International Journal of Research in Medical Sciences Mahajan N et al. Int J Res Med Sci. 2023 Dec;11(12):4355-4359 www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012
DOI: https://dx.doi.org/10.18203/2320-6012.ijrms20233699
Original Research Article
Knowledge, attitudes and practice among healthcare workers towards
COVID-19 in a tertiary care centre in north India
Neha Mahajan1, Neelisha Saroch1, Pooja Sharma1, Anish Gupta2*
1Department of Obstetric and Gynaecology, SMGS Hospital, Jammu, Jammu and Kashmir, India 2Department of HPB and Liver Transplant Surgery, BLK MAX Super Specialty Hospital, New Delhi, India Received: 19 August 2023 Revised: 14 September 2023 Accepted: 20 September 2023 *Correspondence: Dr. Anish Gupta, E-mail: dranishgupta@yahoo.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT Background: Coronavirus disease pandemic has affected the entire world and till date, there is no definitive cure for it with prevention of infection and knowledge about the disease being the only proven effective methods to contain it. Healthcare workers (HCWs) are highly susceptible to getting infected and their knowledge about COVID-19 infection has been known to be inversely proportional to the rates of COVID-19 infection. Methods: Cross-sectional questionnaire-based study assessing knowledge, attitude and practices towards COVID-19 preventive measures was carried out amongst HCWs at a tertiary care hospital in North India. Results: Around 95% of HCWs had received training regarding COVID-19 infection and more than 95% HCWs had adequate knowledge about COVID-19 infection. More than 95% HCWs experienced anxiety and fear while monitoring and treating COVID-19 patients. 85% HCWs felt that there is sufficient awareness in the society regarding COVID-19 infection. Most of the respondents followed correct practices for avoidance of COVID-19 infection with around 90% respondents using face masks and practicing frequent hand washing. Social distancing and avoidance of large gatherings was practiced by around 95% respondents. More than 95% respondents had either taken COVID-19 vaccine or wish to take it. Conclusions: The study suggested that the majority of HCWs had good knowledge and positive attitude toward COVID-19 but there are still some lacunae present in the knowledge regarding prevention of COVID 19 infection. Further education and training are required for HCWs so as to fight COVID and prevent its spread in a better way. Keywords: COVID 19 infection, Corona virus, Healthcare workers, KAP study, Knowledge
INTRODUCTION
Coronavirus disease 2019 (COVID-19) after being first reported in Wuhan City of China in December 2019 spread to over 223 countries and became a global pandemic.1 COVID 19 infection presented with a multitude of symptoms with the spectrum of presentations ranging from completely asymptomatic patients (around 80%) to severe illness including shortness of breath, septic shock and multi-organ failure in 20%, and fatal in 2% mainly due to severe acute
respiratory distress syndrome(ARDS) with there being no definitive treatment for the infection as yet.2 Elderly and those with underlying chronic disease have been known to be at higher risk for severe COVID infections. Coronavirus spreads mainly from person-to person by close contact with infected people. The best prevention is to avoid being exposed to COVID-19. This is done by washing hands with soap and water, and using face masks, isolating confirmed and suspected cases.3 Sound knowledge of the disease and a positive attitude have been known to contain outbreaks of the pandemic. Lack
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of knowledge, overcrowding and illiteracy have helped in the propagation of COVID 19 virus especially in our part of the world. India reported the first case of COVID 19 on 27 January 2020.4 There have been around 4.5 crore documented cases of COVID in India so far with there being over 5 lakh reported deaths due to COVID infection.5 Healthcare workers (HCW’s) are the most susceptible group to get infected because of close contact with COVID cases and there have been multiple reports which indicated significantly higher number of COVID- 19 death rates among healthcare workers.6
Similar to the general population, lack of knowledge increases the risk of infection in healthcare workers and it was found that the rates of infection were inversely proportional to increase in knowledge about COVID-19.7 There have been limited studies done in tertiary care hospitals in India to assess the knowledge, attitudes and practices of frontline healthcare workers.8
We performed the study with the aim of assessing the knowledge levels, attitudes and practices amongst healthcare workers towards covid-19 preventive measures at a tertiary care hospital in North India.
METHODS
A cross-sectional questionnaire-based study was conducted to assess the KAP related to COVID-19 among the consenting HCWs aged between 18-60 years working in Government Medical College (GMC), Jammu (India) between June 2021 to July 2021. The questionnaire was constructed and hand delivered to all these HCWs and the filled questionnaires were collected after 1 week from these respondents. Those who did not respond after first week were given another week to respond. Those who did not respond even after 2 weeks were excluded. The study was questionnaire based where data on demographic factors, knowledge, attitudes and practices on COVID-19 prevention among healthcare workers. To assess knowledge of the respondents, the questionnaire had 20 questions each with a ‘yes’ or ‘no’ answer. For attitude and practices, there were 10 questions each with a ‘yes’ or ‘no’ answer accounting for a total of 40 questions that had to be answered by each participant with each correct answer equalling 1 score with higher scores indicating more knowledge about COVID-19.
All consenting healthcare workers who responded to questionnaire were included in the study while those who did not consent or did not respond to questionnaire were excluded from the study. A total of 500 healthcare workers were handed out these questionnaires out of which 284 (56.8%) responded. All the eligible HCWs were informed about the objectives of the study, and a written consent was taken from all the participants before answering the questionnaire. The study was approved by the Institutional Ethics Committee GMC Jammu.
Statistical analysis
The descriptive statistics were used to present the demographics of participants and frequencies of personnel with adequate knowledge, positive attitude, and applying safety practices most of the time. Data collected was entered into Excel worksheets and Statistical analyses were performed with Statistical Package for the Social Sciences (SPSS), version 25 (IBM Corp., Armonk, NY).
RESULTS
The study population included 284 healthcare workers of which 90 were males and 194 were females. 58 were aged <25 years, 182(%) were between 25-30 years of age and 44 were >30 years with an average age of 27.3 years. There were 146 doctors, 70 nurses, 38 ward assistants, 22 operation theatre technicians and 8 dental surgeons. 42 were undergraduate, 118 graduates and 124 post graduates of which 227 were urban residents while 57 were rural residents. 231 were married while 53 were unmarried. Over 94.7% of the healthcare workers had received training on COVID-19 while 5.3% had not (Table 1).
Table 1: Socio demographic profile of the study
population.
Knowledge
An 82 to 100% of the respondents answered correctly to the knowledge assessment questionnaire (Table 2). The question 5 on the knowledge questionnaire ‘antibiotics are used to treat COVID 19’ had the least correct
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responses. 100% of the respondents knew COVID to be a viral infection spreading via close contact to an infected
person. Overall 96.5% respondents had adequate knowledge about COVID 19 infection.
Table 2: Knowledge questionnaire items.
Table 3: Attitude questionnaire items.
Attitude
Respondents with correct responses to attitude questionnaire items ranged from 85 to 99.3%. More than 95% healthcare workers experienced anxiety and fear while monitoring and treating COVID 19 patients. 85% HCWs felt that there is sufficient awareness in the society regarding COVID 19 infection. Around 5 % respondents felt that there is no need to wear masks post vaccination and people who have been vaccinated can not get infected (Table 3).
Practice
A 66-98% respondents followed correct practices for avoidance of COVID 19 infection. Around 90% respondents were using face masks and practicing frequent hand washing. Social distancing and avoidance of large gatherings was practiced by around 95% respondents. More than 95% respondents had either taken COVID vaccine or wish to take it (Table 4).
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Table 4: Practice questionnaire items.
DISCUSSION
Having claimed more than 5 lakh lives in India alone, COVID pandemic has been the deadliest pandemic and has been responsible for creating havoc in lives of majority of the global population.5 HCWs are the frontline workers who are maximally exposed to COVID 19 infection and their knowledge, attitude, and practice decide the impact and magnitude of COVID 19 infection.
Our present study included responses from 284 HCWs in tertiary care centre in North India with majority of the respondents lying in the age group of 25-30 years and majority of the respondents being graduates living in urban areas. The study revealed that most of our healthcare workers had sufficient knowledge and right attitude towards COVID-19 and its prevention. The level of knowledge in our centre was better than other reported studies in HCWs which suggested appropriate knowledge in 69-74% of HCWs.9,10 The difference might be due to high prevalence of COVID 19 training (~95%) in HCWs in our centre. The study revealed that around 90 % of the health care workers practiced appropriate COVID 19 preventive measures and more than 95% had either received COVID 19 vaccine or were willing to take it. In a study conducted by Uzuntarla et al amongst healthcare workers, the found similar proportion of HCWs (90%) following correct preventive measures for COVID 19 infection.11
It was observed that a significant number of healthcare workers (>95%) felt either anxious or feared infection during management of COVID 19 infected patients which is higher than the study by Zhang et al, who showed that around 85% of the HCWs were afraid of getting infected while caring for COVID 19 infected patients.12 15% of the respondents still believed that the awareness regarding COVID was not sufficient in the society.
This study has some limitations in the interpretation of results due to certain reasons. Firstly, it has taken account of knowledge, attitude and practices amongst healthcare workers in a single tertiary care centre which might not
truly represent the knowledge and attitude of the HCWs of the entire region. Secondly, the results showing high level of knowledge regarding COVID 19 infection may be due to high percentage of HCWs working in our centre having received COVID 19 training and as such, the results can not be generalised to all healthcare workers across the region and also, to the general population. Further, similar larger sized studies would be required to estimate knowledge and attitude amongst HCWs on a national level and amongst the general population so that appropriate interventions can be made and further spread of COVID 19 can be prevented.
CONCLUSION
The study suggested that the majority of HCWs at our centre had good knowledge and positive attitude toward COVID-19 but there are still some lacunae present in the knowledge regarding prevention of COVID 19 infection. Further education and training are required for HCWs so as to fight COVID and prevent its spread in a better way.
ACKNOWLEDGEMENTS
Authors would like to thank all health care workers who fought against COVID 19 infection and participated in the study.
Funding: No funding sources Conflict of interest: None declared Ethical approval: The study was approved by the Institutional Ethics Committee of GMC Jammu (ECR/454/Inst/JK/2013/RR-20)
REFERENCES
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Cite this article as: Mahajan N, Saroch N, Sharma P, Gupta A. Knowledge, attitudes and practice among healthcare workers towards COVID-19 in a tertiary care centre in north India. Int J Res Med Sci 2023;11:4355-9.
International Journal of Research in Medical Sciences | December 2023 | Vol 11 | Issue 12 Page 4359