Outbreak of coronavirus disease 2019 (COVID 19) in Pakistan: Psychological impact and coping strategies of health care professionals

Objective: This study was conducted to explore factors that can impact psychological health and coping strategies to help health care professionals (HCPs) to perform their duties.Methods: A cross sectional survey was conducted using structured questionnaire electronically shared with the participants after ethical approval. Descriptive statistics were calculated for socio demographic variables. Chi squared χ2 test was used to compare the responses between different groups of HCPs.Results: Survey was completed by 250 participants. They performed their duties diligently during outbreak but were concerned about their safety, had fear of infecting themselves and their family members. Lack of evidence-based guidelines for patient management, news about pandemic situation through media and to deal with uncooperative patients not willing for quarantine added to their stress. receiving honour and respect from general public in recognition of services, monetary benefit, adequate training to treat COVID-19, provision of personal protective equipment from government were reported as coping strategies for psychological impact.Conclusions: COVID-19 outbreak had psychological impact on HCPs, yet they continued to perform their duties carefully as moral obligation. Continued moral with financial support and acknowledgement of their services by government, organization and general public was reported to have psychological benefit

COVID-19 pandemic awareness, attitudes, and practices among the Pakistani general public

Background: Outbreak of COVID-19, in many countries, has imposed a lockdown on their residents. The usefulness of extenuative actions is extremely reliant on society\u27s knowledge, attitudes, and practices (KAP) toward pandemic control. Objective: This study aimed to explore the awareness, attitudes, and practices of the general Pakistani population to COVID-19. Methods: From June 13, 2020, until June 30, 2020, a cross-sectional online KAP survey was conducted among the Pakistani public. For data collection, a validated self-administered questionnaire was used. The survey instrument consisted of six demographic characteristics, 14 items on knowledge, four on attitudes, and six items on practices, modified from a previously published questionnaire on COVID-19. Results: The present study included 2,307 participants, 58.3% males and 41.7% of females. The majority (86.7%) sought information from social media (SM) and television, 95% had good practices, 89.9% had positive attitudes, and two-thirds (67.4%) of the respondents had adequate knowledge. The students and people from younger age groups had more positive attitudes compared with others. Highly educated w with other groups (p \u3c 0.001). In logistic regression analysis, the odds ratio indicated that the private job was negatively associated, and high monthly income was positively associated with adequate knowledge (OR = 0.595). Old age was the predictor of negative attitude, and high school degrees and master\u27s degrees were associated with good practice scores. Conclusion: The Pakistani general population has an overall positive attitude and proactive practices against COVID-19, but their knowledge is inadequate. The most important source of information was SM, followed by television. These are playing a crucial role in educating the Pakistani public

Factors responsible for delay in provision of care to suspected COVID-19 patients presenting in surgical emergency and ways to combat it

Introduction: Health care workers are found to be at three times greater risk of getting infected as compared to the general public.  Scientists and doctors all over the world have agreed upon the use of PPE including gloves, masks, head covers, face shields, goggles, and jumpsuits in protection against COVID-19. Materials and Methods: This observational prospective study was conducted in the surgical emergency of Holy Family Hospital, Rawalpindi over a period of 2 months and 21 days. Patients included all those who presented to surgical emergency with suspicion of being positive for COVID-19 and time taken by first-line health care workers in attending them. 157 patients were observed for this purpose and 23 first-line surgeons including general, orthopedic, and neurosurgeons were interviewed regarding their fears and concerns about contracting COVID-19 and infecting their families. Results: It was observed that a surgeon took on an average of 10 minutes (+/-3 minutes) in wearing all the personal protective equipment and a total of 14minutes (+/- 5 minutes) in reaching a patient in the trauma room with symptoms suggestive of COVID-19. This was in contrast to a patient presenting to a trauma room who had no respiratory symptoms or fever, in which case, the patient was seen within 3 minutes (+/- 2 minutes) of presentation to a surgical emergency. Out of 23 surgeons, 15 had reasonably aware of the disease while 7 were knowledgeable up to the mark. 17 surgeons were extremely fearful about contracting the disease and infecting their friends and families. 7 surgeons confessed to avoiding COVID-19 patients and 9 surgeons confessed that they commanded their junior surgeons to see suspected COVID-19 patients in the emergency room. Conclusion: We concluded that delay in attending trauma patients suspected of being positive for COVID-19 was a worrisome problem that needed to be addressed. Numerous local and regional circumstances served as a factor for this delay, most important of which came out to be an inadequate provision of PPE, time consumed in collecting and wearing PPE, fear of the disease, and anxiety provoked due to this fear among surgeons

Compliance on the Use of Different Types of Face Mask by Healthcare Workers and General Public in Tertiary Care Hospital of RMU during COVID-19 Pandemic

Objective: To determine the compliance on the use of different types of facemask among HCWs, patients and the general public in different hospital settings of tertiary care hospital of RMU during COVID-19 pandemic Material and Methods: Cross-sectional descriptive study was done among 397 study subjects of either gender consisting of HCWs, patients, and the general public visiting the tertiary care hospital from 6th April-6th June 2020. Subjects were enrolled through convenience non-probability sampling. Data was gathered by a self-structured proforma. The study consisted of questioning the frequency of washing hands, using hand sanitizers, practicing physical distancing, using eye protection goggles or face shields, the practice of sterilizing or changing of shoes and clothes after coming back to home, frequent use of disposable gloves, use of caps or head covers and water-repellant aprons and gowns. Data were analyzed by SPSS version 25.0. Results: A total of 397 study subjects including 206 (52%) males and 190 (48%) females were enrolled in the study. 118 (29.7%) had an underlying disease, 93 (78.8%) of them showed regular use of masks. The mean age of participants was 34.7 ± 12.2 years. 90.4% of study subjects had good compliance with using face masks in hospital settings, 25.9% study subjects used respirator type of masks while the use of homemade cloth was 4.8%. A total of 57.8% of study subjects had use of single masks, 22.5% used double masks, and 10.4% people used triple masks remaining 9.3% uses no masks at all. Among 189 HCWs 54% were using respirator type of masks and 46% were using surgical masks. The general public preferred to use locally made surgical masks or homemade cloth because they are cheap and easily available. Conclusion: The selection and use of PPE especially facemasks vary among HCWs and non HCWs. Even among HCWs usage varies according to the type of healthcare workers and the working environment. Overall compliance with the use of face masks and other PPE was considerably low among non HCWs. Our study has provided preliminary data about the usage of masks among HCWs and non HCWs. Longitudinal studies must be conducted to collect better evidence about the use of the face mask as PPE and its associated factors

Opportunities and Development of Telemedicine in Response to COVID-19: Experience from Public Sector Medical University

Over the past six months, the world has undergone drastic changes related to unprecedented emergence of deadly virus namely novel Coronavirus, COVID-19. Telemedicine service provides excellent platform for technology based remote patient care in the time of current pandemic crisis. It is emerging as an effective and sustainable solution if current pandemic continues for long time. Telemedicine is revolutionising patient care and help to support the health system of country by reducing the impact of pandemic. There is a need to create the multidisciplinary team of health professionals striving to serve the patients by provision of quality health care service delivery.</p

Assessment of medical professionalism: Development and psychometric analysis of professionalism assessment Tool (PAT) in Pakistani context using Delphi techniques

Objective: This study aims to develop and assess the content validity along with the reliability of a Professionalism Assessment Tool (PAT) with an intention to measure professionalism among undergraduate medical students. Methods: This psychometric analytical study validation study was carried out at Rawalpindi Medical University from 1st February to 1st June, 2021 after establishing feasibility and obtaining ethical approval. The non-probability convince sampling was employed to collect data. Using Nunnally\u27s, the ratio of e subjects per item was selected, as our preliminary tool has 48 items so 384 sample size was estimated for scale validation. The preliminary 48-item tool with five subscales(cSS) developed through mutual consensus by the Delphi technique namely Communication skill(cSS1),-7 item, Accountability(cSS2)-8 item, Altruism(cSS3)-13 item, Self-Directed Learning (cSS4)-10 item and Ethics(cSS5),-10 item was labelled as Professionalism Assessment Tool (PAT). The tool was administered to 4th year MBBS students, the data obtained was analyzed by calculating Cronbach\u27s alpha to estimate the reliability. The SPSS version 26 was used for data analysis. Results: The 48-item PAT had an overall reliability (Cronbach\u27s alpha) of 0.783. The Reliability of the new Subscales were communication skills (0.405), self-directed learning (0.527), Accountability (0.378), Altruism (0.486) and Ethics (0.715). Conclusion: The final tool developed for assessment of professionalism had 48 items on a seven point Likert like scale, across five Subscales. Results showed that it was determined as a useful tool in assessing professionalism in undergraduate medical students to generate reliable results for valid decision-makin

Vaccine hesitancy and intention to take the vaccine: attitude of general public towards COVID-19 vaccination

Objective: The objective of this study is to determine the gender-based differences in factors responsible for hesitancy and acceptance towards-19 the COVID-19 vaccination among the general public residing in different cities of Pakistan.Material and Methods: This cross-sectional comparative study was conducted among the general public residing in different cities of Pakistan. Data was collected from15th April to 30th April 2021. The estimated sample size was found to be 380, convenience sampling was used for data collection. The Chi-square test was applied to find gender-based differences in reasons responsible for refusal and uptake of vaccination. P-value &lt; 0.05 was taken as significant. Data were analyzed by using SPSS version 26.0.Results: Out of the total of 380 participants, 101(27%) were males and 279(73%) were females. Significant motives for vaccine uptake include family and friend recommendations, helping society to get back to normal again (75%), and health care recommendations (30%). Males were more receptive to vaccine uptake (p=0.001). Major factors contributing towards vaccine refusal were a perception that Corona Virus is not harmful (90%), mistrust (89%), reservations about vaccine safety (90%) and efficacy (80%), the opposition of friends and family (55%). Females were more hesitant towards COVID vaccination (p=0.04). One of the major reasons for hesitancy towards vaccination was vaccine-associated misinfodemic disseminated by social media.Conclusion: The study concluded the gender-based differences in factors responsible for hesitancy and acceptance of COVID vaccination among the general public. COVID-19 vaccination awareness campaigns should be launch with a special focus on the issues related to vaccine safety and efficacy, offering reassurance and trust-building, addressing misconceptions, especially in females.