In a recent study posted to Research Square*, researchers conducted a global survey to assess the knowledge, attitudes, and practices (KAP) of physicians towards coronavirus disease 2019 (COVID-19). Physicians' perceptions on healthcare policies, vaccination concerns, experiences, and future recommendations were explored.

Background

Healthcare professionals (HCPs) have been the frontline workers in the management of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections, working round the clock abiding by global COVID-19 protocols. Thus, KAP and vaccination concerns of HCPs must be thoroughly evaluated as understanding physician experiences could enable the identification of deficiencies in COVID-19 interventions and policies.

Previous KAP studies on COVID-19 have been conducted majorly within the early periods of the disease at national levels. Data from the studies may not be representative of the present KAP of physicians all over the globe.

About the study

In the present study, the team conducted an international cross-sectional analysis to investigate physician KAP. They also explored physicians' perspectives on global healthcare policies and their advice for the future.

A mixed-methods questionnaire-based survey was distributed online via social media to physicians across the globe from August 9^th to August 30^th, 2021. The final questionnaire (S1 file), with data from COVID-19 World Health Organization (WHO) Online Resources, updated until July 7^th, 2021, comprised eight sections: sociodemographic characteristics, information sources, knowledge, practices, perspective on vaccinations, perspective on policies implemented, attitudes, and personal reflections.

In total, 16 items were structured to assess the knowledge of physicians regarding COVID-19 and vaccines. Correct answers were allotted 1 point, and incorrect answers were given 0 points. A total of the scores indicated the physician's knowledge. Based on Bloom's cut-off value, the knowledge was categorized as good and poor, based on a percentage greater than 60% and below, respectively.

The practice section contained five questions that aimed to evaluate the preventative measures followed by the physicians. There were three answers to this section: 'occasional," never, or 'always.' The former two scored 0 points, whereas the latter was given 1 point. A total of the points denoted the total practice score. Based on Bloom's cut-off value, physicians' practice was classified as good and poor based on scores greater than or less than 80%, respectively.

Physician responses were evaluated by three infection control specialists. A pilot test was performed based on ten physician responses to assess the clarity, acceptability, relevance, and readability of the survey. Pilot study data and unfinished surveys were excluded before the final statistical analysis. Descriptive statistics and inductive thematic analysis were used to obtain the results.

Results and discussion

In this study, 399 physicians practicing general medicine, surgery, or internal medicine from 62 nations responded with almost equal participation from high-income countries (54%) and middle or low-income countries (46%). Although most physicians (87.5%) had good knowledge regarding COVID-19 and vaccinations, only 54% followed strict adherence to COVID-19 preventative measures. Most physicians were knowledgeable about the disease transmission (71.5%), actions taken for patients (72.5%), and the nature of vaccines (89.5%). However, poor knowledge regarding the nature (52%) and treatment (59.9%) of disease was identified.

The majority of physicians obtained information from government websites (51%). Other information sources included news media and social media. Most respondents worried about their workload, mental stress, future, and acquiring COVID-19 as well as infecting close contacts. More than half of the physicians reported a negative COVID-19 experience.

However, most physicians (87%) expressed their willingness to work in healthcare facilities during the pandemic. Approximately one-third of respondents indicated that the policies implemented by health facilities and public health agencies, and health facilities were inadequate.

The practice most and least followed by the majority of physicians were handwashing with soap or hydro-alcoholic gels and wearing gloves while working, respectively. Over 60% of physicians were concerned about vaccine distribution, whereas 50% of physicians were worried about the long-term side effects of vaccines.

More than 70% of physicians considered the Pfizer-BioNTech vaccine as the most effective vaccine. Almost 50% of physicians reported that the AstraZeneca (Vaxzevria and Covishield), Janssen, and Sputnik V vaccines were associated with many complications. Almost all physicians (96%) were vaccinated, whereas only 4% of physicians were reluctant to get vaccinated.

Conclusion

The study findings showed that although physicians were knowledgeable about COVID-19 and vaccinations, enhanced adherence to COVID-19 protocols among HCPs is required globally.

As physicians in the study recommended, COVID-19 management must involve the reinforcement of healthcare systems with increased investments in resources and HCP training, appropriate delegation of decision-making duties, minimizing dissemination of irrelevant information, and acknowledging a worldwide responsibility. 

*Important notice

Research square publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be considered conclusive, guide clinical practice/health-related behavior, or treated as established information.

Written by

Pooja Toshniwal Paharia

Dr. based clinical-radiological diagnosis and management of oral lesions and conditions and associated maxillofacial disorders.