INTRODUCTION:

COVID‑19 is a viral infectious disease caused by the most recently discovered coronavirus named as SARS‑CoV‑2. In December 2019, a pathogenic human coronavirus SARSCoV-2, coronavirus disease 2019 (COVID-19), was recognized and initially diagnosed from Wuhan, China and has caused serious illness and numerous deaths.¹ The disease spread from person to person through droplets discharged from the nose or mouth of a person with COVID‑19 while coughing or exhaling or through fomites.² The infection rate of COVID-19 in India is reported to be 1.7%, significantly lower than the worst affected countries, as the report on 29 March 2020¹⁰.

After a 14-hour ‘Janata Curfew’, India immediately announced the implementation of a nation-wide complete lockdown for 21 d (i.e. up to 14th April 2020), which only allowed essential services to operate over the entire 130 million population of India.³ As more and more information and evidence are emerging about this disease, the stakeholders (health‑care workers) must upgrade themselves regarding effective measures. Their observance of the prevention measures is essential for controlling the spread of COVID-19, which is affected by their knowledge, attitudes, and practices (KAP) towards COVID-19. Therefore, we conducted a survey to investigate the KAP towards COVID-19 among the nursing officers of a Covid Care Centre Chamarajanagar during the rapid rise period of the COVID-19 outbreak.

OBJECTIVES:

1. To assess the knowledge, attitude and practice of nursing officers regarding Covid-19.

2. To find out the association between knowledge, attitude and practice scores with selected demographic Variables.

ASSUMPTIONS:

Assumptions of the study are:

1. Nursing officers may have some knowledge regarding Covid-19.

2. Nursing officers may have positive attitude towards regarding Covid-19.

3. Nursing officers may have good practices regarding Covid-19

VARIABLES OF THIS STUDY:

The variables of the study were:

· Knowledge, attitude and practice regarding Covid-19.

· Age in years, gender, professional qualification, type of health facility, working area, year of experience, Source of information.

DELIMITATIONS:

1. The study is delimited to nursing officers in government designated Covid Care Centers who are willing to participate in the study.

2. The study is further delimited to only those Nursing officers who are working in Government designated Covid Care Centers comes under chamarajanagar district.

METHODOLOGY:

Research Approach/Design:

Research approach used in this study a web-based cross-sectional survey. Study refers to non-experimental research that focuses on obtaining information regarding the knowledge, attitude and practice of nursing officers regarding Covid-19.

Participants and data collection:

This cross-sectional survey was conducted among the Nursing officers from Government designated Covid Care Centers in Chamarajanagar district of Karnataka from August 2020 to September 2020. As we all know, social-distancing is the best way of prevention from COVID-19, therefore, instead of conducting a community-based survey, this study collected the data using Google form platform as an online survey. The link of Google form was posted and circulated using various social media platforms like WhatsApp Group and e-mail address of the nursing officers. The study participants were informed about the details of the study objectives for filling the questionnaire and confidentiality at the beginning of the survey, and informed consent was obtained from each participant. It has been disclosed to all the participants that their identity will keep confidential and the results will be used only for research purposes.

Tool:

A self-designed questionnaire was prepared, which comprised two parts to collect demographic details of the participants along with KAP towards COVID-19. The questions were established on the basis of some published literature and the authors’ experience of KAP. After the preparation of the questionnaire, it was sent to some experts to consult their opinions regarding the validity of the questionnaire. The first part of the questionnaire covered demographic information of the participants and the second part contained questions for KAP assessment. Demographic variables included Age in years, gender, professional qualification, type of health facility, working area, year of experience, Source of information. The self-designed questionnaire comprised 9 questions regarding knowledge, 6 for attitude, and 5 for practice.

Knowledge questions mainly dealt with the participants’ knowledge regarding COVID-19. These questions were responded on a true/false basis. The true answer was given with 1 mark ‘false ’with 0 mark. Higher scores represented a better knowledge of COVID-19. Similar options were assigned for the questions related to attitude with yes or no option. While three options namely ‘always’, ‘sometimes’ and ‘Occasionally’ were assigned for the questions related to practice towards COVID- 19.

Statistical analysis:

Statistical analyses were performed using SPSS, version 22. Knowledge, attitude, and practice scores were tested for normality of distribution using a one-sample Kolmogorov Smirnov test. Measurement data were expressed as mean±SD and categorical data were expressed as frequency and percentage. Parametric tests (t and ANOVA) were used for comparison between different subgroups of the participants pre-intervention. Comparisons of KAP scores among the students with respect to demographic variables are done using independent samples t-test and one-way analysis of variance (ANOVA), as appropriate. The statistical significance level of the test was expressed as α=0.05.⁴

Plan of Data Analysis:

Section I: Frequency and Percentage Distribution of Subjects According to their Selected Personal Variables:

Characteristics

Category

Respondents

Number

Percent

Age in years

18-25

26-30

40-60

46.00

52.00

02.00

Gender

Male

female

40.00

60.00

Professional qualification

GNM

BSc. Nursing

MSc. Nursing

100.00

Type of health facility

District Hospital

Primary Health Centre

Community Health Centre

48.00

16.00

36.00

Working area

OPD

General ward

ICU

24.00

20.00

56.00

Year of experience

1-5 Yrs

6-11 yrs

12 yrs and above

70.00

12.00

18.00

Source of information

Mass and social media

Family and friends

Training undergone

24.00

16.00

60.00

Section II: Knowledge Assessment:

		True	False
1	WHO has recommended that Hand rub by sanitizer should be conducted for minimum of 20 seconds	47 (94%)	3 (6%)
2	Persons with COVID-19 can only infect other people if they have fever.	26 (52%)	24 (48%)
3	Corona viruses can be transmitted from person to person.	42 (84%)	8 (16%)
4	Lactating mothers having Covid 19 cannot breast feed to their child.	36 (72%)	22 (35%)
5	1 – 14 days is time period between exposure to COVID-19 infection and the appearance of the first symptoms (Incubation period)	49 (98%)	1 (2%)
6	One should ideally maintain a minimum of 3 feet distance from others to prevent spread of COVID 19 infection	43 (86%)	7(14%)
7	People older than 60 years of age and those with under -19 lying comorbidities are at risk of severe illness with the COVID	46 (92%)	4(8%)
8	As a precaution double-layered bags (2 bags) should be used for collection of bio medical waste from COVID-19 isolation wards.	46 (92%)	4 (8%)
9	Biomedical waste from COVID-19 wards should be separately labelled as ‘Covid – 19 Waste’.	50 (100%)	0

Section III: Attitude Assessment:

		Yes	No
1	Will you volunteer your services to work in a Covid-19 isolation ward?	41 (82%)	8 (16%)
2	Do you agree that washing hands frequently can lower the risk of COVID 19 infections in healthcare workforce?	47 (94%)	3 (6%)
3	Will you undertake a training on emergency healthcare preparedness post COVID 19?	39 (78%)	11 (22%)
4	Are you confident that the existing protocols (like personal protective equipment, bio medical waste management, 5 moments of hand hygiene etc.) will minimize the spread of Covid-19 infection to medical workforce?	44 (88%)	6 (12%)
5	Will you educate your routine patients on importance of social distancing regularly, to curb the impact of Covid-19?	45 (90%)	5 (10%)
6	Do you feel fearful and anxious of getting infected while treating a patient with Covid-19; despite take all necessary precautions?	35 (70%)	15 (30%)

Section IV: Practice Assessment

	Always	Sometimes	Occasionally
How often do you follow hand hygiene protocol as per WHO guidelines while touching a patient, before any aseptic procedure and after exposure to body fluids	50 (100%)	-	-
Do you ensure that high touch surfaces in the clinic/ward are regularly disinfected?	44 (88%)	6 (12%)	-
Do you practice maintaining agreeable social distance with other colleagues in your healthcare setting?	32 (64%)	12(24%)	6 (12%)
Do you follow the donning sequence (Gown, Mask, Goggles, Gloves) while putting on the PPE?	48 (96%)	1 (2%)	1 (2%)
Do you follow the doffing sequence (Gloves, Goggles/face shield, Gown, Mask, Washing of Hands) while removing the PPE?	25 (50%)	19 (38%)	6 (12%)

Scetion V: Comparison of Knowledge, attitude, and practice scores among Different Demographic Variables.

Characteristics

Knowledge Scores

Attitude Scores

Practice Scores

Mean SD

t/f Value

p-value

Mean SD

t/f Value

p-value

Mean SD

t/f Value

p-value

Age in years

18-25

26-30

40-60

9.45±1.22

9.22±1.32

9.13±1.14

0.52

0.546

3.20±1.12

3.18±1.34

3.16±1.18

0.72

0.235

7.12±1.22

7.15±1.10

7.65±1.01

2.44

0.001

Gender

Male

Female

9.25±1.56

9.26±1.88

0.92

0.48

3.23±1.40

3.90±1.46

0.82

0.785

7.14±1.35

7.65±1.01

0.35

0.717

Type of health facility

District Hospital

Primary Health Centre

Community Health Centre

9.55±101

9.25±1.58

9.31±1.41

2.24

0.495

3.12±1.11

3.16±1.55

3.77±1.02

2.45

0.556

7.44±1.41

7.22±1.23

7.14±1.22

1.38

0.002

Working area

OPD

General ward

ICU

9.02±1.11

9.02±1.44

9.22±1.95

2.28

0.123

3.76±1.02

3.88±1.22

3.89±1.03

2.56

0.12

7.19±1.91

7.16±1.42

7.11±1.02

2.44

0.38

Year of experience

1-5 Yrs

6-11 Yrs

12 Yrs and above

9.14±1.12

9.85±1.98

9.14±1.52

2.98

0.856

3.45±1.19

3.11±1.04

3.99±1.53

2.89

0.89

7.89±1.62

7.74±1.61

7.991±1.22

2.77

0.56

Source of information

Mass and social media

Family and friends

Training undergone

9.33±1.21

9.10±1.09

9.21±1.77

2.08

0.246

3.91±1.77

3.55±1.72

3.88±1.76

2.12

0.76

7.00 ±1.01

7.12±1.23

7.19±1.46

2.11

0.74

FINDINGS OF THE STUDY:

Findings in the present study that maximum number on nursing officers belongs to the age group 26-30(52%), and majority 30(60%) of nursing officers were females, and all 50(100%) nursing officers had GNM Qualification. Maximum number 35(70%) of nursing officers had 1-5 years of experience and 24(48%) nursing officers are working in district hospital. Majority of 28(56%) nursing officers are in working in ICU set up. 30(60%) attended training sessions. No similar literature could be retrieved to compare these studies.

Majority of 49(98%) nursing officers had knowledge on incubation period of virus and 47(94%) of nursing officers adequate knowledge of hand washing technique given by WHO. Majority of 47(94%) of nursing officers had positive attitude towards washing hands to minimize the risk of getting infection. All the nursing officers had followed hand hygiene protocol given by WHO.

In the present study, the knowledge, attitude, and practice of the nursing officers towards COVID-19 were assessed. We found that, during the COVID-19 pandemic, 85.5% of the participants had extensive knowledge of COVID-19. In addition, more than 83.66 % of the participants had a positive attitude towards COVID-19 and 79.8% of the participants had good practice. However, no significant difference was found in mean knowledge or attitude scores with respect to all demographic variables, but age played a significant role in mean practice scores. Considering that the present study assessed, so it is recommended that more demographic factors should be included in further studies.

CONCLUSION:

A web-based cross-sectional survey to assess the knowledge, attitude and practice of nursing officers regarding Civid-19 in selected Government Covid care Centre of Chamarajanagar District. Data was collected from 50 nursing officers; collected data was analyzed by using SPSS, version 22 and presented in the form of graphs and tables.

The research findings had shown that there found to be no significant association between the knowledge and attitude scores of nursing officers with any of their personal variables and the practice score was found to be significant for their age.

RECOMMENDATIONS:

Keeping in view of the findings of the present study, the following recommendations were made:

· A similar study may be replicated on a large sample for better generalization of results.

· A similar study can be conducted for other health care professionals.

· A similar study can be conducted for private covid care centers.

REFERNCES:

1. China National Health Commission. Homepage. [Online] Availabl from frhttp://www.nhc.gov.cn/jkj/s7916/202001/44a3b8245e8049d2837 f27529cd386.shtml

2. Paules CI, Marston HD, Fauci AS. Coronavirus infections-more than just the common cold. JAMA 2020; 323(8): 707-708.

3. Wikipedia. 2020 coronavirus pandemic in India [Online] Available from https://en.wikipedia.org/wiki/2020_ coronavirus_pandemic_in _India#cite_note-:2-8. [Accessed on 29 March 2020].

4. Taber KS. The use of Cronbach’s alpha When developing and reporting research instruments in science education. Res Sci Educ 2018; 48: 1273-1296.

Received on 16.02.2021 Modified on 24.02.2021

Asian J. Nursing Education and Research. 2021; 11(3):351-354.

DOI: 10.52711/2349-2996.2021.00084

Section II: Knowledge Assessment:

True

False

1

WHO has recommended that Hand rub by sanitizer should be conducted for minimum of 20 seconds

47 (94%)

3 (6%)

2

Persons with COVID-19 can only infect other people if they have fever.

3

Corona viruses can be transmitted from person to person.

4

Lactating mothers having Covid 19 cannot breast feed to their child.

5

6

One should ideally maintain a minimum of 3 feet distance from others to prevent spread of COVID 19 infection

7

8

As a precaution double-layered bags (2 bags) should be used for collection of bio medical waste from COVID-19 isolation wards.

9

Biomedical waste from COVID-19 wards should be separately labelled as ‘Covid – 19 Waste’.

Section III: Attitude Assessment:

Section IV: Practice Assessment