Lupine Publishers | Scholarly Journal Of Psychology And Behavioral Sciences
Abstract
The
COVID-19 pandemic is a global health emergency that could severely impact
mental health. Fear of COVID-19 or its risk perceptions is strongly associated
with COVID-19 preventive behaviors. This study aimed to examine the
associations between the anxiety of COVID-19 and preventive behaviors among
People in the Gaza Strip. The sample consists of 682 participants. A
cross-sectional online survey design was used; all participants completed the
Fear of COVID-19 Scale (FCV-19S) and preventive behavior scale. The required
data were collected and analyzed. The mean fear of COVID-19 score was 2.51 (SD
= 0.83, range: 7–35), while the mean score for preventive behavior was 2.48 (SD
= 0.38, range: 3–30). Besides, results showed participants from the North Gaza
governorates and those with low educated levels had the highest level of fear
of COVID-19. In contrast, females and highly educated participants were more
likely to engage in preventive behaviors than other participants. Our findings
show no significant associations between fear of COVID-19 and adherence to
preventive behaviors. It is essential to continue monitoring the psychological
reactions of people during the outbreak.
Keywords: COVID-19; Fear; Preventive
Behaviors; Palestine; Gaza Strip.
Introduction
The
COVID-19 pandemic is a global health emergency that could severely impact
public health [1]. The outbreak was first revealed in late December 2019 when
clusters of pneumonia cases of unknown etiology were found in the city of Wuhan
of Hubei Province, in China [2]. Ever since the coronavirus disease 2019 (COVID
19) attained a pandemic status [3], there have been strenuous efforts by health
experts and authorities worldwide to mitigate the spread of the virus [4]. This
includes installing health protocols such as washing hands regularly, wearing a
face mask and keeping at least a physical distancing meter from each other
during a social gathering [5]. Toward prevention of COVID-19, the Ministry of
Health (MOH) declared a state of emergency and recommend that several safety
protocols such as hand washing, wearing of face mask, physical distancing, and
quarantining, all travellers coming through Rafah and Beit Hanon (Erez)
crossings had undergone a compulsory quarantine at one of the MOH designated
facilities, isolation hospitals, and health quarantine centers. People stay for
21 days in quarantine centers. On 26 August 2020, MOH in Gaza confirmed the
first COVID-19 spread through the Gaza strip community. The total number of
confirmed cases is 63428, of which 6614 are still active cases, 56211 cases
fully recovered and were discharged, while the number of deaths reached 603
deaths. However, reliance on government action alone is insufficient to control
COVID-19 disease totally (WHO) proposed several personal preventive behaviors
for individuals to engage in to prevent COVID-19 infection. Therefore,
understanding the factors associated with individuals’ preventive behaviors is
an important topic during the COVID-19 pandemic [6- 10].
One
psychological aspect of the COVID-19 pandemic is fear. Fear is an unpleasant
emotional state triggered by the perception of threatening stimuli [11]. Also,
fear of COVID-19 or its risk perceptions is strongly associated with COVID-19
preventive behaviors [8]. After reviewing the literature, the authors found
that fear of COVID-19 are associated with preventive COVID-19 infection
behaviors. Some accurate COVID-19 information (e.g., the death rate and numbers
of confirmed cases) may trigger an individual’s fear of COVID-19 and induce
psychological distress [12]. The authors believe that trust in COVID-19
information sources may improve awareness of preventive behavior; on the other
hand, it may affect mental health, including an increase in fear of COVID-19
and induce psychological distress. A study aimed to assess the prevalence and
predictors of depression among the Palestinian community during this pandemic
found that the prevalence of depression was 57.5% [13-17]. As well known, life
in Gaza is so tricky due to the unusual circumstances that the Palestinian
people are living under the continuing Israeli blockade. There are many forms
of suffering that the Palestinian people experience, such as unemployment,
poverty, security instability, siege, and finally impact of the COVID-19 pandemic.
All of these factors, when combined, increase mental health problems [18-20]. A
recent study aimed to examine the psychological distress among healthcare
providers during the COVID-19 Pandemic in Gaza Strip, which found that
depression level 68%, anxiety 69%, stress 67% [21]. In Gaza, no studies were
conducted to examine the associations between fear of COVID-19 and preventive
behaviors according to the authors’ knowledge. This study will provide
information and data for all concerned people. On the other hand, this study
will increase the mental health body knowledge in Palestine; this study seeks
to examine the associations between fear of COVID-19 and preventive behaviors
among People in the Gaza Strip.
Methods
Study population, sample, and setting
The
target population comprises all 18 years or older people and currently living
in the Gaza Strip. The sample consists of 682 participants. We adopted a
cross-sectional survey design to measure fear COVID-19 and to assess how
individuals perform preventive COVID-19 infection behaviors among the study
sample by using an online survey. A snowball sampling method focused on
recruiting the general public living in Gaza Strip during the pandemic was
conducted. The online survey was first disseminated on Facebook and WhatsApp
applications to friends, and they were encouraged to pass it on to others.
Procedure
Since
the MOH recommended the public to minimize face-toface interaction and isolate
themselves at their homes, potential respondents were electronically invited.
All of them completed the questionnaires in Arabic through an online survey.
Ethics approval was obtained from the Helsinki Ethical Committee in the Gaza
Strip, Palestine (Code: PHRC/HC/735/20). Privacy was strictly protected during
the procedure. The purposes of the study and information about it were posted
on the first page of the questionnaire. To protect data and preserve privacy,
the authors contacted the participants by phone and electronically and
explained the objectives of the study and the content of the questionnaires and
thanked them for participating in the study. The questionnaire was sent to a
specialist in English translation. After that, the Arabic version was sent to a
specialist in Arabic for accreditation, and then finally, back translation to
Arabic was done. All respondents provided online informed consent before
starting the questionnaire. Data collection took place over seven days (28
September to 5 October 2020).
Instrument
Demographic information
The
demographic variables explored included the age, gender, marital status,
governorate region where the participant resided, and education level.
Fear of COVID-19 scale
(FCV-19S)
includes seven items with a 5-point Likert scale (1 = strongly disagree; 5 =
strongly agree) to assess how an individual fears COVID-19. The validity and
reliability of the tool were verified. The Arabic Version of (FCV-19S) has
excellent psychometric properties; internal consistency (Cronbach’s alpha=.88),
with concurrent validity indicated by significant and positive correlations
with HADS (r = .66).
COVID-19 preventive behavior scale
It
consists of 10 items formulated based on WHO measures to prevent the spread of
COVID-19. Items were assessed on a 3-point Likert scale (always=3, sometimes=2,
rarely=1). A higher score indicates a more outstanding commitment to protective
behaviors COVID-19. The validity of the questionnaire was confirmed using the
viewpoints of nine public health and psychology experts. The reliability of the
questionnaire was investigated by calculating internal consistency (Cronbach’s
alpha=.825) [22].
Results
Characteristics of the study sample
In
this study, 682 participants completed and returned the questionnaire, 46.5%
were male, and 53.5% were female, the age group between 21 and 40, represented
68% of the participants, 49.6 % are single, most of the participants (70.7%)
were currently studying in college, and On the other hand, 10.7% of them are
studying a master or doctorate (Table 1).
Table 1: Sociodemographic
characteristics (n = 682).
Fear of COVID-19 and preventive behaviors
scales
The
highest score item was item 2, “It makes me uncomfortable to think about
coronavirus,” by 52% of participants. While item 3, “My hands become clammy
when I think about coronavirus,” is considered the lowest item with (7.8%).
Result shows (58.5%) of the participants disagree that they have a fear of
COVID-19. The most preventive behaviors were Cover the nose and mouth when
coughing or sneezing, where 90.67% of respondents always said, “I place a
tissue paper or bending elbow in front of my mouth and nose when coughing or
sneezing.” According to the concerned authorities, they always told: “I adhere
to the instructions when leaving the house” by 85.67%. While washing hands
regularly with soap and water for at least 20 seconds came thirdly 85.33%.
On
the other hand, the lowest prevention behaviors keeping a safe space between
themselves and other people were just 74.67% of the sample said: “keep a
distance of at least 1.5 m. from others” (Table 2).
Table 2: Fear
of COVID-19 and preventive behaviors scales.
Correlation between fear of Covid-19 and
preventive behaviors
Using
Pearson correlation, the correlation coefficient was low and not significant (r
= 0.006, P = 0.875).
Variations of fears and preventive measures
concerning socio-demographic characteristics
Significant
differences are shown between fears of COVID-19 and preventive behaviors with
education level and residence place (P < 0.001). Post-Hoc Sheffie’s test
revealed fear of COVID-19 is more in the northern part of the Gaza strip and
among low educated participants. In contrast, preventive behaviors are more
adopted in Gaza city and among the highly educated. Concerning gender, the
significance is reported with preventive behaviors favoring females (P = 0.004)
(Table 3).
Table 3: Comparison
between fears of COVID-19 and preventive behaviors concerning socio-demographic
characteristics.
Discussion
This
current study examined the associations between fear of COVID-19 and Preventive
behaviors among people in the Gaza Strip. Contrary to expectation, there were
no significant associations between fear of COVID-19 and adherence to
preventive behaviors. Participants’ commitment can be attributed to factors
other than fear, such as their autonomous motivation and government
legislation; this is in line with the findings [23]. These disagree with the
findings of previous studies that there exists an association between fear of
COVID-19, mental health, and COVID-19 preventive behaviors [4,24]. There are no
statistically significant differences at a substantial level (α ≤ 0.05) between
demographic factors, age, gender, marital status, and fear of COVID-19. This is
inconsistent with other reports showing greater psychological vulnerability in
women than men during the COVID-19 pandemic [2,5,9]. On the other hand, there
is a statistically significant difference at a substantial level (α ≤ 0.05)
between the place of residence favoring the North Gaza Governorate, low
educational level, and the fear of COVID-19. This can be explained due to a
vast outbreak of COVID-19 in the North Gaza Governorate; lockdown measures were
implemented, leading to amplifying adverse psychological reactions to COVID-19.
This finding is consistent with [17]. The entirety conclusions suggest that
fear of COVID19 may play an integral role in the health and preventive
behaviors among low educated participants.
There
are no statistically significant differences concerning the preventive behavior
results at a significant level (α≤0.05) between demographic factors, age,
marital status, and preventive behavior. In contrast, there is a statistically
significant difference at a considerable level (α ≤ 0.05) between the place of
residence in favor of Gaza city, high educational level, gender in favor of
female and preventive behavior. This is due to the high level of fear among
females, which motivates them to adhere to preventive behaviors. Urban residents
like Gaza Governorate can buy the necessary health equipment for prevention.
Their work can be performed from home; unlike in other areas staying at home
would imply dropping their primary source of livelihood; this finding is in
line with the Rossi. Participants reported high adherence to preventive
behaviors, and those with high education levels were associated with more
commitment to preventive behaviors. This may be due to participants’
characteristics, as (81.4%) have a bachelor’s degree or higher, these results
were found in line with previous studies [15,19].
Conclusion
Our
findings show that there were no significant associations between fear of
COVID-19 and adherence to preventive behaviors. This study demonstrated a
statistically significant difference at a significant level (α ≤ 0.05) between
the place of residence in favor of the North Gaza Governorate, low educational
level, and the fear of COVID-19. On the other hand, there is a statistically
significant difference at a significant level (α ≤ 0.05) between the place of
residence in favor of Gaza city, high educational level, gender in favor of
female and preventive behavior. The current study indicated a
lower-than-average level of fear of COVID-19 and an increased commitment to preventive
behaviors among participants. Education level and gender have an essential role
in the management of people’s health and preventive behaviors. Health experts
and communicators may capitalize on these findings to educate people on
COVID-19. It is crucial to continue monitoring the psychological reactions of
people during the outbreak.
https://lupinepublishers.com/psychology-behavioral-science-journal/fulltext/the-associations-between-fear-of-covid-19-and-preventive-behaviors-among-people-in-gaza-strip-palestine.ID.000208.php
For more Lupine Publishers Open Access Journals Please visit our website: https://lupinepublishersgroup.com/
For more Psychology And Behavioral Sciences Please Click
Here: https://lupinepublishers.com/psychology-behavioral-science-journal/
To Know more Open Access Publishers Click on Lupine Publishers
Follow on Linkedin : https://www.linkedin.com/company/lupinepublishers
Follow on Twitter : https://twitter.com/lupine_online
No comments:
Post a Comment