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 Table of Contents  
ORIGINAL ARTICLE
Year : 2022  |  Volume : 10  |  Issue : 2  |  Page : 81-88

Knowledge, attitude, and practices regarding COVID-19 among the postgraduate medical students of a government medical college in Gujarat (India)


1 Department of Pulmonary Medicine, All Institute of Medical Sciences, Rajkot, Gujarat, India
2 Department of Respiratory Medicine, Government Medical College, Bhavnagar, Gujarat, India

Date of Submission06-May-2022
Date of Acceptance19-Jul-2021
Date of Web Publication19-Dec-2022

Correspondence Address:
MD, EDRM Sanjay Singhal
Associate Professor, Department of Pulmonary Medicine, All India Institute of Medical Sciences, Rajkot, Gujarat
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jacp.jacp_21_22

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  Abstract 


Abstract
Objective: To assess postgraduate students’ knowledge, attitude, and practices regarding COVID-19. Methods: A self-designed online questionnaire was circulated to the postgraduate students. Mean knowledge, attitude, and practice scores were calculated and compared among different study groups with the ANOVA test. Results: Out of 254 postgraduate students approached, 220 responses were received, so the final sample size was 220. Out of 220 students enrolled, 159 (72.27%) students had good knowledge and 61 (27.73%) students had poor knowledge; 167 (75.90%) students had a positive attitude, 51 (23.18%) students had a neutral attitude, and only two (0.92%) students had a negative attitude; 196 (89.09%) students observed good practices whereas 24 (10.91%) students observed poor practices. Conclusion: Most students had good knowledge, a positive attitude, and good practices.

Keywords: Attitude and practice, COVID-19, knowledge, postgraduate students


How to cite this article:
Parekh A, Dave J, Singhal S, Deokar K. Knowledge, attitude, and practices regarding COVID-19 among the postgraduate medical students of a government medical college in Gujarat (India). J Assoc Chest Physicians 2022;10:81-8

How to cite this URL:
Parekh A, Dave J, Singhal S, Deokar K. Knowledge, attitude, and practices regarding COVID-19 among the postgraduate medical students of a government medical college in Gujarat (India). J Assoc Chest Physicians [serial online] 2022 [cited 2023 Jan 31];10:81-8. Available from: https://www.jacpjournal.org/text.asp?2022/10/2/81/364440




  Introduction Top


The coronavirus disease is caused by a novel coronavirus Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The significant symptoms include fever, fatigue, dry cough, malaise, and breathing difficulty.[1] Coronavirus disease 2019 (COVID-19) has become an important public health issue, affecting 400 million people globally and accounting for ~58 lakh deaths globally, affecting >200 countries and territories; accounting for 42.48 million cases and 5.06 lakh deaths in India as of February 10, 2022.[2] The outbreak began in December 2019 in the Wuhan province of China. Since then, the number of cases has been on the rise. On March 11, 2020, World Health Organization (WHO) changed the status of the COVID-19 emergency from public health international emergency (January 30, 2020) to a pandemic.[3] The first COVID-19 case in India was reported on January 30, 2020. At the time of this study (October 2020), India was suffering from first wave of COVID-19 pandemics, with 5.04 lakh confirmed cases and 6552 deaths as of October 5, 2020, the day of commencement of this study.[2] Effective treatment or vaccination was not available. So, more emphasis was placed on infection control practices and personal protection, which remains an essential aspect of infection control even today.

The observation of COVID appropriate behavior is significantly influenced by the level of knowledge, attitude, and practices regarding COVID-19. Moreover, the ongoing pandemic had greatly affected postgraduate students’ education and quality of life. So, we conducted a study to assess postgraduate students’ knowledge, attitude, and practice survey toward COVID-19 in a medical college in Gujarat.


  Material and Methods Top


This cross-sectional study was conducted among the postgraduate students of a government medical college in Gujarat between October 5, 2020 and December 31, 2020. Due to the ongoing pandemic, a consent waiver was obtained from the institutional ethics committee. Because of the continuing pandemic, instead of a community-based survey, the questionnaire was circulated as a Google form via e-mail and online social media platforms such as WhatsApp. All the participants were informed about the objectives of filling the questionnaire and assured that their identity would remain confidential and results would be utilized for study purposes only. Only those students who gave consent participated in the study. Only the postgraduate students were included in the study. Undergraduate students, senior residents, and faculties were excluded from the study. The sampling method was convenience sampling. Out of 254 resident doctors approached, 220 responses were received, so the final sample size was 220.

Questionnaire

The self-designed questionnaire contained personal details, knowledge, attitude, and practice areas. The personal information included name, age, sex, hometown, department, and whether they have undergone COVID-19 training or not. There were 15 questions in the knowledge section, 10 questions in the attitude section, and 15 questions in the practice section. The questions were established based on published literature and expert recommendations.[1],[4],[5] After formulating the questionnaire, a pilot study was conducted with 10 doctors (not included in the study sample) to validate the questionnaire. The Cronbach alpha score was 0.84.[6] The questions mainly focused on causative organism, symptoms, mode of transmission, government-issued guidelines, attitude toward successful control, and observation of COVID appropriate behavior.

Scoring

For the knowledge section, a correct answer was assigned as point 1, and an incorrect answer was given 0 points. For the attitude section, a positive response was assigned 2 points, neutral answer 1 point, and negative answer 0 points. COVID appropriate practice was assigned 1 point for the practice section, and inappropriate practice/behavior was given 0 points. Thus, the total knowledge score ranged from 0 to 15, total attitude score ranged from 0 to 20, and total practice score ranged from 0 to 15, the total score being 50. Students scoring >10 points were considered to have good knowledge and scoring ⋚10 poor knowledge; students scoring between 0 and 7 were supposed to have a negative attitude, 8 and 13 neutral attitude, and >14 positive attitude; and students scoring >10 were considered to have good practices and those scoring ⋚10 poor practices.

Statistical analysis

The statistical analysis was done using SPSS (Statistical Package For Social Sciences (SPSS), IBM Corp., Released 2015, IBM Stastics For Windows Version 23.0. ARMONK, NY) software. The knowledge, attitude, and practice scores were expressed as mean ± SD and categorical data as frequency and percentage. Analysis of variance (ANOVA) test was used to compare the mean knowledge, attitude, and practice score percentage among three groups (first-year resident doctor, second-year resident doctor, and third-year resident doctor). The P-value < 0.05 was considered statistically significant.


  Results Top


Out of 254 postgraduate students approached, 220 responses were received, so the final sample size was 220. Of the 220 participants, 99 (45%) were males, and 121 (55%) were females. Ninety-one students (41.4%) out of 220 were first-year resident doctors, 70 students (31.8%) were second-year resident doctors, and 59 students (26.8%) were third-year resident doctors. Out of 220 participants, 197 students (89.5%) had undergone COVID-19 training conducted by their institution, whereas the remaining 23 students (10.5%) had not undergone COVID-19 training. The prevalence of poor knowledge among trained residents was 27%, whereas poor knowledge among untrained residents was 31%. [Table 1] shows the sociodemographic characteristics of the study participants.
Table 1 Demographic variables studied

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Out of 220 students enrolled, 159 (72.27%) students had good knowledge, and 61 (27.73%) students had poor knowledge. About 214 (97.3%) students agreed that the main clinical symptoms of COVID-19 are fever, fatigue, dry cough, and myalgia. About 213 (96.8%) students agreed that persons with COVID-19 can transmit the virus to others when symptoms are not present. About 211 (95.9%) students agreed that people who have contact with someone infected with the COVID-19 virus should be immediately isolated in a proper place. However, 109 (49.5%) students believed that the COVID virus is the same as the flu virus. About 130 (59%) students did not know that the minimum distance between two people in social distancing guidelines is 2 m.

A total of 167 out of the 220 students (75.90%) had a positive attitude, 51 (23.18%) students had a neutral attitude, and only two (0.92%) students had a negative attitude. About 208 (94.5%) students hoped the outbreak to stop quickly so that they could return to their regular curriculum soon. About 194 (88.2%) students believed that they were capable enough to endure such public health emergencies. And 199 (90.5%) students were ready to serve as frontline workers. However, 199 (90.5%) students agreed that the outbreak had greatly affected their studies.

About 196 (89.09%) students observed good practices, whereas 24 (10.91%) students observed poor practices. About 215 (97.7%) students washed their hands frequently, 216 (98.2%) students used hand sanitizers often, 198 (90%) students maintained social distancing, and 211 (95.9%) students avoided unnecessary travel during the outbreak. About 70 (31.8%) did not refrain from going to restaurants, and 85 (38.6%) students used coworkers’ phones, desks, offices, or other work tools and equipment. These results are summarized in [Figure 1].
Figure 1 Knowledge, attitude, and practices among study participants.

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The mean knowledge score of first-year residents was 11.47 ± 1.36, second-year residents was 11.42 ± 1.36, and third-year residents was 11.33 ± 1.36. The mean attitude score of first-year residents was 15.77 ± 1.36, second-year residents was 15.54 ± 1.36, and third-year residents was 15.36 ± 1.36. The mean practice score of first-year residents was 13.14 ± 1.36, second-year residents was 12.92 ± 1.36, and third-year residents was 12.86 ± 1.36. [Table 2],[Table 3],[Table 4] summarize the knowledge, attitude, and practices. On comparing the data by the ANOVA test, there was no statistically significant difference between mean knowledge, attitude, and practices scores among first, second, or third-year resident doctors (P = 1.46).
Table 2 Knowledge of participants regarding COVID-19

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Table 3 Attitude of participants regarding COVID-19

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Table 4 Practices of participants regarding COVID-19

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  Discussion Top


In the present study, we found that 73% of students had good knowledge, and 27% had poor knowledge. Out of this 27%, 11% of students had not undergone COVID-19 training. The proportion of participants with adequate knowledge is lower than other studies carried out in India and abroad. For example, in a study carried out among undergraduate students in Dehradun, India, 92% of participants had extensive knowledge about COVID-19.[4] In another study carried out in Uttar Pradesh, India, around December 2020, the mean knowledge score was 84.5% for resident doctors, whereas in the present study, the mean knowledge score was 75.6%.[7] In a study carried out in Villupuram, India, 86% of participants had adequate knowledge regarding COVID-19.[8] In a study among healthcare workers in China, 89% of Health care worker (HCWs) had sufficient knowledge of COVID-19.[5] In a study carried out in Pakistan, 94.8% of healthcare professionals scored adequately (>14) for COVID-19-related knowledge.[9] In a study carried out in Uganda, 83.9% of students had adequate knowledge.[10] The differences in the questions administered, the inclusion of faculties and senior consultants, and the time of conducting the study are some of the factors responsible for discrepancies in the prevalence of adequate knowledge in our study compared to other studies; most of the studies were conducted after the first wave when the majority of the population was aware regarding COVID-19. In another study in Sierra Leone, 72.7% of participants were knowledgeable regarding COVID-19.[11] In a study carried out in Nepal, 73% of participants had adequate knowledge.[12] These results were consistent with our study. In the present study, 50% of the study participants were unaware of the minimum distance to be observed according to social distancing guidelines, and 20% of the participants were unaware of the average incubation period of coronavirus. More than 90% of the students were aware of the common symptoms modes of transmission. So, the training program could have focused more on guidelines issued by the government rather than just symptomatology and pathogenesis. The prevalence of adequate knowledge in our study was better than that in similar studies conducted in Lima, Peru (25.2%)[13] and Dubai (57.4%).[14] But 72.2% of the participants in the study conducted in Dubai were nurses; the study conducted in Peru included healthcare workers of all cadres, whereas this study included only postgraduate students. A significant difference was observed in the prevalence of adequate knowledge.

In the present study, 76% of students had a positive attitude regarding COVID-19. This is again lower compared to other studies carried out in India. In the survey carried out in Dehradun, 80% of participants had a positive attitude,[4] and in the study carried out in Villupuram, 84% of participants had a positive attitude.[8] The mean attitude score in our study was 77.8%, which is consistent with the study carried out in Uttar Pradesh.[7] In the study conducted in Pakistan,[9] 97.9% displayed an optimistic attitude (>42), while only 78.4% had a positive attitude in the study carried out in Uganda.[10] In the study conducted in Nepal, 54.7% reported a positive attitude,[12] whereas, in the study conducted in Sierra Leone, 58.3% HCWs show positive attitudes toward COVID-19.[11] In the survey conducted among healthcare workers in Dubai,[14] 33% of participants had positive attitude scores, whereas, in the study conducted in Lima, Peru,[13] 37.5% of participants had positive attitude scores. These results are consistent with the positive correlation between knowledge and attitude in the other studies.[7],[10] The prevalence of adequate knowledge was higher than our study in studies carried out in Dehradun, Villupuram, Uttar Pradesh, Pakistan, and Uganda; thus, the majority of positive attitudes are also higher than our research.In the present study, 89% of students observed positive practices, consistent with other studies.[4],[5],[7],[8] The prevalence of positive practices is less than the study carried out in Pakistan.[9] The majority of good practices is more than that found in similar studies conducted in Uganda, Nepal, Sierra Leone, Lima, Peru, and Dubai.[] The prevalence of positive practices in our study was better than that in similar studies conducted in Lima, Peru (31.5%)[12] and Dubai (33%).[13] Since, 88% of the study participants had undergone COVID-19 training, the practice score was better than other studies. For example, 90% of the study participants maintained social distancing, and 99% of the participants covered their coughs or sneezed with a handkerchief. Around 38.6% of resident doctors used coworkers’ phones, desk, or office tools, and 31.8% did not refrain from eating in restaurants. There was no significant difference in mean scores of knowledge, attitude, and practices among students compared with the ANOVA test. This might be because 88% of the study participants had undergone COVID-19 training.

The study’s primary limitation is that the sample is limited to a single government medical college’s students. Since the questionnaire was self-administered, there might be a misinterpretation of specific questions resulting in reporting bias. As the study was online, those with internet issues might not have taken part, thus giving rise to selection bias.

Knowledge, Attitude, and Practice (KAP) studies can help assess the knowledge, attitude, and practices among the population studied. The training programs conducted by the government can focus more on poor knowledge areas and emphasize refraining from prevalent poor practices. In the present study, poor knowledge areas were microbiology, social distancing guidelines, personal protection guidelines, and incubation period of the disease.


  Conclusion Top


In the present study, 27% of students had poor knowledge, despite appropriate training by the institution. The knowledge gap is significantly higher compared to other studies. However, most of the students had a positive attitude and observed good practices. There was no significant difference in mean knowledge, attitude, and practice scores among first, second, and third-year resident doctors.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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    Figures

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    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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