ABSTRACT

Coronavirus Disease 2019, known as covid19 is an extremely expanding pandemic caused by a

novel human coronavirus, severe acute respiratory syndrome corona virus (Sarscov-2). Covid19
has impacted and changed lives on a global scale since its emergence and spread from China in
the late 2019.It has caused millions of infections and thousands of deaths worldwide. However,
the control of this pandemic still remains unachievable in many African countries including
Nigeria. Health care workers are at the front-line defense against the coronavirus disease
2019(covid19) pandemic. Inadequate knowledge and incorrect attitude and practice among
midwives can directly influence control and lead to delayed diagnosis, poor infection control
practice, and spread of disease. The study was carried out to assess the knowledge, attitude and
practice of corona virus disease infection control among midwives at Plateau Specialist
Hospital, Jos Plateau state A descriptive cross-sectional study was conducted in Plateau
Specialist Hospital among 134 health care workers using a self - administered questionnaire.
Participants demography, knowledge, attitude, and practice were obtained using a convenience
sampling technique. Data collected was subjected to logistics regression and the survey found
that the majority of Hcw's have good knowledge (99.3%), A positive attitude (60.8%) towards
covid19. Of note, 99.5 % (n=130) of HCWs used social media as their main source of
information, followed by radio and television. A positive correlation test revealed significant
positive linear correlation (R=028, P=0.050). It was discovered that HCWs in Plateau
Specialist Hospital have a sound knowledge attitude and practice towards coronavirus disease.
 CHAPTER ONE

INTRODUCTION

BACKGROUND OF THE STUDY

According to the world health organization (WHO), the outbreak of corona virus disease

2019 or (covid19) has become a global pandemic. As at a time of writing this publication was

released by WHO, (WHO, August 2021, corona virus has affected over 200,353,706 people and

caused 4,260,635 deaths, With 180,600,447 recoveries worldwide. It has affected over 570,000

health care workers (HCW's) and caused over 2, 5000 deaths among midwives worldwide. It is a

fact that health care workers are at a risk of infection in the epidemic chain; it is a critical issue

because HCW's helps in controlling the outbreak. Therefore, all possible actions must be taken to

control the spread of the infection and then by taking appropriate measures to reduce the risk.

Health related infections are the major problem of public health in many nations of the world,

which ultimately causes an increase in the mortality rate and morbidity rate and additional cost in

health care setting (Mauldin et al 2010; Defez et al, 2008 and Liata et al ,2009). Ensuring hand

hygiene is therefore one of the basic means of preventing the spread of such infections. In 1983,

Semmelweis highlighted that cleansing of contaminated hands with antiseptic products before

and after contact with patients may reduce health related infections. (Semmelweis 1. 1988).

Therefore, center for disease control and prevention published the first formal guidelines of hand

washing practice in hospitals (Garneer J, Favero M.S 1986), followed by guidelines from the

associations of professional in infection control and epidemiology (Apic) (Larson et al 1995).

Corona viruses are common virus that most people get sometimes in their lives and many also

affect animals. Human corona viruses (HCOV) which has been globally trending for over a
period of time now, usually causes upper respiratory tract illness. Several acute respiratory

syndromes (SARS-COV) that occurred back in 2003 served as a remainder to this newly

emerging zoonotic corona viruses which has the potential to transmit from person to person and

to cause severally human illness. Novel corona virus (nCOV) is a particular strain different from

any other known hCov with a possibility of zoonotic transmission. However, center for disease

control and prevention (2004) revealed that investigation was carried out to figure the reservoir

and source of infection, route of transmission to human, symptoms, prevention, severity and

clinical effect with gradual increase in numbers of reported cases on daily basis.

There has been a rapid intentional response following the news of this new virus from Wuhan

in, China on the 1st of December 2019 which has now spread to every nook and cranny of the

world. An interim case definition was developed rapidly by WHO to ensure that a systematic

approach is followed for appropriate identification and investigations of suspected cases. The

body has also made arrangement for disturbing huge amount of money for the prevention and

cure of these pandemic disease now known as Covid19 to the high risk affected nations of the

world

STATEMENT OF THE PROBLEM

As complied by JOHNS HOPKINS from WHO (1-point 3acres, worldometer.info). over 10,000

health workers in Africa are infected with covid19(Brazzaville et al 23 July 2020). So far, a sign

of the challenges medical staff on the front line of the outbreak face. The growth of covid19

cases in Africa is placing an even greater strain on health services across the continent (Dr

Matshidiso moeti et al 2020)" this have very real consequences for the individuals who works for

them, and there is no more sobering example of this than rising numbers of health workers

infection.
So far, about 10% of all cases globally are among health workers, though there is a wide range

between individual countries. In Africa, information on health workers infection is still limited,

but preliminary data from (WHO) finds that health workers make up more than 5% of cases in

14 countries in sub- Saharan Africa alone and in four of these, health workers make up more than

10% infection cases. In Nigeria there are over 812 health workers infected, they are not just

figures, 29 of these workers works for NCDC, (Chikwe Ihekweagu et al 2020). Director General

of NCDC. Inadequate access to personal protective equipment or weak infection prevention and

control measures raises the risk of health workers infection. Surging global demand for PPE as

well as global restrictions on travels have triggered supply shortages, health workers can also be

exposed to patients who do not show signs of the disease and are in the health facilities for a

range of other services.

The effect of covid19 pandemic outbreak to the economics of the world will surely be discussed

in its aftermath. The initial response in China to contain the virus has been applauded by WHO

and considered much improved compared with its response to the 2003 SARS-Cov epidemic.

Intentionally, we have seen rapid generation and sharing of knowledge to the benefit of the

outbreak response, but also counterproductive action by some countries, including limiting trade

and shutting of boarders to its detriment with the increasing frequency of zoonotic spill overs

leading to human infection and transmission.it is apparent that pandemic preparedness and

awareness has become a priority for the global health agenda. It is on this claim that this study

aims to examine the knowledge, attitude, and practice of corona virus disease infection control

among midwives by using health workers in Plateau state specialist hospital as a case study.
OBJECTIVE OF THE STUDY

The objective of this study is to examine the knowledge, attitude, and practice of corona virus

disease infection control among midwives by using Plateau Specialist Hospital as a case study.

The specific objective is

1. To identify the preventive measures practiced by midwives in Plateau Specialist Hospital.

2. To establish the symptoms of covid19 and the steps to take when these symptoms occur.

3. To understand the attitude, knowledge, and practice of midwives in Plateau Specialist

Hospital.

4. To study the effect of covid19 on the economic status of the world.

SIGNIFICANCES OF THE STUDY

Theoretically, this study stands to provide additional knowledge to the body of exiting literatures

on the spread of this pandemic disease to the world and of particular reference to Nigeria. The

result of this study will serve as good basis or guide for future reference, and it also encourage

further research on the importance of staying healthy. Furthermore, this study will provide

relevant information on how the disease was spread from China to the rest of the world at large.

Practically, the findings of this study will reveal the reasons for regular health checkup for the

benefit of staying healthy at all times. The result from this research will help midwives to design

relevant persuasive health messages that will help change the people’s attitude on the utilizations

of hospital and to create more awareness on the situation of health care services in the country.

This study will be of great significance to the medical professionals who have defaulted in

carrying out their duties to their patients.

RESEARCH QUESTIONS

The following question were generated during the course of the study.

1. What are the attitude, knowledge, and practice of midwives in Plateau Specialist Hospital

to the general public towards the control of covid19 in Plateau State?

2. What are the symptoms of covid19 and the steps to take when these symptoms occur?

3. What are the strategies used by midwives in Plateau State to control the general spread of

covid19?

SCOPE OF THE STUDY

This study focuses mainly on the knowledge, attitude and practice of corona virus disease

infection control among midwives in Plateau Specialist Hospital. It will, therefore, be carried out

among midwives in Plateau Specialist Hospital.

LIMITATION OF THE STUDY

The time frame was not enough for the researcher to delve into the issue as comprehensively as

would have been desired. This also informed the decision to focuses on one department so the

time would be invested in identifying and evaluating all possible aspects of the study as

comprehensive as possible. The use of a case Study arguably has many limitations; however, it

allows for a level of research that was commensurate with the nature of result expected.

OPERATIONAL DEFINITION

The following definitions are essential in gaining understanding during the course of the study
 Knowledge: Facts, information and skills acquired through experience or education; the

theoretical or practical understanding of a subject.

 Attitude: a settled way of thinking or feeling about something

 Covid19: corona virus disease 2019 (covid19) is defined as illness caused by a novel

corona virus now called severe acute respiratory syndrome coronavirus 2 (SARS- COV-

2; formerly called 2019-nCoV), which was first identified as an outbreak of respiratory

illness cases in Wuhan city, Hubei Province China.

 Practice: is refers to the act of continually doing something in order to get better at it. An

example of practice is to make a habit of something.

 An infection: is the invasion of an organism's body tissues by disease-causing agents,

their multiplication, and the reaction of host tissues to the infectious agents and the toxins

they produce. An infectious disease, also known as a transmissible disease or

communicable disease, is an illness resulting from an infection.

 Disease: is an “illness or sickness characterized by specific signs or symptoms.”

 A midwife: are health professional trained to support and care for women during

pregnancy, labor, childbirth, and puerperium.

 CHAPTER TWO

LITERATURE REVIEW

This chapter deal with review of related literature on the research topic, the literature will be

reviewed under the following headings: conceptual Review, theoretical review & Empirical

study (empirical review of related literature)

CONCEPTUAL REVIEW

Source: most of the sources on conceptual Review was gotten through electronical means

through medRxiv preprint doi http:/doing.Org/10.1101/2020.04.13.20063198. This version was

posted on April 17, 2020.

KNOWLEDGE ON COVID19

Corona virus is a large and diverse group of viruses that are rather common throughout the

community. Historically evidence has shown that the virus is transmitted through birds and

mammals, with human being particularly vulnerable to infection and transmission of the virus.

Data from published epidemiology and virology studies (April 2,2020) provide evidence that

covid19 is primarily transmitted from symptomatic people to others who are in close contact

through respiratory droplets by direct contact with infected persons or by contact with

contaminated object and surfaces, covid19 have an incubation period of 2-14days. The of corona

virus such as severe acute respiratory syndrome corona virus (SARS-COV) and middle east

respiratory syndrome corona virus (MERS-COV) in 2003 and 2015, shows similarities to the

novel corona virus, which was first reported in December 2019, and is currently a disease in

question resulting in the worldwide coronavirus disease-2019 outbreak.

It was first reported by Chinese's authority in Wuhan city, the capital of Hubei province in China

at the end of December 2019. The infection began to spread rapidly throughout many countries

including Nigeria, the world health organization (WHO) declared that covid19 infection was a

public health emergency of international concern. The WHO data was updated May 2020, there

were 4,753,643 confirm cases and 313,889 deaths worldwide. In Nigeria (Lagos) the first case

originated from an Italian man on the 27 February who work in Nigeria had returned on 25th

February from Milan, Italy as reported by NCDC. As at (July 2020) there is still increasing cases

of covid19 infection, the 2403 cases in Plateau State (NCDC, July-August 2021) were mainly

travelers and students returning from Lagos, Kaduna and Abuja which are the epicenter of

covid19 in Nigeria. Till date there is no antiviral treatment that has been explicitly

recommended, in September 2020, The World Health Organization (WHO) today listed the

Comirnaty COVID-19 mRNA vaccine for emergency use, making the Pfizer/BioNTech vaccine

the first to receive emergency validation from WHO since the outbreak began. The elderly

patient who suffered with chronic medical conditions like diabetes and cardiovascular disease are

more likely to get severe infection. The main manifestation of covid19 are fever, dry cough

dyspan, myalgia, hypoglycemia, and radiographic evidence of pneumonia. Complications (e.g.,

acute respiratory distress syndrome {ARDS}, arrhythmia, shock, acute cardiac injury, secondary

infection, acute kidney injury) and death may occur in severe cases. Therefore, applying

preventive measures to control covid19 infection is the most critical intervention. Midwives are

the primary sector in contact with patient and are an important source of exposure to infected

cases in health care setting; Thus, midwives are expected to be at high risk of infection.

Literature suggests that lack of knowledge and practice among midwives lead to delayed

diagnosis, spread disease and poor infection practices.

As at (12 March 2020), WHO officially declared covid19 a pandemic. Data has showed that

many of those most at risk are those with commodities caused by four major NCD's and smokers

are more likely to developed and die from covid19.

NCDC (August 4, 2020) confirm 8,626 active cases in Nigeria, with 1120 health workers

infected. The emergence of this infectious disease has caused much anxiety within Plateau State

and the wide population across Nigeria due to the increasing number of suspected cases and the

virus unpredictable future. In addition to knowledge level, some risk factors including work

experience and job category influence midwives’ attitude and practice concerning covid19.

Measure must be taken to protect midwives from risk linked to job category, work experience,

working hours, educational attainment and frontline HCW's.

RISK FACTORS FOR TRANSMISSION OF COVID-19 AMONG HEALTH CARE

WORKERS

SARS – CoV.2 spread through respiratory droplet when a person coughs, sneeze or speaks. It

can also spread when one touches a surface on which these respiratory droplets have landed on.

Some evidence indicates that it may be possible for SARS-CoV to spread through feces though

the research on this is limited. Risks for transmission includes:

 Going out of the isolation room without proper disposal of Personal Protective

Equipment (PPE)

 Poor aseptic technique which leaves the environment of the isolation room contaminated

such surfaces include tabletops, counters, doorknobs, and bathroom fixtures.

  Inadequate hand hygiene practices by HCW’s. Hand washing is a single and most

effective way of protecting self and minimizing the spread of infection, although it is

commonly overlooked at most times.

 Inadequate knowledge, attitude, perception of the virus increases risk of transmitting the

virus to people or to surfaces (touching of eyes, mouth, and nose)

FACTORS INFLUENCING ATTITUDE AND PERCEPTION OF HEALTH CARE

WORKERS TOWARD THE PREVENTION OF COVID-19

 Good referral system between primary levels of health care to other level of health care.

So that the most at risk can access lifesaving care.

 Shared knowledge, development and distribution of new diagnostic drugs and vaccines.

 Use of respirators, or face mask gown and eye protection. Patients are also provided with

facemask and educate on how to use them.

 Prioritizing airborne infection isolation for these patients who requires aerosol generating

procedure.

THEORETICAL REVIEW:

The theoretical framework underpinning this study is the “health belief model theory”

for understanding the knowledge, attitude, and perception of health workers towards the

prevention and transmission of Covid-19. Health belief model (HBM) is a theoretical model

constructed based on psychological and social theory. HBM is used in behavioral research to

understand the health behavior of individuals. The HVM is used in behavioral research to

understand the health behavior of individuals. The HBM attempt to explain to explain and

predict behavioral outcomes based on the two main aspect: the desire to avoid a health threat
(i.e., infection/illness) and the perception of the effectiveness of the behavior adopted to

counteract that threat. The perception of threat is composed of an individual’s perceived

susceptibility and perceived severity to specific illness, the effectiveness of a specific health

behavior is dependent on the interaction between the perceived benefit of the behavior and

perceived barrier to taking actions to mitigate threat or illness. In addition, cues to action are

prompted to event that trigger the behavior of interest, cues to action can be divided into internal

(e.g., physical symptoms) or external (e.g., mass media, reminder, advice) trigger.

Lastly, health motivates (or self-efficiency), explain how predisposed an individual is to

respond to cues for actions based on the value of their health. The HBM has been adopted as an

explanatory model on how the knowledge of Covid-19 have influence the attitude and perception

of HCW’s towards the prevention and transmission of Covid-19 (JMIR PUBLICATIONS,

2020).

Sonia Muktar et al in terms of perceived stress, stress appraisal and coping strategies for

the general public and medical staff during Covid-19. Prevent remains the main stay in the

treatment, containment and controlling of Covid-19 pandemic in Nigeria. Anyone suspected or

infected of Covid-19 either practice self-isolation and social distancing at home or admit to

health care facility with infrastructure to handle Covid-19. Health problem and emotional

distress in self-solation and quarantine individuals (Kelvin and Rubino, 2020). Besides, health

care workers continuous work in isolated units of hospital Covid-19 experience confinement

phenomena causing collective hysteria (Montemurro, 2020, Kang et al, 2020).

The victimization of vicarious traumatization could be significantly higher in general

public and non-front line medical workers (Li et al, 2020) because Nigeria 24/7 active news

channels are inducing the update around the World regarding Covid-19 pandemic outbreak – as
 compared to front line workers who are trained with the empirical immediate knowledge about

the transmission and prevention control of Covid-19. There is anxiety of feeling sick or fear to

death that could be amplify as sense of helplessness (nothing can be done conviction and

inability to mobilize effect), hopelessness (the feeling that any effort for constructive change is

not worthwhile) exhaustion and burnout (continuous stressors psychological stain hamper coping

mechanisms over long-term) and nervous anticipation (what may yet to come), negative

emotions, work-life balance, and personal life stressor’s further comprise physical, mental and

emotional well which requires resilience (interactive and dynamic process of adjusting, dealing

and adopting to adversity by cultivating a sense of empowerment and belongingness and

nurturing mindfulness).

EXTERNAL VARIABLES
Demographic variables Threat (motivation)
Age, sex, occupation, Perceived susceptibility
socioeconomic status, religion,
education
Personality traits
Perceived severity

Extraversion
Agreeableness Health motivation Behaviour
Conscientiousness
Neuroticism Response effectiveness
Openness Perceived benefits
Other psychological factors Cues to action
Peer pressure
Perceived barriers
Self-efficacy

HEALTH BELIEF MODEL THEORY

 The community and HCW’s should be equipped with precise knowledge and tools to

effectively address and cope with impact of Covid-19. Evidence – based model like health belief

model (HBM) can explain and predict health – related behaviors with the regards of medication

of patient – up – taking health services to mitigate threat to health (champion and skinner, 2008).

Applying HBM to Covid-19 in mitigating behaviors which provides anxiety and fear and convert

individuals beliefs informed by preconceived impression of a perceived threat and direct cues of

perceived benefit from perceived barriers to action inform behavior (through perceived self-

efficiency, perceived susceptibility, perceived severity and perceived threat modify behavior in a

way that an individual is more likely to take healthy outcomes serous, if perceived threat is

greater). As the perceived threat will be bigger if the perceived severity is bigger. If the

perceived susceptibility is bigger thus an individual experience adverse outcomes perceived

benefit adherence with quarantine by spending time with family members, or quality time spent

along to cultivate desiring hobbies or habit. Exploring way to mitigate or eliminate perceived

barrier help individual, personal, cultural, financial, and vocational barriers. Perceived efficiency

is about preventive behaviors by reinforcing positive steps and the belief that one has the ability

that one has the ability to overcome a given situation. Effective mitigation of disease and Covid-

19 mitigation behavior require significant efforts to strengthen belief about the disease which

include severity and susceptibility of threat, eliminate barrier to act and reinforce self –

efficiency beliefs. Empirical findings are salient features at this state regarding health risk and

perceived threat, reiterating mental health concern predispose to fixation on the unempirical view

and encouraging lifestyle medication and motivate behavior change help stress appraisal and

coping strategies. (Article information: Brain Behave Immune, 2020, April 10).

EMPIRICAL REVIEW
 SSRN Electronic Journal (April 2020) Amidst the current pandemic, WHO has issued

several guidelines and also started online courses and training sessions to raise awareness and

preparedness regarding the prevention and control and control of Covid-19 among HCW’s. In

addition to WHO, National Institute of Health (NIH) have established recommendations for

health workers to reduce occupational spread of infection among HCW’s. Although educational

campaigns have increased their awareness regarding Covid-19 yet it remains unclear to what

extent this knowledge can be put into practice to actually reduce Covid-19 infection. Currently

there is scarce information regarding the awareness level of HCW in Plateau State.

Beyond the tragic health hazard, the human consequences of the Covid-19 pandemic, the

economic uncertainties and disruptions that have resulted came at a significant cost to the global

economic, the pandemic is far more than a health crisis; it is affecting societies and economics at

their core. While the impact of the impact of the pandemic will vary from country to country, it

will most likely increase poverty and inequalities at a global scale, making achievement of SDGs

even more urgent. Most central banks, finance ministries and independent economy expert

around the world have taken solace in the prediction that the impact might be sharp but short-

lived and economic activities would return to normal thereafter. UN Covid-19 response et al

(led by WHO and the Global Humanitarian response plan).

The slow-down in the global economy and lockdown in some countries such as Italy,

USA, and Nigeria as a result of Covid-19 has also taken its toll on the global demand for oil. The

virus is also taking its toll on health facilities and infrastructures across the globe. USA is

currently the largest affected country with death rate surpassing Italy and China. The virus has

pushed the country national health service to a breaking point emphasizing the test that other

countries, especially developing countries like Nigeria. The decision to close educational
institutions and schools around the globe in an attempt to contain the pandemic has also led to a

soaring number of children youth and adult not attending schools. According to UNESCO

monitoring report on Covid-19 educational disruption and response. The emergence of Covid-19

and its increasing incidence in Nigeria has called for drastic measures such as ban on interstate

travel, limited trading and lockdown imposed on Plateau State by the state governor has been

lifted while its people adhere strictly to guidelines on preventive measures.

Peterson K Ozile et al. the cutting down on expenditure in Nigeria has led to

unemployment, according to Bureau of Statistic (NBS) ranks Nigeria 21 st among 181 countries

with an unemployment rate of 23.1%. Nigeria is now facing U.S dollar shortage due to the oil

price crash and is expected to devalue its currency by 10% by the end of June.

Without urgent socio-economic responses, global suffering will escalate, jeopardizing

lives and livelihoods for years to come. Immediate development responses in this crisis must be

undertaken with an eye to the future. Development trajectory in the long-term will be affected by

the choices countries make now and the support they receive. The government in Nigeria

responded to the crisis by providing financial assistance to businesses, not to households that

were affected by the outbreak. The monetary authority adopted accommodative monetary

policies and offered a targeted 3.5 trillion loan support to some sectors. Tis effort should have

prevented the economic crisis from occurring, but it did not. Economic agent refused to engage

in economic activities for fear of Covid-19 disease that was spreading fast.

PREVENTIVE MEASURES PRACTICED BY HEALTH CARE WORKERS IN

PLATEAU STATE SPECIALIST HOSPITAL

Source: According to WHO (2020).

 Health care workers have set up campaigns to educate het public on practices that

promote good hygiene such as washing of hands, social distancing should be adhere,

discouraging large gatherings of more than 50%, and encouraging employers to protect

the jobs of employees who requires quarantined treatment. Campaigns should not elicit

the help of religious and civil society leaders, for maximum effect to set up portable sinks

throughout public areas to encourage hand washing and to provide good examples on

how some of these measures can be undertaking.

 Government health workers/specialists are working in collaborations with WHO and

other partners to ensure that hospitals and clinic have adequately trained personnel and

enough capacity for testing those with the virus.

 Health workers follows established occupational safety and health procedures, in order to

avoid exposing others to health and safety.

 Healthcare workers use provides protocols to assess, triage and treat those patients

infected with Covid-19.

 Health workers to report to their immediate superior any situation which they have

reasonable justification to believe present an imminent and serious danger to life or

health.

 Health workers should self-monitor for signs of Covid-19 and self-isolate or report illness

to managers, if it occurs.

 Health workers should put on, use, take off and dispose off personal protective equipment

(PPE) properly.

 Health workers should advise management if they are experiencing signs of undue stress

or mental health challenges that require support intervention.

  Health care workers should swiftly follow establish public health reporting procedures of

suspected and confirmed cases of Covid-19.

SIGNS AND SYMPTOMS OF COVID-19

Mayo clinic et al (August 07, 2020). The SARS-Cov-2 virus causes Covid-19. This disease

primarily causes symptoms that affect the lungs and airways passage. The symptoms of Covid-

19 resemble those of common cold/flu. The WHO listed the most common Covid-19 symptoms

as: dry cough, fever, shortness of breath other symptoms such as sore throat, headache, diarrhea,

muscle pain. A study by (Susan perry April 2020) also found out that many people who have

Covid-19 experience a temporary loss of taste and smell.

The symptoms of Covid-19 typically appear within 22 – 14 days of contracting SARS-CV-2.

However, some people remain asymptomatic, the research indicates that 80% of people develop

mild-moderate symptoms, while 13.8% develop very severe symptoms requiring intensive care.

STEPS TO TAKE WHEN SYMPTOMS OCCURS

 SELF ISOLATION: means staying at home and staying away from other family

members to avoid spreading the virus. Persons infected should remain in one room and

use a separate bathroom.

 SEEK MEDICAL HELP: contact NCDC to report those symptoms and seek for further

advice. Huang, et al (2020).

 PRACTICAL SELF-CARE: at present there is no specific treatment for Covid-19.

However, the following home self-care helps to elevate symptoms such as:

 Drinking plenty of fluid to stay hydrated

 Eating healthful diet to help the body fight the infection

  Getting plenty rest to aid recovery

 Using acetaminophen to lower a fever/ache (Caring for the sick at home, 2020).

CHAPTER THREE

RESEARCH DESIGN

This is a non- experimental single variable research which is aimed at finding the knowledge,

attitude, and practice of corona virus disease infection control among midwives in Plateau state

specialist hospital.

RESEARCH SETTING...................

TARGET POPULATION

The target population for the study was total number of health care workers which comprises of

doctors, nurses, pharmacist, laboratory technicians and scientists, within the age limit of 20-

55years. With various levels of qualification, working in Plateau Specialist Hospital both male

and female with a population of 134 HCWs in the hospital who voluntary to participate.

SAMPLE SIZE

Formula for the cross-sectional study. Using Taro- Yamane's formula to calculate the sample size

N
n= 2
1+ N (e)
Where n = sample size
e = error term (0.05)
N = target population (134)
 134
n= 2
1+ 134(0.05)
134
n=
1+ 134 x 0.00250
134
n=
1+ 0.335
134
n=
1.34
n = 100

SAMPLE TECHNIQUE

The sample was 134 subjects, using systematic random sampling technique. I.e., the subject is

chosen at random from specialties.

INSTRUMENT FOR DATA COLLECTION

A self-structured questionnaire was the instrument which was used. Free informed consent of the

participants was obtained and sincerity in ticking the correct option provided and they were

informed that their response will be treated with outmost confidentiality. The questionnaire

contains 27 questions both close and open-ended question was used.

VALIDITY OF INSTRUMENT

A self-structured questionnaire was formulated and submitted to my supervisor for full content

validity.

METHOD OF DATA COLLECTION

Questionnaire was issued out by the researcher to health workers in Plateau Specialist Hospital

and collected immediately after the respondents have finished ticking the option provided to

them.

METHOD OF DATA ANALYSIS

The data to be obtained was analyzed using IBM, SPSS version 25 and result was expressed

using tables and regression analyses.

ETHICAL CONSIDERATIONS

A letter was collected for permission from the school to the administrative department of Plateau

Specialist Hospital in order to obtain the hospital consent before administering the questionnaire.

The purpose of the study was explained to the respondent, and they were told that all information

obtained will be kept confidential, the questionnaire was distributed to fill in appropriate after

which it was collected back from them.

 CHAPTER FOUR

RESULT

This chapter deals with arrangement, organization, presentation, and analysis of data the data

collected from the questionnaire were analyzed using graphical presentations, tables,

percentages, and regression analysis in accordance with the research questions of the study.

ANALYSIS AND PRESENTATION OF RESULTS

Graphical presentation

30
Physician
20

10

30
Nurse
20

10

0
Occupation
Count
30
Pharmacist
20

10

30 Laboratory
20 Technician
10

30

20 Others
10

Male Female 4.0

Gender
Table 2: Occupation * Knowledge

Occupation

Knowledg Mean N % Of total sum Range % Of total N

Yes 2.589 129 98.8% 3.0 99.2%

No 4.000 1 1.2% 0 0.8%

Total 2.600 130 100.0% 3.0 100.0%

The mean knowledge score of healthcare workers was 2.6 (range 3.0) percent 98.8% (N = 129)

of the participate score 99.2% were considered to have good knowledge. Only 1 participant

scored 0.8%. factors associated with knowledge was occupation (doctor, nurses, pharmacist, lab

technician) the mean knowledge score of nurses was higher).

Table 3: Occupation * Attitude

Occupation

Attitude Mean N % Of total Range % Of total N

sum

1.0 3.000 1 0.9% .0 0.8%

Undecided 2.750 4 3.3% 1.0 3.1%

Agree 2.761 46 37.6% 3.0 35.4%

 Strongly 2.494 79 58.3% 3.0 60.8$

agree

Total 2.600 130 100.0% 3.0 100.0%

The mean attitude score 3.0 there was good attitude among health care workers toward Covid-19.

Only 3.3% (4) have poor attitude.

Table 4: Occupation * Perception

Occupation

Perceptio Mean N % Of total sum Range % Of total N

Yes 2.589 129 98.8% 3.0 99.2%

No 4.000 1 1.2% 0 0.8%

Total 2.600 130 100.0% 3.0 100.0%

Some 99.2% (n = 129) of health care worker educate their patient on Covid-19, were gloves

mask and gown before touching patient. Unfortunately, 0.8% (n = 1) of the participant do not

practice personal and respiratory hygiene.

The survey found that the majority of HCW’s have good knowledge (99.2%), a positive attitude

(60.8%) towards Covid-19. Of note, 99.5% (N = 130) of HCW’s used social media as their main

source of information, followed by radio and television. These findings are consistent with other

studies which reported that the majority of HCW’s use social media to seek information on

Covid-19. HCWs should consult reliable sources, such as guidelines and reports published by

WHO.
Analysis II: Regression analysis for factors associated with knowledge and attitude

regarding coronavirus

Model summary

Mode R R square Adjusted R square Std. Error of the estimate

1 .283a .080 .050 1.0268

a. Predictors: (Constant), Knowledge, Experience, Attitude, Perception

Coefficients

Model Unstandardized Standardized T Sig. 95.0% Confidence

Coefficients Coefficients Interval of B

B Std. Error Beta 98.8% 3.0 Lower Upper

Bound Bound

1. (Constant) 2.391 1.232 1.941 .055 -047 4.828

Experience -185 .081 .196 -2.277 .024 -346 -024

Attitude -200 .143 -121 -1.398 .165 -483 .083

Perception .038 .035 .095 1.100 .274 -030 .106

Knowledge 1.525 1.033 .127 1.477 .142 -519 3.569

a. Dependent variable: Occupation

p<0.05 was considered to indicate significance

Pearson’s correlation test revealed significant positive linear correlation (r = 028, p = 0.050).

This correlation may be explained by action theory. This theory state that a Pearson’s intention to
undertake a specific heavier is a function of their attitude towards that behavior. Future studies

should be conducted to understand possible factors that underlie knowledge, attitude and

perception toward HCWs.

 CHAPTER FIVE

DISCUSSION OF FINDINGS

This chapter focuses on the research findings, nursing implications, summary,

conclusions recommendations and suggestion for further studies findings.

DISCUSSION OF FINDINGS

It was discovered that HCWs in Plateau State Specialist Hospital have a sound

knowledge, attitude, and perception towards coronavirus. Testing for significance between the

various occupations in HCWs, correlation test was used, and it revealed that there is significance

in the HCWs.

Identifications of key finding what is implied with literature support and alignment of

finding of research work will be discussed din relation to literature review, research question and

responses to the questionnaire.

RESEARCH QUESTION 1: What is the level of Knowledge of Coronavirus disease 2019

(COVID-19) among health care workers in VCH?

From the data collected and analyzed in table 2 of chapter four, it reveals that majority of

respondent with mean value of 2.6 are knowledgeable about Covid-9. They are aware that

Covid-19 is a viral infection that majorly causes respiratory symptoms and are transmitted

through direct contact and via infected droplet. The findings agree with M. Soqlain and N.

Mashood (2020), which concluded that the knowledge of healthcare workers in generally good

regarding the transmission, symptoms and treatment of Covid-19.

RESEARCH QUESTION 2: What is the attitude of HCWs towards Covid-19?

 Data presented and analyzed in table 3 shows majority of the respondent with mean value

2.8 adhere to the universal precaution given by WHO, NCDC to prevent spread of the virus and

respondent adhere to the usage of personal equipment when dealing with Covid-19 patients. The

findings correlate with Giao et al (2020), which finds out there are high positive attitude among

healthcare workers towards Covid-19. A possible explanation is that good knowledge about

Covid-19 might have led to the positive attitude.

RESEARCH QUESTION 3: What are the perceptions of health workers toward the

prevention and transmission of Covid-19?

The data is analyzed and presented in table 4 shows that majority of respondents with

mean value of 2.6 educate their patients about coronavirus disease and practice good respiratory

and personal hygiene. The findings correlate with Bhagabathula (2020). That health care workers

have good perception on regards to Covid-19, showing that this group have skills and experience

of dealing with public health emergency.

IMPLICATION OF THE FINDINGS IN NURSING

 These findings will enable student nurses, practicing nurses and other health care workers

research by brooding their knowledge on the knowledge, attitude, and perception of

Covid-19, towards necessary precautions to prevent the transmission of Covid-19 to their

patients.

 This study can be used as an educational article to be kept in any nursing and general

library to educate nurses and health care workers and the general public about the

knowledge, attitude and perception towards preventing the transmission of Covid-19.

  This study will help the nurse to be knowledgeable to improve in her role of advocating

for health care workers to government on varies standard precautionary equipment’s to

prevent the transmission of Covid-19.

LIMITATION OF THE STUDY

The study has a lot of limitations:

 It was a cross sectional study conducted during lockdown and End-SARS protest

 The researcher is a beginner in research work and so, only has limited knowledge and

experience in research work.

 Financial constraint made it difficult for the researcher to go beyond the setting and chose

only sample size she could afford to manage.

 The time frame for the research work was limited.

SUMMARY

A self-administered validated questionnaire was used to assess the knowledge, attitude,

and perception of health care workers in Plateau State Specialist Hospital regarding the

prevention and transmission of Covid-19.

Findings showed that HCW’s have good knowledge (98.8% N = 129) a positive attitude

(Mean = 2.494) (R = 3) and good perception (98.8% N = 129). Healthcare worker with perceived

poor knowledge regarding transmission and prevention (1.2% N = 4).

Regression analysis indicated that nurses were more likely to demonstrate good

perception than other health care workers. The study finds health care workers in Plateau State
Specialist Hospital have good knowledge, attitude and perception towards the transmission and

prevention of Covid-19.

CONCLUSION OF THE STUDY

Based on the result of the analysis, it has been concluded that;

 The study does not find gaps in specific aspect of knowledge, attitude and perception that

should be focus on in future awareness and educational campaign.

 The finding also demonstrates that health care workers in Plateau State Specialist

Hospital were using an authentic source of information in regard to Covid-19, this source

have increased their knowledge and is reflected by their attitude and perception.

 It was discovered that HCWs in Plateau State Specialist Hospital have a sound

knowledge, attitude, and perception toward coronavirus. Knowledge on Covid-19 was

significant high among the various occupations in HCWs correlation test was used and it

revealed that there is significance in the HCWs.

 There was no statistical difference in the level of knowledge about Covid-19 among

health care workers in Plateau State Specialist Hospital irrespective of their professions

or qualifications.

RECOMMENDATION

The study recommend that health ministries should provide a comprehensive training

program. Target all health care workers to promote all precautionary and preventive measures of

Covid-19 to achieve equilibrium in terms of clinical knowledge in regard to Covid-19.

 Continued professional educations advised among HCWs hence adverting negative

attitude and promoting positive preventive and therapeutic practices. We recommend follow up

studies involving teaching and non-teaching hospitals across the country.

SUGGESTION OF THE STUDY

Further studies should be conducted to understand possible factors that underline knowledge

patterns and attitude expressed by health care workers.

 REFERENCES

Bhagathula AS, Aldhaleei WA, Rahman J. Mahabadi MA, Bandari DK, Novel.

Cascella M, Ranjnik M, A, dulebon SC, DiNapoli R. Features, evaluation, and treatment.

CDC. Coronavirus disease (covid19) 2020. {online}. Available from

http.//www.CDC.gov/coronavirus/2019-nCoV.

Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China.

Lancet.2020; 395:497:507

Coronavirus (covid19) {updated 2020 APR6} IN; Statpearls (internet). Treasure island,

FL: sartpeal publishing (200)

Coronavirus (covid19) knowledge and practice: a survey on healthcare workers.

Covid19 Health Advisory platform by ministry of National HealthServicesregulation and

coordination (available at:)

For all WHO covid19 situation report see: http://www.who.into/ emergencies/disease/novel-

coronavirus -2019/situations-reports/

How Gan W. Wahlum J. Koh.D preventing intra -hospital infection and control of covid19

in health workers saf midwives. 2020

Infection, prevention, and control during health care when novel coronavirus (nCoV)

infection is suspected on http//www.who.into/publications-detail/infection-practices

and control- during health care when -coronavirus (nCoV)- infection-is-suspected

20200125
Medscape. In Memoriam: HealthCare workers who have died of Covid19. (2020)

NematiM *Ebrahimi B. * NematiM F. Assessment of Iranian Midwives and Nurses'

knowledge and anxiety towards Covid19 during the current outbreak in Iran.

Schoeman D, fielding B. coronavirus envelope protein: current knowledge. Viral I 2019;

16(1):69

WHO Director Generals opening remarket the media briefing on covid19---11- March

2020 (assessed April 10, 2020).

World Health organization. Coronavirus disease (Covid19) outbreak: Right, Role, and

Responsibilities of health workers, including key considerations for occupation

safety and health (2020)

World Health Organization. Coronavirus disease (Covid19). Advice for the public (2020)

World Health Organization. Infection prevention and control During Health care when

novel coronavirus (nCoV) infection is suspected, world health organization: Geneva

(2020)
QUESTIONNAIRE

Joint Professional Training Support,

Behind Benue Links,

Secretariat Junction, Jos,

Plateau state.

Dear respondent,

The researcher is a final year student of Joint Professional Training Support (JPTS) Jos,

(carrying out research on “Knowledge, Attitude and Practice of Corona Virus Disease Infection

Control among Midwives in Plateau Specialist Hospital ". I will not ask questions about the

names of those health workers that contracted covid19. And the information you will give be

strictly confidential. Please truthfully and correctly answer the questions as your response will be

used only for the purpose of this study. Thanks for your time. Please read carefully and tick/write

the appropriate answer in the space provided.

Yours faithfully,

------------------------------

QUESTIONNAIRE

Section: Demographic information of health workers.

1. Occupation (a) physician (b) nurse (c) pharmacist (D) laboratory technicians (e) laboratory

scientist
2. Gender (a)male (b) female

3. Age (a) less than 30 years (b) 31-39 years (c)40-49 (d) more than 50 years

4. Experience (a)less than 1 year (b) 1-4 years (c) 4-6 years(d) more than 6years

Section 2: knowledge of health workers towards covid19

5. Heard about covid19? (A)Yes (B) No

6. Source of information regarding covid19 (a) Seniors or colleagues (b) newspapers and

magazine (c) posters & pamphlet (d) seminars & workshops (e) radio &television (f)social media

Answer Yes or NO in this section

7. Covid19 is a viral infection? Yes/No

8. Covid19 spread through close contact like caring and/or touching of contaminated surface?

Yes/No

9. coronavirus infection could be fetal? Yes/No

10. Incubation period for covid19 is 2-14days? Yes/No

11. The main source of the virus may be plant.? Yes/ No

12. Vaccination of covid19 is available? Yes/No

13.covid19 patients develop severe acute respiratory illness? Yes or No

14.Antibiotics are first line of treatment for covid19? Yes/ No

15. Fever cough, and shortness of breath are symptoms of covid19? Yes/ No
16. Washing of hands vigorously with (soap/water) can be used to minimize the spread of

covid19? Yes/No

Section 3: attitude of health professional towards covid19

Answer () strongly disagree () disagree () undecided () agree () strongly agree

17. Health care workers must acknowledge themselves with all information about covid19?

18.Transmission of covid19 infection can be prevented by using universal precautions given by

WHO, NCDC?

19.any related information about covid19 should be disseminated among health care workers?

20. Covid19 patients should be kept in isolation?

21. Gowns, gloves, mask, and goggles must be used when dealing with covid19 patients?

Section 4: practice of health care workers towards covid19

22. Do you use soap or hand sanitizer to wash your hands continuously? () sometimes () Yes

23. Do you cover your nose and mouth with tissue during sneezing or coughing? () No ()

sometimes () Yes

24.Do you throw the used tissue in the trash? () No () sometimes () Yes

25. Do you educate your patient about the disease () No () sometimes () Yes

26. Do you avoid touching your eyes, nose, or mouth as far as you can? () No () sometimes ()

Yes

27. Do you use face mask in crowds? () No () sometimes () Yes