Knowledge, attitudes, and practices (KAP) toward COVID-19: a cross-sectional study in South Korea

Background The public must routinely practice precautionary behaviors to control the spread of COVID-19, as no vaccines and antiviral treatments are currently available. This paper examines the publics knowledge, attitudes, and practices (KAP) related to COVID-19 and their relationships and identified the pandemics vulnerable populations to provide recommendations for behavioral interventions and policies. Methods Data collection took place over 3 days (June 26–29) via an online survey 5 months after the Korea Centers for Disease Control and Prevention (KCDC) confirmed the first COVID case in South Korea; 970 subjects were included in the statistical data analysis. Results Knowledge directly affected both attitudes (e.g., perceived risk and efficacy belief) and practices (e.g., personal hygiene practices and social distancing). Among the influencing factors of COVID-19 preventive behaviors, efficacy belief was the most influential and significant practice factor. It mediated the relationship between knowledge and all three preventive behaviors (wearing facial masks, practicing hand hygiene, and avoiding crowded places). The level of knowledge varied by sociodemographic characteristics. Females (β = 0.06, p <  0.05) and individuals with higher levels of education (β = 0.06, p <  0.05) demonstrated higher levels of knowledge. Conclusion To increase precautionary behaviors among the public, health officials and policymakers must promote knowledge and efficacy belief. Future interventions and policies should also be developed in a person-centered approach, targeting vulnerable subgroups, embracing them, and closing the gap of KAP toward COVID-19.This work was supported by the National Research Foundation of Korea (BK21 Center for Integrative Response to Health Disasters, Graduate School of Public Health, Seoul National University); the Ministry of Health and Welfare, South Korea. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Dentists attitudes toward patient-centered care and its predictors: a cross-sectional study in South Korea

Background Patient-centered care (PCC) has been one of medical practices most frequently discussed principles. However, attitudes toward PCC among dentists remain underexplored. This study focuses on examining dentists patient-centered attitudes and investigating their predictors. Methods The Patient–Practitioner Orientation Scale which consists of Sharing and Caring subscales was used to assess patient-centered attitudes. The statistical analysis included 217 dentists from South Korea. Hierarchical linear regression analysis was performed to examine the predictors such as sociodemographic aspects, academic factors, work-related factors, and empathy. Results A patient-centered attitude of Caring subscale (M = 4.29, SD = 0.56) emerged, but the provider-centered attitude was higher in Sharing subscale (M = 3.40, SD = 0.48). Work year, academic track, and empathy were associated significantly with an overall caring aspect of patient-centered attitude, while the gender effect remained insignificant. Empathy had a critical and significant impact on the patient-centered attitude. Conclusions Efforts to enhance patient-centeredness in Sharing are needed; post-graduate education and transition to a more patient-centered health system are recommended. Moreover, empathy still matters as it was found to be a significant predictor of patient-centered attitudes. The findings of this study support the need for efforts to enhance patient-centered attitudes among dentists, which will help generate discussion on improving the curriculum of post-graduate education and health system reform

Burnout and peritraumatic distress of healthcare workers in the COVID-19 pandemic

Background To evaluate the current status of emotional exhaustion and peritraumatic distress of healthcare workers (HCWs) in the COVID-19 pandemic, and identify factors associated with their mental health status. Methods An online survey involving 1068 of consented HCWs that included nurses, physicians, and public health officers was conducted in May 2020. Descriptive statistics and multivariate regression analyses were performed on the collected data. Results Although no significant difference in peritraumatic distress was observed among the surveyed HCWs, the workers’ experience of emotional exhaustion varied according to work characteristics. Respondents who were female, older, living with a spouse, and/or full-time workers reported higher levels of emotional exhaustion. Public health officers and other medical personnel who did not have direct contact with confirmed patients and full-time workers had a higher level of peritraumatic distress. Forced involvement in work related to COVID-19, worry about stigma, worry about becoming infected, and perceived sufficiency of organizational support negatively predict emotional exhaustion and peritraumatic distress. Conclusions Job-related and emotional stress of HCWs should not be neglected. Evidence-based interventions and supports are required to protect HCWs from mental illness and to promote mental health of those involved in the response to the COVID-19 pandemic.This work was supported by the Gyeonggi-do Public Health Policy Institute, funded by the Gyeonggi-do Province Government, South Korea. The funding body had roles in the design of the study, data collection and analysis

Mental health and psychological resilience amid the spread of the Omicron variant: a comparison between China and Korea

ObjectivesBesides physical health risks, large public health events also exert negative impacts on people's mental health. We aimed to explore the prevalence and correlates of mental distress and its association with psychological resilience among countries amid the Omicron wave.MethodsWe conducted cross-sectional surveys simultaneously in China and South Korea from March 15 to 30, 2023. Brief Resilience Scale (BRS), Generalized Anxiety Disorder 7-item (GAD-7) scale, and Patient Health Questionnaire-9 (PHQ-9) scale were used to measured psychological resilience and mental distress.ResultsSelf-reported rates of anxiety and depressive symptoms in 3,000 Chinese participants were 24.5% and 30.5%, while the above-mentioned rates were 17.2%and 34.4% in 1,000 Korean participants. Chinese participants had a marginally higher BRS score. Psychological resilience was inversely associated with the prevalence of anxiety symptoms and depressive symptoms. Similar results can be observed in Korea. Results remained robust in all models.ConclusionChinese and Korean populations reported a high prevalence of mental distress with variations in different characteristics, indicating practical implications for developing tailored mental health policies and services in the context of large public health events

First snapshot on behavioral characteristics and related factors of patients with chronic kidney disease in South Korea during the COVID-19 pandemic (June to October 2020)

Background The recent novel coronavirus disease 2019 (COVID-19) pandemic has led to unprecedented changes in behavior. We evaluated the current status of precautionary behavior and physical activity in chronic kidney disease (CKD) patients during the COVID-19 pandemic. Methods A population of CKD patients (n = 306) registered in the Study on Kidney Disease and Environmental Chemicals (SKETCH, Clinical Trial No. NCT04679168) cohort recruited from June 2020 to October 2020 was included in the study. We conducted a questionnaire survey related to risk perception of COVID-19, precautionary behavior, and physical activity. Results There were 187 patients (61.1%) with estimated glomerular filtration rate of <45 mL/min/1.73 m2. This population showed a higher degree of risk perception for COVID-19 than the general population. Age was the most significant determinant of risk perception among CKD patients. During the pandemic, social distancing and hygiene-related behavior were significantly increased (p < 0.001). The frequency of exercise was decreased only in those who took regular exercise, without diabetes, or with a lower Charlson comorbidity index (CCI) (p < 0.001), with no change among the other groups. Socioeconomic status and comorbidities significantly affected behavioral characteristics regardless of the category. Education and income were significantly associated with precautionary behaviors such as staying at home and hand sanitizer use. Patients with higher CCI status significantly increased frequency of exercise (adjusted odds ratio, 2.10; 95% confidence interval, 1.01–4.38). Conclusion CKD patients showed higher risk perception with active precautionary behavioral changes than the general population. Healthcare providers should be aware of the characteristics to comprise precautionary behavior without reducing physical activity

How Well Does Societal Mobility Restriction Help Control the COVID-19 Pandemic? Evidence from Real-Time Evaluation

One of the most widely implemented policy response to the novel coronavirus (SARS-CoV-2) pandemic has been the imposition of restrictions on mobility (1). These restrictions have included both incentives, encouraging working from home, supported by a wide range of online activities such as meetings, lessons, and shopping, and sanctions, such as stay at home orders, restrictions on travel, and closure of shops, offices, and public transport (2-5). The measures constitute a major component of efforts to control the COVID-19 pandemic. Compared to previous epidemic responses, they are unprecedented in both scale and scope (6). The rationale underpinning these public health measures is that restricting normal activities decreases the number, duration, and proximity of interpersonal contacts and thus the potential for viral transmission. Transmission simulations using complex mathematical modelling have built on past experience such as the 1918 influenza epidemic (7), as well as assumptions about the contemporary scale and nature of contact in populations (8). However, the initial models were not always founded on empirical evidence from behavioral scientists on the feasibility or sustainability of mass social and behavior change in contemporary society. While reductions in interpersonal contact and increases in physical distancing are known to decrease respiratory infection spread (9), the paucity of recent examples of large-scale restrictions on mobility has limited the scope for research on their impact on transmission. Where restrictions have been imposed, as with Ebola, they have involved diseases with a different mode of transmission. Nonetheless, the rapidity of progression of this pandemic has forced many governments into trialing various approaches to containment with limited evidence of effectiveness (10). More conventional public health prevention measures (such as quarantine of contacts, isolation of infected individuals and contact tracing) and control measures in health systems (such as patient flow segregation, negative pressure ventilation, and use of personal protective equipment) (11-14), have been applied widely to control the epidemic in many countries as part of a portfolio of policy responses. However, mobility restriction as a new large-scale mass behavioral and social prescription has incurred considerable costs (15, 16). Estimates suggest global GDP growth has fallen by as much as 10% (17), at least in part due to mobility restriction policies. Although views differ, not least because of the lack of information of what would happen if the disease was unchecked and the emerging evidence of persisting disability in survivors, some have argued that this is greater than would be accounted for by the economic impact of direct illness and deaths from COVID-19 (18, 19). To inform decisions on large scale restrictions of mobility, there is an urgent need to assess their effectiveness in limiting pandemic spread. To this end, we examined the association of mobility with COVID-19 incidence in Organization of Economic Cooperation and Development (OECD) countries and equivalent economies such as Singapore and Taiwan

Mobility restrictions were associated with reductions in COVID-19 incidence early in the pandemic: evidence from a real-time evaluation in 34 countries

Most countries have implemented restrictions on mobility to prevent the spread of Coronavirus disease-19 (COVID-19), entailing considerable societal costs but, at least initially, based on limited evidence of effectiveness. We asked whether mobility restrictions were associated with changes in the occurrence of COVID-19 in 34 OECD countries plus Singapore and Taiwan. Our data sources were the Google Global Mobility Data Source, which reports different types of mobility, and COVID-19 cases retrieved from the dataset curated by Our World in Data. Beginning at each country's 100th case, and incorporating a 14-day lag to account for the delay between exposure and illness, we examined the association between changes in mobility (with January 3 to February 6, 2020 as baseline) and the ratio of the number of newly confirmed cases on a given day to the total number of cases over the past 14 days from the index day (the potentially infective 'pool' in that population), per million population, using LOESS regression and logit regression. In two-thirds of examined countries, reductions of up to 40% in commuting mobility (to workplaces, transit stations, retailers, and recreation) were associated with decreased cases, especially early in the pandemic. Once both mobility and incidence had been brought down, further restrictions provided little additional benefit. These findings point to the importance of acting early and decisively in a pandemic

Lessons Learned From Six Countries During the COVID-19 Pandemic

Government-led risk and crisis communication (RCC) is an essential priority in directing and supporting effective pandemic response in a country. Ineffective RCC during public health emergencies such as the COVID-19 pandemic can lead to public confusion, fear, and distrust, which eventually become barriers to the acceptance and practice of risk preventive behavior. In this analysis of five key RCC objectives in six countries (Ghana, Republic of Korea [Korea], Singapore, the United States [US], the United Kingdom [UK], and Vietnam), several lessons for future consideration are identified. First, governments ought to explore reasons for not being able to rapidly initiate and implement effective RCC so barriers can be identified and overcome before another crisis emerges. Second, public leaders must be committed to enhancing consistency, transparency, and accountability in their messaging, by prioritizing deference toward expert advice from scientific and public health experts. Third, it would be prudent to evaluate laws, standard operating procedures, and existing workflows to enhance public-private partnerships that enable cross-utilization of multistakeholder expertise and resources during a crisis. With this goal, it may be useful to proactively identify and acknowledge the important role that information and communication technologies (ICT) can play during non-pandemic times in enhancing health literacy and health communication. Strengthening laws and regulations to ensure privacy and human rights protections for those using ICT should be an ongoing priority, so that when ICTs must be leveraged during a crisis, there is a baseline level of assurance and confidence surrounding their safe and responsible use. Efforts to encourage the familiarization of the public with how infectious disease outbreaks spread and how people can keep themselves and each other safe should also be an ongoing priority, as scientific and health literacy can help the public prepare itself to receive and interpret RCC that is provided during a crisis. The continuous exposure to the technologies and means of sharing health information throughout various subpopulations within a country is an essential part of trust building over time, thus mitigating the fear, anxiety, social stigma, and potential distrust that could occur in times of an evolving pandemic, when levels of uncertainty are still quite high. Routine, repeated assessments of the public’s perceptions and needs during a crisis are key, as are other efforts to increase a nation’s preparedness to launch RCC rapidly and effectively (for example, government commitment to exploring public private partnerships)

The Outrage Effect of Personal Stake, Familiarity, Effects on Children, and Fairness on Climate Change Risk Perception Moderated by Political Orientation

Outrage factors are perceived characteristics of risk that provoke emotional responses and influence risk perception. Although several studies examined how multiple influences affect climate change risk perception, outrage factors have not been comprehensively assessed in the context of climate change risk perception. Using an online survey in South Korea (n = 592), we investigated outrage factors associated with climate change risk perception and whether political orientation moderates these outrage effects. We considered 11 of 20 outrage factors: voluntariness, controllability, familiarity, fairness, uncertainty, delayed effects, effects on children, trust, reversibility, personal stake, and human vs. natural origin. Factors that overlapped with the selected outrage factors or those that were not relevant to climate change were excluded. The survey revealed that the climate change risk perception of an individual increased when they perceived climate change to be relevant to their personal lives, when they felt unfamiliar with climate change, when they thought climate change would have a severe impact on children, or when they thought climate change would have unequal consequences. Moreover, respondents who identified as political conservatives were subject to a greater outrage effect of personal stake for climate change. The implications of the outrage effect on climate change risk perception and the greater vulnerability of conservatives to outrage effect are discussed