Knowledge, attitude and practice among Ophthalmic Health Care Personnel (HCP) towards COVID-19 pandemic in Nepal: A web-based cross-sectional study

  1. Dr Zahir Ansari
  2. Dr Babu Dhanendra Chaurasiya
  3. Dr Sirjana Adhikari
  4. Dr Uday Chandra Prakash
  5. Bikram Adhikari
  6. Dr Sahana Khatoon

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Abstract

Background: Being an added high-risk group, ophthalmic HCP are actively providing emergency eye care services, also enthusiastically participating in prevention and control of the COVID-19 pandemic. Hence, this study aimed to assess the level of knowledge, attitude, and practice (KAP) among ophthalmic HCP towards COVID-19 pandemic. Methods: A web-based cross-sectional study was conducted during the period of lockdown among ophthalmic HCP including consultant ophthalmologist, resident, optometrist, ophthalmic assistant, nursing staff, and other paramedics of eye care centers in Nepal. The KAP questionnaire was designed and distributed online. Data were analyzed using the Chi-square test, Pearson correlation, and binary logistic regression. All tests were performed at 95% Confidence Interval (CI) and p-value <0.05 was considered statistically significant. Results: Of 694 participants, the majority were male (59.1%) from the age group 31-40 years (41.5%) and tertiary eye center (68.9%). Among ophthalmic HCP, there were 29.8% consultants ophthalmologist, 22.6% residents, 23.3% optometrist, 15% ophthalmic assistant, and 9.2% other ophthalmic paramedics, 11.7% working as front-liners in COVID-19 centers. Findings showed, 98.1% had good knowledge, 59.4% had a positive attitude and only 13.3% had good practice regarding COVID-19. Binary logistic regression analysis demonstrated the age of HCP to be a significant determinant of good knowledge (Crude Odds Ratio (COR)=0.72, 95%CI=0.62-0.82), positive attitude (COR=0.92, 95%CI=0.90-0.94) and good practice (COR=1.16, 95%CI=1.10-1.21). Lower odds of poor practice was seen among junior resident (COR=0.26, 95% CI=0.14-0.47) and higher odds of poor practice was seen among HCP with job experience of 5-10 years (COR=2.38, 95% CI=1.23-4.60) towards COVID-19 pandemic. Conclusion: The majority of ophthalmic HCP have good knowledge, insufficient positive attitude, and inadequate evidence-based practice towards the COVID-19 pandemic in Nepal. Hence, this study conclusively recommends to modify existing guidelines and formulate new policies to improve KAP among ophthalmic HCP to effectively control the spread of COVID-19.

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    SciScore for 10.1101/2020.08.13.20174052: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementConsent: Instant online consent was taken from each participant before participating in the survey after a brief introduction to this survey.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variable15.1) 416(84.9) 5-10 yrs 158(100) 44(95.7%) 0 2(4.3%) 110(69.6%) 30(65.2%) 48(30.4%) 16(34.8%) 11(7%) 7(15.2%) 147(93%) 39(84.8%) 0.019 <0.001 P <0.001 Gender Male Female 0.855 0.803 0.547 Designation HCP Optometrist Ophthalmic assistant Others <0.001 <0.001 <0.001 Job experience >10 yrs

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical analysis Responses recorded in Google-form were exported to and cleaned in Microsoft Excel 2019 and later imported to Statistical Package for Social Sciences (version-20.0) for statistical analysis.
    Microsoft Excel
    suggested: (Microsoft Excel, RRID:SCR_016137)

    Results from OddPub: Thank you for sharing your data.

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Being an online survey, responses mainly depend upon the honesty and partly affected by recall ability and thus may subject to recall bias, potential sample clustering and statistical errors due to multiple significance testing may limit the generalization (external validity) of the results, non-probability sampling method and those who don’t have internet facility, could not get chance to enroll in the study are its limitation. Though the majority of ophthalmic HCP have good knowledge, they are lacking sufficient positive attitude and satisfactory level of evidence-based practice towards the COVID-19 pandemic. Hence, this study can be taken as a reference during this COVID-19 era to modify existing guidelines; formulate new policies and guidelines for eye care service; and guide concerned authorities for effective implementation of initiatives like motivation, incentives, insurance policy, job security and provision for families of HCP, to combat this battle against COVID-19. This study has also highlighted the need to uplift our preparedness by the provision of sustained supply of PPE while augmenting awareness on infection prevention and training programs for control measures. Supporting information S1 data.Questionnaire for participants (DOCX). S2 dataset (SAV). Acknowledgment We would like to acknowledge all the participants of this study who gave their valuable time for the research, our teachers particularly Prof Badri Prasad Badhu, Prof Poonam Lavaju, Dr. B.G. Shresth...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

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  2. Version published to 10.1101/2020.08.13.20174052v1 on medRxiv