Perceived Knowledge, Attitude, and Practices (KAP) and Fear toward COVID-19 among Patients with Diabetes Attending Primary Healthcare Centers in Kuwait
Abstract
:1. Introduction
2. Methods
2.1. Study Design and Setting
2.2. Study Participants and Data Collection Procedures
2.3. Study Instrument
2.4. Sample Size
2.5. Piloting Phase
2.6. Data Analysis
3. Results
3.1. Patients’ Demographics and Medical Information
3.2. Patients’ Knowledge about COVID-19
3.3. Patients’ Attitudes toward COVID-19
3.4. Patients’ Practices of Prevention from COVID-19 Infection
3.5. Patients’ Perceptions of Fear with Regard to COVID-19
3.6. Factors Associated with Patients’ Perceived Fear and Knowledge, Attitude, and Prevention Practices toward COVID-19
4. Discussion
Study Strengths and Limitations
5. Conclusions
Implications for the Future and Practice
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Acknowledgments
Conflicts of Interest
References
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Governorate | Number of Diabetes Clinics Visits in 2020 | Percentage | Number of Questionnaires per Governorate |
---|---|---|---|
Hawally | 166,739 | 18% | 86 |
Capital | 139,173 | 15% | 72 |
Al Ahmadi | 244,941 | 26% | 125 |
Farwaniya | 264,524 | 28% | 135 |
Al Jahra | 129,367 | 13% | 62 |
Total | 944,844 | 100% | 480 |
Characteristics | n (%) |
---|---|
Age | Median 52 years (min. 18, max. 87) |
18 to 34 years 35 to 49 years 50 to 64 years 65 years and older | 20 (8.0) 71 (28.3) 138 (55.0) 22 (8.8) |
Gender | |
Male Female | 166 (66.1) 85 (33.9) |
Marital status | |
Single Married Divorced Widowed | 26 (10.4) 176 (70.1) 26 (10.4) 23 (9.2) |
Nationality | |
Kuwaiti Non-Kuwaiti | 135 (53.8) 116 (46.2) |
Educational status | |
Illiterate High school Diploma Bachelor’s degree Postgraduate degree | 7 (2.8) 89 (35.5) 58 (23.1) 84 (33.5) 13 (5.2) |
Employment status | |
Student Employed (government/private) Self-employed Unemployed Retired | 7 (2.8) 142 (56.6) 17 (6.8) 26 (10.4) 59 (23.5) |
Monthly income | |
Less than 500 KWD 500 to 1000 KWD 1000 to 2000 KWD More than 2000 KWD | 76 (30.3) 93 (37.1) 57 (22.7) 24 (9.6) |
Characteristics | n (%) |
---|---|
Type of diabetes | |
Type 1 diabetes Type 2 diabetes | 24 (9.6) 227 (90.4) |
Duration of diabetes | Median 7 years (min. 0.2, max. 41) |
Less than 1 year 1 to less than 5 years 5 to less than 10 years 10 years or more | 7 (2.8) 56 (22.3) 82 (32.7) 106 (42.2) |
Last HbA1c value | Median 8% (min. 5.8%, max. 13.0%) |
Less than 7% 7% and above | 22 (8.8) 229 (91.2) |
Treatment | |
Diet and exercise only Oral hypoglycemic agents Insulin Combined oral hypoglycemic agents + insulin | 6 (2.4) 168 (67.0) 31(12.3) 46 (18.3) |
Other chronic conditions * | |
Hypertension Heart disease Cancer Respiratory disease (e.g., COPD, asthma) Autoimmune diseases (e.g., thyroid diseases, rheumatoid arthritis) | 120 (47.8) 40 (15.9) 0 (0.0) 25 (10.0) 14 (5.6) |
Past diagnosis of COVID-19 | |
Yes ** No | 38 (15.1) 213 (84.9) |
Receipt of COVID-19 vaccine **** | |
Yes *** No | 101 (40.2) 149(59.4) |
Knowledge Questions | Correct n (%) | Incorrect n (%) |
---|---|---|
Coronavirus infection spreads from person-to-person within close distance of each other (about 6 feet; 2 m). | 166 (66.1) | 85 (33.9) |
Coronavirus infection spreads through respiratory droplets, which occur when infected people cough and sneeze. | 244 (97.2) | 7 (2.8) |
The infection can spread by touching a surface or object, to which the virus is attached, and then touching one’s mouth, nose, or, perhaps, eyes. | 238 (94.8) | 13 (5.2) |
Eating wild animals or direct contact with them can lead to infection with the Coronavirus. | 112 (44.6) | 139 (55.4) |
The coronavirus does not spread through the use of insulin injection. * | 95 (37.8) | 155 (61.8) |
Home deliveries can contribute to the spread of Coronavirus infection. | 203 (80.9) | 48 (19.1) |
Infected people cannot transmit the Coronavirus to others if they have no fever. | 172 (68.5) | 79 (31.5) |
The main symptoms of Coronavirus infection are fever, fatigue, dry cough, muscle aches, and shortness of breath. | 233 (92.8) | 18 (7.2) |
A stuffy nose, runny nose, and sneezing are the most common symptoms of Coronavirus infection. | 41 (16.3) | 210 (83.7) |
Diarrhea, skin rash, or discoloration are symptoms of Coronavirus infection. | 105 (41.8) | 146 (58.2) |
All people infected with Coronavirus develop symptoms and feel unwell. | 180 (71.7) | 71 (28.3) |
All people infected with Coronavirus develop severe and serious symptoms. ** | 202 (80.5) | 47 (18.7) |
People with diabetes mellitus are more likely to develop severe symptoms and even die from Coronavirus infection. * | 192 (76.5) | 58 (23.1) |
Coronavirus infection is more dangerous in the elderly than in the young. | 211 (84.1) | 40 (15.9) |
It is not necessary for children and young people to take the precautions required to limit the spread of Coronavirus infection. * | 206 (82.1) | 44 (17.5) |
Knowledge Questions | Correct n (%) | Incorrect n (%) |
---|---|---|
Antibiotics are an effective treatment for Coronavirus infection. * | 117 (46.6) | 133 (53.0) |
At present, there is no effective treatment for Coronavirus infection, but early symptomatic and supportive treatment can help most patients recover from the disease. | 198 (78.9) | 53 (21.1) |
At present, there is no effective vaccine to prevent Coronavirus infection. | 104 (41.4) | 147 (58.6) |
After coughing, sneezing, or nose-blowing in a public place, wash hands with soap and water for at least 20 s, or use a hand sanitizer that contains at least 60% alcohol. | 236 (94.0) | 15 (6.0) |
People can wear general medical masks to prevent infection with Coronavirus. | 236 (94.0) | 15 (6.0) |
People should only wear a mask if they are infected with the Coronavirus, or if they are caring for a person suspected of having the infection. | 183 (72.9) | 68 (27.1) |
Wearing gloves is more effective than regular hand washing with soap and water. | 177 (70.5) | 74 (29.5) |
Avoiding crowded places and maintaining a minimum distance of 1 meter from others can prevent the spread of Coronavirus. | 206 (82.1) | 45 (17.9) |
Outdoor gatherings are safer than indoor gatherings. | 201 (80.1) | 50 (19.9) |
Isolation and symptomatic treatment of patients with Coronavirus infection are effective ways to reduce the spread of the disease. | 241 (96.0) | 10 (4.0) |
If you have accidentally come in contact with a person infected with Coronavirus, you must immediately isolate yourself for a minimum period of 14 days, and you must go immediately to the nearest hospital if you feel unwell. | 234 (93.2) | 17 (6.8) |
Healthy food and drinking water help to increase the body’s immunity and resistance to getting Coronavirus infection. | 227 (90.4) | 24 (9.6) |
Some diabetes medications should be stopped in patients with Coronavirus infection. | 37 (14.7) | 214 (85.3) |
Attitude Questions | Strongly Agree n (%) | Agree n (%) | Neutral n (%) | Disagree n (%) | Strongly Disagree n (%) |
---|---|---|---|---|---|
Regular hand washing, maintaining social distancing, and covering the face with masks are necessary to protect from COVID-19. | 204 (81.3) | 39 (15.5) | 4 (1.6) | 2 (0.8) | 2 (0.8) |
To protect me from Coronavirus exposure, I should stay at home if I’m sick unless seeking medical care. | 188 (74.9) | 46 (18.3) | 9 (3.6) | 8 (3.20) | 0 (0.0) |
I will perform a coronavirus test if I suspect symptoms of Coronavirus infection. | 185 (73.7) | 54 (21.5) | 6 (2.4) | 6 (2.4) | 0 (0.0) |
If I got infected with Coronavirus, I would accept isolation in a health facility if necessary. | 192 (76.5) | 47 (18.7) | 5 (2.0) | 6 (2.4) | 1 (0.4) |
I trust the prevention measures recommended by the MOH | 170 (67.7) | 51 (20.3) | 15 (6.0) | 11 (4.4) | 4 (1.6) |
I believe that vaccines can reduce the spread of Coronavirus infection. | 134 (53.4) | 79 (31.5) | 30 (12.0) | 7 (2.8) | 1 (0.4) |
COVID-19 will eventually be brought under control. | 131 (52.2) | 91 (36.3) | 25 (10.0) | 3 (1.2) | 1 (0.4) |
Practice Questions | Always/Often n (%) | Sometimes n (%) | Rarely/Never n (%) |
---|---|---|---|
When you leave home, do you wear a mask? * | 229 (91.2) | 18 (7.2) | 3 (1.2) |
When you leave home, do you wear gloves? | 63 (25.1) | 106 (42.2) | 82 (32.7) |
When you leave home, do you maintain a distance of at least 1 meter from other people? | 178 (70.9) | 68 (27.1) | 5 (2.0) |
When you leave home, do you apply social distancing measures and avoid hand shaking or kissing? | 194 (77.3) | 51 (20.3) | 6 (2.4) |
Do you wash your hands using soap for at least 20 s? | 178 (70.9) | 70 (27.9) | 3 (1.2) |
Do you avoid touching your nose, eyes, and mouth with your hands before washing them? | 138 (55.0) | 110 (43.8) | 3 (1.2) |
Do you cover your mouth and nose after coughing/sneezing and wash your hands thereafter? * | 169 (67.3) | 72 (28.7) | 9 (3.6) |
Do you clean/disinfect frequently touched objects and surfaces? | 140 (55.8) | 74 (29.5) | 37 (14.7) |
Do you avoid close contact with people who have flu/cold symptoms such as coughing, sneezing, or fever? | 222 (88.4) | 20 (8.0) | 9 (3.6) |
Do you stay home when you feel sick unless you get medical care? | 201 (80.1) | 45 (17.9) | 5 (2.0) |
Do you avoid large gatherings? | 192 (76.5) | 51 (20.3) | 8 (3.2) |
Do you avoid consuming food outside the home to prevent the spread of Coronavirus infection? | 155 (61.8) | 67 (26.7) | 29 (11.6) |
Do you practice sports more regularly than before the Coronavirus? | 46 (18.3) | 85 (33.9) | 120 (47.8) |
To limit the spread of Coronavirus, do you use herbs or traditional medicines? | 53 (21.1) | 101 (40.2) | 97 (38.6) |
To avoid catching Coronavirus infection, do you eat fruits and vegetables? | 121 (48.2) | 87 (34.7) | 43 (17.1) |
Characteristics | Odds Ratio of Fear (95% Confidence Interval) | Odds Ratio of Having Better Knowledge (95% Confidence Interval) | Odds Ratio of Having a Better Attitude (95% Confidence Interval) | Odds Ratio of Having Better Prevention Practices (95% Confidence Interval) |
---|---|---|---|---|
Age | ||||
18 to 34 years (reference group) 35 to 49 years 50 to 64 years 65 years and older | 1.00 | 1.00 | 1.00 | 1.00 |
1.05 (0.61–1.83) | 1.01 (0.58–1.78) | 1.55 (0.85–2.82) | 1.59 (0.92–2.77) | |
0.85 (0.51–1.39) | 1.06 (0.63–1.76) | 0.83 (0.49–1.40) | 0.98 (0.60–1.61) | |
1.34 (0.55–3.25) | 1.36 (0.53–3.47) | 1.49 (0.56–3.95) | 0.51 (0.20–1.28) | |
Gender | ||||
Male (reference group) Female | 1.00 | 1.00 | 1.00 | 1.00 |
0.89 (0.53–1.50) | 0.96 (0.56–1.65) | 1.07 (0.62–1.85) | 1.10 (0.65–1.86) | |
Marital status | ||||
Single (reference group) Married Divorced Widow | 1.00 | 1.00 | 1.00 | 1.00 |
1.52 (0.88–2.61) | 0.87 (0.50–1.53) | 1.60 (0.91–2.78) | 1.16 (0.68–2.00) | |
0.36 (0.15–0.87) * | 0.99 (0.43–2.28) | 0.50 (0.22–1.13) | 0.47 (0.20–1.13) | |
1.45 (0.60–3.49) | 1.46 (0.58–3.70) | 0.83 (0.34–1.99) | 1.06 (0.45–2.49) | |
Nationality | ||||
Kuwaiti (reference group) Non-Kuwaiti | 1.00 | 1.00 | 1.00 | 1.00 |
1.00 (0.61–1.64) | 1.55 (0.92–2.59) | 0.13 (1.50–0.88) | 2.49 (1.49–4.14) ** | |
Educational status | ||||
Illiterate (reference group) High school Diploma Bachelor’s degree Postgraduate degree | 1.00 | 1.00 | 1.00 | 1.00 |
1.01 (0.60–1.70) | 0.93 (0.55–1.59) | 0.81 (0.47–1.39) | 1.28 (0.76–2.15) | |
1.15 (0.64–2.06) | 0.70 (0.39–1.27) | 0.94 (0.51–1.73) | 0.91 (0.51–1.64) | |
1.14 (0.67–1.93) | 1.18 (0.68–2.03) | 1.22 (0.70–2.12) | 0.69 (0.41–1.17) | |
0.07 (0.01–0.53) * | 1.42 (0.42–4.74) | 1.23 (0.37–4.11) | 2.71 (0.81–9.04) | |
Employment status | ||||
Student (reference group) Employed (government/private) Self-employed Unemployed Retired | 1.00 | 1.00 | 1.00 | 1.00 |
1.02 (0.62–1.68) | 0.78 (0.46–1.30) | 1.22 (0.72–2.05) | 1.56 (0.94–2.59) | |
1.02 (0.38–2.72) | 1.15 (0.41–3.21) | 0.76 (0.28–2.06) | 1.02 (0.38–2.73) | |
0.89 (0.40–2.01) | 3.81 (1.27–11.41) * | 0.60 (0.26–1.35) | 0.98 (0.43–2.21) | |
1.19 (0.66–2.14) | 0.80 (0.44–1.45) | 1.31 (0.70–2.45) | 0.67 (0.37–1.21) | |
Monthly income | ||||
Less than 500 KWD (reference group) 500 to 1000 KWD 1000 to 2000 KWD More than 2000 KWD | 1.00 | 1.00 | 1.00 | 1.00 |
0.71 (0.43–1.19) | 1.04 (0.62–1.77) | 0.72 (0.42–1.23) | 0.85 (0.51–-1.42) | |
1.20 (0.66–2.18) | 1.08 (0.59–1.99) | 0.82 (0.45–1.51) | 0.72 (0.40–1.31) | |
0.42 (0.17–1.01) | 1.27 (0.52–3.08) | 1.70 (0.65–4.44) | 0.97 (0.42–2.25) |
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Alsaleh, F.M.; Elzain, M.; Alsairafi, Z.K.; Naser, A.Y. Perceived Knowledge, Attitude, and Practices (KAP) and Fear toward COVID-19 among Patients with Diabetes Attending Primary Healthcare Centers in Kuwait. Int. J. Environ. Res. Public Health 2023, 20, 2369. https://doi.org/10.3390/ijerph20032369
Alsaleh FM, Elzain M, Alsairafi ZK, Naser AY. Perceived Knowledge, Attitude, and Practices (KAP) and Fear toward COVID-19 among Patients with Diabetes Attending Primary Healthcare Centers in Kuwait. International Journal of Environmental Research and Public Health. 2023; 20(3):2369. https://doi.org/10.3390/ijerph20032369
Chicago/Turabian StyleAlsaleh, Fatemah M., Muna Elzain, Zahra K. Alsairafi, and Abdallah Y. Naser. 2023. "Perceived Knowledge, Attitude, and Practices (KAP) and Fear toward COVID-19 among Patients with Diabetes Attending Primary Healthcare Centers in Kuwait" International Journal of Environmental Research and Public Health 20, no. 3: 2369. https://doi.org/10.3390/ijerph20032369