice toward the preventive measures of COVID-19 was 74.4% (95% CI: 70.2-78.6%, I2 = 99.7%, P < 0.001] using a random effects model. Being female [OR = 1.97: 95% CI 1.75, 2.23; I2 = 0.0%, P < 0.698], rural residence [OR = 0.53: 95% CI 0.44, 0.65; I2 = 73.5%, P < 0.013], attending higher education level [OR = 1.47: 95% CI 1.18, 1.83; I2 = 75.4%, P < 0.001], being employed [OR = 2.12: 95% CI 1.44, 3.12; I2 = 91.8%, P < 0.001], age < 30 [OR = 0.73: 95% CI 0.60, 0.89; I2 = 73.9%, P < 0.001], and knowledgeable [OR = 1.22: 95% CI 1.09, 1.36; I2 = 47.3%, P < 0.077] were the independent predictors of adequate practice level.

Conclusions

nearly three-fourths of the general population has an adequate preventive practice level toward COVID-19. Thus, the global, regional, national, and local governments need to establish policies and strategies to address the identified factors.

Knowledge, attitudes and behaviours toward COVID-19: A cross-sectional survey among Nigerian University students

Background

The effect of the highly contagious coronavirus disease 2019 (COVID-19) began in Wuhan, Hubei Province, China, from which it spread worldwide. In Nigeria, to curb the spread of the virus, the government elected to close public places, halt the general use of public transportation, enforce isolation and manage infected persons.

Aim

This study evaluated Nigerian university students’ knowledge, attitudes and behaviour (KAB) towards COVID-19.

Setting

This was an online survey of Nigerian university students.

Method

A cross-sectional study was conducted among 1268 respondents aged 16 to 60 who completed the survey questionnaire. The respondents’ demographic data and KAB toward COVID-19 were collected, allocated and scored based on specific stratified divisions. Data were analysed using student’s t-test, analysis of variance and logistic regression analysis.

Results

The respondents demonstrated good knowledge of COVID-19, with a mean knowledge score of 78.7%; this positively influenced their attitude and behaviour scores (84.1% and 72.3%, respectively). Multiple linear regression analysis showed that 98.9% of the variance associated with poor knowledge is explained by gender (98.9%), age (97.3%), education (97.3%), occupation (97.2%) and marital status (91.4%).

Conclusion

The respondents had a positive attitude and satisfactory compliance with safety practices required to curb the spread of the virus. Nevertheless, there is a need to intensify health education campaigns targeting all Nigerians, especially the less educated, via community outreach programmes using local languages.

Contribution

The findings of this study demonstrate the imperative role of the knowledge of COVID-19 in curbing the spread of the infection via improved attitudes and positive behaviours in compliance with safety practices.

The Relationship of Breathing and COVID-19 Anxiety When Using Smart Watches for Guided Respiration Practice: A Cross-Sectional Study

COVID-19 mortality rates are increasing worldwide, which has led to many highly restrictive precautionary measures and a strong sense of anxiety about the outbreak for many people around the world. There is thus an increasing concern about COVID-19 anxiety, resulting in recommending approaches for effective self-care. From a positive psychology perspective, it is also important for people to have positive affect when dealing with this pandemic. According to previous literature, respiration is considered to be an effective way to enhance people’s mental health. Among all the wearable devices, Apple Watch has the largest market share, so this study recruited Chinese users that use respiration exercise function on Apple Watch; a total of 316 valid data were retrieved. Meanwhile, to understand one approach related to using Apple Watch to practice respiration to reduce COVID-19 anxiety about being infected during the COVID-19 outbreak, this study used a web-based cross-sectional survey to examine anxiety about being infected by COVID-19 among Chinese people who had been using the Apple Watch to practice respiration during the period of the COVID-19 outbreak. The study was based on the Health Theoretical Model, and the model was developed with four dimensions and was validated with structural equation modeling. The results of this study showed that practicing few minutes had a positive relationship on positive attitude, and positive attitude had a negative relationship on pandemic anxiety and a positive relationship on continuance use intention. Anxiety about the pandemic had a negative relationship on the intention to continue using the function. This showed that respiration practice can help to suppress the increase in anxiety levels regarding this pandemic.

Association between Online Learning Predictors and Psychological Distress among Nursing Students during the COVID-19 Pandemic

BACKGROUND: The global coronavirus disease-2019 pandemic has forced nursing schools in Indonesia to implement online learning. The association between online learning variables and psychological distress among nursing students is not fully understood. AIM: This study aimed to assess psychological distress among nursing students and the association between online learning variables and psychological distress. MATERIALS AND METHODS: A cross-sectional study was conducted from November 2020 to February 2021. Six hundred and thirty-five nursing students from four universities in Indonesia participated in this study and were recruited through a consecutive sampling method. The measurement of psychological distress used the 10-item Kessler Psychological Distress Scale. Ordinal logistic regression was used to analyze the association between online learning predictors and psychological distress. RESULTS: Most of the respondents had severe psychological distress (n = 194; 30.6%). Older age was found to act as a protective factor against psychological distress (adjusted odds ratio [aOR] = –0.159, p = 0.035; 95% confidence interval [CI]: (–0.307)–(–0.011)). Contrarily, not living at their own home during lockdown (aOR = 1.019, p = 0.001; 95% CI: 0.657–1.382), always feeling that online learning is expensive (aOR = 1.387, p = 0.001; 95% CI: 0.645–2.130), always experienced poor Internet connection during online learning (aOR = 3.380, p = 0.001; 95% CI: 1.935–4.826), and having no motivation toward online learning (aOR = 3.154, p = 0.001; 95% CI: 2.372–3.936) acted as risk factors for having psychological distress. CONCLUSION: Cost and Internet access barriers as well as low motivation during the abrupt shift to implementation of online learning in the current pandemic situation acted as risk factors for psychological distress among nursing students.

Risk perception and preventive behaviours of COVID-19 among university students, Gondar, Ethiopia: a cross-sectional study

OBJECTIVE

This study aimed to assess COVID-19 preventive behaviours and their associated factors among university students.

METHODS

An institution-based cross-sectional study was employed among 405 university students and the study participants were chosen using a stratified simple random selection procedure. A pretested self-administered questionnaire was used to assess participants' perception of and preventive behaviour towards COVID-19. A multivariable logistic regression analysis was employed to identify factors associated with COVID-19 preventive behaviour.

RESULT

A total of 405 students participated in this study with a response rate of 97.4%. The mean age of the participants was 23.6 (SD ±2.4, range 19-30) years. Two hundred and twenty of the participants (45.7% with 95% CI 41.0% to 51.0%) had good preventive behaviour towards COVID-19. COVID-19 preventive behaviour was significantly associated with age (adjusted OR (AOR)=1.1, 95% CI 1.00 to 1.2), female sex (AOR=1.6, 95% CI 1.02 to 2.60), knowing anyone infected with COVID-19 (AOR=4.05, 95% CI 1.9 to 8.8), participants who had high perceived susceptibility (AOR=2.14, 95% CI 1.44 to 3.35) and participants who were enrolled in health programmes (AOR=4.23, 95% CI 2.6 to 7.0).

CONCLUSION AND RECOMMENDATION

The overall COVID-19 preventive behaviour among university students is unsatisfactory. Students' COVID-19 preventive behaviour was influenced by age, sex, knowing a COVID-19 infected person, perceived susceptibility and the sort of programme in which they had enrolled. The findings revealed that health communication interventions aimed at changing people's perceptions of COVID-19 and related prevention strategies are urgently needed to improve this population's COVID-19 preventive behaviour.

Associations of COVID-19 Risk Perception, eHealth Literacy, and Protective Behaviors Among Chinese College Students Following Vaccination: A Cross-Sectional Study

Background

In spite of strict regulation of coronavirus disease 2019 (COVID-19) preventive measures and containment in China, there are still confirmed cases sporadically occurring in many cities. College students live in groups and have active social activities so that it will trigger a serious public health event once an infection event occurs. Thus, identifying the status and related factors of protective behaviors among them after receiving vaccination will be crucial for epidemic control. This study aimed to gather information on the protective behaviors and to identify the associations of COVID-19 risk perception, eHealth literacy, and protective behaviors for Chinese college students following vaccination.

Methods

A cross-sectional survey of college students engaged in protective behaviors post vaccination was conducted using the COVID-19 risk perception scale, eHealth literacy scale, and protective behaviors following vaccination questionnaire in one of the groups. Multiple linear regression analysis was used to confirm the correlation among the COVID-19 risk perception, eHealth literacy, and protective behaviors for Chinese college students.

Results

A total of 5,641 Chinese college students were included. Male students comprised 59.01% with an average age of (21.39 ± 2.75) years and most students rating their health as very good (44.85%) or pretty good (46.98%). A smaller percentage (13.76%) believed that they would likely or most likely be infected with COVID-19 after getting vaccinated. In addition, more than 1 in 10 (10.35%) college students had ever suspected to suffer from post-vaccination reactions following the COVID-19 vaccination. The mean score of protective behaviors was 26.06 ± 3.97. Approximately one-third (30.42%) of the students always or often did not wear a mask when going out. Some college students (29.25%) did not maintain distance of at least 1 m from others in social situations. Older female college students who were in good health and perceived as being at a low risk of getting infected with COVID-19, and those never suspected to suffer from post-vaccination reactions expected to engage in post-vaccination protective measures. Those with a higher level of perceived risk, severe risk perception and eHealth literacy, and a lower level of unknown risk perception were more likely to engage in further protective behaviors after getting vaccinated.

Conclusions

Overall, the level of protective behaviors among the Chinese college students following vaccination could be improved, especially for male, younger college students in poor health. This study revealed the predictive effects of risk perception and eHealth literacy on protective behaviors, recommending that the negative and positive effects of risk perception should be balanced in epidemic risk management, and eHealth literacy promotion should also be emphasized for public health and social measures.

Levels and Predictors of COVID-19-Related Anxiety in Older Adults

BACKGROUND: Prolonged quarantine during the COVID-19 outbreak is a stressful factor. AIM: This study aims to analyze the psycho-emotional state of Jordan’s older population during the Covid-19 pandemic. MATERIALS AND METHODS: The study on 620 older adults (mean age, 66.4±5.3 years) was conducted in 2020 in Amman (Jordan). All respondents were asked to complete an online survey on coping strategies, a HUDS questionnaire, and a specially designed questionnaire. RESULTS: The dominant predictors of stress were uncertainty (62%) and a fear other family members getting ill (60%). Of all the respondents, 15% agreed with the necessity to prolong the quarantine period, 47% had a neutral attitude, and 38% exhibited a negative attitude. High levels of anxiety in older population were associated with the lower use of humor (H=11.498, p≤0.002). On the other hand, such respondents demonstrated the higher use of planning (H=6.227, p≤0.039), venting (H=11.087, p≤0.004), avoidance (H=7.457, p≤0.019), and active coping (H=6.043, p≤0.037). CONCLUSIONS: Most of Covid-19 cases are registered in healthcare institutions and for that reason, there is a need to provide psychiatric care to medical workers who do not have the necessary experience in this area. This may also require the state to promote psychiatric care training.

Assessment of the physical and emotional health concerning the students' physical activity during the COVID-19 pandemic

Introduction. SARS CoV-2 caused the third global pandemic and by applying quarantine / isolation / lockdown, the movement was restricted, the physical contact between people was reduced, the physical activity was low, but the activities using electronic devices at home were frequent. The aim of the study was to assess the physical and emotional health in relation to the physical activities done during quarantine/ isolation during the pandemic. Material and method. The study was cross-sectional and consisted of completing an online questionnaire. It was conducted in a period of 6 months and it included 334 students. In order to point out the symptoms caused by quarantine / isolation/ lockdown, we considered it useful for students to participate by completing an online questionnaire about physical activities, physical health and emotional state, related to the implications of participating in online courses. Results. The questions in this questionnaire were grouped on the following aspects: physical activity, physical health, emotional state, all in the context of the pandemic period, including the period in which the academic activity was online. Thus, in the first year, there is a positive correlation between physical condition, physical activity, emotional signs and cognitive ones. In the second year, the positive correlation is present between the physical and the affective signs, whereas the negative correlation is between the affective signs, the cognitive ones and the physical activity. In the third year, the positive correlation is obvious between the affective signs, the cognitive ones and the physical activity, whereas the negative one between the physical and cognitive signs, as well as between the physical activity and the cognitive and physical signs. Discussions. There is a link between emotional and cognitive symptoms and physical health. Fear, anxiety, behavioral disorders, and limited physical activity among students during this period can be a public health issue. Conclusions. The COVID-19 pandemic affected the physical and mental state, with a greater resonance for youth, especially pupils and students. Many of them had emotional, behavioral, physical and cognitive symptoms. These symptoms are found to a greater extent in students in the final years, due to the social impact, social and professional integration. Keywords: physical health, mental state, students,

University Students’ Knowledge, Attitude, and Practice (KAP) towards COVID-19 in Malaysia

Covid-19—associated with the human-to-human transmission is recent medical concern which also associated with public health concerns. A cross-sectional online survey was conducted among clinical year veterinary and medical students studying in a university in Malaysia to determine the students’ knowledge, attitude, and practice towards COVID-19. The questionnaire consisted of 4 sections, namely, socio-demographic characteristics (6 items), knowledge (14 items), attitude (10 items), and practice (24 items) towards COVID-19. The collected data were subjected to descriptive statistics, Mann-Whitney U, Kruskal-Wallis H, and Spearman’s correlation analysis. A total of 219 students participated in this study, and they consisted of 52.1% and 47.9% of veterinary and medical students, respectively. The total scores were categorised into poor (<60%), moderate (60-79%), and high (>80%) based on Bloom’s cut off point. Overall, the students acquired high knowledge (80%), moderate attitude (76%) and high practice (86%) against COVID-19. In the attitude section, the veterinary student scored significantly higher than medical students (U=3791, p= .001), and female students scored significantly higher than males (U=3183, p= .001). The analysis revealed a statistically significant association between attitude and practice (P< .05) despite no association between knowledge to attitude and practice variables. Overall, the results indicated that both veterinary and medical students had high knowledge with moderate to high attitudes towards COVID-19. Thus, they were practising good preventive measures in limiting the spread of the disease.

Evaluation of Sleep Habits, Generalized Anxiety, Perceived Stress, and Research Outputs Among Postgraduate Research Students in Hong Kong During the Coronavirus (COVID-19) Pandemic

Purpose

The current study aimed to evaluate the impact of coronavirus (COVID-19) pandemic on sleep hygiene, anxiety levels, perceived stress, and research output among postgraduate research students in Hong Kong.

Methods

An online survey was developed and distributed to Hong Kong postgraduate research students. The sleep hygiene, anxiety levels, and perceived stress during the outbreak of COVID-19 were assessed. Questions about COVID-19’s impact on research outputs were asked.

Results

A total of 108 (response rate, 72%) full-time postgraduate students (PhD, 64%; M Phil, 8%; and Masters, 28%) participated. Approximately 83% of students reported poor sleep hygiene. Similarly, nearly 76% of students reported mild to severe levels of self-perceived anxiety levels. Most of the respondents (89%) expressed a moderate level of perceived stress. Sleep hygiene scores were moderately associated with anxiety levels (r = 0.384, p < 0.01) and perceived stress scores (r = 0.423, p < 0.01). Perceived stress was strongly correlated with anxiety levels (r = 0.601, p < 0.01). A hierarchical regression analysis revealed a significant association between respondents’ ethnicity (B = −0.923, p = 0.003), past medical history (such as hypertension, diabetes, and musculoskeletal disorders) (B = 1.112, p = 0.005), or poor sleep hygiene (B = 0.259, p = 0.000) and high levels of perceived stress. Additionally, prior medical history (such as hypertension, diabetes, and musculoskeletal disorders) (B = 1.957, p = 0.001) and poor sleep hygiene (B = 0.312, p = 0.000) were found to be strongly related to anxiety levels among postgraduate research students.

Conclusion

This is the first study that highlights poor sleep hygiene, moderate-to-severe levels of anxiety, and perceived stress during the COVID-19 pandemic in postgraduate research students in Hong Kong. These findings will help educators to prepare strategies to alleviate the stress and psychological problems in postgraduate students.

Knowledge, attitude, and practices toward COVID-19 among the international travelers in Thailand

BACKGROUND

International travel is among the leading impactful factors of COVID-19 transmission; thus, adequate knowledge, good attitude and good preventive practices toward COVID-19 for international travelers are particularly essential for successful pandemic control.

METHODS

A cross-sectional, questionnaire-based study was conducted to determine knowledge, attitude and practices (KAP) of international travelers (both Thai and non-Thai) and expatriates in Thailand. The data were collected at the Thai Travel Clinic, Bangkok, Thailand and via online platforms during May to October 2020. The independent T-test, Chi-square test and multiple regression analysis (MRA) were applied to determine factors influencing the KAP.

RESULTS

Of 399 travelers, 46.6% were male, 72.1% had a Bachelor's degree or higher, and the mean age was 35.6 ± 9.6 years. Due to unexpected travel restrictions and lock down, 77.9% of participants were Thai and the respective major purpose of travel was business/work. Travel cancellation/postponement was reported at 73.9%. While sufficient knowledge (≥ 60% correct answers) was reported in 77.9% of participants, a low percentage of correct answers was found in the questions regarding disease transmission. The travelers reported a neutral attitude and an overall moderate concern regarding the COVID-19 situation. Adequate preventive practices were determined by the average practice score 3.54 ± 0.38 (0 = never and 4 = always). The MRA revealed that the factors influencing good practices were travelers who: i) enrolled from outside the hospital (online platform); ii) received pretravel advice at hospital; iii) were female; iv) participated before the declaration of the end of the outbreak; v) were aged 40-49 years, and vi) visited friends and relatives.

CONCLUSIONS

The majority of travelers in this study had sufficient knowledge, a neutral attitude and adequate preventive practices toward COVID-19. The factors influencing good practices included pretravel advice, sex, age and the point in the timeline of the outbreak. In order to better control the COVID-19 pandemic situation, pretravel counselling and advice should be promoted as a means to improve knowledge, particularly in disease transmission, increase awareness and emphasize appropriate preventive measures toward COVID-19 among international travelers. Furthermore, preventive practices should be bolstered at all times regardless of the outbreak situation.

Knowledge, Attitude, and Practice Survey of COVID-19 Among Healthcare Students During the COVID-19 Outbreak in China: An Online Cross-Sectional Survey

Background: The ongoing coronavirus disease (COVID-19) outbreak has placed the healthcare system and student training under considerable pressure. However, the plights of healthcare students in the COVID-19 period have drawn limited attention in China. Methods: A cross-sectional on-line survey was undertaken between January and March 2020 to explore the COVID-19 knowledge, attitude, and practice (KAP) survey among Chinese healthcare students. Demographic information and data on KAP were obtained using a self-reported questionnaire. The percentage KAP scores were categorized as good or poor. Independent predictors of good knowledge of COVID-19 were ascertained to use a logistic regression model. Results: Of the 1,595 participants, 85.9% (1,370) were women, 53.4% were junior college students, 65.8% majoring in nursing, and 29.8% had received training on COVID-19. The overall median percentage for good KAP was 51.6% with knowledge of 28.3%, attitude 67.8%, and practice 58.6%, respectively. Independent predictors of good knowledge of COVID-19 were being students ≥25 (95% CI = 0.27-0.93, P = 0.02), those taking bachelor degrees (95% CI = 1.17-2.07, P = 0.00), and those having participated in COVID-19 treatment training. Conclusions: The result of this study revealed suboptimal COVID-19-related KAP among healthcare students in China. To effectively control future outbreaks of COVID-19, there is a need to implement public sensitization programs to improve the understanding of COVID-19 and address COVID-19-related myths and misconceptions, especially among healthcare students.

Student Pharmacists during the Pandemic: Development of a COVID-19 Knowledge, Attitudes, and Practices (COVKAP) Survey

Background: The COVID-19 pandemic has caused innumerable changes to all aspects of human life and behavior, including academic life. This study describes the development of a COVID-19 Knowledge, Attitudes, and Practices (COVKAP) Survey among U.S. student pharmacists. The survey was administered at Doctor of Pharmacy programs in three states—Tennessee, Ohio, and Pennsylvania. Methods: The COVKAP survey—an online cross-sectional survey—was distributed to U.S. student pharmacists enrolled in three different colleges of pharmacy in three states during the fall semester of 2020. The survey was developed using literature review and Dillman’s recommendations for survey design. The COVKAP survey consisted of 23 closed and Likert-scale questions, and three open-ended questions. The research team conducted descriptive and inductive thematic analyses on the quantitative and qualitative data, respectively using SPSS (v27) and Dedoose^® software. Results: A total of 421 responses were received. Respondents were predominantly female (72%) and White (79%). The average age of respondents was 23.4 years. The qualitative analysis revealed three themes: (1) Wellbeing and mental health struggles; (2) Being part of the decision-making process; (3) Necessity of adequate protection measures. Conclusions: Preliminary study findings indicate that student pharmacists’ concerns and the challenges that they face in their academic pursuits are largely similar across the three states in this study and inform about the importance of recognizing and mitigating the impact of widespread disruption in education. This disruption provides an opportunity for pharmacy academia to examine practices and methods that can be improved upon to help students become successful practitioners.

Insight on Knowledge, Risk Perception and Practices to Prevent the Spread of COVID-19: A Cross-Sectional Study among Italian University Students

Addressing adherence to non-pharmaceutical interventions among young adults represents a public health priority since this age group did not directly experience a health risk from COVID-19. The study aims were to investigate the level of knowledge, risk perception and practices to prevent the spread of COVID-19 among undergraduate university students in Southern Italy. This cross-sectional study was conducted between the 1st and 31st of July 2020. An anonymous and structured questionnaire was sent via institutional email. Among the 1323 sampled students, more than two-thirds gave the correct answer to all the knowledge statements. Good knowledge about COVID-19 showed a positive association with those studying medical or life sciences majors. Almost two-fifths (38.5%) of the sample declared to have quite a bit/extreme fear of falling ill with COVID-19 and it was significantly more likely among females and those with good knowledge. Only 30.2% of the students did not touch their face mask while using it. Moreover, practicing respiratory etiquette was more likely among females, among respondents with higher levels of fear of falling ill with COVID-19 and among those who exhibited good knowledge about COVID-19. The study insights will be valuable for the ongoing mitigation of the current pandemic especially with regard to the correct use of face masks.

Students' Wellbeing during Transition from Onsite to Online Education: Are There Risks Arising from Social Isolation?

The COVID-19 pandemic has caused disruption to activities in many fields, including education and lifestyle. Major changes have taken place in the education system, where specific activities migrated suddenly from onsite to online. As a result, this period has witnessed an increased interest in impact studies that analyse the perceptions of the actors involved in the educational process. Based on the survey data (N = 665), the perceptions of the students in Romanian universities with regard to the effects of online education during the pandemic on their wellbeing were analysed. The empirical apparatus-SEM analysis-reached the following conclusions: the students' wellbeing was increased under the traditional education system; the economic crisis has caused concern, and a decrease in their wellbeing; their contamination fear is moderate to low, and does not influence their wellbeing; they have been discouraged in terms of their personal development during the pandemic, and their wellbeing has suffered as a result; the role of institutions is extremely important, given that the students' ability to study online depends on the universities' efficiency in implementing the online system.

Knowledge, Attitude, and Preventive Practices Towards COVID-19 Among Students of Ethiopian Higher Education Institutions

INTRODUCTION

COVID-19 has been a global public health problem since December 2019. Higher education institutions are risky areas for the transmission of COVID-19. But, still there is insufficient information on the prevention of the disease in this setting.

OBJECTIVE

To assess knowledge, attitude, and prevention practices towards COVID-19 among students of Ethiopian higher education institutions.

METHODS

Institutin  -based cross-sectional study design was conducted from December 1 to 30, 2020 among randomly selected 407 undergraduate students from higher education institutions in Ethiopia. The outcome variables were knowledge, attitude, and practices towards COVID-19. Binary logistic regression models at 95% confidence interval (CI) were used to determine the factors affecting knowledge, attitude, and practices towards COVID-19. In multivariable analysis, variables with a p-value of less than 0.05 were considered statistically significant and independently associated with outcome variables at 95% CI.

RESULTS

About 75.9% (95% CI: 72.2-79.9%) of University students had a good knowledge, 62.4% (95% CI: 58.2-67.1%) had a positive attitude, and 56.8% (95% CI: 52.6-61.9%) had a good COVID-19 prevention practices. Students over the age of 30 (AOR=5.8; 95% CI: 1.5, 10.6), third-year students (AOR=3.1; 95% CI: 1.1, 8.9), and being health science students (AOR=4.4; 95% CI: 2.2, 8.9) were significantly associated with a good knowledge towards COVID-19. Urban residents (AOR=0.6; 95% CI: 0.3-0.9), having an average family monthly income of $75USD (AOR=3.5; 95% CI: 1.8-6.7), use of at least one type of social media (AOR=4.7; 95% CI: 1.7-12.9), and having a positive attitude (AOR=2.2; 95% CI: 1.3-3.5) were significantly associated with COVID-19 prevention practices.

CONCLUSION

Despite three-fourths of the participants had a good knowledge, the attitude and prevention practices were low. Age, study year, College of study, presence of chronic illnesses, use of social media, family income, and residence were factors of knowledge, attitude, and prevention practices towards COVID-19. Hence, multiple information dissemination strategies using multiple media outlets should be implemented continuously.

Knowledge, Attitudes, and Practices of Medical Students Regarding COVID-19 in Afghanistan: A Cross-Sectional Study

BACKGROUND

The coronavirus pandemic has had devastating effects on many nations, including Afghanistan. Public awareness and following recommendations play an important part in managing such a large-scale crisis, which are affected largely by knowledge, attitudes, and practices (KAP). Medical students can act as reliable sources of information for the public in such a scenario. This study aimed to investigate KAP of medical students regarding COVID-19.

METHODS

A cross-sectional online survey was conducted in October 2020 among medical students in Afghanistan, Kabul University of Medical Sciences. Information on sociodemographics and KAP, was collected using a web-based questionnaire.

RESULTS

A total of 1,169 medical students completed the survey. More than half were female (54.6%), a majority (95%) aged ≥20 years, and more than half (56.2%) lived in the city of Kabul. Overall, students had acceptable KAP regarding COVID-19, except for a few undesirable responses with regard to the risks of close contact with COVID-19 patients, incubation periods, and groups vulnerable to COVID-19.

CONCLUSION

Overall, the students had acceptable KAP regarding COVID-19, except for the few undesired aforementioned responses, which need more focus during awareness campaigns in future.

Assessing Knowledge, Preventive Practices, and Depression among Chinese University Students in Korea and China during the COVID-19 Pandemic: An Online Cross-Sectional Study

To investigate the knowledge, preventive practices, and depression of Chinese university students living in South Korea and Mainland China during the COVID-19 outbreak and explore the determinants of depression among these students, an online cross-sectional questionnaire survey was conducted from 23 March to 12 April 2020. The online questionnaire included questions on knowledge and preventive practices related to COVID-19, and the Patient Health Questionnaire-9 was used to diagnose depressive symptoms. A total of 420 Chinese university students were finally included in the study (171 students from South Korea and 249 students from Mainland China). The majority of these students had a good level of knowledge of COVID-19. Students living in South Korea displayed better preventive practices than those living in Mainland China; however, the proportion of students (28.7%) with moderate-to-severe depression in this group was relatively higher than that (18.9%) of the Mainland Group (χ² = 5.50, p < 0.05). More severe depression was related to high levels of concern about family members and contracting COVID-19 as well as suspecting themselves of having come into contact with patients. Displaying more preventive behaviors decreased the depressive symptoms in both groups. These data could be used as a reference for further studies in different regions to take measures (e.g., psychological counseling and encouragement for physical activities) to reduce depressive symptoms in university students.

Assessing the Psychological Impact of COVID-19 among College Students: An Evidence of 15 Countries

Mental health issues among college students is a leading public health concern, which seems to have been exacerbating during the COVID-19 pandemic. While previous estimates related to psychological burden among college students are available, quantitative synthesis of available data still needs to be performed. Therefore, this meta-analysis endeavors to present collective evidence discussing the psychological impact of COVID-19 among college students. Bibliographical library databases, including Embase, Medline, CINAHL, Scopus, and PsycINFO, were systematically searched for relevant studies. Titles, abstracts, and full articles were screened, and two reviewers extracted data. Heterogeneity was assessed by I² statistic. The random-effects model was utilized to obtain the pooled estimates of psychological indicators among college students. Location, gender, level of severity, and quality scores were used as moderator variables for subgroup analyses. Funnel plot and Egger linear regression test was used to assess publication bias. Twenty-seven studies constituting 90,879 college students met the inclusion criteria. The results indicated 39.4% anxiety (95% CI: 28.6, 51.3; I² = 99.8%; p-value < 0.0001) and 31.2% depression (95% CI: 19.7, 45.6; I²= 99.8%, p < 0.0001) among college students. The pooled prevalence of stress (26.0%), post-traumatic stress disorder (29.8%), and impaired sleep quality (50.5%) were also reported. College students bear a disproportionate burden of mental health problems worldwide, with females having higher anxiety and depression levels than males. This study‘’s findings underscore the need to develop appropriate public health interventions to address college students’ emotional and psychosocial needs. The policies should be reflective of demographic and socioeconomic differentials.

A Cross-Sectional Study on University Students' Knowledge, Attitudes, and Practices Toward COVID-19 in the United Arab Emirates

The unprecedented coronavirus pandemic is hitting the whole world, including the United Arab Emirates. Public awareness and adherence to the recommendations play a major role in managing a crisis of this magnitude which is largely affected by knowledge, attitudes, and practices (KAP). Hence, the aim of this study was to assess COVID-19–related KAP of the University of Sharjah (UOS) students and compare between health-related (HR) and non-HR (NHR) majors. A cross-sectional study was conducted in May 2020 in which 1,012 (481 health-related and 531 NHR) students participated via an online KAP questionnaire. The students’ sociodemographic characteristics and sources of information were also recorded, and data were analyzed. Students were aged 20–25 years, with an overall knowledge score of 72.4%, and the main source of their information was the Internet and social media (85.2%). Those in HR majors had a higher knowledge score (76%) than those in NHR students (69%). Regarding attitudes, both HR and NHR students demonstrated comparable and positive attitudes to curb the spread. With respect to practices, more NHR students used masks (92.3%), almost all the time than HR students (88.4%). HR students (99.4%) avoided crowded places and practiced social distancing more than NHR students (99.4% versus 97.4% and 97.7% versus 93.2%, respectively). In conclusion, UOS students demonstrated adequate knowledge, and possessed good attitudes and low-risk practices toward prevention of COVID-19. It is recommended that universities including UOS continue to use digital university communication platforms to regularly disseminate vital information in such emergencies.

Methods of prophylaxis and control for young people during COVID-19 period

The agent that caused the third global pandemic is SARS-CoV-2, a newly identified B-coronavirus. The pandemic triggered by COVID-19 brought to the world not only an increased risk of death but also an important psychological pressure. In the EU quarantine and emergency measures were applied in order to limit the spread of the virus. Thus there were restrictions on movement and physical contact between people, and inactivity was increased. An active lifestyle presented even online could have had a positive effect during the quarantine period on health management, and it could have improved functional capacity for people in isolation. The COVID-19 pandemic is a public health problem that influences the economic, political, and scientific fields of the world. The lockdown in Romania, established on March 16, 2020, caused by the COVID-19 pandemic had an influence on the health conditions of the population, regardless of age group. During the lockdown and later during the alert state, the students carried out their scientific/academic activity in the online environment. In this context, the reduction of physical activity has led to the impairment of physical, motor, and sensory capacity. Exercise programs must be permanently accompanied by elements of respiratory gymnastics with a particularly prophylactic character in order to prevent the occurrence of any ailments at the upper respiratory tract.

Demographic, gadget and internet profiles as determinants of disease and consequence related COVID-19 anxiety among Filipino college students

In the context of the nationwide shift to online learning due to the COVID-19 pandemic and its possible effect on mental health, this study investigated the relationship between demographic, gadget and Internet profiles, and disease and consequence related COVID-19 anxiety among Filipino college students. This is a quantitative cross-sectional study. A total of 952 students participated in the online survey. Descriptive and inferential statistics were used to draw insights from the data. Findings suggest that majority of the student respondents had high levels of disease and consequence related COVID-19 anxiety. Students from poorer households, who do not own laptops and desktop computers, and those with limited Internet connection exhibited higher levels of disease-related COVID-19 anxiety. Younger, poorer, female students who were enrolled in lower year levels, do not own laptops or tablets, and have limited or borrowed Internet connectivity demonstrated higher levels of consequence-related COVID-19 anxiety.

Anxiety and Stress Levels Associated With COVID-19 Pandemic of University Students in Turkey: A Year After the Pandemic

The outbreak of COVID-19 has been affecting the daily lives of almost everyone and puts huge psychological pressure on people worldwide, including Turkey. Anxiety and stress levels among university students were already a public health concern. Our study aims to demonstrate the anxiety and stress levels of university students in Turkey after the outbreak of COVID-19 according to the Coronavirus Anxiety Scale (CAS) and COVID Stress Scale (CSS). CAS is a brief mental health screener to identify probable cases of dysfunctional anxiety associated with the COVID-19 pandemic, and CSS was developed to understand and assess COVID-19-related distress. An online questionnaire was administered to active 1,265 university students in Turkey between February 27 and March 8, 2021, via Google forms. The questionnaire consists of three parts that assess participants' demographic information, anxiety, and stress levels related to the pandemic. According to CAS and CSS analysis, anxiety and stress levels were associated with each other and influenced university students during the COVID-19 pandemic. Both were associated with gender and family member loss. The academic year of students had a relationship with anxiety. It was observed that the danger factor was the highest stressor in university students in Turkey related to the novel coronavirus, followed by contamination fears. Both factors were shown as moderate stressors. As a result of the study, it was revealed that anxiety and stress associated with the COVID-19 pandemic are now included in the social, academic, and physical burdens of the university years, which are decisive and important in terms of mental development and psychological health of the person. It is essential to ascertain the long-term effects of COVID-19 and take effective precautions to support the physical and mental health of today's university students accordingly.

Association Between Preventive Behaviour and Anxiety at the Start of the COVID-19 Pandemic in Slovenia

Introduction

The first large outbreak of SARS-CoV-2 in Europe occurred in Northern Italy in February 2020. The relatively fast spread of the infection to Slovenia was expected, and preventive measures for its suppression were widely discussed.

Methods

An online questionnaire was designed to evaluate adherence to preventive measures and the extent to which the taking of preventive measures was associated with people's anxiety level, psychological burden, their perceived vulnerability to disease, germ aversion and a number of demographic characteristics in the early stage of Covid-19 spread. The survey was active for 24 hours (13-14 March 2020). There were 12,307 responses and 7,764 questionnaires were completed in full.

Results

Higher preventive behaviour was found in individuals who experienced greater psychological distress, were more anxious, and expressed greater perceived infectability and germ aversion. Greater compliance with preventive behaviour was found among women, those sharing a household with people aged over 65, the elderly and those who knew somebody who had been infected. These groups also showed higher anxiety levels, which appeared to be significantly increased in general as a result of the specific situation. Quarantine was evaluated as the most efficient preventive measure, and was respected relatively strictly even before it became an officially announced protective measure.

Conclusion

This research reveals a strong association between preventive behaviour and anxiety. Anxiety, together with social distancing, may affect physical and psychological health in the population in the long term. Other aspects of public health might therefore be influenced by the measures currently being enforced to prevent the spread of SARS-CoV-2.

A Cross-Sectional Study of the Impact of COVID-19 on Domestic Violence, Menstruation, Genital Tract Health, and Contraception Use among Women in Jordan

The COVID-19 pandemic is a major global concern for public health where high numbers of COVID-19-infected cases and deaths have been recorded. This study assessed the COVID-19 pandemic impact on domestic violence, genital tract health, menstruation, and contraception use among 200 women in Jordan using a self-validated survey questionnaire. The questionnaire was structured to compare frequencies of domestic violence, reproductive tract infections, menstrual irregularities, and contraception use, type, source, and replacement during or after total curfew in Jordan with 6-months before the pandemic; 20.5% of women suffered from increased domestic abuse during the COVID-19 pandemic. Incidence of menstrual problems and genital tract infections was significantly reduced during total curfew compared with 6 months prior (10.5% versus 17.5%; P = 0.016 and 19% versus 25.5%; P = 0.041, respectively). Pre-pandemic state of menstrual problems and genital tract infections was resumed after total curfew. During total curfew, phone consultations were significantly increased (17.5% versus 8.5%; P = 0.01), whereas visiting clinics was significantly reduced (23% versus 5.5%; P = 0.000) to manage menstruation or birth canal infections. Contraception use during total curfew significantly decreased compared with prior (59.5% versus 65.5%; P = 0.017). Using contraception for family planning was reduced significantly during the pandemic than before (P = 0.007). Maternity and childhood centers were more common sources for contraception before than after (14.8% versus 7% or 9.5%; P = 0.001 or P = 0.022). This study is important to evaluate preparedness of Jordanian healthcare systems in facing pandemic situations concerning reproductive health services.

Knowledge, attitudes, and practices toward COVID-19 among university students in Japan and associated factors: An online cross-sectional survey

The coronavirus disease (COVID-19) pandemic has greatly altered peoples’ daily lives, and it continues spreading as a crucial concern globally. Knowledge, attitudes, and practices (KAP) toward COVID-19 are related to individuals’ adherence to government measures. This study evaluated KAP toward COVID-19 among university students in Japan between May 22 and July 16, 2020, via an online questionnaire, and it further investigated the associated determining KAP factors. Among the eligible respondents (n = 362), 52.8% were female, 79.0% were undergraduate students, 32.9% were students whose major university subjects were biology-related, 35.4% were from the capital region, and 83.7% were Japanese. The overall KAP of university students in Japan was high. All respondents (100%) showed they possessed knowledge on avoiding enclosed spaces, crowded areas, and close situations. Most respondents showed a moderate or higher frequency of washing their hands or wearing masks (both at 96.4%). In addition, 68.5% of respondents showed a positive attitude toward early drug administration. In the logistic regressions, gender, major subjects, education level, nationality, residence, and psychological factors (private self-consciousness and extroversion) were associated with knowledge or attitudes toward COVD-19 (p < 0.05). In the logistic and multiple linear regressions, capital regions, high basic knowledge, high information acquisition, correct information explanations contributed positively to preventative action (p < 0.05). Non-capital regions, male gender, non-bio-backgrounds, high public self-consciousness, high advanced knowledge, incorrect information explanations, and high extroversion contributed negatively to self-restraint (p < 0.05). Moreover, self-restraint was decreasing over time. These findings clarify the Japanese university students’ KAP and the related factors in the early period of the COVID-19 pandemic, and they may help university managers, experts, and policymakers control the future spread of COVID-19 and other emerging infections.

Is It Just About Physical Health? An Online Cross-Sectional Study Exploring the Psychological Distress Among University Students in Jordan in the Midst of COVID-19 Pandemic

Background

Since the spread of COVID-19 on a global scale, most of efforts at national and international levels were directed to mitigate the spread of the disease and its physical harm, paying less attention to the psychological impacts of COVID-19 on global mental health especially at early stages of the pandemic.

Objectives

This study aimed to assess and explore (i) The levels of psychological distress and its correlates (ii) Motivation for distance learning (iii) Coping activities and pandemic related concerns, among university students in Jordan in the midst of COVID-19 pandemic.

Methods

A cross-sectional study was conducted using an online self-administered questionnaire. The measure of psychological distress was obtained using the 10-item Kessler Psychological Distress Scale, while other questions have explored our study's second and third aims.

Results

A total of 381 completed questionnaires were included in the analysis. Female participants slightly predominated the sample (n = 199, 52.2%). The respondents aged 18-38 years (mean 22.6 years, SD: 3.16). Concerning distress severity, most of respondents were regarded as having severe psychological distress (n = 265, 69.5%). 209 students (54.9%) reported that they had no motivation for distance learning. Ordinal logistic regression revealed a significant correlation between distress severity and many predictors. Among the predictors that were found to act as protective factors against higher levels of distress included older age (aOR = 0.64, P = 0.022; 95% CI: 0.44-0.94), and having a strong motivation for distance learning (aOR = 0.10, P = 0.048; 95% CI: 0.01-0.96). In contrary, being a current smoker (aOR = 1.99, P = 0.049; 95% CI: 1.10-3.39), and having no motivation for distance learning (aOR = 2.49, P = 0.007; 95% CI: 1.29-4.80) acted as risk factors for having higher levels of psychological distress among the students. The most common coping activity reported was spending more time on social media platforms (n = 269, 70.6%), and 209 students (54.9%) reported distance learning as their most distressing concern.

Conclusion

The COVID-19 pandemic and related control measures could impact the mental health of individuals, including students. We recommend a nationwide psychological support program to be incorporated into Jordan's preparedness plan and response strategy in combating the COVID-19 pandemic.