key: cord-1021059-g5p6tym8 authors: Saadeh, Rami; Alfaqih, Mahmoud A.; Al‐Shdaifat, Amjad; Alyahya, Mohammad; Alrabadi, Nasr; Khader, Yousef; Beni Yonis, Othman; Allouh, Mohammed Z. title: Perceptions of primary healthcare physicians in Jordan of their role in the COVID‐19 pandemic: A cross‐sectional study date: 2021-09-14 journal: Int J Clin Pract DOI: 10.1111/ijcp.14797 sha: a4eb53ac3345ba0cfcdfa34198ab37dde73ec622 doc_id: 1021059 cord_uid: g5p6tym8 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. Since its detection in Wuhan, China in December 2019, the pandemic has proliferated quickly worldwide, and was eventually announced as a pandemic by the World Health Organization (WHO) in March 2020. 1 Indeed, by the time of writing this report, it is estimated that COVID-19 has already infected more than 33 million individuals worldwide with a total death toll of 1 014 291. 2 Following the spread of COVID-19 outside Wuhan, it quickly became apparent that many public health systems worldwide were not prepared to manage such a pandemic. The fatality rates in many of these countries were higher than the estimates (ie, 2%-53%) provided in the earlier reports. [3] [4] [5] This discrepancy might be explained by (a) differences in the protocols stipulated by different public health systems to control the spread of the virus, (b) the continuously evolving knowledge of the behavior of COVID-19, 3, 5 and (c) differences in the population structure among different countries. Some countries have a larger population of elderly citizens with a high level of comorbidity, and these individuals are particularly more vulnerable to COVID-19 infections. 4, 6 Regardless of these differences, global cumulative experience has clearly demonstrated that personnel working in health-related fields, including physicians, nurses, and medical laboratory technicians, are on the frontline to contain the pandemic and prevent it from overwhelming the healthcare system of the respective countries. Among these professionals, primary care physicians (PCPs) play a central role. The nature of the services provided by PCPs entails that they meet patients of different ages, backgrounds, and socioeconomic status more frequently and by a larger volume than other specialists. The responsibility of PCPs in a pandemic situation is not only limited to patient diagnosis and treatment but also covers prevention, disease surveillance, and above all, patient knowledge and education. 7 Public knowledge and education are of particular importance during a pandemic. Several studies found these to be directly related to public compliance with governmental measures implemented to control the spread of the pandemic. [8] [9] [10] [11] Importantly, lack of knowledge or misinformation may even facilitate the spread of the disease. 12 For example, during the Ebola epidemic, the poor understanding of the infectivity of the virus, including its airborne mode of transmission, remarkably contributed to the high number of cases and fatalities. 13 Despite the established and wide range of roles that PCPs play during outbreaks, studies aiming to evaluate the way PCPs perceive these roles during the COVID-19 pandemic have been scarce. Considering the above deficiency in the literature, this study aimed to survey the perceptions of PCPs in Jordan towards their roles during the COVID-19 pandemic. This was a cross-sectional study that used a self-administered questionnaire. The study sample consisted of primary healthcare physicians practicing in the Ministry of Health, academic institutions, and the private healthcare sector in Jordan. The collection of data was conducted through a web-based survey application, named "Google forms." Two authors of this research, who are PCPs, distributed the survey to PCPs within their social media networks, and the target population was every PCP within this network. The social media groups of these networks included registered PCPs from the abovementioned sectors, which are used for communication, education, and socialization. A link to the survey was sent to 309 PCPs via a social media messaging application inviting them to participate in the study. A statement of optional participation was included in the survey, which included a consent to participate in the study and the right to withdraw at any time. practices (seven items). In addition to these twenty items, the survey also collected demographic information, including data on sex, age, years of experience, and specific specialty of the survey taker (four items). The study items were developed after reviewing pertinent literature and the latest WHO infection control recommendations and were further reviewed by a team of four experts in public health, epidemiology, family medicine, and infectious diseases (one expert from each specialty). The survey was first tested on a group of 10 PCPs and then further modified according to their recommendations. Descriptive statistical analysis was used to analyse data on the items included in the survey. Frequencies and means were used to describe categorical and continuous variables respectively. A total of 221 out of 309 PCPs completed the survey (response rate 71.5%). The baseline characteristics of the participants are presented in Table 1 . Most participants were males (59.7%) in the age group of 25-35 years (59.3%) and were practicing family medicine (61.1%). Most participants reported that they did not receive any training related to infection control (59.7%) or COVID-19 (81%). However, 44.8% of participants reported treating patients with COVID-19. • Social distancing and personal protection equipment are essential in reducing the spread of COVID-19. • Healthcare providers play a crucial role in raising awareness and disease prevention. • Primary care physicians believe in their important role to prevent the spread of COVID-19. • Although many of them are aware of their role in education and disease prevention, most of them lack the proper training needed to properly apply prevention and education approaches. (Table 2) . Table 3 summarises the practices that PCPs would employ to reduce the possibility of COVID-19 transmission at their workplace. Over 80% of the participants would apply social distancing, hand sanitation, facial masks and patient education. However, only half of them (51.1%) reported that they were planning to order COVID-19 The role of PCPs in controlling the spread of COVID-19 is considered a cornerstone in the global health response to defeat this pandemic. This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors. The authors declare no conflict of interest. Data is available upon request. COVID-19 patients' clinical characteristics, discharge rate, and fatality rate of meta-analysis Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy Cross-country comparison of case fatality rates of COVID-19/SARS-COV-2. 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