Assessment of knowledge, attitude and practices of health care professionals working in jumbo COVID care center towards mental health care needs: A cross sectional survey
Neelam N Andrade1, Minal Madhukar Kshirsagar2, Tanvi Andrade3, Vaibhav V Bandgar4, Sandeep Pimpale5, Ankush Chavan1
1 Department of Oral and Maxillofacial Surgery, Nair Hospital Dental College, Mumbai, Maharashtra, India
2 Department of Public Health Dentistry, Nair Hospital Dental College, Mumbai, Maharashtra, India
3 Department of Orthodontics, Nair Hospital Dental College, Mumbai, Maharashtra, India
4 Department of Prosthodontics, Nair Hospital Dental College, Mumbai, Maharashtra, India
5 Department of Periodontics, Nair Hospital Dental College, Mumbai, Maharashtra, India
|Date of Submission||11-Dec-2020|
|Date of Acceptance||19-Feb-2022|
|Date of Web Publication||31-Jan-2023|
Dr. Minal Madhukar Kshirsagar
Department of Public Health Dentistry, Nair Hospital Dental College, Mumbai, Maharashtra
Source of Support: None, Conflict of Interest: None
Background: The present COVID-19 pandemic is a major threat worldwide. Health professionals being within the front line of the COVID-19 outbreak response are at the highest risk of getting infected. Such pandemics are always associated with ill effects on mental health also.
Materials and Methods: A cross-sectional study included all the health care professionals working in the Jumbo COVID Care Center, Mumbai. Details of health care professionals were obtained from the authority of Jumbo COVID Care Center, Mumbai. Amongst 350 health care professionals, 285 responded (Response rate: 81.42%). A questionnaire, consisting of 19 structured, self-administered, and closed-ended questions, was employed online, and information regarding age, gender, profession, etc., was collected. It was then tabulated and subjected further to an analysis.
Results: Most health care professionals (96.1%) were aware that COVID-19 is not only affecting physical but mental health too, also posts on social media (86.3%) are affecting mental health more than the actual disease. A total of 95.8% agreed that health care/frontline workers are at the highest risk and felt the need for psychiatrists in the present pandemic. (81.4%) They were also worried thinking about elderly people with comorbidities in their homes. (82.1%).
Conclusion: From the present study, it can be concluded that the present pandemic is affecting not only physical but mental health also, and there is an increased need for psychiatrists and mental health care professionals to overcome the same.
Keywords: Attitude, knowledge, mental health, pandemic, psychology
|How to cite this article:|
Andrade NN, Kshirsagar MM, Andrade T, Bandgar VV, Pimpale S, Chavan A. Assessment of knowledge, attitude and practices of health care professionals working in jumbo COVID care center towards mental health care needs: A cross sectional survey. Adv Biomed Res 2023;12:22
|How to cite this URL:|
Andrade NN, Kshirsagar MM, Andrade T, Bandgar VV, Pimpale S, Chavan A. Assessment of knowledge, attitude and practices of health care professionals working in jumbo COVID care center towards mental health care needs: A cross sectional survey. Adv Biomed Res [serial online] 2023 [cited 2023 Jun 6];12:22. Available from: https://www.advbiores.net/text.asp?2023/12/1/22/368996
| Introduction|| |
In December 2019, there was an outbreak of pneumonia cases of unknown origin in the Wuhan city of China. The pathogen responsible was later declared severe acute respiratory syndrome coronavirus-2. On 11th March 2020, by the World Health Organization (WHO), the coronavirus disease 2019 (COVID-19) was declared a global pandemic., The disease is claimed to infect people through droplets of saliva or discharges from the nose of an infected person, especially sneezing or coughing. This outbreak in China has caused panic and psychological disturbances amongst people getting infected worldwide. Pandemics are not just a medical phenomenon. They restrict people from attending workplaces, cause financial ups and downs, and the long-term unwanted impact on the economy will exhibit its effect on new and existing usual mental illnesses., It has totally disturbed the usual lifestyle, education and finances, businesses, etc., especially after a complete lockdown was declared in most countries.
Health care professionals and groups have devoted literally themselves to providing healthcare to patients during the present pandemic. During a pandemic, psychiatric reactions play a vital role in the outbreak of the disease, the occurrence of emotional distress before, during, and after the same. As health care professionals are continuously getting exposed to infected people, they are not only suffering from occupational hazards, but it has a psychic health impact also., It is quite possible that health care professionals will be at high risk of mental illness, particularly if they are working in public health, or emergency services. The disease load among all health care professionals may have increased by overcrowding, lack of awareness regarding isolation, personal hygiene facilities, contaminated surrounding, etc.
A knowledge, attitude, and practice (KAP) survey is a feasible way to assess current programs and to recognize the efficacious plan of action for behavioral changes in the community. Currently, there is no/limited literature available regarding the awareness of health care professionals towards mental health care needs. Hence, the present study was aimed to identify the current status of knowledge, attitude, and practices of health care professionals working in Jumbo COVID Care Center, Mumbai regarding mental health care needs in India.
| Materials and Methods|| |
The present study was performed in keeping the Declaration of Helsinki in mind. On account of lockdown, as universities/colleges were closed; the study protocol was approved by the Hospital Board/Jumbo COVID Care Center, Mumbai.
The questionnaire included a consent section that stated the aim and objectives, nature of the present study, voluntary informed consent, and declaration of confidentiality.
The present study was a crosssectional descriptive study in nature. The renowned Jumbo COVID Care Center located in Mumbai (Nesco Jumbo COVID Care Center, Goregaon) was selected where particularly patients suffering from COVID-19 were admitted. Permission was obtained from the Dean of the center after explaining the purpose, protocol of the study, and assured confidentiality regarding the collected data. The present study was conducted at NESCO Jumbo COVID Care Center (DCH), Goregaon, Mumbai in India. The present center was divided into three sections – Intensive Care Unit (ICU), General ward, and Control/Monitor room (Not in direct contact with patients). On the basis of convenience sampling, all the health care professionals working in Jumbo COVID Care Center, Goregaon, Mumbai were considered for the present study. The present study was conducted for a period of 15 days. After sending the questionnaire to all the health care professionals, ample time was given to them to respond.
The present study was directed at health care professionals working in Jumbo COVID Care Center, Mumbai city (Maharashtra, India). A questionnaire, consisting of 19 structured, self-administered, and closed-ended questions, was employed online and tested on 20 subjects. (Pilot Survey). The validity of the questionnaire was pretested by giving it to the subject matter experts (content validity). The reliability of the questionnaire was tested by Cronbach's alpha analysis, which was found to be 0.8. The questionnaire was finalized after making the required changes. In view of the present pandemic, for the safety of the investigating team, the questionnaire was administered online through Google survey forms. The collected data were kept confidential and tabulated in Microsoft Excel and analyzed.
Subjects working in Jumbo COVID Care Center, Mumbai, age group 18–74 years (WHO survey age groups), willing to give informed consent for the present study, who were capable to comply with the study protocol, who had internet access, and filled the questionnaire completely were included in the present study. Subjects with intellectual disabilities, who had filled the questionnaire incompletely, and who participated in the pilot survey were excluded from the present study.
| Results|| |
Amongst 350 health care professionals, 285 responded (Response rate: 81.42%).
The majority of the health care professionals were female (n = 198, 69.4%) in the 25–34 year age group (n = 133, 46.6%). A total of 81.7% of the participants had less than 5 years of working experience and were unmarried (82.4%). Amongst all, 71.9% were directly working on patients [Table 1].
Most of the health care professionals (96.1%) were aware that COVID-19 is affecting physical and mental health as well, and posts on social media (86.3%) were affecting mental health more than the actual disease [Table 2].
|Table 2: Knowledge of health care professionals working in jumbo COVID care center towards mental health care needs (n=285)|
Click here to view
A total of 95.8% agreed that health care/frontline workers were at the highest risk and felt the need for psychiatrists and mental health professionals in the present pandemic. (81.4%) They also had worrisome thoughts about elderly people with comorbidities in their homes. (82.1%) [Table 3].
|Table 3: Attitude of health care professionals working in jumbo COVID care center towards mental health care needs (n=285)|
Click here to view
Almost all the health care professionals were practicing safety measures to avoid getting infected with COVID-19 [Table 4].
|Table 4: Practice of health care professionals working in jumbo covid care center towards mental health care needs (n=285)|
Click here to view
| Discussion|| |
KAP surveys are usually used to recognize knowledge gaps and behavioral approaches in order to execute effective actions. It was seen that there is a need for a deeper understanding and association of factors that may alter attitudes and practices towards COVID-19. From the present study, it was seen that the maximum participants were from 25 to 34 old age group (n = 133, 46.6%) and were female. (n = 198, 69.4%). Previous literature suggests that some outcomes suggest younger populations with higher degrees of education had higher knowledge., Most health care professionals (81.7%) were having 0–5 years of working experience still they had good knowledge. This might be due to the fact that the younger population is highly educated and tend to use the internet more than the older or less educated population. In the present study, 82.4% (n = 235) participants were unmarried. Marriage is also an important factor that affects mental health. Depending upon the support from a new family, spouse, and the extent of adjustment required, many people get do adapt over a period of time but for some others, the stress, sadness and helplessness, difficulty in adjustment also lead to anxiety and depression. It was seen that most of the participants (71.9%) who were directly working on the patients (ICU/Ward) were eventually at higher risk than health care professionals working in the control/monitor room.
From the present study, it was seen that most of the health care professionals were well familiar with that COVID-19 has an impact on not only physical but mental health also, and social media posts are affecting it more than the actual disease. Undoubtedly, the media has started reporting the impact of the present pandemic on mental health and its response. These findings are contradictory to the Ugandan study in which health care workers (HCWs) who gained information from the traditional news media like television, radio, and newspapers were having more knowledge. Previous literature suggests that most health care workers are using the internet/social media to seek information which has its own pros and cons on mental health.,, Around 40% of the participants found difficulty in getting sleep due to stress as they were working in a COVID center; at the same time, they worried also about their family members getting infected because of them. It was seen that surprisingly few of the participants were not much stressed when people around them talk about COVID-19, and some of them were not so worried about getting infected.
Most of the participants thought that health care professionals being frontline workers have the highest risk of getting infected also they were worried about the elderly people in their homes who have comorbidities; this might be because the risk of the raised severity was observed in the elderly people with underlying chronic diseases. So the best prevention is to avoid being exposed to COVID-19. They also thought that during the pandemic, there is more need for a psychiatrist to overcome this mental health illness as this might trigger the existing mental health issues. Psychiatrists may help in boosting the self-confidence and willpower of suspected/confirmed cases, their families, and also health care providers to educate people about common mental illnesses, health care practices, problem solving, special care of mental health illness, and the patients in contact with mental health services that are at risk for COVID-19 infection. It was seen that almost half of the participants agreed that nowadays they were thinking about COVID-19 more than any other thing. They were feeling overburdened working in the COVID-19 pandemic situation and were stressed seeing so many patients around. From the present study, a positive attitude was reported towards recovery rate being more than the disease rate, and isolation of 14 days was more for control/prevention of COVID-19 but at the same time, a negative attitude was reported when asked about the steps taken by the government are sufficient for control of COVID-19. These findings are vital and should be appreciated by the government and policymakers to initiate effective policies highlighting the prevention or control of COVID-19. Wafaa YAW et al. also found that physicians had a less supportive attitude with regards to the COVID-19 pandemic in Egypt and the role of government in its prevention and control.
It was seen from the present study that most health care professionals were practicing safety measures like social distancing, frequent use of sanitizer/gloves/masks, and covering the nose and mouth while sneezing or coughing. This is in accordance with the study conducted by Wafaa YAW et al. who concluded that their study participants had a rational level of knowledge irrespective of their job, particularly the disease preventive measures; although little previous literature suggests contradictory findings of the present study.,,
| Conclusion|| |
From the present study, we can conclude that most health care workers were well aware that COVID-19 is not only affecting physical health but also mental health, and that social media also has a bigger impact on the same. Most of them also agreed that health care/frontline workers are at the highest risk and felt an increased need for psychiatrists and mental health professionals in the present pandemic. At the same time, they were also practicing safety measures.
The present study has its own limitations. Cross-sectional studies are carried out at one-time point, and there is no follow-up. Further studies on larger sample size are recommended.
The authors would like to thank all the participants who gave their valuable time and consent for the present study, also we are grateful to the authorities of Nesco Jumbo COVID Care Center, Goregaon, Mumbai (Muncipal Corporation of Greater Mumbai) for providing us the opportunity to interact with the currently working health care professionals in the center.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Saqlain M, Munir MM, Rehman SU, Gulzar A, Naz S, Ahmed Z, et al.
Knowledge, attitude, practice and perceived barriers among healthcare workers regarding COVID-19: A crosssectional survey from Pakistan. J Hosp Infect 2020;105:419-23.
Wafaa YAW, Enas MH,·Mona IA, Nashwa SH. Assessment of knowledge, attitudes, and perception of health care workers regarding COVID19, A crosssectional study from Egypt. J Community Health 2020;45:1242-51.
Bhat R, Singh VK, Naik N, Kamath CR, Mulimani P, Kulkarni N.
COVID 2019 outbreak: The disappointment in Indian teachers. Asian J Psychiatr 2020;50:102047.
Chatterjee SS, Malathesh BC, Mukherjee A. Impact of COVID-19 pandemic on pre-existing mental health problems. Asian J Psychiatr 2020;51:102071.
Zandifar A, Badrfam R. Iranian mental health during the COVID-19 epidemic. Asian J Psychiatr 2020;51:101990.
WHO. Coronavirus Disease (COVID-19) Outbreak: Rights, roles and responsibilities of health workers, including key considerations for occupational safety and health. 2020. Available from: www.who.int/publications-detail/coronavirus-disease-(covid-19)-outbreak. [Last accessed on 2020 Nov].
Gan WH, Lim JW, Koh D. Preventing intra-hospital infection and transmission of COVID-19 in healthcare workers. Saf Health Work 2020;11:241-3.
Papagiannis D, Malli F, Raptis DG, Papathanasiou IV, Fradelos EC, Daniil Z, et al.
Assessment of knowledge, attitudes, and practices towards new coronavirus (SARS-CoV-2) of health care professionals in Greece before the outbreak period. Int J Environ Res Public Health 2020;17:4925.
Zhang M, Zhou M, Tang F, Wang Y, Nie H, Zhang L, et al.
Knowledge, attitude and practice regarding COVID-19 among health care workers in Henan, China. J Hosp Infect 2020;105:183-7.
Abdelhafiz AS, Mohammed Z, Ibrahim ME, Ziady HH, Alorabi M, Ayyad M, et al.
Knowledge, perceptions, and attitude of Egyptians towards the novel coronavirus disease (COVID-19). J Community Health 2020;45:881-90.
Olum R, Chekwech G, Wekha G, Nassozi DR, Bongomin F. Coronavirus disease-2019: Knowledge, attitude, and practices of health care workers at Makerere University Teaching Hospitals Uganda. Front Public Health 2020;8:181.
Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al.
Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med 2020;382;1199-207.
World Health Organization. Infection Prevention And Control During Health Care When Novel Coronavirus (nCoV) Infection Is Suspected. Geneva: World Health Organization; 2020. Available from: https://www.who.int
. [Last accessed on 2020 Nov].
Giao H, Han NTN, Van Khanh T, Ngan VK, Van Tam V, Le An P. Knowledge and attitude toward COVID-19 among healthcare workers at District 2 Hospital, Ho Chi Minh City. Asian Pac J Trop Med 2020;13:260-5.
Sima K, Chua HC, Vieta E, Fernandez G. The anatomy of panic buying related to the current COVID-19 pandemic. Psychiatry Res 2020;288:113015.
Kumar J, Katto MS, Siddiqui AA, Sahito B, Jamil M, Rasheed N, et al.
Knowledge, attitude, and practices of healthcare workers regarding the use of face mask to limit the spread of the new coronavirus disease (COVID- 19). Cureus 2020;12:e7737.
Ng K, Poon BH, Kiat Puar TH, Shan Quah JL, Loh WJ, Wong YJ, et al.
COVID-19 and the risk to health care workers: A case report. Ann Intern Med 2020;172:766-7.
[Table 1], [Table 2], [Table 3], [Table 4]