Design
A correlational cross sectional research design was used.
Setting
This study was conducted at Suez Canal University hospitals (established in 1993 at Ismailia City, serves Canal and Sina area, involved more than 15 departments with 4 large building and more of multidisciplinary healthcare workers).
Participants
Convenient accidental sample of all available healthcare workers. Electronic online questionnaires were sent to all available healthcare workers to meet aim of the study, actually involved medical staff (physicians) “112,” paramedical staff (healthcare workers who provide clinical services to patients under the supervision of a physician) nurses “183,” pharmacists “31,” and laboratory technicians “38” who were agreed and recruited in the study between 1 and 14 July 2020.
Tools for data collection
Tools were utilized to collect data for the current study, as the following:
Tool (I): online self-administrated questionnaire
it adopted by the researchers based on related literature review and other studies, sent online through registered contact’s way to all available healthcare workers [18,19,20]. Consisted of the following:
Part 1
Part 1 used to assess the studied healthcare workers’ demographic characteristics, such as age, gender, occupation, degree, years of experience, marital status, place of before working here, place of residence, smoking.
Part 2
Consisted of 15 items, used to assess the studied healthcare workers brief level of knowledge regarding COVID-19 (definition, risk factors, mode of transmission, clinical manifestation, prevention, and management).
Scoring system: Adapted from Zhou et al. [19]. The total score of knowledge will be from 0 to 15 grades, each correct answer was given one grade, ≥ 60% will be considered an adequate level of knowledge.
Part 3
Consisted of 20 items, used to assess the studied healthcare workers’ level of infection control measures.
Scoring system: Adapted from Al-Hanawi et al. [21]. The total score of knowledge will be from 0 to 20 grades, each correct answer was given one grade, ≥ 60% will be an adequate level of practice.
Part 4
Part 4 used to assess the studied healthcare workers’ attitude toward COVID-19, consists of 6 questions, adopted from Al-Hanawi et al. [21].
Scoring system: The level of agreement on 3 points Likert scale; with 3 = “agree,” 2 = “neutral,” 1 = “disagree"
Tool (II): COVID-19 stress scales
Sent online although through registered contact’s way; developed by Taylor et al. [22] in May 2020 and translated in to Arabic valid language by Elgilany and Elwasify [23] in June 2020, is a stable 5-factor solution was identified, was used to assess COVID-related stress and anxiety symptoms: (1) danger and contamination fears, (2) fears about economic consequences, (3) xenophobia (4) compulsive checking and reassurance seeking, and (5) traumatic stress symptoms about COVID-19.
Scoring system: Adopted from [10, 11], is a 30-item questionnaire; total scores will range from 0 to 120 degree
While (0) means very well, (1) means mild, (3) mean moderate, (4) severe. Totally, score under 50 are likely to be well, 50-66 are likely to have a mild, 66-82 are likely to have moderate, while over 82 and over are likely to have a severe mental disorder.
Content validity
Tools of data collection were tested for validity by a panel of 5 experts in the related field to determine whether the included items are comprehensive, understandable, applicable, clear, and suitable to achieve the aim of the study.
Content reliability
Coefficient of reliability of the evaluating tools I and II was measured by Cronbach’s α alpha, the reliability scores were 0.81 and 0.80 which indicate high internal consistency of the used tools.
A pilot study
A pilot study was carried out on 10% of healthcare workers to test clarity, applicability, feasibility, and to estimate the needed time to complete each tool. Necessary modifications were done.
Field work
Preparatory phase
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The study started and completed within planned time “two months.”
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Contacts’ ways obtained from healthcare workers who agreed to participate in the study after explaining the aim of the study.
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Data collection established in various sessions among participants based on their rooster time.
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The researchers’ contacts were being available on call for any interpretations post sending online questionnaires’ link.
Implementation phase
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Data collection was being collected in suitable time away from working’s time.
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Data collection was being collected using a valid and registered healthcare workers’ contacts to send online questionnaires’ links through e-mail contact, WhatsApp, Facebook messenger, and so on.
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Data was collected through online questionnaires within 2 weeks by the researchers using a simplified English and Arabic language among participants.
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Meeting online through zoom or webinar video apps for any interpretation.
Administrative design
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An official letter for data collection was obtained from the head of ethics committee to start data collection in Faculty of Nursing “code No. 81, dated 6/2020.”
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An official permission for data collection was obtained orally from president of Suez Canal University and written consent from director of Suez Canal University hospitals.
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Online consent of the healthcare workers was obtained.
Ethical considerations
The ethical research consideration in this study includes the following:
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The objectives and aims of the study were clarified to the participants.
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The studied healthcare workers were assured of maintaining anonymity and confidentiality of collected data.
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The studied healthcare workers were informed that they have the right to withdraw from the study at any time, in despite of online consent.
Statistical design
The raw data coded and entered into SPSS system files (version 22) will be conduct using the following statistical measures:
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Descriptive statistics will be used including frequency; distribution, mean, and standard deviation will be used to describe different characteristics.
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Univariate analyses, including Student t test, ANOVA test, Mann Whitney test, and Kruskal-Wallis test will be used to test the significance of results of quantitative variables.
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Spearman’s rank correlation coefficient or Spearman’s rho is a nonparametric measure to assess how well the relationship between two variables can be described using a monotonic function.
Significance of results
Non-significant—P > 0.05
Significant—P ≤ 0.05