Knowledge, Attitude, and Practice Regarding COVID-19 among Healthcare Workers in a Tertiary Teaching Hospital

Authors

  • Rama Krishna Supramanian Department of Social and Preventive Medicine, University Malaya, Malaysia. Occupational Safety Health and Environment (OSHE) Unit, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia. Email: rama.krishna@ummc.edu.my
  • Lim Yin Cheng Department of Social and Preventive Medicine, University Malaya, Malaysia. Occupational Safety Health and Environment (OSHE) Unit, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia. Email: yclim@um.edu.my
  • Victor Hoe Chee Wai Abdullah Department of Social and Preventive Medicine, University Malaya, Malaysia. Occupational Safety Health and Environment (OSHE) Unit, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia. Email: victorhoe@um.edu.my
  • Bala Murali Sundram Department of Social and Preventive Medicine, University Malaya, Malaysia. Occupational Safety Health and Environment (OSHE) Unit, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia. Email: bala.murali@um.edu.my
  • Amalina Anuar Clinical Research Centre (CRC), Tuanku Fauziah Hospital, Ministry of Health, Malaysia. Email: rama.krishna@ummc.edu.my
  • Sarbhan Singh Institute of Medical Research (IMR), National Institute of Health, Malaysia. Email: rama.krishna@ummc.edu.my
  • Nur Fadhlina Othman Department of Social and Preventive Medicine, University Malaya, Malaysia. Email: rama.krishna@ummc.edu.my
  • Wong Chee Kuan Department of Medicine, University Malaya, Malaysia. Email: ckwong@um.edu.my
  • Orawan Kaewboonchoo Faculty of Public Health, Mahidol University, Bangkok, Thailand. Email: orawan.kae@mahidol.ac.th
  • Noor Hashimah Hashim Lim Department of Urban and Regional Planning, Faculty of Built Environment, University Malaya. Email: shimalim@um.edu.my
  • Teh Bor Tsong Department of Urban and Regional Planning, Faculty of Built Environment, University Malaya. Email: tehbortsong@um.edu.my
  • Nik Hazwani Nik Hashim Department of Urban and Regional Planning, Faculty of Built Environment, University Malaya. Email: nikhazwani@um.edu.my
  • Sneha Sellva Kumar Department of Social and Preventive Medicine, University Malaya, Malaysia. Email: snehasellvakumar@gmail.com

Keywords:

COVID-19, Knowledge, Attitude, Practice, Healthcare workers

Abstract

Healthcare workers are the frontline battling the COVID-19 pandemic and are at a high risk of infection. This paper assesses knowledge, attitude, and practice towards COVID-19 among healthcare workers in Universiti Malaya Medical Centre (UMMC). This cross-sectional study was conducted among healthcare workers in UMMC, Kuala Lumpur. Data collection period was from 1st March to 30th April 2021. A validated 19-item was used to measure knowledge, attitude and practice (KAP) scores. Univariate and multivariate analyses were conducted to identify factors associated with KAP scores, with significance set at p<0.05. A total of 162 respondents participated, including nurses (37.7%), allied health professional (24.7%), clinical specialist (6.8%), medical assistant (6.2%), medical doctors (4.9%), pharmacist (1.2%) and others (18.5%). Majority of HCWs (98.8%, n=160) had good knowledge, poor attitude (93.2%, n=151) and good COVID-19 preventive measure practices (97.5%, n=158). Multivariate logistic regression demonstrated that gender (adjusted Odds Ratio, OR 4.41; 95% Confidence Intervals, 95%CI: 1.25, 15.62) and profession (aOR 2.49; 95%CI: 0.68, 9.12) were found to be the significant factors associated with good attitude towards COVID-19 prevention measures.  While healthcare workers demonstrated good overall knowledge and practice, their attitude towards COVID-19 prevention was poor. Behavioural interventions are recommended to improve attitude and strengthen safety culture in healthcare settings.

References

Region A. COVID-19 Epidemiological. World Health Organization (WHO). 2024. p. 1–8 Coronavirus disease (COVID-19) pandemic. Available on: https://www. regione. puglia. it/documents/65725/216593/Bollettino+Covid_15032021.pdf/64801426-f249-72ea-01c1-6fc9fab8552b.

World Health Organization. The Impact of COVID-19 on Health and Care Workers: A closer look at deaths (Working paper 1). 2021.

Zhan M, Qin Y, Xue X, Zhu S. Death from Covid-19 of 23 Health Care Workers in China. N Engl J Med. 2020; 382(23): 2267–8. DOI: 10.1056/NEJMc2005696.

Kursumovic E, Lennane S, Cook TM. Deaths in healthcare workers due to COVID-19: the need for robust data and analysis. Anaesthesia. 2020; 75(8): 989–92. DOI: 10.1111/anae.15116.

Cook T, Kursumovic E, Lennane S. Exclusive: deaths of NHS staff from covid-19 analysed. Health Service Journal. 2020 Apr 22; 22. Available on: https://www.hsj.co.uk/exclusive-deaths-of-nhs-staff-from-covid-19-analysed/7027471.article.

Chirico F, Nucera G, Magnavita N. COVID-19: Protecting Healthcare Workers is a priority. Infect Control Hosp Epidemiol. 2020;41(9):1117. DOI: 10.1017/ice.2020.148

World Health Organization (WHO). Infection prevention and control during health care when COVID-19 is suspected: interim guidance, 19 March 2020. World Health Organization; 2020.

Cobb N, Papali A, Pisani L, Schultz MJ, Ferreira JC. Pragmatic Recommendations for Infection Prevention and Control Practices for Healthcare Facilities in Low- and Middle-Income Countries during the COVID-19 Pandemic. Am J Trop Med Hyg. 2021; 104(3 Suppl): 25. DOI: 10.4269/ajtmh.20-1009

Harith AA, Ab Gani MH, Griffiths R, Abdul Hadi A, Abu Bakar NA, Myers J, et al. Incidence, Prevalence, and Sources of COVID-19 Infection among Healthcare Workers in Hospitals in Malaysia. Int J Environ Res Public Health. 2022; 19(19):12485. DOI: 10.3390/ijerph191912485

Wan KS, Tok PSK, Ratnam KKY, Aziz N, Isahak M, Zaki RA, et al. Implementation of a COVID-19 surveillance programme for healthcare workers in a teaching hospital in an upper-middle-income country. PLoS One. 2021; 16(4 April): 1–15. DOI: 10.1371/journal.pone.0249394

Teslya A, Pham TM, Godijk NG, Kretzschmar ME, Bootsma MCJ, Rozhnova G. Impact of self-imposed prevention measures and short-term government-imposed social distancing on mitigating and delaying a COVID-19 epidemic: A modelling study. PLoS Med. 2020; 17(7): e1003166. DOI: 10.1371/journal.pmed.1003166

Gordon C, Thompson A. Use of personal protective equipment during the COVID-19 pandemic. Br J Nurs. 2020; 29(13): 748–52. DOI: 10.12968/bjon.2020.29.13.748

Maude RR, Jongdeepaisal M, Skuntaniyom S, Muntajit T, Blacksell SD, Khuenpetch W, et al. Improving knowledge, attitudes and practice to prevent COVID-19 transmission in healthcare workers and the public in Thailand. BMC Public Health. 2021; 21(1): 1–14. DOI: 10.1186/s12889-021-10768-y

Hossain MA, Rashid MU Bin, Khan MAS, Sayeed S, Kader MA, Hawlader MDH. Healthcare workers’ knowledge, attitude, and practice regarding personal protective equipment for the prevention of COVID-19. J Multidiscip Healthc. 2021; 14: 229–38. DOI: 10.2147/JMDH.S293717

An P Le, Huynh G, Nguyen HTN, Pham BDU, Nguyen TV, Tran TTT, et al. Knowledge, attitude, and practice towards COVID-19 among healthcare students in Vietnam. Infect Drug Resist. 2021; 14:3405–13. DOI: 10.2147/IDR.S328677

Tien TQ, Tuyet-Hanh TT, Linh TNQ, Hai Phuc H, Van Nhu H. Knowledge, Attitudes, and Practices Regarding COVID-19 prevention among Vietnamese Healthcare Workers in 2020. Heal Serv Insights. 2021; 14. DOI: 10.1177/11786329211019225

Fatimah, Taiwo, Baba, Aishatu, Omeiza, Hadiza, et al. COVID 19: Evaluating the Knowledge, Attitude and Preventive Practices of Healthcare Workers in Northern Nigeria. Int J Matern Child Heal AIDS. 2021; 10(1): 88–97. DOI: 10.21106/ijma.418

Jemal B, Aweke Z, Mola S, Hailu S, Abiy S, Dendir G, et al. Knowledge, attitude, and practice of healthcare workers toward COVID-19 and its prevention in Ethiopia: A multicenter study. SAGE Open Med. 2021; 9: 205031212110343. DOI: 10.1177/20503121211034389

Abdel Wahed WY, Hefzy EM, Ahmed MI, Hamed NS. Assessment of Knowledge, Attitudes, and Perception of Health Care Workers Regarding COVID-19, A Cross-Sectional Study from Egypt. J Community Health. 2020; 45(6): 1242–51. DOI: 10.1007/s10900-020-00882-0

Anuar A, Ang WC, Ahmad Musadad NM, Abdol Wahab SN, Abdul Sukur N, Warijo O. Knowledge, attitude and practice towards COVID-19 and perceived challenges of working during the movement control order: a quantitative analysis among healthcare workers in a Malaysian northwestern state. Curr Med Res Opin. 2021. DOI: 10.1080/03007995.2021.2000738

Nunnally J, Bernstein I. Psychometric Theory 3rd edition (MacGraw-Hill, New York).

Kunno J, Yubonpunt P, Supawattanabodee B, Wiriyasirivaj B, Sumanasrethakul C. Covid-19 Knowledge, Attitudes, and Practices Among Healthcare Workers in Urban Community Bangkok, Thailand. Rocz Panstw Zakl Hig / Ann Natl Inst Hyg. 2022; 73(1): 17–26. DOI: 10.32394/rpzh.2022.0200

Marthoenis M, Maskur M. Knowledge, attitude, and practice of nurses toward COVID-19: A cross-sectional study in a referral hospital of Indonesia. Iran J Nurs Midwifery Res. 2021; 26(6): 569–72. DOI: 10.4103/ijnmr.IJNMR_362_20

Sondakh JJS, Warastuti W, Susatia B, Wildan M, Sunindya BR, Budiyanto MAK, et al. Indonesia medical students’ knowledge, attitudes, and practices toward COVID-19. Heliyon. 2022; 8(1): e08686. DOI: 10.1016/j.heliyon.2021.e08686

Salman M, Ul Mustafa Z, Asif N, Zaidi HA, Shehzadi N, Khan TM, et al. Knowledge, attitude and preventive practices related to COVID-19 among health professionals of Punjab province of Pakistan. J Infect Dev Ctries. 2020; 14(7): 707–12. DOI: 10.3855/jidc.12878

Parikh PA, Shah B V., Phatak AG, Vadnerkar AC, Uttekar S, Thacker N, et al. COVID-19 Pandemic: Knowledge and Perceptions of the Public and Healthcare Professionals. Cureus. 2020; 12(5). DOI: 10.7759/cureus.8144

Buccheri C, Mammina C, Giammanco S, Giammanco M, Guardia M La, Casuccio A. Knowledge, attitudes and self-reported practices of food service staff in nursing homes and long-term care facilities. Food Control. 2010; 21(10): 1367–73. DOI: 10.1016/j.foodcont.2010.04.010

Tokuç B, Ekuklu G, Berberoǧlu U, Bilge E, Dedeler H. Knowledge, attitudes and self-reported practices of food service staff regarding food hygiene in Edirne, Turkey. Food Control. 2009; 20(6): 565–8. DOI: 10.1016/j.foodcont.2008.08.013

Ballard M, Bancroft E, Nesbit J, Johnson A, Holeman I, Foth J, et al. Prioritising the role of community health workers in the COVID-19 response. BMJ Glob Heal. 2020; 5(6): 1–7. DOI: 10.1136/bmjgh-2020-002550

Supramanian RK, Isahak M, Hairi NN. The effective strategies to prevent noise-induced hearing loss: A systematic review. ASM Sci J. 2020; 13(Specialissue5): 112–26. Available on: https://www.akademisains.gov.my/asmsj/article/the-effective-strategies-to-prevent-noise-induced-hearing-loss-a-systematic-review/.

Supramanian RK, Hairi NN, Isahak M. Effects of a Training and Education Program on Knowledge, Attitude and Practice Towards Noise-Induced Hearing Loss Prevention Among Vector Control Workers. J Heal Transl Med. 2023; 26(1): 154–62. DOI: 10.22452/jummec.vol26no1.21

Department of Occupational Safety and Health M of HR. Occupational Safety and Health (Noise Exposure) Regulations 2019. 2019. p. 409–23.

Franks J, Merry C. Preventing occupational hearing loss: a practical guide. US Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Division of Biomedical and Behavioral Science, Physical Agents Effects Branch. 1996; 96–110.

Nwagbara UI, Osual EC, Chireshe R, Bolarinwa OA, Saeed BQ, Khuzwayo N, et al. Knowledge, attitude, perception, and preventative practices towards COVID-19 in sub-Saharan Africa: A scoping review. PLoS One. 2021; 16(4 April): 1–20. DOI: 10.1371/journal.pone.0249853

Lee M, Kang BA, You M. Knowledge, attitudes, and practices (KAP) toward COVID-19: a cross-sectional study in South Korea. BMC public health. 2021 Dec; 21: 1-0. DOI: 10.1186/s12889-021-10285-y

Downloads

Published

2025-12-22

Issue

Vol. 55 No. 3 (2025): Vol. 55 No. 3 (Sep - Dec 2025)

Section

Original Articles

License

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Creative Commons License CC-BY-ND