Background
Methodology
Questionnaire development
First stage: items and domains development
Domains | No. of Items | Measurements | Response choices |
---|---|---|---|
Demography | 14 | Socio-demographic, occupation, level of education, history of previous hajj or Umrah in the last 5 years, comorbidities, history of vaccination | Open-ended, closed-ended, multiple-choice |
Knowledge | 29 | Etiology, transmission, risk groups, signs and symptoms, complications, the use of PPE and prevention practices | Yes/No/I don’t know; 1 = correct answer, 0 = wrong/I don’t know |
Attitude | 12 (5 reverse scored items) | Prevention attitudes regarding RTI based on health belief model | 1 = Strongly disagree, 2 = Disagree, 3 = Not sure, 4 = Agree, 5 = Strongly agree |
Practice | 14 | Preventive and risk-reduction infection practices, including healthy life style, the use of facemask, vaccination, hand hygiene and cough etiquette | 0 = Always, 1 = Occasional, 2 = Never, 3 = Not applicable |
Second stage: validation
Item response theory
Exploratory factor analysis (EFA)
Reliability
Results
Questionnaire development and content and face validity
Descriptive statistics of the participants
Variables | Mean (SD) | Frequency | Percentage (%) |
---|---|---|---|
Age | 43.85 (15.80) | ||
Gender | |||
Male | 110 | 37.4 | |
Female | 184 | 62.6 | |
Ethnicity | |||
Malay | 289 | 98.7 | |
Chinese | 0 | 0 | |
Indian | 1 | 0.3 | |
Others | 3 | 1.0 | |
Marital status | |||
Single | 85 | 28.9 | |
Married | 198 | 67.4 | |
Divorced/widowed | 11 | 3.7 | |
Occupation | |||
Student | 20 | 6.8 | |
Civil servant | 76 | 26.0 | |
Private sector | 92 | 31.5 | |
Pensioner | 45 | 15.6 | |
Housewife | 32 | 10.9 | |
Self-employed | 27 | 9.2 | |
Highest level of education | |||
PhD | 4 | 1.4 | |
Master’s degree | 20 | 6.8 | |
Bachelor’s degree | 58 | 19.7 | |
Diploma | 93 | 31.6 | |
Secondary school | 107 | 36.4 | |
Primary school | 12 | 4.1 | |
History of vaccination | |||
Meningococcal vaccine | 111 | 37.8 | |
Influenza (flu) vaccine | 52 | 17.7 | |
Pneumococcal vaccine | 25 | 8.5 | |
Presence of Co-morbidities | |||
Chronic lung disease | 4 | 1.4 | |
Neuromuscular disease | 10 | 3.4 | |
Allergic rhinitis | 5 | 1.7 | |
Diabetes | 21 | 7.1 | |
Hypertension | 46 | 15.6 | |
Heart disease | 8 | 2.7 | |
Chronic kidney disease | 2 | 0.7 | |
Immune deficiency disorders | 1 | 0.3 |
Item response theory
Items | b | a | λ | χ2 (df = 8) | P values |
---|---|---|---|---|---|
K1 Flu-like illnesses are caused by: | |||||
Penyakit seperti selsema disebabkan oleh: | |||||
K1i Virus | −1.04 | 3.12 | 0.87 | 120.2 | < 0.001 |
Virus | |||||
K1ii Bacteria | −0.54 | 2.16 | 0.78 | 62.98 | < 0.001 |
Bakteria | |||||
K1iii Allergies | −0.41 | 3.50 | 0.9 | 100.55 | < 0.001 |
Alergi | |||||
K2 Flu-like illnesses are spread by: | |||||
Penyakit seperti selsema disebarkan oleh: | |||||
K2i Water | 0.24 | 2.32 | 0.82 | 88.76 | < 0.001 |
Air | |||||
K2ii Sharing towels with an infected person | −0.32 | 3.95 | 0.94 | 52.78 | < 0.001 |
Berkongsi tuala dengan penghidap | |||||
K2iii Dust | −0.86 | 2.24 | 0.79 | 26.19 | 0.001 |
Debu | |||||
K2iv Air | −1.10 | 3.39 | 0.88 | 24.34 | 0.002 |
Udara | |||||
K2v Shaking the hands of an infected person with a cough and/or cold | −0.16 | 1.90 | 0.75 | 52.42 | < 0.0001 |
Berjabat tangan dengan pengidap yang batuk atau demam | |||||
K3 Flu-like illnesses are spread quickly | −1.17 | 1.41 | 0.64 | 101.32 | < 0.001 |
Penyakit seperti selsema tersebar dengan pantas | |||||
K4 The following persons are at an increased risk of flu-like illnesses: | |||||
Berikut merupakan mereka yang berisiko tinggi mengalami penyakit seperti selsema: | |||||
K4i Senior citizens aged 65 and older | −0.57 | 1.94 | 0.75 | 29.26 | < 0.001 |
Warga emas berusia 65 tahun ke atas | |||||
K4ii Smokers | −0.14 | 3.08 | 0.87 | 75.46 | < 0.001 |
Perokok | |||||
K4iii Asthmatics | −0.87 | 2.83 | 0.86 | 43.63 | < 0.001 |
Pesakit asma | |||||
K4iv Diabetics | 0.40 | 4.32 | 0.93 | 21.16 | 0.007 |
Pesakit diabetes | |||||
K4v People with arthritis | 0.43 | 2.34 | 0.80 | 50.84 | < 0.001 |
Penghidap artritis | |||||
Kvi Those in crowded places/among a lot of people | −1.13 | 1.83 | 0.73 | 49.71 | < 0.001 |
Mereka yang berada di tempat yang sesak/dalam kalangan ramai orang | |||||
K5 What are the complications of flu-like illnesses? | |||||
Apakah komplikasi penyakit seperti selsema? | |||||
K5i Pneumonia | −0.27 | 2.76 | 0.90 | 91.12 | < 0.001 |
Paru-paru berair | |||||
K5ii Bronchitis | −0.14 | 2.93 | 0.91 | 126.49 | < 0.001 |
Bronkitis | |||||
K5iii Difficulty in breathing | 0.64 | 6.26 | 0.88 | 22.80 | 0.004 |
Kekejangan | |||||
K5iv Multi-organ failure | 0.55 | 2.85 | 0.89 | 170.57 | < 0.001 |
Kegagalan pelbagai organ | |||||
K6 The following practices can help protect you from flu-like illnesses: | |||||
Amalan berikut dapat menghindari anda daripada penyakit seperti selsema: | |||||
K6i Ensuring a healthy diet | −1.05 | 2.29 | 0.50 | 38.14 | < 0.001 |
Memastikan pemakanan yang sihat | |||||
K6ii Receiving vaccinations | −0.80 | 2.26 | 0.85 | 66.51 | < 0.001 |
Menerima vaksinasi | |||||
K6iii Washing your hands with hand sanitizers | −0.86 | 6.29 | 0.78 | 15.08 | 0.058 |
Membasuh tangan dengan sanitasi | |||||
K6iv Covering your nose with your hands | −0.67 | 1.75 | 0.92 | 71.99 | < 0.001 |
Menutup mulut dengan tangan | |||||
K6v Wearing a face mask | −1.22 | 5.07 | 0.71 | 10.75 | 0.216 |
Memakai topeng muka | |||||
K7 The following are reasons for wearing a mask: | |||||
Berikut merupakan sebab memakai topeng muka: | |||||
K7i Being in crowded places | −1.03 | 6.11 | 0.97 | 11.82 | 0.160 |
Berada di tempat yang sesak | |||||
K7ii Being near people who are coughing | −1.26 | 4.83 | 0.96 | 20.75 | 0.008 |
Berada berdekatan orang yang batuk | |||||
K7iii When I am sick | −0.91 | 4.33 | 0.94 | 49.03 | < 0.001 |
Apabila saya sakit | |||||
K8 A cloth facial mask is as effective as a 2-ply surgical facial mask | 1.02 | 1.29 | 0.60 | 60.85 | < 0.001 |
Topeng wajah kain sama berkesan dengan topeng wajah pembedahan dua lapisan | |||||
K9 If I am not sick, the used face mask can be stored in a bag for later use | 0.72 | 1.56 | 0.67 | 182.10 | < 0.001 |
Jika saya tidak sakit, topeng muka terpakai boleh disimpan dalam beg untuk kegunaan seterusnya |
Exploratory factor analysis
Factors | Items | Factor loading | Reliability (Cronbach’s alpha) |
---|---|---|---|
Barriers to compliance | A3: Since the bird flu, SARS, MERS-COV and H1N1 crises are over, I no longer need to worry about contracting flu-like illnesses | 0.527 | 0.81 |
Sejak krisis selesema burung, SARS, MERS-COV and H1N1 berakhir, saya sudah tidak perlu bimbang mendapat penyakit mirip influenza (demam selesema/influenza like illness) | |||
A8: I am generally opposed to wearing a face mask | 0.741 | ||
Secara amnya saya menentang penggunaan penutup hidung dan mulut | |||
A9: Flu vaccinations have unpleasant side effects | 0.641 | ||
Vaksinasi influenza mengakibatkan kesan sampingan yang tidak selesa | |||
A10: I am influence by negative news about flu vaccines | 0.791 | ||
Saya dipengaruhi oleh berita negatif mengenai vaksin selsema | |||
A11: It is too much trouble to get a flu vaccine | 0.662 | ||
Agak susah untuk mendapatkan vaksin influenza | |||
Self-motivation | A4 If I have a flu-like illness, I may spread it to others | 0.58 | 0.70 |
Jika saya menghidap penyakit mirip influenza (demam selesema/influenza like illness), saya mungkin menjangkiti orang lain | |||
A5: I feel that someone that have influenza-like illness should: | |||
Seseorang yang mengalami penyakit mirip influenza (demam selesema/influenza like illness) haruslah: | |||
A5A: cover his mouth and nose with his bare hand when coughing or sneezing | 0.462 | ||
Menutup mulut dan hidung dengan tangannya apabila batuk atau bersin | |||
A5B: cover his mouth and nose with a handkerchief when coughing or sneezing | 0.414 | ||
Menutup mulut dan hidung dengan sapu apabila batuk atau bersin | |||
A6: Influenza vaccines protects hajj pilgrims from influenza | 0.568 | ||
Vaksin influenza melindungi jemaah haji daripada demam selesema | |||
A7: Using a hand wash can prevent you from getting flu like illness | 0.434 | ||
Penggunaan sanitasi tangan dapat mencegah anda daripada menghidap penyakit mirip influenza (demam selesema/influenza like illness) | |||
A12A: I think coughs and the flu can be prevented by wearing a mask outside my house | 0.588 | ||
Saya rasa penyakit mirip influenza (demam selesema/influenza like illness) boleh dicegah dengan pemakaian sungkup muka di luar rumah | |||
A13: Wearing a well-fitting face mask is effective in preventing flu-like illnesses | 0.414 | ||
Memakai sungkup muka yang betul-betul sesuai pada wajah adalah berkesan untuk mencegah penyakit seperti selsema |
Factors | Items | Factor loading | Reliability (Cronbach’s alpha) |
---|---|---|---|
Health lifestyle | P1: I eat vegetables | 0.917 | 0.83 |
Saya makan sayur | |||
P2: I eat fruits | 0.878 | ||
Saya makan buah-buahan | |||
P5: I use soap to wash my hands | 0.556 | ||
Saya menggunakan sabun untuk membasuh tangan saya | |||
Prevention practices | P4: When wearing a mask, I test it to ensure it fits properly | 0.433 | 0.83 |
Ketika memakai penutup hidung dan mulut (face mask), saya memastikan ianya benar-benar kemas | |||
P6: I use disinfectant or disposable wipes or hand gel to wash my hands | 0.543 | ||
Saya menggunakan penyahinfektan atau pengelap pakai buang atau gel tangan untuk membasuh tangan saya | |||
P7: I use a washable cloth handkerchief to clean my hands | 0.315 | ||
Saya menggunakan sapu tangan yang boleh dibasuh untuk membasuh tangan saya | |||
P8: I wash my hands after: | |||
Saya membasuh tangan saya: | |||
P8A: touching the personal items of someone who has a cough and/or cold | 0.67 | ||
Selepas menyentuh barang peribadi seseorang yang mengalami batuk atau selsema | |||
P8B: shaking hands with people who have a cough and/or cold | 0.769 | ||
Selepas berjabat tangan dengan seseorang yang mengalami batuk atau selsema | |||
P8C: touching door knobs | 0.679 | ||
Selepas menyentuh tombol pintu | |||
P9: I refrain from: | |||
Saya menghindari daripada: | |||
P9A: being close to those who cough or sneeze | 0.571 | ||
berada rapat dengan orang yang batuk atau selesema | |||
P9B: shaking the hands of those who have a cough and/or cold | 0.671 | ||
berjabat tangan dengan orang yang batuk atau selesema | |||
P9C: often touching my nose | 0.474 | ||
kerap menyentuh hidung saya | |||
P10: I received the flu vaccine | 0.486 | ||
Saya menerima vaksin selsema |