Assessment and feedback of the COVID-19 pandemic’s effects on physicians’ day-to-day practices: good knowledge may not predict good behavior

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KEY POINTS

Despite effective vaccines, infection control, and prevention practices remain vital. Healthcare professionals’ attitudes and practices regarding infectious diseases may affect disease severity, degree of transmission, and general mortality rate. The pandemic process can mediate determining health workers’ deficiencies in acquiring professional knowledge. To produce policies that increase the knowledge of healthcare professionals and improve their awareness and commitment.

Table 1. Descriptive characteristics of residents participating in the study during the first year [Group 1] and second year [Group 2] of the pandemic.

	Group 1		Group 2
	n	%	n	%	p
Sex
Male	62	49.2	42	42.9	.345
Female	64	50.8	56	57.1
Department
Surgical	55	43.7	47	48.0	.521
Internal	71	56.3	51	52.0
Working in COVID-19 clinic
Yes	102	81.0	63	64.3	.005
No	24	19.0	35	35.7
Age
Mean	28.94		28.91
[SD] [min – max]	[4.49] [17-]54]		[5.25] [17–]60]
24–26 years	31	24.6	23	23.5
27, 28 years	40	31.7	33	33.7	.276
29, 30 years	33	26.2	33	33.7
>30 years	22	17.5	9	9.2
Professional working experience as a resident
	3.98		3.81
Mean	[4.58] [1–16,,24,25–31]		[5.43] [1–16,,24,25–36]
[SD] [min – max]		18.3	19	19.4
1 year	23	23.0	23	23.5
2 years	29	19.0	18	18.4	.448
3 years	24	11.9	19	19.4
4 years	15	27.8	19	19.4
5+ years	35
Marital status
Married	57	45.2	43	43.9	.839
Single	69	54.8	55	56.1
Total	126	100	98	100

Table 2. Residents’ knowledge and attitudes regarding infection control and prevention of COVID-19 during the first year [Group 1] and second year [Group 2] of the pandemic.

	Group 1		Group 2		p
	n	%^a	n	%
(1) Remembering the correct order of wearing PPE^b [scrubs, mask, goggles, gloves]	77	61.1	59	60.2	.890
(2) Remembering the correct order of removing PPE [gloves, goggles, scrubs, mask]	76	60.3	36	36.7	.001
(3) Questioning symptoms and exposure to COVID-19 in hospitalized patients	103	81.7	66	67.3	.013
(4) Thinking that he/she had asked about all symptoms during symptom questioning	80	63.5	62	63.3	.972
(5) Daily repetition of symptom questioning until the end of hospitalization	32	25.4	36	36.7	.067
(6) Patients being admitted into single rooms in the clinic at which the resident works	48	38.1	23	23.5	.02
(7) Watching the videos found on the hospital website regarding the order of wearing and removing PPE	69	54.8	44	44.9	.143
(8) Difficulty procuring PPE	23	18.3	29	29.6	.046
(9) Reliably finding PPE provided by the hospital	77	61.1	61	62.2	.863
(10) Mask used in the polyclinic
Surgical mask only	44	34.9	47	48.0
Two surgical masks only	40	31.7	29	29.6	.015^c
Mask with high protection only	13	10.3	14	14.3
Surgical mask + mask with high protection	29	23.0	8	8.2
Total	126	100.0	98	100.0

Note: ^a PPE: Personal protective equipment.

^aNumber and percentage for only the answer ‘Yes’ were given.

^bFactor providing significance as a result of post-hoc Bonferroni test; mask with high protective + surgical mask use increased in Group 1 and surgical mask use increased in Group 2.

Table 3. Evaluation of residents’ opinions on general information regarding COVID-19.

	Group 1		Group 2		p
	M	SD	M	SD
Drugs are effective
Favipiravir	3.92	1.24	2.43	1.71	<.001
Remdesivir	3.12	1.50	1.83	1.46	<.001
Immunomodulator	3.19	1.59	3.11	1.80	.731
Plasma	3.40	1.52	2.12	1.56	<.001
Steroid	3.99	1.26	4.29	1.26	.085
Chloroquine	1.83	1.24	1.36	0.98	.002
	Group 1		Group 2
	n	%^a	n	%^a	p
Indications to use highly protective masks
During patient examination	27	21.4	32	32.7	.041
Intubation	99	78.6	79	80.6	.741
Bronchoscopy	102	81.0	78	79.6	.799
Endoscopy	93	73.8	73 [	74.5	.908
Respiratory function test	81	64.3	81	64.3	.522
Cases receiving 5 L/min oxygen	32	25.4	48	49.0	<.001
Aspiration	96	76.2	76	77.6	.811
Taking samples for COVID	96	76.2	63	64.3	.055
Every time in the hospital	29	23	31	31.6	.172

Note: ^aMore than one option was selected.

Table 4. Gap analysis according to the descriptive variables of residents’ awareness regarding infection control and prevention measures against COVID-19 in the first [Group 1] and second [Group 2] years of the pandemic.

	Group 1 Infection Control and Prevention Awareness Score		Group 2 Infection Control and Prevention Awareness Score		p
	M	SD	M	SD
Sex
Female	5.97	2.42	5.05	2.07	.037
Male	5.89	2.11	5.27	1.77	.106
p	.849		.580
Department
Surgical	5.29	2.13	4.89	1.88	.324
Internal	6.42	2.24	5.43	1.97	.013
p	.005		.171
Age
28 years and under	6.03	2.24	5.18	2.03	.029
28 years and over	5.80	2.29	5.17	1.83	.145
p	.576		.976
Professional working
experience
2 years and less	5.48	2.24	5.19	2.20	.530
2 years and more	6.24	1.73	5.16	1.73	.002
p	.062		.940
Working in COVID clinic
Yes	5.80	2.13	5.60	1.79	.534
No	6.46	2.72	4.40	1.97	.001
p	.202		.003
Marital status
Married	5.63	2.24	5.09	2.00	.216
Single	6.17	2.26	5.24	1.90	.015
p	.180		.718
Total	5.93	2.26	5.17	1.94	.009

Gurses AP, Dietz AS, Nowakowski E, et al. Human factors-based risk analysis to improve the safety of doffing enhanced personal protective equipment. Infect Control Hosp Epidemiol. 2019;40(2):178–186. DOI:10.1017/ice.2018.292

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