Knowledge, Attitudes, and Practices of People living with SCI towards COVID-19 and their Psychological State during In-patient Rehabilitation in Bangladesh

Hossain, M. A.; Jahid, I. K.; Hossain, K. M. A.; Sakel, M.; Kabir, M. F.; Saunders, K.; Faruqui, R.; Hossain, M. S.; Uddin, Z.; Kader, M.; Walton, L. M.; Haque, M. O.; Shafin, R.

Study Design: A prospective cross-sectional survey. Objective: The study aimed to examine the Knowledge, Attitudes, and Practices (KAP) of people living with Spinal cord injury (SCI) towards COVID-19 and their psychological status during in-patient rehabilitation in Bangladesh. Setting: The Centre for the Rehabilitation of the Paralyzed (CRP) and the National Institute of Traumatology and Orthopedic Rehabilitation (NITOR), two tertiary level hospitals in Dhaka, Bangladesh. Methods: From July to September 2020, a prospective, cross-sectional survey of SCI subjects, 13-78 years of age, carried out in two SCI rehab centers in Bangladesh. Data has been collected by face to face interview through a pretested, and language validated questionnaire on KAP and Depression, Anxiety, Stress (DASS). Ethical approval and trial registration obtained prospectively. As all the patients were previously living with Spinal cord injury (SCI), therefore, all the patients admitted/ attend SCI rehab centers were considered as SCI positive samples. Results: A total of 207 people with SCI responded, 87%were male, and 13% were female with mean age34.18 (SD 12.9) years. 33.8% was tetraplegic and 66.2% was paraplegic and 63.8% of them were diagnosed ASIA-A, with a motor score mean 45.38, the sensory score of 97.2, SpO2 95.07, and Vo2max 35.7 mL/kg/min. 178 people had at least one health issue. Overall knowledge score was 8.59 (SD 2.3) out of 12, depression 11.18 (SD 8), anxiety 7.72 (SD 5.1), and stress were 9.32 (SD 6.7) from a total of 21 scores each. There was a correlation between Knowledge and DASS with age (P<.05); and Knowledge with gender (P<.05), and education (P<.01). Binary logistic regression found a higher association of Knowledge and DASS with gender (OR 6.6, 6.6, .95, 6.6; P<.01); and young age (OR.418, P<.01), illiterate (OR3.81, P<.01), and rural people (OR.48, P<.05) with knowledge. A linear relation was noted between depression and anxiety scores (r.45, P<.01) and stress scores (r.58, P<.01). A positive attitude was reported for the majority of subjects. SCI Persons reported they and the caregiver followed health advisory in consulting health professionals (65.7%), isolation (63.8%), droplet precaution (87.4%), and hygiene (90.3%). Conclusions: During in-patient rehabilitation in Bangladesh, the majority of SCI reported that they had communicated with health professionals and practiced behaviors that would reduce transmission and risk of COVID-19.