Preparedness, Risk Perception, Concerns and Risk Acceptance among Hospital Healthcare Workers (HCWs) in facing the emerging new Corona Virus (COVID-19) Outbreak in Najran Hospitals, Saudi Arabia, at the early phase of the pandemic (Preprint)

BACKGROUND Coronavirus disease 2019 (COVID-19) pandemic extended to reach most countries in the globe during a few months. The preparedness of healthcare institutions and healthcare workers is crucial for applying effective prevention and control measures. OBJECTIVE This study aimed to assess HCWs and institutional preparedness in facing the new emerging coronavirus (COVID-19) infection at the early phase of the pandemic, and to explore HCWs' risk perception, concerns, and risk acceptance. METHODS A cross-sectional survey was conducted among hospital HCWs in the main hospitals, in Najran city, southwestern Saudi Arabia, at the early phase of the pandemic, during March-April, 2020. RESULTS Overall, 563 completed questionnaires were received (382; 67.9% from KKH and 181; 32.1% from NNH). The majority were females (78.6%), nurses constituted (74.7%). The age range of the participants was 20-63 years, with the mean age of physicians 36.5±9.15 years and 31.8±7.48 years for nurses. Among participants, 65.8% attended training program/s for COVID-19 infection, of whom 69.9% were satisfied with this training. Almost all (97.4%) of the participants reported reading the official circulars assigned for guidelines, case definition and, infection control measures regarding COVID-19 infection, 97.1% received basic infection control training, 98.9% checked for the best-fitted size of N95 mask, and 89.4% were influenza vaccinated. Of the participants, 82.6% reported that they have sufficient knowledge about t COVID-19 pandemic, 82.0% being confident that they can protect themselves and their patients when dealing with COVID-19 cases, 92.9% reported that they understand the risk of COVID-19 infection for patients and healthcare staff and 83.2% reported agreement of accepting the risk of getting the infection being a part of their job. The study participants attained a 20.26±2.60 knowledge score on a scale of 26 maximum points (77.9%), of them 74.5% attained 20 points or more (>75%) indicating good working knowledge about the COVID-19 pandemic. Exploring the participants’ perception about the preparedness of their institutions towards the COVID-19 pandemic, 70.8% agreed that institutional precautionary measures to COVID-19 in the workplace are sufficient, 71.6% agreed that all personal protective equipment (PPE) are provided and always available in the workplace, and 90.6% mentioned that the staff in their institutions have had adequate training. Exploring risk perception and the affective aspect of the pandemic on HCWs, 79.0%, 35.2%, 64.2% of the participants felt that they, their families, and the Najran community are at high risk of getting an infection with the COVID-19 virus respectively, and 54.7% and 55.1% were concerned about their personal and family health respectively. CONCLUSIONS Findings revealed good knowledge about the COVID-19 pandemic among HCWs in Najran hospitals, Saudi Arabia. Concerns and worries were expressed regard working with the highly infectious COVID-19 patients. Participants appreciated important aspects of institutional preparedness. Experience gained from the previous MERS-CoV outbreak may explain good knowledge, risk acceptance, self-efficacy, and good and rapid institutional preparedness at the early stage of the pandemic.

COVID-19 Knowledge/Practices, Mental Status, and Return-To-Work Concerns Among Healthcare Workers in Huangzhou District, Huanggang City, China

Objective:This study investigated the COVID-19-prevention knowledge and practices of healthcare workers (HCWs), their psychological states concerning the return to work, and their trust and requirements in using traditional Chinese medicine (TCM) to prevent and treat COVID-19. It is hoped that the study can serve as a reference for policy making during the resumption of work in other countries or regions experiencing similar situations.Methods:This study comprised a quantitative cross-sectional online survey design. Purposive sampling and Cluster sampling were used to recruit all HCWs working in public hospitals in Huangzhou District, Huanggang City, Hubei Province, China. From April 23 to May 14, 2020, surveys were sent electronically to all 13 public hospitals in this area.Results:In total, 2,079 responses were received and 2,050 completed forms were included. After analysis, 47.9 and 46.6% of HCWs indicated that they possessed very good knowledge or good knowledge of preventative measures, respectively. Multivariable log-binomial regression indicated that male, tertiary hospital, medical staff, and undergraduate/postgraduate qualification were associated with good knowledge. Good knowledge was also well-correlated with good practice (OR: 3.277; 95% CI: 2.734–3.928; P < 0.01). 59.8% of HCWs reported worries about resuming work; especially asymptomatic infections. The Self-Rating Anxiety Scale (SAS) indicated that 10.8% of participants had mild anxiety, 1.5% moderate anxiety, and 0.1% severe anxiety. Female, divorced/widowed, and working in a high risk hospital (the Huangzhou District People's Hospital was used for throat swab examinations of returning workers) were risk factors for concerns about resuming work and anxiety symptoms. However, good preventive knowledge was a protective factor for anxiety. HCWs' trust in using TCM to treat COVID-19 was significantly higher than their trust in using TCM for prevention (P < 0.001). Regarding preferences for preventative TCM products, oral TCM granules were the most preferred (62.4%). HCWs also indicated they wanted to know more about the clinical efficacy, applicable population, and adverse reactions of preventative TCM products (89.3, 81.1, and 81.4%, respectively).Conclusion:While HCWs had good knowledge of COVID-19 preventative measures, this did not eliminate the psychological impact of resumption of work. Promotion of COVID-19 prevention knowledge reduces the risk of infection, and alleviates the worries and anxiety symptoms of HCWs about resuming work (especially in administrative staff, those with low education, and those working in primary hospitals). Additional psychological support is required for female HCWs, divorced/widowed HCWs, and those working in high-risk hospitals. Finally, systematic trials of preventative TCM products are recommended.

Impact of Coronavirus Infectious Disease (COVID-19) pandemic on willingness of immunization—A community-based questionnaire study

Background Coronavirus infectious disease 2019 (COVID-19) has had a great impact on global health, but with relatively few confirmed cases in Taiwan. People in Taiwan showed excellent cooperation with the government for disease prevention and faced social and behavioral changes during this period. This study aimed to investigate people’s knowledge of COVID-19, attitudes and practices regarding vaccinations for influenza, pneumococcus and COVID-19. Methods We conducted a community-based, cross-sectional questionnaire survey from September 2020 to October 2020 among adults in northern Taiwan. The four-part questionnaire included questions on sociodemographic characteristics, knowledge, attitude, and practice toward COVID-19. Results Among a total of 410 respondents, 58.5% were categorized as having “good knowledge” responding to COVID-19. Among the total respondents, 86.6% were willing to receive influenza or pneumococcal vaccines, and 76% of them acted to receive COVID-19 immunization once the vaccine became available. Compared with the respondents with poor knowledge of COVID-19, those with good knowledge had a more positive attitude toward receiving influenza or pneumococcal immunization (OR 3.26, 95% CI = 1.74–6.12). Conclusions Participants with good knowledge of COVID-19 had greater intent to receive immunization for influenza or pneumococcal vaccine. The promotion of correct knowledge of both COVID-19 and immunization preparations is necessary.

Facility and care provider emergency preparedness for neonatal resuscitation in Kano, Nigeria

Introduction The knowledge, attitude, and practice of emergency neonatal resuscitation are critical requirements in any facility that offers obstetric and neonatal services. This study aims to conduct a needs assessment survey and obtain individual and facility-level data on expertise and readiness for neonatal resuscitation. We hypothesize that neonatal emergency preparedness among healthcare providers in Kano, Nigeria is associated with the level of knowledge, attitudinal disposition, practice and equipment availability at the facility level. Methods A semi-structured, self-administered questionnaire was administered to a cross-section of health providers directly involved with neonatal care (n = 112) and attending a neonatal resuscitation workshop in Kano state. Information regarding knowledge, attitude, practice and facility preparedness for neonatal resuscitation was obtained. Bloom’s cut-off score and a validated basic emergency obstetric and neonatal care assessment tool were adopted to categorize outcomes. Multivariable logistic regression was employed to determine independent predictors of knowledge and practice. Results Almost half (48% and 42% respectively) of the respondents reported average level of self-assessed knowledge and comfort during resuscitation. Only 7% (95% CI:3.2–13.7) and 5% (95% CI:2.0–11.4) of health providers demonstrated good knowledge and practice scores respectively, with an overall facility preparedness of 46%. Respondents’ profession as a physician compared to nurses and midwives predicted good knowledge (aOR = 0.08, 95% CI: 0.01–0.69; p = 0.01), but not practice. Conclusion Healthcare provider’s knowledge and practice including facility preparedness for emergency neonatal resuscitation were suboptimal, despite the respondents’ relatively high self-assessed attitudinal perception. Physicians demonstrated higher knowledge compared to other health professionals. The low level of respondents’ awareness, practice, and facility readiness suggest the current weak state of secondary health systems in Kano.

EVALUATION OF CLINICAL AWARENESS OF DIABETIC MELLITUS AMONG RAKMHSU MEDICAL STUDENTS- A QUESTIONNAIRE SURVEY

Introduction: The number of patients with diabetes are increasing in rapid phase and the present medical students will encounter with such patients in the future very often. It was essential to understand and update their knowledge through education and awareness programs. Materials and methods: The cross-sectional questionnaire survey has been conducted in RAK Medical and Health Sciences University (RAKMHSU) with due approval from research ethics committee. After going through various indexed articles related to our topic, a pre designed pre validated questionnaire was prepared. The questionnaire assessed the knowledge about symptoms, investigations, treatment and complications. This was applied after validation to second, third, fourth and fifth year medical students. Results: The study showed the majority in both groups 93.5% and 89.2% agreed that they will be involved in taking care of diabetic patients in their future practice. The study also found that 65.2% group A agreed that excessive thirst and urination is a indicative of low blood sugar when compared with 31.7% from group B. With regard to symptoms majority in both groups agreed itchy skin is not a symptom of DM. When asked about insulin misuse, only 36.8% and 55.4% students agreed that blood glucose will go below 50mg/dl. Discussion and conclusion: Our study correlated with various studies which showed many students had problems in treatment aspects. But we also had positive results which correlated with other study showing they have good knowledge about symptoms. We also found our students had good knowledge about diabetic ketoacidosis. In conclusion, there is a need for conducting regular workshops, seminars, conferences in medical colleges to upgrade the knowledge of students and make them a competent general physician. Key words: Diabetes, Keto acidosis, Education, Knowledge, Risk factors

Clinical - Psychological and Psychotherapeutic Intervention

The purpose of this work was to general familiarize psychiatrists with various aspects and directions of psychotherapeutic methods. It is common knowledge that most couple psychiatrists ignore the value of psychotherapy. This article indicates the importance of psychotherapy in the practice of psychiatrists. A good knowledge of psychotherapeutic methods is necessary for modern and high-quality provision of mental health care to the population.

Perception Regarding Knowledge of COVID-19 Prevention in a Sample of a Middle Eastern and North African (MENA) Community in Houston, Texas, USA

(1) Background: Knowledge of COVID-19 prevention among communities is the first step towards protective behaviors. The objective of this study was to assess COVID-19 prevention knowledge among a Middle Eastern and North African community in Houston, Texas. (2) Methods: A cross-sectional study was conducted using a validated quantitative survey; survey questions consisted of three parts: COVID-19 specific questions, general health questions, and sociodemographic questions. A multivariable logistic regression model was used to determine predictors of perception of knowledge on preventing COVID-19 spread. The outcome of interest comprised of “good/excellent” versus “average and below” knowledge. (3) Results: A total of 366 participants (66.39% males) completed the survey. A univariate analysis demonstrated significant differences in self-reported COVID-19 prevention knowledge among those with and without health insurance, different ages, level of knowledge, and perceived severity of COVID-19 infection. In the multivariate logistic regression, two predictors were identified: those in the 18–25-year-old group were more likely to have “excellent/good” knowledge on COVID-19 spread compared to the ≥40-year-old group (OR: 6.36; 95% CI: 1.38, 29.34). Those who somewhat agree with knowing how to protect themselves from COVID-19 were more likely to have “excellent/good” knowledge of preventing COVID-19 spread compared to those that neither agree nor disagree or disagree (OR: 7.74; 95% CI: 2.58, 23.26). (4) Conclusions: Younger adults reported higher knowledge of COVID-19 prevention.

Dissemination of Prevention of the Spread of COVID 19 through the 7 Slum Indicators Approach in Cirebon City

Slum areas are known to be incubators of disease because they are occupied by high density residents. This activity aims to conduct dissemination in slum settlements in 11 urban villages (Kesenden, Kebonbaru, Pegambiran, Jagasatru, Pulasaren, Drajat, Sunyaragi, Karyamulya, Argasunya, Harjamukti, and Kecapi) with the theme of Prevention of the spread of COVID-19 through the 7 slum indicators approach. The methods applied in this activity were lecture along with question and answer. This activity was implemented by carrying out health protocols to prevent the transmission of COVID-19 wherein there were only 30 participants attended in each village who were required to wear masks and keep social distancing. This dissemination activity was limited to only 2 hours, effective from 08.30 to 11.00 a.m. Based on the results of the activity implementation, basically most of the people had a fairly good knowledge on COVID-19, but not all had a good attitude since there were some people who thought that the virus mostly attacks the middle to upper class. There was also indifference attitude towards government recommendations since they thought that God determines their health status.

Cadre Empowerment and Exclusive Breastfeeding Assistance for Pregnant Women in Sempor Village, Sempor District, Kebumen

Breast milk is the ideal food for babies. Preparation for exclusive breastfeeding should start during pregnancy. The success of exclusive breastfeeding requires a lot of support from husband and family. Health volunteers are the spearhead of providing health information in the village so it is necessary to empower health volunteers in the socialization of exclusive breastfeeding to pregnant women. The purpose of the activity is to empower health volunteers regarding the importance of exclusive breastfeeding so that they can provide assistance on exclusive breastfeeding for pregnant women. The method of activity is to empower health volunteers about exclusive breastfeeding. Pre-test and post-test were carried out before the activity as an evaluation. The tools and materials used are LCD, screen, leaflet, questionnaire. A sample of 15 health volunteers. The results, before empowering health volunteers there were 8 health volunteers with sufficient knowledge of exclusive breastfeeding (53%) and 2 health volunteers with good knowledge of exclusive breastfeeding (13.3%). After empowering health volunteers, there was an increase in the knowledge of health volunteers, namely 13 health volunteers had good knowledge of exclusive breastfeeding (86.6%) and the remaining 2 health volunteers had sufficient knowledge (13.3%). At the mentoring stage, 15 health volunteers managed to provide assistance to 15 pregnant women who were willing to prepare themselves during pregnancy to provide exclusive breastfeeding to their babies after birth. The conclusion is that there is an increase in knowledge of health volunteers after empowering health volunteers so that pregnant women get assistance in preparing exclusive breastfeeding.

Increasing Paud Teachers Knowledge About Childrens Growth Detection with KPSP

Children are the nation's most valuable asset in the future, monitoring and stimulation of growth and development is one way for children to achieve optimal growth and development. Every child needs to be stimulated and monitored regularly as early as possible appropriately and continuously, both in the family and at school. Monitoring growth and development is carried out to find out whether children grow and develop according to their age and stage of development and can detect deviations in child growth and development. The purpose of this community service is to increase knowledge and provide training to early childhood teachers regarding early detection of child growth and development. This community service method is to conduct counseling about growth and development and early detection, followed by training for early detection of growth and development. Community service results: Pretest results show that of the 35 early childhood teachers who participated in the activity, 13 teachers had poor knowledge, and 12 teachers had sufficient knowledge, and 10 teachers had good knowledge. The results of the posttest after the counseling were 35 early childhood teachers who had good knowledge. The conclusion of community service is: There is an increase in knowledge after counseling on growth and development and early detection.