Materials and Methods
The study was a cross-sectional survey done in the Department of Cardio-Thoracic and Vascular Surgery at the tertiary care hospital in western Rajasthan, India, from September 2021 to November 2021. The institute’s ethical committee approved the study protocol, consent form, questionnaire, and information sheet, which followed the Declaration of Helsinki guidelines. All postoperative cardiac surgical patients with valvular heart disease, coronary artery disease, and congenital heart disease of age 18 years and above, surgically treated at the institute, were included after informed consent. The KAP questionnaire was designed based on the extensive literature review published on COVID-19 and guidelines issued by health ministry, Government of India. A questionnaire was created with 20 questions on the Knowledge, Attitude & Practices of cardiac surgical patients during this pandemic in Hindi and was validated by 2 Biostatisticians and two cardiac surgeons. The questionnaire comprised three parts: Demographic details, knowledge-attitude-practice (KAP), and access to medical facilities. The demographic and clinical details included age, gender, place of residence (rural vs. urban), educational status, surgical status, and current New York Heart Association (NYHA) grade. All the participants were evaluated during their follow-up visit by a single interviewer with the aid of a validated questionnaire at the outpatient clinic.
The KAP questionnaire consisted of a total of 20 questions. Fourteen questions were dedicated to assessing knowledge about the novel coronavirus disease, four questions pertaining to attitude towards pandemic, and finally, two questions related to practices towards COVID-19 (Table 1 – Questionnaire). These questions were based on public health information and Covid-19 guidelines from the Government of India. The questions assessed knowledge of clinical symptoms, spread, treatment, and prevention of COVID-19. Each correct response was awarded a score of 1 while do not know, and an incorrect response was given a zero score. Maximum scores were 43 for knowledge, 9 for attitude, and 8 for practice questions. The higher the total score, the more knowledgeable the participant was considered. The design, setting, analyses, and reporting of this study adhered to the STROBE guidelines for cross-sectional survey in epidemiology.