Volume 35, Issue 139 (December 2022)                   IJN 2022, 35(139): 504-519 | Back to browse issues page


XML Persian Abstract Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Ehsani M, Seyedoshohadaee M, Haghani S, Shojaeimotlagh S. Knowledge, Attitude and Practice Regarding COVID-19 in Patients With Diabetes. IJN 2022; 35 (139) :504-519
URL: http://ijn.iums.ac.ir/article-1-3642-en.html
1- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
2- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran. , sashomo@gmail.com
Full-Text [PDF 6690 kb]   (240 Downloads)     |   Abstract (HTML)  (594 Views)
Full-Text:   (191 Views)
Introduction
Although all people in different age groups and with different demographic and health characteristics are exposed to COVID-19, their conditions and severity of symptoms and the need for hospitalization and special care are different and worse in people with chronic diseases such as diabetes. Their knowledge, attitude, and practice (KAP) are of special importance for having preventive behaviors, self-care and appropriate health-seeking behaviors. Success or failure in dealing with COVID-19 depends highly on these behaviors. This study aims to assess the KAP towards COVID-19 in patients with diabetes .

Methods
In this descriptive cross-sectional study, participants were 384 patients with type 1 and type 2 diabetes referred to Firouzgar and Hazrat Rasool-e Akram hospitals in Tehran, Iran. For sampling, a continuous method was used. Two questionnaires were used to collect data. The first questionnaire was a demographic form surveying age, gender, educational level, occupation, marital status, type of diabetes, duration of disease, and having other chronic diseases such as high blood pressure, heart disease, asthma or chronic lung diseases. The second questionnaire measures the KAP towards COVID-19 designed by Honarvar et al. [29], which has 46 items, 17 for knowledge, 10 for attitude, and 18 for practice (the ways of transmission, methods of prevention, and treatment). The total score of knowledge is between 0 and 25, where a higher score indicates higher knowledge. Based on the scores, the knowledge level was divided into three groups: adequate (>70% of the total score), moderate (40-70% of the total score) and poor (<40% of the total score). The total score of practice subscale is between 0 and 70. Based on these scores, the practice level was divided into three categories: Adequate, moderate, and poor. To determine the validity of the KAP tool, it was sent to 5 members of the Faculty of Nursing and Midwifery, Iran University of Medical Sciences. After applying their opinions, the validity was confirmed. Also, to ssess the reliability, the questionnaire was given to 20 patients with diabetes who met the inclusion criteria and were excluded from the study after completing the instruments. The Cronbach’s alpha coefficient was obtained 0.78, 0.75, and 0.81 for knowledge, attitude, and practice subscales, respectively.

Findings
In this study, the mean age of participants was 40.15±15.01 years, and the mean duration of diabetes in them was 11.76±8 years. Most of participants were male (51%), married (70.6%), with associate degree and bachelor’s level degree (38.8%). More than half of them had type 1 diabetes (56.3%). In addition to diabetes, 31.5% of patients had hypertension, 9.9% heart disease, and 2.6% asthma or chronic lung disease. According to the findings, the knowledge of COVID-19 in 52.6% of patients was at moderate level, 42.2% had at an adequate level, and 5.2% at a poor level. The mean score of attitude towards COVID-19 was 30.90±4.89. The practice regarding COVID-19 in 57.8% of patients was at an adequate level; 40.9% had at a moderate level, and only 1.3% had poor practice. A significant relationship was observed between the knowledge level of patients and their marital status (P=0.006), employment status (P<0.001), and duration of disease (P<0.001). In addition, there was a statistically significant relationship between the employment status and attitude level (P=0.018) and also between practice level and the variables of gender (P=0.010), marital status (P=0.001), and type of diabetes (P<0.001).

Conclusion
The findings of this study showed that the KAP of patients with diabetes in Tehran were at moderate to adequate level. The findings indicate the effectiveness of information and public awareness and confirm the importance of education and its impact on preventive measures during the pandemic. It is recommended that similar studies be carried out on other patients who are at high risk of contracting COVID-19, such as people with high blood pressure, autoimmune diseases, patients receiving drugs that weaken the immune system, etc.

Ethical Considerations
Compliance with ethical guidelines

This study was approved by the ethics committee of Iran University of Medical Sciences (Code: IR.IUMS.REC.1400.796). All ethical principles were considered in this study.

Funding
This study was extracted from a master thesis approved by the School of Nursing and Midwifery, Iran University of Medical Sciences. It was not funded by any organizations.

Authors' contributions
Conceptualization: Samad Shojaeimotlagh , Maryam Ehsani; Sampling: Samad Shojaeimotlagh; Data analysis: Samad Shojaeimotlagh, Shima Haghani and Maryam Ehsani; Approval of final draft: All authors.

Conflict of interest
The authors declare no conflict of interest.

Acknowledgments
The authors would like to thank the Personnel of Hazrat-e Rasool and Firouzgar hospitals and all participants for their cooperation.


References
  1. Siswati T, Paramashanti BA, Rialihanto MP, Waris L. Epidemiological transition in indonesia and its prevention: A narrative review. J Complement Altern Med Res. 2022; 18(1):50-60. [DOI:10.9734/jocamr/2022/v18i130345]
  2. Al-Hanawi MK, Angawi K, Alshareef N, Qattan AMN, Helmy HZ, Abudawood Y, et al. Knowledge, attitude and practice toward COVID-19 among the public in the Kingdom of Saudi Arabia: A cross-sectional study. Front Public Health. 2020;8:217. [PMID] [PMCID]
  3. Moradzadeh R, Nazari J, Shamsi M, Amini S. Knowledge, attitudes, and practices toward coronavirus disease 2019 in the central area of Iran: A population-based study. Front Public Health. 2020; 8:599007. [DOI:10.3389/fpubh.2020.599007] [PMID] [PMCID]
  4. van Doremalen N, Bushmaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN, et al. Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. N Engl J Med. 2020; 382(16):1564-7. [DOI:10.1056/NEJMc2004973] [PMID] [PMCID]
  5. Al-Matouq J. Saudi Arabia-Eastern province COVID-19 Snapshot MOnitoring (COSMO Saudi Arabia-Eastern province): Monitoring knowledge, risk perceptions, preventive behaviours, and public trust in the current coronavirus outbreak in Saudi Arabia-Eastern province. PsychArchives. 2020. [Link]
  6. WHO. WHO Coronavirus (COVID-19) dashboard. Geneva: WHO; 2022. [Link]
  7. MOHME. [COVID-19 statistics 2022 (Persian)]. Tehran: Ministry of Health and Medical Education; 2022. [Link]
  8. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study. Lancet. 2020; 395(10229):1054-62. [DOI:10.1016/S0140-6736(20)30566-3] [PMID]
  9. Arokiasamy P, Salvi S, Selvamani Y. Global burden of diabetes mellitus. In: Kickbusch I, Ganten D, Moeti M, editors. Handbook of global health. Cham: Springer; 2021. [DOI:10.1007/978-3-030-45009-0_28]
  10. Zahedi M, Dehvan F, Albatineh AN, Gheshlagh RG. Knowledge of Type II diabetic patients about their diabetes: A systematic review and meta-analysis. Adv Nurs Midwifery. 2020; 29(1):36-43. [Link]
  11. Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract. 2010; 87(1):4-14. [DOI:10.1016/j.diabres.2009.10.007] [PMID]
  12. Binhardi BA, de Souza Teixeira CR, de Almeida-Pititto B, Barbosa-Junior F, Franco LJ, de Melo KFS, et al. Diabetes self-care practices and resilience in the Brazilian COVID-19 pandemic: results of a web survey: DIABETESvid. Diabetol Metab Syndr.. 2021; 13(1):87. [DOI:10.1186/s13098-021-00706-8] [PMID] [PMCID]
  13. Pranata R, Henrina J, Raffaello WM, Lawrensia S, Huang I. Diabetes and COVID-19: The past, the present, and the future. Metabolism. 2021; 121:154814. [PMID] [PMCID]
  14. Sahebi A, Golitaleb M, Aliakbari F, Yousefi K, Sheikhbardsiri H. The knowledge, attitudes, and practice (KAP) of the Iranian public towards COVID-19: A systematic review. Disaster Emerg Med J. 2021; 6(4):186-93. [DOI:10.5603/DEMJ.a2021.0033]
  15. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020; 382(18):1708-20. [DOI:10.1056/NEJMoa2002032] [PMID] [PMCID]
  16. Yang JK, Feng Y, Yuan MY, Yuan SY, Fu HJ, Wu BY, et al. Plasma glucose levels and diabetes are independent predictors for mortality and morbidity in patients with SARS. Diabet Med. 2006; 23(6):623-8. [DOI:10.1111/j.1464-5491.2006.01861.x] [PMID]
  17. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China.JAMA. 2020; 323(11):1061-9. [DOI:10.1001/jama.2020.1585] [PMID] [PMCID]
  18. Allard R, Leclerc P, Tremblay C, Tannenbaum TN. Diabetes and the severity of pandemic influenza A (H1N1) infection. Diabetes Care. 2010; 33(7):1491-3. [DOI:10.2337/dc09-2215] [PMID] [PMCID]
  19. Badawi A, Ryoo SG. Prevalence of comorbidities in the Middle East respiratory syndrome coronavirus (MERS-CoV): A systematic review and meta-analysis. Int J Infect Dis. 2016; 49:129-33. [DOI:10.1016/j.ijid.2016.06.015] [PMID] [PMCID]
  20. Alraddadi BM, Watson JT, Almarashi A, Abedi GR, Turkistani A, Sadran M, et al. Risk factors for primary Middle East respiratory syndrome coronavirus illness in humans, Saudi Arabia, 2014. Emerg Infect Dis. 2016; 22(1):49-55. [DOI:10.3201/eid2201.151340] [PMID] [PMCID]
  21. Al-Tawfiq JA, Hinedi K, Ghandour J, Khairalla H, Musleh S, Ujayli A, et al. Middle East respiratory syndrome coronavirus: A case-control study of hospitalized patients. Clin Infect Dis. 2014; 59(2):160-5. [DOI:10.1093/cid/ciu226] [PMID] [PMCID]
  22. Pal R, Yadav U, Grover S, Saboo B, Verma A, Bhadada SK. Knowledge, attitudes and practices towards COVID-19 among young adults with Type 1 Diabetes Mellitus amid the nationwide lockdown in India: A cross-sectional survey. Diabetes Res Clin Pract. 2020; 166:108344. [DOI:10.1016/j.diabres.2020.108344] [PMID] [PMCID]
  23. Ghosh A, Arora B, Gupta R, Anoop S, Misra A. Effects of nationwide lockdown during COVID-19 epidemic on lifestyle and other medical issues of patients with type 2 diabetes in north India. Diabetes Metab Syndr. 2020; 14(5):917-20. [DOI:10.1016/j.dsx.2020.05.044] [PMID] [PMCID]
  24. Melesie Taye G, Bose L, Beressa TB, Tefera GM, Mosisa B, Dinsa H, et al. COVID-19 knowledge, attitudes, and prevention practices among people with hypertension and diabetes mellitus attending public health facilities in Ambo, Ethiopia. Infect Drug Resist. 2020; 13:4203-14. [DOI:10.2147/IDR.S283999] [PMID] [PMCID]
  25. Azlan AA, Hamzah MR, Sern TJ, Ayub SH, Mohamad E. Public knowledge, attitudes and practices towards COVID-19: A cross-sectional study in Malaysia. Plos One. 2020; 15(5):e0233668. [PMID] [PMCID]
  26. Al Ahdab S. Knowledge, Attitudes and Practices (KAP) towards pandemic COVID-19 among Syrians. 2020 [Unpublished]. [DOI:10.21203/rs.3.rs-27859/v1]
  27. Nasirzadeh M, Aligol M. [Assessmentof knowledge, attitude, and factors associated with the preventive behaviors of COVID-19 in Qom, Iran, in 2020 (Persian)]. Qom Univ Med Sci J. 2020; 14(7):50-7. [DOI:10.29252/qums.14.7.50]
  28. Jasim Alsadaji A, Zendehtalab HR, Jasim Mohammed Z, Behnam Vashani HR. Evaluation of effective factors on the Knowledge, Attitude, and Practice (KAP) about COVID-19 in patients with chronic diseases referred to Teaching Hospitals in Iraq and Iran. Health Provid. 2022; 1(2):87-96. [Link]
  29. Honarvar B, Lankarani KB, Kharmandar A, Shaygani F, Zahedroozgar M, Rahmanian Haghighi MR, et al. Knowledge, attitudes, risk perceptions, and practices of adults toward COVID-19: A population and field-based study from Iran. Int J Public Health. 2020; 65(6):731-9. [DOI:10.1007/s00038-020-01406-2] [PMID] [PMCID]
  30. Wen X, Wang F, Li X, Gu H. Study on the Knowledge, Attitude, and Practice (KAP) of nursing staff and influencing factors on COVID-19. Front Public Health. 2021; 8:560606. [DOI:10.3389/fpubh.2020.560606] [PMID] [PMCID]
  31. Akalu Y, Ayelign B, Molla MD. Knowledge, attitude and practice towards COVID-19 among chronic disease patients at Addis Zemen Hospital, Northwest Ethiopia.Infect Drug Resist. 2020, 13:1949-60. [PMID]
  32. Mark E, Udod G, Skinner J, Jones M. Knowledge, attitudes, and practices [KAP] toward COVID-19: A cross-sectional study in the New York Metropolitan Area and California Bay Area. Plos One. 2022; 17(8):e0271212. [Link]

 
Type of Study: Research | Subject: nursing
Received: 2022/12/10 | Accepted: 2022/12/22 | Published: 2022/12/22

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2015 All Rights Reserved | Iran Journal of Nursing

Designed & Developed by : Yektaweb