key: cord-254782-fzuasf2o authors: Tadesse, Degena Bahrey; Gebrewahd, Gebremeskel Tukue; Gebre, Gebre Teklemariam title: Knowledge, attitude, practice and psychological response toward COVID-19 among nurses during the COVID-19 outbreak in Northern Ethiopia, 2020 date: 2020-10-14 journal: New Microbes New Infect DOI: 10.1016/j.nmni.2020.100787 sha: doc_id: 254782 cord_uid: fzuasf2o Background Coronavirus disease in 2019 (COVID-19) is not only a deadly outbreak disease but also affects the mental status of the population, including nurses. Nurses play a vital role in dealing with COVID-19 victims. Nurses’ infection control measures are affected by their knowledge, attitude, practice (KAP), and psychological responses towards COVID-19. Therefore, this study aimed to determine the knowledge, attitude, practice, and psychological response among nurses toward the COVID-19 outbreak in Northern Ethiopia. The hospital-based cross-sectional study design was employed. The data were collected from March to April 2020. Data were collected through a self-administered questionnaire. The data were entered into Epi-data manager version 4.2 and exported to SPSS 23 for analysis. Descriptive analysis was reported to describe the demographic, mean knowledge, attitude practice, and psychological response score of nurses. Results A total of 415 nurses participated in this study, resulting in a 100% response rate. Of the participants, 241 (58.1%) were female. Of the 415 nurses, 307 (74%), 278 (67%), 299 (72%), and 354 (85.3%) had good knowledge, good infection prevention practice, a favorable attitude, and disturbed psychological response towards COVID-19, respectively. The World Health Organization (WHO) declared that the COVID-19 outbreak was a public Hubei, China, first announced this at the end of December 2019 [2] [3] [4] . This virus has low 27 pathogenicity and high transmissibility capability [5] . According to the WHO, the outbreak of 28 coronavirus disease in 2019 has been a pandemic that infected more than 3 million 29 people at the time of writing this research paper and caused more than 200,000 deaths 30 worldwide [6] . In Africa, morbidity and mortality reached greater than 30,000 and 1200, 31 respectively. Of those, 122 morbidities and 3 deaths were from Ethiopia [6] . 32 Transmission of microbes among nurses is affected by hand disinfection, mask wearing , 33 overcrowding, lacks of single room for isolation and is enhanced by the fact that some nurses 34 have inadequate awareness of infection control practices [7] . Knowledge A self-administered structured questionnaire was used to collect the knowledge, attitude, 68 practice, and psychological response towards the COVID-19 outbreak. The questionnaire was 69 adopted from other published articles [10] [11] [12] [13] [14] [15] [16] , and further modification was done to fit the local 70 context and research objective. Two Bachlor of Science holder nurses were recruited for data 71 collection, and one Master of Science holder nurse was recruited as a supervisor. Overall, the 72 data collection process was coordinated and supervised by the principal investigator. The total knowledge score for the nurses varied between 0 (with no correct answer) and 18 (for 81 all correct answers), and a cut-off level of ≤9 was evaluated as poor knowledge, and >9 indicated 82 good knowledge [13] [14] [15] [16] [17] . The question regarding attitude was eleven (with a minimum score of 11 and a maximum score 85 of 55). The attitude score was based on a 5-point Likert scale, in which a score of 1 to 5 was 86 J o u r n a l P r e -p r o o f given from strongly disagree to strongly agree. A mean score >33 (answering for strongly agree 87 or agree) was carried out as a favorable attitude, and a score of 11 to 33 indicated an unfavorable 88 attitude (answering strongly disagree or dis-agree or neutral) [11, 13, 15, 16] . Practice to prevent COVID-19 90 The question regarding the practice was fourteen (with minimum score 14 and maximum score 91 70). The score of the practice was based on 5 points, in which a score of 1 to 5 was given from 92 never to always. A mean score >42 (answering for always or most of the time or sometimes) 93 was carried out as having good practice, and a score of ≤42 indicated a poor practice (answering 94 never or occasionally) [13, 15, 16] . Psychological response to COVID-19 96 The question regarding the psychological response was nine (with minimum score 9 and 97 maximum score 36). The psychological response score was based on 4 points, in which a score 98 of 1 to 4 was given from not disturbed at all to almost daily disturbance. A mean score >18 99 (answering for almost daily disturbance or disturbed for more than 7 days) was carried out as 100 having psychological disturbance, and a score of ≤18 indicated having no psychological 101 disturbance (answering not disturbed at all or for a few days disturbance) [16] . (Table 1) . J o u r n a l P r e -p r o o f 149 The nurses' attitude towards the COVID-19 measured eleven questions using five criteria and by 150 proving numerical value (1= Strong dis-agree, 2= Dis-agree, 3=Neutral, 4=Agree, and 5=Strong 151 agree) (Table 3) . The psychological response towards the COVID-19 was measured using nine questions using 153 four criteria and by proving numerical value (1=: Not disturbed at all, 2= for a few days 154 disturbance, 3= Disturbed for more than 7 days, 4= Almost daily disturbance) ( The datasets used and/or analyses during the current study are presented within the manuscript 218 and available from the corresponding author on reasonable request. Nurses had nearly three-fourths of good knowledge and favorable attitudes regarding COVID-195 19. More than two-thirds of the nurses had good infection prevention practices towards COVID-196 19. Nurses had an almost disturbed psychological response to COVID-19. The WHO and the 197 Ministry of Health still must provide more information for better control of the infectious The data presented in this study are self-reported and partly dependent on the participants' 201 honesty and recall ability; thus, they may be subject to recall bias Abbreviations 203 COVID-19: Corona Virus Disease in 2019, WHO: World Health Organization Written 208 consent was obtained from the respondents. Confidentiality was assured for all the information 209 provided, and no personal identifiers were used on the questionnaire Mental Health Strategies to Combat the Psychological Impact of COVID-230 19 Beyond Paranoia and Panic Coronavirus envelope protein: current knowledge. 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A questionnaire-based survey Coping responses of emergency physicians and nurses to the 278 2003 severe acute respiratory syndrome outbreak. Academic emergency medicine Community responses during the early phase of the COVID-19 epidemic in 281 risk perception, information exposure and preventive measures. medRxiv Authors thank all staff of Aksum University, College of Health Science and Comprehensive 227 Specialized Hospital, data collectors and supervisors who had a dedicated output. The authors declare that they have no competing interests.