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 Table of Contents  
ORIGINAL ARTICLE
Year : 2019  |  Volume : 4  |  Issue : 1  |  Page : 1-5

Psychological impact and knowledge of coronavirus disease 2019 among dental interns and postgraduates: A cross sectional study


1 Department of Public Health Dentistry, Asan Memorial Dental College, Chengalpattu, Tamil Nadu, India
2 CRRI, Asan Memorial Dental College, Chengalpattu, Tamil Nadu, India

Date of Submission15-Mar-2021
Date of Acceptance24-Sep-2021
Date of Web Publication29-Nov-2021

Correspondence Address:
Dr. Parvathy Premnath
Department of Public Health Dentistry, Asan Memorial Dental College and Hospital, Chengalpattu, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijosr.ijosr_2_21

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  Abstract 


Background: Coronaviruses are a large family of viruses that cause a wide range of illness from the common cold to more severe diseases. The coronavirus disease 2019 (COVID-19) pandemic is a public emergency of international concern that affects several nations. The widespread outbreak of COVID 19 virus has brought major psychological pressure among the dental interns. However, the awareness and psychological impact on dental interns and postgraduates has not been studied in Chennai. Aims: This study aimed to evaluate the fear and awareness of infection among dental interns and postgraduates practicing during the current COVID-19 pandemic in and around Chennai and to explore their knowledge about guidelines to fight the virus and to assess various modifications in dental practice. Materials and Methods: An online survey was submitted to dental professionals. Data were collected through a validated questionnaire consisting of 26 closed-ended questions. The gathered data were statistically analyzed. Results: Totally, there were 150 respondents. Majority of students (81%) were anxious about treating the patients during the pandemic. Almost all are afraid of getting quarantined if they get infected. On overall awareness and knowledge part, postgraduates have a slight edge when compared with dental interns. Conclusions: The COVID-19 pandemic has a significant impact on dental professionals. Dental professionals were always vulnerable to infections, many long before the novel coronavirus. Hence, they need to proceed with utmost caution and treat everyone as a potential risk without causing more anxiety.

Keywords: Coronavirus disease-2019, dentist, fear and anxiety, infection, infection control, knowledge of COVID-19, precautions


How to cite this article:
Premnath P, Vishakha S, Yamuna T, Kumar M Y, Abullah Z. Psychological impact and knowledge of coronavirus disease 2019 among dental interns and postgraduates: A cross sectional study. Int J Soc Rehabil 2019;4:1-5

How to cite this URL:
Premnath P, Vishakha S, Yamuna T, Kumar M Y, Abullah Z. Psychological impact and knowledge of coronavirus disease 2019 among dental interns and postgraduates: A cross sectional study. Int J Soc Rehabil [serial online] 2019 [cited 2024 Mar 29];4:1-5. Available from: https://www.ijsocialrehab.com/text.asp?2019/4/1/1/331421




  Introduction Top


The first outbreak of coronavirus disease 2019 (COVID-19) was reported in Wuhan, China, in December 2019. Since then, it has spread worldwide.[1],[2],[3],[4] On January 30, 2020, the World Health Organization announced that the COVID-19 outbreak was a pandemic. Till November 2020, the case count was more than 60 million.[5] COVID-19 spreads primarily among humans is through person-to-person contact, either when people come in direct contact with an infected individual or through respiratory droplets, which are currently considered the major routes of transmission.[5]

The majority of clinical manifestations (80%) is mild and may include a variety of symptoms such as fever, dry cough, shortness of breath, and fatigue. More severe presentations of COVID-19 are the development of sputum production, headache, hemoptysis, diarrhea, and vomiting. Finally, a high mortality risk has been associated with patients developing pneumonia or acute respiratory distress syndrome.[6] Population groups at risk of developing pneumonia or acute respiratory distress include older adults or patients with a preexisting chronic illness such as asthma, chronic obstructive pulmonary disease, diabetes, cardiovascular disease, or immunosuppression. The diagnosis for COVID-19 is made by identifying contact history, clinical manifestations, radiographic changes on computed tomography chest imaging, and laboratory tests.[4]

Considering the overall frequency of the global transmission of the disease, dental professionals are at the greatest risk of getting infected because they are exposed to body fluids such as blood, saliva, and multifarious aerosol/droplets during dental procedures. Studies have shown that direct contact with oral fluids, mucus membrane, contaminated surfaces/instruments, or inhalation of aerosol/droplets from infected individuals during dental procedures favors transmission of this disease.[2] Under these conditions, it may be common for dentists to develop a fear that their patients if exposed to virus may infect them too.[7]

Such procedures subject dental care to significant physical and psychological pressure, leading to burnout, depression, stress, and anxiety. According to Cooper's theory of stress, stress is a continuous cycle where various stressors produce stress, and stress affects the stressors positively in return.[5]

According to the occupational safety and health administration, dental health care professionals are put in a very high-risk category because dentists work near to the oral cavity of the patient.[7] While the MOHFW has issued preventive recommendations, most dentists are still hesitant to treat patients in such a situation and feel afraid.[7] Practice in times of COVID necessitates that the dental interns and postgraduates should be aware of the critical situation and understand all standard of practices. Therefore, the present study aims to evaluate and measure the psychological impact and knowledge of COVID-19 among dental interns and postgraduates.[2]


  Materials and Methods Top


Before the start of the study, ethical approval was taken from the Institutional Review Board of Asan Memorial Dental College and Hospital.

This cross-sectional study was conducted among the dental interns and postgraduates from various dental colleges in Tamil Nadu. A simple random sampling was adapted to select the samples, and the interns and postgraduates in and around Chennai were selected. The STROBE guidelines were used to ensure the reporting of this observational study. The survey was sent to the participants through e-mail and social media applications.

Sample size was determinedy using the formula N = (Zα2 × P × Q)/L2 (Zaki Hakami et al.[5] and the sample size determined as 150 participants. The study duration was conducted between the time period between December 15, 2020 and January 15 2020.

Dental interns and postgraduate students from different specialties who are studying in college in and around Chennai were included.

Before answering the questions, the respondents were informed that their participation in the questionnaire survey was voluntary and anonymous. Their informed consent was subsequently obtained. The validated questionnaire comprised three sections with a total of 27 questions.[5]

  • First section: Fear and anxiety assessment of dental care professionals
  • Second section: Knowledge and practice of dentists about COVID-19
  • Third section: Concerns of dental student self-care with regard to COVID-19.


Statistical analysis

The data collected were entered and analyzed using SPSS Version 25 (IBM Corporation, Armonk, NY, USA). Chi-square test was used to compare categorical variables. P <0.05 was set to be statistically significant.


  Results Top


There were 150 respondents in the study. The respondents comprised 100 (77%) females and 50 (33%) males. The distribution of respondents according to the academic levels was as following: dental interns (87%) and dental postgraduates students (13%).

Majority of students (81%) were anxious about treating the patients during the pandemic [Table 1] more over about 92% of individuals are fear that you could carry the infection from your dental office to your family [Table 2].
Table 1: The anxiety level among the dentist to provide treatment to patients who is coughing or suspected to be infected with coronavirus disease 2019 among different gender and designation

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Table 2: The fear among the dentist that they could carry the infection from the dental office to their family

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Almost all are afraid of getting quarantined if they get infected [Table 3]. [Table 4] interpreted that interns (81%) are more anxious about the cost of treatment for COVID-19. Compared with interns postgraduates (90%) are more updated with the who guideline of the infection control [Table 5], even post graduates (90%) are the one who routinely followed universal precautions of infection control for every patient [Table 6]. On overall awareness and knowledge part, postgraduates have a slight edge when compared with dental interns. [Table 7] showed that 90% post graduates know which authority to contact if they come across a COVID patient.
Table 3: The number of dentist afraid for getting quarantine if they get infected

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Table 4: The level of anxiety about the cost of treatment if they get infected

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Table 5: The amount of dentist updated with the current CDC or WHO guidelines for cross-infection control regarding coronavirus disease 2019

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Table 6: The number of dentists who routinely follows universal precautions of infection control for every patient

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Table 7: The number of dentists who are aware of which authority to contact if they come across a patient with suspected coronavirus disease 2019 infections

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Nearly half (43%) said Indian Government dental care guidelines on patient management is fully efficient [Figure 1].
Figure 1: Perceived efficiency in dental care delivery as per the Indian Government guidelines on patient management

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Surprisingly, with this much of fear and knowledge about COVID-19, only 31% said that they will request antibody test before starting any aerosol procedures [Figure 2].
Figure 2: Questing coronavirus disease 2019 antibody test from patients

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  Discussion Top


The COVID-19 pandemic has shocked the whole planet, created anxiety among the humans, especially the health-care workers. Since COVID-19 is a highly infectious disease requiring strict infection control measures. Dental professionals are especially vulnerable to infections during pandemics. Dental interns and postgraduates' high levels of stress resulting from heavy work overload. They are also liable to anxiety and fear attributed to the greater risk of infection during treatment provision in the dental office, especially during pandemics.[8]

To reduce the spread of disease as well as to reduce the level of anxiety among the health-care workers, high level of knowledge is crucial and must be obtained.[8]

To our knowledge, only a few studies have examined the awareness of COVID-19 among dental health-care providers. In this study, the degree of knowledge and level of anxiety among the dental interns and postgraduate students of colleges in and around Chennai is evaluated.[9],[10]

The current research documented the awareness, anxiety, and fear of dental interns and postgraduates could become infected while operating during the ongoing global pandemic. For this reason, a questionnaire based on closed-ended questions was used to collect information about the insecurity of dental students and any improvements in protocol to counter the COVID-19 virus.[11],[12] Questionnaire-based studies are known to acquire information about participants' interests, behaviors, opinions, and experiences; however, careful collecting and analysis of data are needed.[7]

The questionnaire was completed by 150 dental interns and postgraduate students. Our findings indicate that 77% of respondents experience immense anxiety and stress related to their return to clinical training, in which 92% of respondents have fear that they could carry the infection from their dental office to their family.

A study conducted by Mariam Mohsen Aly et al. among Egyptian dentists[3] showed high percentage of dental professionals experiencing fear and anxiety of getting infected while providing dental care,[3] similarly Suhail H. AlAmad et al. study[3] also showed higher anxiety level among the practitioners.[13],[14],[15],[16]

A study conducted by Nigusie Shifera Aylie et al.[17] revealed students who had depression and anxiety and higher risk of developing stress compared to those who had no depression and anxiety. This may be due to an exaggerated information dissemination about the health, social, and economic crisis of COVID-19.

Almost all are afraid of getting quarantined if they get infected. Compared with interns, postgraduates (90%) are more updated with who guideline of the infection control even postgraduates (90%) are the one who routinely followed universal precautions of infection control for every patient. On overall awareness and knowledge part, postgraduates have a slight edge when compared with dental interns.

In relation to the knowledge subscale, postgraduate students showed a statistically higher level of knowledge when compared to other groups. This difference might be predicted by their higher experience and more advanced skills in information search, critical reading, as well as problem-focused observation.[2] A study conducted by Reham Al Jasser et al.[2] also showed a significance that students with higher level possess more knowledge.

Aleksandar Kecojevic et al.'s[2] study revealed that, with increase in knowledge about COVID-19, students' attitude toward treating patients also changed.

Surprisingly, in this study, dental students even though they are with more knowledge and fear regards the COVID-19, only 31% of the students said that they will request antibody test before start of any aerosol procedure, which brings a serious doubt that whether students completely understood the symptoms and transmission of COVID-19, this also shows most people fear is due to hype created by the media.[13],[14]

Comparatively, we found that fear and anxiety to be higher in women than men. Factors that are associated with a greater psychological vulnerability seem to be more important than factors associated with the risk of infection in predicting mental health consequences of the pandemic.[10]

Multiple factors can predispose and provoke fear in the daily practice of dental students; one of these factors is the infection transmission. Most dental procedures generate aerosols, which are considered the main way of spreading COVID-19 and lead to anxiety and stress in dental students to return to training in dental college during COVID-19 crisis. The most of the surveyed participants in this study were young and had a lack of experience, that's why the most significant causes of fear among them were related to dental practice.

Min Luo et al.[12] have found that some factors such as having up-to-date and accurate health information and taking precautionary measures could help decrease the psychological impact among the dental interns and postgraduates.[12]

The fear of transmitting infections to important others and loved ones was another COVID-19-related stress inducing factor observed in the present study.

Limitations

This study was conducted with a very smaller number of sampling. To identify the clear picture of the purpose of this study, practicing dentist also should be included.


  Conclusions Top


We have founded postgraduates are having more fear about getting infected and being quarantined when compared to the undergraduates which indicates that there is a direct association between fear, knowledge, and anxiety. More the knowledge more amount of fear and anxiety. The data show students were having more fear that then will transmit the disease to their family than getting disease to themselves.

Dental professionals were always vulnerable to infections, many long before the novel coronavirus. Hence, they need to proceed with utmost caution and treat everyone as a potential risk without causing more anxiety. This will require many necessary changes. We need to assure our staff, students, and our patients that we were committed to maintaining the highest standard of infection control, sanitization, and accessibility to personal protective equipment.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Kharma MY, Koussa B, Aldwaik A, Yaseen J, Alamari S, Alras H, et al. Assessment of anxiety and stress among dental students to return to training in dental college in COVID-19 Era. Eur J Dent 2020;14:S86-90.  Back to cited text no. 1
    
2.
Al Jasser R, Al Sarhan M, Al Otaibi D, Al Oraini S. Awareness toward COVID-19 precautions among different levels of dental students in King Saud University, Riyadh, Saudi Arabia. J Multidiscip Healthc 2020;13:1317-24.  Back to cited text no. 2
    
3.
Aly MM, Elchaghaby MA.Impact of novel coronavirus disease (COVID-19) on Egyptian dentists' fear and dental practice (a cross-sectional survey). BDJ Open 2020;6:19. doi: 10.1038/s41405-020-00047-0.  Back to cited text no. 3
    
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Aboalela A, AlShafei A, Almousa MA, Alharbi GK, Alqahtani AS, Bin Shraim NM. Knowledge and Awareness of COVID-19 among Dental Students, Interns, Clinicians and Academics. International Journal of Medical Research & Health Sciences 2020;9:25-31.  Back to cited text no. 4
    
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Hakami Z, Khanagar SB, Vishwanathaiah S, Hakami A, Bokhari AM, Jabali AH, et al. Psychological impact of the coronavirus disease 2019 (COVID-19) pandemic on dental students: A nationwide study. Journal of Dental Education 2021;85:494-503.  Back to cited text no. 5
    
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Özdede M, Sahin SC. Views and anxiety levels of Turkish dental students during the Covid-19 pandemic. J Stoma 2020;73:123-8. [doi: 10.5114/jos. 2020.96867].  Back to cited text no. 6
    
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Bawa SK, Sharma P, Jindal V, Malhotra R, Malhotra D, et al. Assessing the dental practitioner's awareness, fear, anxiety and practices to battle the covid-19 pandemic in Himachal Pradesh, India. Dental Res Manag 2020;4:34-8. DOI:10.33805/2572-6978.142.  Back to cited text no. 7
    
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Ammar N, Aly NM, Folayan MO, Khader Y, Virtanen JI, Al-Batayneh OB, et al. Behavior change due to COVID-19 among dental academics – The theory of planned behavior: Stresses, worries, training, and pandemic severity. PLoS One 2020;15:e0239961.  Back to cited text no. 8
    
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Al-Amad SH, Hussein A. Anxiety among dental professionals and its association with their dependency on social media for health information: Insights from the COVID-19 pandemic. BMC Psychol 2021;9:9.  Back to cited text no. 9
    
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Schäfer SK, Sopp MR, Schanz CG, Staginnus M, Göritz AS, Michael T. Impact of COVID-19 on public mental health and the buffering effect of a sense of coherence. Psychother Psychosom 2020;89:386-92.  Back to cited text no. 10
    
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Kecojevic A, Basch CH, Sullivan M, Davi NK. The impact of the COVID-19 epidemic on mental health of undergraduate students in New Jersey, cross-sectional study. PLoS One 2020;15:e0239696.  Back to cited text no. 11
    
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Luo M, Guo L, Yu M, Jiang W, Wang H. The psychological and mental impact of coronavirus disease 2019 (COVID-19) on medical staff and general public – A systematic review and meta-analysis. Psychiatry Res 2020;291:113190.  Back to cited text no. 12
    
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Shetty A, Bhat R, Shetty P, Hegde MN, Krishna Nayak US, D'souza N. The psychological impact of the COVID-19 pandemic on dental healthcare professionals. J Int Oral Health 2020;12, Suppl S2:98-105.  Back to cited text no. 13
    
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Collin V, O Selmo E, Whitehead P. Psychological distress and the perceived impact of the COVID-19 pandemic on UK dentists during a national lockdown. Br Dent J 2021. doi: 10.1038/s41415-020-2592-5.  Back to cited text no. 14
    
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Hakami Z, Khanagar SB, Vishwanathaiah S, Hakami A, Bokhari AM, Jabali AH, et al. Psychological impact of the coronavirus disease 2019 (COVID-19) pandemic on dental students: A nationwide study. J Dent Educ 2021;85:494-503.  Back to cited text no. 15
    
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Singh H, Kumar A, Gupta A, Redhu A, Singh A. Impact of COVID-19 on Indian dentists: A cross sectional survey. J Indian Acad Oral Med Radiol 2020;32:360-5.  Back to cited text no. 16
  [Full text]  
17.
Aylie NS, Mekonen MA, Mekuria RM. The psychological impacts of COVID-19 pandemic among university students in Bench-Sheko Zone, South-west Ethiopia: A community-based cross-sectional study. Psychol Res Behav Manag 2020;13:813-21.  Back to cited text no. 17
    


    Figures

  [Figure 1], [Figure 2]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7]



 

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