Healthcare adjustments and concerns: a qualitative study exploring the perspectives of healthcare providers and administrative staff during the COVID-19 pandemic in Saudi Arabia.

Background: Healthcare systems have modified their strategies to manage their staff, supplies, and space to deal systematically with the COVID-19 pandemic. This research aimed to explore the nature of hospital adjustments and the concerns of healthcare providers and administrative staff working in Governmental and private hospitals throughout the Qassim Region of the Kingdom of Saudi Arabia (KSA) during the pandemic. Methods: A qualitative phenomenological study using semi-structured in-depth interviews were conducted with 75 purposively selected healthcare providers and administrative staff working at three main hospitals in the Qassim Region, KSA. The maximum variation sampling technique was utilized. Recruitment of participants was continued until data saturation was reached. All interviews were audiotaped, transcribed verbatim, and analyzed thematically. Results: Four core themes were identified in this paper: (1) changes in hospital policy and procedures, (2) workforce management, (3) the well-being of the workforce, and (4) apprehensions and expectations of the workforce. The participants showed satisfaction with timely administrative decisions and new policies during the COVID-19 pandemic. Furthermore, the psychological health of healthcare professionals was affected more than their physical state. Finally, the providers perceived the emergence of multiple concerns in the coming months. Conclusion: Although healthcare providers were initially overwhelmed, they gradually accepted new administrative policies. Numerous innovative interventions effectively reduced their physical workload and increased their productivity, but they remained significantly affected by a wide range of psychological disorders, with a high prevalence of obsessive-compulsive disorder. There were some concerns about the new SARS-CoV-2 variant, but the majority were optimistic.

Parents' Intentions and Associated Factors to Vaccinating Their Children Aged 12-17 Years with COVID-19 Vaccines: A Cross Sectional Study.

No available vaccine against COVID-19 had yet been proven for 12-17-year-olds in Egypt during the study period. This is the first study to assess Egyptian parents' intentions and associated factors in relation to vaccinating their children with COVID-19 vaccines. A cross-sectional study using a questionnaire was conducted between 17 October and 17 November 2021, via social media platforms. The target group was parents with children aged 12-17 years. Parents' intention to vaccinate their children and factors associated with vaccinating their children, reasons for not intending to vaccinate their children, and circumstances whereby the parents would change their mind were recorded. Among the 1458 parents recruited, 65.6% were planning to vaccinate their children. The main concerns were fear of the vaccine's side-effects (68.3%) and conspiracy theories (18%). The factors associated with parents' intention to vaccinate their children were mother's older age (40-49 years: aOR = 1.45, 95% CI = 1.05-1.99; ≥50 years: aOR = 2.09, 95% CI = 1.16-3.75), high family income (aOR = 1.99, 95% CI = 1.41-2.79), and children with a history of chronic conditions (aOR = 2.02, 95% CI = 1.25-3.25), while higher mother's education level was negatively associated (aOR = 0.41, 95% CI = 0.27, 0.64). A comprehensive health education program regarding vaccinating children with COVID-19 vaccines is highly recommended for parents, particularly for young and highly educated mothers, to enhance children vaccination rate when the vaccine becomes available.

The Concern of COVID-19 Vaccine Safety Is behind Its Low Uptake among Patients with Diabetes Mellitus in Sudan.

Diabetic patients are vulnerable to developing severe complications and have a higher risk of death due to COVID-19 infection. Vaccination remains the mainstay during the current situation to mitigate the risks related to COVID-19 infection. Therefore, the aim of the current study was to assess the vaccination status and the factors associated with COVID-19 vaccine uptake among patients with diabetes mellitus (DM) in Sudan. A hospital-based cross-sectional study was conducted from January to February 2022 at Gadarif Hospital in eastern Sudan. Information on sociodemographics, the contracting of COVID-19 during the pandemic, beliefs toward COVID-19 vaccinations, and barriers related to COVID-19 vaccinations was obtained through an interview questionnaire among adult (≥18 years) patients with DM. Bivariate and multinomial logistic regression analyses performed. A total of 568 diabetic patients were enrolled, with a mean (SD) age of 53.07 (12.69) years. The majority of the participants were female (67.6%), urban residents (63.4%), uneducated (60.6%) and employed (73.2%). There was a history of COVID-19 in 97.4% of participants, and 29.2% of them had hypertension along with DM. About 31% received the vaccine, out of which 17.9% received the first dose, 13.2% received the second dose, and 0.2% received the third dose. Multinomial logistic regression analysis showed a significant association between belief in the safety of the COVID-19 vaccine and having had two doses of it (adjusted Odds ratio = 20.42, p < 0.001). The prevalence of COVID-19 infection was high, while the rate of COVID-19 vaccination uptake was low and inadequate among the participants. Appropriate health education and targeted interventions toward awareness of safety concerns are highly recommended.

Face Mask Practice and Technique During the COVID-19 Pandemic: A Nonrepresentative Cross-Sectional Study in Sudan.

Background: The World Health Organization issued guidelines for face mask use in community settings during the current COVID-19 pandemic. However, data are limited on public compliance with those guidelines in Sudan. Therefore, this study assessed face mask-wearing practice and technique during the COVID-19 pandemic among residents of Sudan. Methods: A cross-sectional study was conducted from July to September 2021 among Sudanese aged ≥18 years. A web-based questionnaire was shared through different social media platforms. Personal characteristics, four knowledge-associated items, three attitude-associated items, one item concerning mask-wearing practice, and five items related to mask-wearing technique were determined. Univariate, bivariate, and multivariable analyses were performed using STATA v17. Results: The survey included 1059 participants (48% males, 52% females) from different regions of Sudan. The overall mean ± SD was 3 ± 0.73 for knowledge of COVID-19 transmission; 2.3 ± 0.71 for attitude toward wearing face masks; 0.38 ± 0.49 for the practice of wearing a face mask; and 4.17 ± 0.97 for face mask-wearing technique. Approximately one-third (38%) of participants always wore a face mask during the pandemic, with age, sex, education level, family income, face mask attitude, occupation, and history of COVID-19 infection affecting the practice. All steps of face mask-wearing technique were performed by 46% of participants (59% performed hand hygiene before putting on a mask and 86% after removing it; 98% covered mouth and nose; 90% adjusted masks at the nose bridge, and 84% tied masks securely), and associated with age, occupation, family income, history of COVID-19 infection, and face-mask attitude. Conclusion: Although knowledge and attitude were relatively good, the practice of wearing a face mask and using proper techniques among participants were low. To ensure optimal face mask use and proper mask-wearing techniques, educational intervention and establishing governmental regulations are highly recommended.

Sociodemographic and Behavioral Predictors of COVID-19 Vaccine Hesitancy in Pakistan.

BACKGROUND: The current coronavirus disease 2019 (COVID-19) pandemic continues with resurgent second and third waves worldwide. Vaccination is one of several measures that are needed to end this pervasive threat. Pakistan, however, has a relatively low rate of routine vaccine acceptance. Our study aimed to determine the proportion and predictors of COVID-19 vaccine hesitancy (VH) among adults in Pakistan. METHODS: An online cross-sectional study was conducted from December 27, 2020 to March 6, 2021. Non-probability sampling was applied to recruit study participants through social media platforms (ie, Facebook and Twitter) and through free messaging services (WhatsApp). Stata 16 was used to generate descriptive statistics and logistic regression models for identifying predictive variables of vaccine hesitancy. A p-value of <0.05 was considered strong evidence against the null hypothesis. RESULTS: Out of 1014 participants, 35.8% (n=363) were hesitant about receiving the COVID-19 vaccine. Reasons for VH included concerns about side effects (42.4%), belief in conspiracy theories (20.1%), perceived inefficacy of the vaccine (13.2%), and perceived protection through precautionary measures (12.6%). Urban residency (AOR 2.34, 95% CI 1.54-3.57), reservations about vaccine safety (AOR 3.29, 95% CI 1.68-6.44), uncertainty about vaccine efficacy (AOR 2.70, 95% CI 1.50-4.86), failure of the vaccine to reduce hospitalization and death (AOR 6.36, 95% CI 4.01-10.22), and unfelt need for vaccination awareness among public (AOR 2.02, 95% CI 1.28-3.14) were associated with higher rates of VH. At least one chronic disease (AOR 0.60, 95% CI 0.39-0.92), knowing someone infected with COVID-19 (AOR 0.56, 95% CI 0.39-0.81), and trusting information from the ministry of health (AOR 0.64, 95% CI 0.41-0.99) and physicians (AOR 0.27, 95% CI 0.13-0.53) were found to be associated with lower rates of COVID-19 VH. CONCLUSION: More than one third of survey participants were VH. COVID-19 vaccine uptake in Pakistan can be improved through targeted health education strategies and planned interventions that address the barriers identified in the present study.

Trends, Uptake, and Predictors of Influenza Vaccination Among Healthcare Practitioners During the COVID-19 Pandemic Flu Season (2020) and the Following Season (2021) in Saudi Arabia.

BACKGROUND: Healthcare practitioners (HCPs) are at high risk of influenza. Seasonal influenza vaccines can reduce influenza-associated morbidity in healthcare settings, but despite mandatory influenza vaccination in the Kingdom of Saudi Arabia, the vaccination uptake rate among HCPs is below expectations. This study investigated vaccination trends from 2017 to 2020 to identify factors affecting vaccination among HCPs during the COVID-19 pandemic flu and subsequent seasons. METHODS: Cross-sectional study among HCPs was conducted in January 2021. A structured questionnaire was shared via social media. Vaccine uptake predictors were identified using descriptive statistics and logistic regression models (p-value 0.05). RESULTS: A total of 424 HCPs (118 physicians and 306 nurses) completed the questionnaire. Vaccine uptake increased from 2017 to 2019 (45% to 52% to 62%) but fell (to 59%) during the 2020 COVID-19 pandemic flu season. Multivariable analysis indicated participants >40 years old (AOR 3.09, 95% CI 1.64-5.83), female (AOR 1.74, 95% CI 1.13-2.67), non-Saudi (AOR 2.62, 95% CI 1.72-4.01), nurses (AOR 2.70, 95% CI 1.75-4.17), and who possessed accurate knowledge of the flu vaccine efficacy duration (AOR 3.04, 95% CI 1.87-4.94) were more likely to have received the vaccine. However, 79% of HCPs declared their intention to be vaccinated in the 2021 flu season, with participants >40 years old, female (AOR 2.25, 95% CI 1.38-3.68), non-Saudi (AOR 3.79, 95% CI 2.34-6.16), or nurses (AOR 2.94, 95% CI 1.82-4.76) more likely to do so. CONCLUSION: Influenza vaccination uptake declined among HCPs during the 2020 flu season compared with the previous season but is expected to increase in the upcoming 2021 season. Nevertheless, the findings are encouraging and indicate increased willingness of HCPs to become vaccinated in the upcoming 2021 season, but coverage could be further increased by policymakers via a comprehensive plan focusing particularly on younger HCPs, Saudis, males, and physicians.

The impact of the COVID-19 pandemic on parents' behavior toward scheduled pediatric vaccinations in Saudi Arabia.

INTRODUCTION: Coronavirus disease (COVID-19) is caused by a newly discovered coronavirus and has resulted in a global pandemic. The World Health Organization recommended avoiding any delay or disruption of immunization services, as this could result in increases in outbreak-prone vaccine-preventable diseases. This study aimed to determine the impact of the COVID-19 pandemic on parents' behaviour towards their children's scheduled vaccinations. METHODOLOGY: This web-based cross-sectional study recruited 1,143 parents/guardians of children below six years of age living in Saudi Arabia between May 1 and May 30, 2020 via social media platforms. A self-developed online questionnaire consisting of eight items was used. Simple and multiple binary logistic regression was used to determine the factors associated with vaccine delay during the COVID-19 pandemic. RESULTS: The parents/guardians were aged 20-60 years; 82% were aged between 20 and 39 years. It was found that 26% of parents did not vaccinate their children on time according to the national immunization schedule in regular situations, and 38% of parents reported delaying vaccination due to the COVID-19 pandemic. The multiple logistic regression analysis found that having two or more children, living in Riyadh or the Western region or not vaccinating children during regular situations were associated with an increased risk of vaccine delay during the COVID-19 pandemic. CONCLUSIONS: Delaying children's vaccinations during the COVID-19 pandemic was influenced most by living in regions with high COVID-19 prevalence and having two or more children.

Handwashing knowledge, attitudes, and practices during the COVID-19 pandemic in Saudi Arabia: A non-representative cross-sectional study.

Handwashing (HW) with water and soap is one of the cheapest and most effective ways of protecting oneself and others against the coronavirus. Here, the HW knowledge, attitudes, and practices of Saudi adults were assessed during the COVID-19 pandemic using a cross-sectional study conducted between May 8 and June 8, 2020, during a partial lockdown period. A web-based validated questionnaire was distributed through different social media platforms, and the sociodemographic characteristics of the participants, seven items related to knowledge, four items related to attitudes, and thirteen items related to the practice of HW were assessed. A total of 1323 (51% male and 49% female) adults from all regions of Saudi Arabia responded to the questionnaire. The overall mean (± SD) was 5.13 (± 1.18) for knowledge of HW and COVID-19, 2.79 (± 0.77) for attitude toward HW, and 7.8 (± 2.56) for HW practice. A multiple linear regression analysis revealed factors associated with knowledge to be age and family income. Sex, educational level, family income, and HW knowledge were associated with negative and neutral attitude, whereas age, sex, family income, and HW knowledge were associated with practice. These results suggest that HW knowledge was strongly associated with positive attitudes toward HW and correct HW practice in Saudi adults during the COVID-19 lockdown.

High Mortality Rate in Adult COVID-19 Inpatients in Eastern Sudan: A Retrospective Study.

AIM: The current pandemic of coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory coronavirus syndrome 2 (SARS-CoV-2). It is a global public health concern that has resulted in the rapid growth in the number of infected patients with significant mortality rates. Hence, we conducted a retrospective study in Gadarif Hospital to evaluate the presenting manifestations, mortality rate, and the risk factors associated with mortality in hospitalized patients. METHODS: A retrospective study was conducted at Gadarif Hospital in Eastern Sudan. Medical files of the patients admitted during the period between April and July 2020 were reviewed. All the files of the adult patients (aged 18 or above), of both sexes, who had a confirmed COVID-19-positive status via laboratory testing using PCR and who were admitted during this period were reviewed. The data extracted included patients' demographics and initial clinical presentation, symptoms, signs, and the laboratory and radiographic findings. The data were analyzed using SPSS v22. RESULTS: Eighty-eight patients were admitted with COVID-19. The median (interquartile) age was 62 (55.00-70.00) years old, and 72 (81.8%) of them were males. Most patients (75%) experienced a one-week duration of symptoms. A fever (87.5%), cough (80.68%), and shortness of breath (77.27%) were the most common presenting symptoms. Following a clinical assessment, both the systolic and diastolic blood pressure were found to be normal in most patients, at 92.05% and 89.77%, respectively. An oxygen saturation of less than 90% was seen in 71.59% of patients. The general mortality rate was 37.5% and most deaths occurred during the first 24 h of admission (21/33 [63.64%]). There was no significant difference in the death rate between females and males (5/16 [31.3%] vs 28/72 [38.9%], P = 0.776). There was no significant difference in the body mass index, tobacco use, or education level between the patients who died and those who survived. A logistic regression showed that being older (AOR = 1.05, 95% CI = [1.01, 1.10]) and having a lower PO2 level (AOR = 1.11, 95% CI = [1.04, 1.16]) were associated with mortality. CONCLUSION: The general mortality rate was 37.5%, and the risk factors that could predict increased mortality in hospitalized COVID-19 positive cases included old age and a lower PO2 level.

The sudden transition to synchronized online learning during the COVID-19 pandemic in Saudi Arabia: a qualitative study exploring medical students' perspectives.

BACKGROUND: The closure of educational activities in the Kingdom of Saudi Arabia due to the ongoing COVID-19 pandemic resulted in an unplanned shift from traditional learning to a setup that exclusively involves digital teaching and learning. Within this context, the present study aimed to explore undergraduate medical students' perceptions regarding the effectiveness of synchronized online learning at Unaizah College of Medicine and Medical Sciences, Qassim University, Saudi Arabia. METHODS: A qualitative study was conducted using virtual focus group discussions synchronously with the help of a discussion guide consisting of seven open-ended questions. Overall, 60 medical students were recruited using a maximum variation sampling technique; these students then participated in eight focus group discussions. All interviews were recorded, transcribed verbatim, and analyzed for thematic contents using the standard (Mayring, Kiger. M. E. and Braun.V) content analysis framework. RESULTS: A thematic content analysis yielded four core themes: (1) educational impact, (2) time management, (3) challenges encountered, and (4) preferences for the future. The online modality was well-received, and all participants agreed that online sessions were time saving and that their performance was improved due to enhanced utility of time; however, they indicated that they encountered some challenges, including methodological, content perception, technical, and behavioral challenges during sessions and online exams. Most of the preclinical students preferred online learning for the upcoming academic years. CONCLUSION: Synchronized online classes were well-accepted by the medical students. This represents significant and promising potential for the future of medical education. The principles of the online learning model and learning outcomes should be rigorously and regularly evaluated to monitor its effectiveness.