The Impact of COVID-19 Pandemic on Patients Receiving Orthodontic Treatment.

OBJECTIVE: The coronavirus disease 2019 (COVID-19) pandemic impacted the provision of dental treatment in a timely manner including orthodontic treatment. The objective of this study was to assess challenges encountered by patients undergoing orthodontic treatment during the pandemic and their attitude toward managing these challenges. MATERIAL AND METHODS: A cross-sectional sample of orthodontic patients at Prince Rashid Hospital in the north of Jordan was recruited to participate in a self-administered questionnaire that included questions related to orthodontic problems encountered during the lockdown, ways to overcome these problems, and concerns about their treatment. RESULTS: A total of 120 patients participated, 40 males and 80 females. Most participants (n = 86) had a fixed orthodontic appliance, who reported various orthodontic problems (82%), but the most common problems reported were exposed wire endings and loosening of brackets. Likewise, the most commonly reported problem among those with removable appliances (n = 34) was a broken or loose appliance (60%). However, patients of both types of appliances ignored the problem and waited until the re-opening of dental offices. Further, most patients missed at least one appointment for different reasons and three-quarters of them (76.6%) did not communicate with their orthodontists during the lockdown. Patients expressed their disagreement with the closure of dental offices during the pandemic because of their concern of a prolonged waiting to receive another appointment. CONCLUSION: The COVID-19 pandemic had a significant impact on orthodontic care and the maintenance of appointments during the lockdown periods. Patients varied in ways they managed their orthodontic problems, including their commitment to communicate with the dentists or maintain their appointments. Hence, patients should be trained on how to manage the appliance problems when they need and encourage them to accept distant communication during the emergencies.

Water, Sanitation, and Hygiene and Infection Prevention and Control in Jordanian Hospitals in the Context of COVID-19: A National Assessment.

Purpose: To identify areas that need improvement in Jordanian health centers regarding infection prevention and control (IPC) programs; water, sanitation, and hygiene (WASH) services; and other protective measures, especially in the context of coronavirus disease (COVID-19). Methods: This is a national assessment study that comprised hospitals of different sectors in Jordan, including, Ministry of Health (MoH), private, and military hospitals. The study included 23 Jordanian hospitals. Assessment tools were developed and adapted mainly from the WASH Facility Improvement Tool (WASH FIT) and other tools. Hospitals were assessed to meet targets based on whether indicators were fully met, partially met, or not met. Results: The mean percentage of the 150 indicators that met the standards was 83.2% (72.6% for MoH, 84.5% for private, and 90.4% for military hospitals). The percentage of indicators, both WASH/IPC and training and education indicators, that met the targets were higher in military hospitals than in MoH and private hospitals. However, in context of COVID-19, only 64.7% of indicators related to precautionary measures were met by all hospitals. Conclusion: The data available on WASH/IPC in Jordan are scarce, and the study findings will help in preventing severe consequences of the COVID-19 pandemic. There is scope for improvement in many WASH/IPC aspects, and urgent actions should be taken, especially to fill the gaps in COVID-19 precautionary measures.

Face-to-face versus distance learning of basic suturing skills in novice learners: a quantitative prospective randomized trial.

BACKGROUND AND AIM: Traditionally, practical skills are taught on face-to-face (F-F) basis. COVID-19 pandemic brought distance learning (DL) to the spotlight because of the social distancing mandates. We sought to determine the acceptability and effectiveness of DL of basic suturing in novice learners. METHODS: A prospective randomized controlled trial involving 118 students was conducted. Participants were randomized into two groups for learning simple interrupted suturing: F-F and DL-groups. Evaluation was conducted by two assessors using a performance checklist and a global rating tool. Agreement between the assessors was calculated, and performance scores of the participants were compared. Participants' satisfaction was assessed via a questionnaire. RESULTS: Fifty-nine students were randomized to the F-F group and 59 to the DL-group. Satisfactory agreement between the assessors was demonstrated. All participants were successful in placing three interrupted sutures, with no significant difference in the performance between the groups. 25(44.6%) of the respondents in the DL-group provided negative comments related to the difficulties of remotely learning visuospatial concepts, 16(28.5%) preferred the F-F approach. CONCLUSION: DL of basic suturing is as effective as the F-F approach in novice learners. It is acceptable by the students despite the challenges related to the remote learning of practical skills.

Perceptions of primary healthcare physicians in Jordan of their role in the COVID-19 pandemic: A cross-sectional study.

BACKGROUND: Following the remarkable spread of coronavirus disease 2019 (COVID-19), worldwide, it quickly became apparent that many public health systems worldwide were not prepared to manage such a pandemic. We aimed to assess the perceptions of primary care physicians (PCPs) in Jordan towards their role during COVID-19. METHODS: A cross-sectional study using a self-administered questionnaire was performed. The study participants included PCPs from the Ministry of Health, academic institutions, and the private sector in Jordan. RESULTS: A total of 221 PCPs participated in the study. Most participants reported not having received any training on infection control (59.7%) or COVID-19 (81%). More than half PCPs (53.4%) felt positive about the way patients received and/or complied with their instructions. More than half PCPs (55.7%) educated their patients on protective measures against COVID-19 infection and considered this as part of their role and responsibility. Over 80% of the participants would apply social distancing, hand sanitation, facial masks, and patient education, but only half (51.1%) reported planning to order COVID-19 test kits. CONCLUSIONS: PCPs had a positive attitude towards controlling COVID-19 infection and showed a willingness to educate patients on how to protect themselves. However, PCPs should be provided special training on COVID-19.

The psychosocial and clinical concerns of physicians treating patients with COVID-19.

OBJECTIVES: This study aims to assess the psychosocial and clinical issues affecting physicians who have been directly involved in treating patients with novel coronavirus (COVID-19). METHODS: We recruited physicians from four hospitals in Jordan. A structured 20-item, self-administered survey was used to gather data. Descriptive statistics were employed to represent the numbers and percentages of the participants' responses to the survey items. Multivariate logistic regression was used to examine the relationship between the participants' traits and items related to the level of fear, the quality of care provided to patients, and social distancing among family members. RESULTS: A total of 135 physicians participated; 65.9% were men. More than half reported moderate to high levels of fear (55.5%). The majority (71.1%) were moderately to highly concerned about becoming infected with COVID-19 from the patients they treated. Most physicians practiced adequate social distancing. While most of them thought that COVID-19 patients received a high quality of care, they generally perceived a shortage of specialised physicians and personal protective equipment (PPE). The ratings for the quality of care and social distancing practices were significantly associated with the presence or absence of training related to COVID-19. CONCLUSIONS: The degree of fear and concerns about COVID-19's impact on physicians and their families was high. There were also concerns about the long-term consequences of COVID-19 on medical services.

Perceptions of obstetricians and pediatricians about the risk of COVID-19 for pregnant women and newborns.

OBJECTIVE: To assess the perception of obstetricians and pediatricians about risks of COVID-19 to pregnant women and possible complications in newborns. METHODS: A structured 27-item online survey was sent via social media messaging to obstetricians and pediatricians from public, academic, and private sectors in Jordan between March 23-30, 2020. Descriptive statistics were used to represent numbers and percentages of participants' responses to survey items. RESULTS: A total of 147 physicians participated (107 obstetricians, 40 pediatricians). Participants were well informed about the symptoms, diagnosis, modes of transmission, and methods of prevention. Participants had variable perceptions about COVID-19 risk during pregnancy, including potential vertical transmission, preferred route of delivery, and safety of breastfeeding. Most participants felt that pregnant women should be prioritized for testing and medical care provision. CONCLUSION: While evidence-based strategies to reduce the risks of COVID-19 in pregnant women and newborns are evolving, healthcare providers showed excellent knowledge of the infection and were vigilant regarding its complications for mothers and newborns. To ensure safe pregnancy, physicians must keep informed of developing guidance on best and safest prenatal and perinatal health services. Implementing local hospital policies and adequate training in infection control measures is strongly encouraged.

Dentists' Awareness, Perception, and Attitude Regarding COVID-19 and Infection Control: Cross-Sectional Study Among Jordanian Dentists.

BACKGROUND: Despite the availability of prevention guidelines and recommendations on infection control, many dental practices lack the minimum requirements for infection control. OBJECTIVE: This study aimed to assess the level of awareness, perception, and attitude regarding the coronavirus disease (COVID-19) and infection control among Jordanian dentists. METHODS: The study population consisted of dentists who worked in private clinics, hospitals, and health centers in Jordan. An online questionnaire was sent to a sample of Jordanian dentists in March 2020. The questionnaire was comprised of a series of questions about dentists' demographic characteristics; their awareness of the incubation period, the symptoms of the disease, mode of transmission of COVID-19 and infection control measures for preventing COVID-19; and their attitude toward treating patients with COVID-19. RESULTS: This study included a total of 368 dentists aged 22-73 years (mean 32.9 years, SD 10.6 years). A total of 112 (30.4%) dentists had completed a master or residency program in dentistry, 195 (53.0%) had received training in infection control in dentistry, and 28 (7.6%) had attended training or lectures regarding COVID-19. A total of 133 (36.1%) dentists reported that the incubation period is 1-14 days. The majority of dentists were aware of COVID-19 symptoms and ways of identifying patients at risk of having COVID-19, were able to correctly report known modes of transmission, and were aware of measures for preventing COVID-19 transmission in dental clinics. A total of 275 (74.7%) believed that it was necessary to ask patients to sit far from each other, wear masks while in the waiting room, and wash hands before getting in the dental chair to decrease disease transmission. CONCLUSIONS: Jordanian dentists were aware of COVID-19 symptoms, mode of transmission, and infection controls and measures in dental clinics. However, dentists had limited comprehension of the extra precautionary measures that protect the dental staff and other patients from COVID-19. National and international guidelines should be sent by the regional and national dental associations to all registered dentists during a crisis, including the COVID-19 pandemic, to make sure that dentists are well informed and aware of best practices and recommended disease management approaches.