Abstract

Background: COVID-19 is highly contagious, So, the best solution for controlling the pandemic is the simultaneous application of preventive methods while still developing novel treatments. Healthcare workers have a critical role in lowering morbidity and mortality. Preventing nosocomial infections and protecting healthcare workers posed great challenges to the healthcare system during the initial COVID-19 outbreak. Healthcare workers are at a high risk of infection from the patients if they do not have ample knowledge and awareness about the disease or if they do not take adequate precautionary measures. Aim of the study: The aim of the current study is to assess the knowledge and perception about COVID-19 among healthcare workers in King Abdullah Medical City in Makkah. Subjects and Methods: A quantitative cross-sectional design was adopted. The study sample consisted of 183 healthcare workers working at King Abdullah Medical City in Makkah. Data have been collected by self-administered questionnaire which was consisted of three parts through convenience sampling method. Results: The mean score of workers’ knowledges about COVID-19 was good, and the mean score of their perception was also good as well. Factors associated with healthcare workers’ knowledge about COVID-19 include the nationality of participants. Conclusion: In-service education and persistent training about COVID-19 should be continued. Future studies should be conducted to provide more evidence about the factors, which are significantly associated with healthcare workers’ knowledge, and perception about COVID-19.

1. Introduction

Globally, viral diseases persist in emerging; these diseases are considered as serious within the context of public health. Epidemics such as severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV), and H1N1 influenza were emerged in the last 12 years ¹. Nowadays, the pandemic of novel coronavirus disease (COVID-19) is considered a serious challenge in the globe, in which there have been 80,155,187 confirmed cases of COVID-19, and 1,771,128 deaths. In Saudi Arabia, there have been 362,339 confirmed cases of COVID-19 with 6,196 deaths ².

COVID-19 is highly contagious, hence the best strategy for controlling the pandemic is the simultaneous application of preventive methods while still developing novel treatments ³. In addition, the wide spread of emerging and reemerging communicable diseases considered a big risk and serious challenge to nurses and other healthcare providers due to decrease in the issue of understanding of the threat related to these disease as well as limited compliance with practices related to infection prevention and control ⁴.

A healthcare worker is anyone who works in a healthcare or social care setting Healthcare workers have a critical role in lowering morbidity and mortality but in doing so they are directly exposed to patients and the causative agents. Preventing nosocomial infections and protecting healthcare workers posed great challenges to the healthcare system during the initial COVID-19 outbreak ⁵. Healthcare workers are at a high risk of infection from the patients if they do not have ample knowledge and awareness about the disease or if they do not take adequate precautionary measures ⁶. In China, more than 2050 cases of COVID-19 were reported in healthcare workers; the majority of the cases were due to lower awareness and experience of handling the disease ². Avoiding cross-infection from patients along with effective care delivery can be achieved if the healthcare professionals, including physicians, pharmacists, nurses, and other medical staff, have sufficient knowledge, a positive attitude, and better practices about COVID-19 ⁶.

More importantly, the burden of the disease in both developed and developing countries had worsened the response and management strategies due to inadequate provision of personal protection equipment for healthcare workers, environmental contamination, overcrowding, and inadequate provision of proper isolation facilities ⁷. Thus, to mitigate the increasing number of COVID-19 cases require the healthcare workers’ adherence to the recommended measures taken to prevent transmission. These measures are affected mainly by knowledge, attitudes, and practices of the frontline healthcare workers ⁸.

Healthcare providers are considered the first-line providers, in close interaction with patients with COVID-19, they are also a critical part of the disease transmission/care chain ⁹. If knowledge is power, this more one knows about risk factors, how to acquire knowledge, prevention practices, attitudes, and perceptions of nurses towards COVID-19 outbreak in the country, this better to break the transmission chain. In fact, given the increase in COVID-19 cases in Saudi Arabia and the need to expedite the country’s pandemic outbreak management, it is crucial to understand how healthcare workers perceive the virus at this critical moment. This baseline information is needed for coordination and planning of care to ensure maximum function of the healthcare system, effective dissemination of accurate and timely information, and improving the well-being of healthcare workers in Saudi health services. Therefore, the main aim of this study was to assess the awareness about COVID-19 among healthcare workers in King Abdullah Medical City in Makkah.

2. Aim of the Study

The aim of the study is to assess the knowledge and perception about COVID-19 among healthcare workers in King Abdullah Medical City in Makkah.

3. Subjects and Methods

A quantitative, descriptive, cross-sectional design was used in this study. The design is useful in describing the study construct as it is suitable in terms of individuals and resources. This study was carried out at King Abdullah Medical City in Makkah. Sample size was calculated using Stephem Thompson Formula [α=0.05, power=0.8, N=520). After calculation, the study sample was 221, in which 183 (82.8%) have responded to participate to the study questionnaire. A convenience sampling method was used to recruit the study participants.

An official approval and permission from KAMC IRB were obtained before conducting the research. The aim of the study was explained to the participants and verbal consent was obtained. The anonymity, privacy of the participants, confidentiality of the data, and the right to refuse to participate or refuse to participate and withdraw from the study were assured.

4. Data Collection

A self-administrated questionnaire in English was adopted from Olum et al. ¹⁰ and used to collect data. It consisted of three sections. The first section consisted of items related to sociodemographic characteristics of the participants including gender, nationality, age, profession, years of experience and working department. The second section consisted of 17 items related to knowledge about COVID-19. The study participants were asked to respond to the questions related to knowledge, in which one score was given for true answer, and zero was given for false answer or for participants who did not know the true answer. The total (highest) score for knowledge domain was 17, and the lowest score was 1. Perceptions toward COVID-19 were assessed using 7 items, and each question was labeled as good (scored as “1”) or poor perception (scored as “0”). Scores ranged from 0 to 7. The participants’ perceptions are classified as good (score >5) or poor (score ≤5).

5. Statistical Analysis

Statistical Package for Social Science (SPSS) version 22 was used to tabulate and analyze the data. The statistical procedure which has been used include descriptive statistics such as means, standard deviations, frequencies and percentages, and inferential statistics such as independent sample t test and One-Way ANOVA.

6. Results

The study sample consisted of 183 participants, distributed as 57.9% as female, while 42.1% of them are males. The study participants who were 31 – 40 years old constituted 51.4% of the study sample, 35.5% of them were 30 years or less. Moreover, 46.4% of the study participants were nurses, 19.7% of them were respiratory therapist, and 10.9% of them were physicians. In addition, 75.4% of the study participants were non-Saudi, while 24.6% of them were Saudi. Regarding the experience of the study participants, 44.8% of them had 6 – 10 years of experience, 35.5% had ≤5 years of experience, while 9.8% had more than15 years of experience. (Table 1)

Table 2 showed the sources of information about COVID-19, the study results showed that the most common source was government websites with a mean percentage 74.0%, while the least source was family and friends with a mean percentage 59.5%.

Table 3 revealed that the mean of healthcare workers’ knowledge about COVID-19 was 13.15 out of 17.0. Table 4 displayed the mean of healthcare workers’ perception about COVID-19 was 5.66 out of 7.0. (Table 4)

Regarding the differences in the mean healthcare workers’ knowledge and perception about COVID-19, Table 5 declares no significant difference in the mean score of healthcare workers’ knowledge and perception about COVID-19 with their gender, nationality, age groups, years of experience, and profession.

On the other hand, there was a significant difference in the mean score of healthcare workers’ perception about COVID-19 regarding their nationality, in which non-Saudi healthcare workers have significantly higher mean score of perception than Saudis p<0.05. (Table 6)

Moreover, there was no significant difference in the mean score of healthcare workers’ knowledge about COVID-19 regarding their age groups, years of experience, and profession p>0.05. (Table 7). Moreover, there was no significant difference in the mean score of healthcare workers’ perception about COVID-19 regarding their gender, age groups, years of experience, and profession (p>0.05). (Table 8)

7. Discussion

Healthcare workers have a crucial role in decreasing morbidity and mortality but in doing so they are directly exposed to patients and the causative agents. Preventing nosocomial infections and protecting healthcare workers presented great challenges to the healthcare system during the initial COVID-19 outbreak in China. Healthcare professionals are at a high risk of infection from the patients if they do not have sufficient knowledge and awareness about the disease or if they do not take adequate precautionary measures ⁵. Hence, this study was conducted to assess the knowledge and perception about COVID-19 among healthcare workers in King Abdullah Medical City in Makkah.

The result of this study indicated that the level of healthcare workers’ knowledge and perception about COVID-19 was good and reflected that they have good knowledge about the disease. This result supported by Nemati et al. ⁷ who studied the assessment of Iranian nurses’ knowledge and anxiety toward COVID-19 during the current outbreak in Iran and stated that nurses had almost good knowledge. Galal et al. ¹¹ and Huynh et al. ¹² also concluded that healthcare workers in general expressed good knowledge, positive attitude, and good practice toward COVID-19. Moreover, Jemal et al. ¹³ reported that the majority of the participant had good knowledge about COVID-19-related issues. In contrast Bhagavathula et al. ¹⁴ revealed that heath care workers have insufficient knowledge about COVID-19. Mehr ¹⁵ also showed that 65.5% had a moderate and another 33.7% had a low level of knowledge.

The result of this study indicated that most common source of information about COVID-19 was government websites, while the least source was family and friends. This result is line with Abdelhafiz et all ⁸ who studied knowledge, perceptions, and attitude of Egyptians towards the novel coronavirus disease (COVID-19) and reported that all participants claimed that they had heard about COVID-19 from social media and the internet. Olum et all ¹⁰ also reported that most of the participants used information from international and governmental media (websites and verified social media pages). In contrast Galal et all ¹¹ and Jemal et all ¹³ noted that the most common sources of knowledge about coronavirus infection among the study group were television followed by social media and international websites.

Regarding the differences in the mean healthcare workers’ knowledge and perception about COVID-19, the study results showed that there was no significant difference in the mean score of healthcare workers’ knowledge about COVID-19 regarding their gender, nationality, age groups, years of experience, and profession. This may be due to small sample size. Olum et all ¹⁰ stated that There was no statistically significant difference in the level of knowledge about COVID-19 among health care workers in Uganda irrespective of their professions or qualifications.

The study results showed that there was no significant difference of healthcare workers’ knowledge about COVID-19 regarding their gender. This result is line with Abdelhafiz et all ⁸ who studied knowledge, perceptions, and attitude of Egyptians towards the novel coronavirus disease (COVID-19) and reported that knowledge was observed for male and female participants with no statistically significant difference.

It was observed that there was no significant difference in the mean score of healthcare workers’ knowledge about COVID-19 regarding their age groups. in contrast a study done by Abdelhafiz et all ⁸ revealed that there were statistically significant differences between knowledge mean scores and age groups.

On the other hand, there was a significant difference in the mean score of healthcare workers’ perception and knowledge about COVID-19 regarding their nationality, in which non-Saudi healthcare workers have significantly higher mean score of perception and knowledge than Saudis. This may be due to most of the front-line nurses in the country are non-Saudis. This result is in line with Al-Dossary et all ⁹ who studied the awareness, Attitudes, Prevention, and Perceptions of COVID-19 Outbreak among Nurses in Saudi Arabia and concluded that non-Saudi nurses self-reported higher perception towards COVID-19 than Saudi nurses.

8. Conclusion

The level of knowledge and perception of COVID-19 among healthcare staff was good, indicating that they are well-versed in the disease

9. Recommendation

Based on the aforementioned findings, this study recommended to conduct online courses to increase awareness of healthcare workers. Future studies should be conducted to provide more evidence about the factors which are significantly associated with healthcare workers’ knowledge and perception about COVID-19.

10. Limitations of the Study

The study did not focus on healthcare providers who were in contact directly with COVID-19 cases. Moreover, data were collected by convenience sampling method which might limit the generalizability of the study results. The data presented in this study are self-reported and partly dependent on the participants' honesty and recall ability; thus, they may be subject to recall bias.

Conflict of Interest

The authors declare no conflict of interest.

References