Physical therapists’ use of personal protective equipment during the COVID-19 pandemic: a cross-sectional study in Saudi Arabia

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Maintaining an efficient healthcare service is achieved by ensuring the safety of a well-informed healthcare practitioner. This study aimed to assess the sources of knowledge, attitude, experience, and accessibility to the personal protective equipment (PPE) of the physical therapists working in Saudi Arabia. Methods: A cross-sectional study was conducted to survey on-duty PT practitioners using a web-based questionnaire. Licensed PT practitioners were invited to participate, and a sample of 424 therapists responded. The questionnaire comprised of 22 questions covering the demographic data and the following domains: sources of knowledge regarding the pandemic, experience, and attitude of the therapists during the pandemic, and accessibility to the PPE. Results: Around 83% of the participants (352) completed all the survey questions. Governmental websites were the most used source of knowledge (39%). Hand sanitization was implemented by the majority of participants (81%). Participants, mainly males and experienced therapist, were willing to treat COVID-19 patients. The COVID-19 complications of prolonged ventilation and immobilization were successfully treated by 91.2% of participants who treated positive cases. About a third of the participants were part of COVID-19 management planning teams or received training to deal with the pandemic. Most of the necessary PPE was adequately accessible during the pandemic. Conclusions: Therapists implemented the recommended hygienic practices and had no problems accessing the necessary PPE. More efforts should target therapists’ education about the social media misleading information and involving the therapists in the pandemic management planning teams." } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://f1000research.com/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://f1000research.com/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://f1000research.com/articles/11-918/v2", "name": "Physical therapists’ use of personal protective equipment during the..." } } ] } Home Browse Physical therapists’ use of personal protective equipment during the... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Elsayed W, Albagmi F, Alghamdi M and Farrag A. Physical therapists’ use of personal protective equipment during the COVID-19 pandemic: a cross-sectional study in Saudi Arabia [version 2; peer review: 1 approved with reservations] . F1000Research 2024, 11 :918 ( https://doi.org/10.12688/f1000research.110204.2 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Research Article Revised Physical therapists’ use of personal protective equipment during the COVID-19 pandemic: a cross-sectional study in Saudi Arabia [version 2; peer review: 1 approved with reservations] Walaa Elsayed https://orcid.org/0000-0001-5586-498X 1 , Faisal Albagmi https://orcid.org/0000-0001-6611-915X 1 , Mohammed Alghamdi 1 , Ahmed Farrag https://orcid.org/0000-0003-4954-2479 2,3 Walaa Elsayed https://orcid.org/0000-0001-5586-498X 1 , Faisal Albagmi https://orcid.org/0000-0001-6611-915X 1 , Mohammed Alghamdi 1 , Ahmed Farrag https://orcid.org/0000-0003-4954-2479 2,3 PUBLISHED 18 Sep 2024 Author details Author details 1 Department of Physical Therapy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia 2 Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia 3 Basic Science Department, Faculty of Physical Therapy, Cairo University, Cairo, Egypt Walaa Elsayed Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Supervision, Validation, Writing – Original Draft Preparation, Writing – Review & Editing Faisal Albagmi Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Writing – Original Draft Preparation, Writing – Review & Editing Mohammed Alghamdi Roles: Data Curation, Investigation, Project Administration, Resources, Software Ahmed Farrag Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Writing – Original Draft Preparation, Writing – Review & Editing OPEN PEER REVIEW DETAILS REVIEWER STATUS This article is included in the Emerging Diseases and Outbreaks gateway. This article is included in the Coronavirus (COVID-19) collection. Abstract Background : Physical therapy (PT) services can be essential for recovery from coronavirus disease 2019 (COVID-19) infection. Maintaining an efficient healthcare service is achieved by ensuring the safety of a well-informed healthcare practitioner. This study aimed to assess the sources of knowledge, attitude, experience, and accessibility to the personal protective equipment (PPE) of the physical therapists working in Saudi Arabia. Methods : A cross-sectional study was conducted to survey on-duty PT practitioners using a web-based questionnaire. Licensed PT practitioners were invited to participate, and a sample of 424 therapists responded. The questionnaire comprised of 22 questions covering the demographic data and the following domains: sources of knowledge regarding the pandemic, experience, and attitude of the therapists during the pandemic, and accessibility to the PPE. Results : Around 83% of the participants (352) completed all the survey questions. Governmental websites were the most used source of knowledge (39%). Hand sanitization was implemented by the majority of participants (81%). Participants, mainly males and experienced therapist, were willing to treat COVID-19 patients. The COVID-19 complications of prolonged ventilation and immobilization were successfully treated by 91.2% of participants who treated positive cases. About a third of the participants were part of COVID-19 management planning teams or received training to deal with the pandemic. Most of the necessary PPE was adequately accessible during the pandemic. Conclusions : Therapists implemented the recommended hygienic practices and had no problems accessing the necessary PPE. More efforts should target therapists’ education about the social media misleading information and involving the therapists in the pandemic management planning teams. READ ALL READ LESS Keywords COVID-19, Attitude, Protection, Physical Therapy, patient care, Rehabilitation Corresponding Author(s) Faisal Albagmi ( [email protected] ) Close Corresponding author: Faisal Albagmi Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2024 Elsayed W et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Elsayed W, Albagmi F, Alghamdi M and Farrag A. Physical therapists’ use of personal protective equipment during the COVID-19 pandemic: a cross-sectional study in Saudi Arabia [version 2; peer review: 1 approved with reservations] . F1000Research 2024, 11 :918 ( https://doi.org/10.12688/f1000research.110204.2 ) First published: 10 Aug 2022, 11 :918 ( https://doi.org/10.12688/f1000research.110204.1 ) Latest published: 18 Sep 2024, 11 :918 ( https://doi.org/10.12688/f1000research.110204.2 ) Revised Amendments from Version 1 In the revised manuscript, we have addressed the reviewers' comments by making the following key changes: Clarification of Terminology: Throughout the manuscript, we replaced the abbreviation "PT," which was initially used to denote physical therapy services, with the appropriate term "physical therapist" to avoid confusion between the profession and the professional designation. Experience Clarified: In the abstract and the manuscript, we clarified that "experience" refers to years in the profession, not experience with COVID-19 patients. This change was made early in the abstract for clearer comprehension. Accuracy of Statistics: We corrected statistical reporting, replacing vague expressions such as "around 83%" with the precise figure of 83% as recommended. Enhanced Focus on Healthcare Workers: The introduction was updated to emphasize the protection of healthcare workers and the patients they serve, aligning the research focus with healthcare workforce protection, in addition to healthcare system efficiency. Additional Data Representation: A new table (Table 2) was added to better represent the sources of knowledge about the COVID-19 pandemic, as suggested. Conclusion Strengthened: The conclusion was expanded to discuss the future relevance of the research, particularly its implications for improving pandemic response strategies among physical therapists. These changes enhance the manuscript's clarity, precision, and relevance to the field of physical therapy, while aligning with the reviewers' insightful recommendations. In the revised manuscript, we have addressed the reviewers' comments by making the following key changes: Clarification of Terminology: Throughout the manuscript, we replaced the abbreviation "PT," which was initially used to denote physical therapy services, with the appropriate term "physical therapist" to avoid confusion between the profession and the professional designation. Experience Clarified: In the abstract and the manuscript, we clarified that "experience" refers to years in the profession, not experience with COVID-19 patients. This change was made early in the abstract for clearer comprehension. Accuracy of Statistics: We corrected statistical reporting, replacing vague expressions such as "around 83%" with the precise figure of 83% as recommended. Enhanced Focus on Healthcare Workers: The introduction was updated to emphasize the protection of healthcare workers and the patients they serve, aligning the research focus with healthcare workforce protection, in addition to healthcare system efficiency. Additional Data Representation: A new table (Table 2) was added to better represent the sources of knowledge about the COVID-19 pandemic, as suggested. Conclusion Strengthened: The conclusion was expanded to discuss the future relevance of the research, particularly its implications for improving pandemic response strategies among physical therapists. These changes enhance the manuscript's clarity, precision, and relevance to the field of physical therapy, while aligning with the reviewers' insightful recommendations. See the authors' detailed response to the review by Matthew R. Hyland READ REVIEWER RESPONSES Introduction Since the emergence of the coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), in China in December 2019, 1 the world has been encountering unprecedented challenges and COVID-19 was declared a global pandemic in March 2020. 2 Numbers of infected cases have been escalating rapidly worldwide, and the governments across the world have had to impose stringent measures to control the rapid spread of the disease. These measures included lockdown, social distancing, travel limitations, public use of personal protective equipment (PPE) and rearrangement of health administrations. 3 The crisis the world has been facing because of the pandemic is attributed to the fast and vast spread of the disease among the population. 4 , 5 This resulted in overloaded healthcare systems and an extensive burden being placed on healthcare workers all over the world. 6 – 8 Reports have shown increased stress and anxiety of the healthcare providers due to increased workload and fear of contracting and transmitting the disease to family and friends. 9 – 12 This may impact the attitude and performance of the healthcare provider and accordingly, the efficiency of the whole healthcare system. 13 , 14 During such a crisis, it is important to maintain an efficient healthcare system. This could be achieved by providing training to, updating the knowledge of, and protecting the healthcare providers. Unfortunately, some reports revealed a shortage of knowledge in healthcare workers regarding the COVID-19 pandemic in Saudi Arabia, with estimates that only about 45% of healthcare workers have a good awareness of COVID-19 when measured in March and April 2020. 15 Misleading information and myths about the pandemic have gone viral across the different media channels, contributing further to limiting the knowledge of the healthcare workers. 16 Furthermore, protection of the healthcare providers should be ensured by sufficient supplies and ease of accessibility to the PPE. Recent reports showed that shortage of the PPE supplies is associated with increased risk of infection and severity of symptoms and elevated anxiety among the healthcare providers. 17 Physical therapy services are essential for the comprehensive recovery of some COVID-19 patients. Cardiopulmonary rehabilitation in acute and post-acute settings can significantly maintain and improve the pulmonary functions. 18 , 19 Physical therapists also manage patients recovering from a COVID-19 infection to help them restore mobility and lung functions. This exposes the physical therapists to a high risk of contracting the infection, considering that the physical therapy practice requires prolonged physical contact with the patients. 20 Therefore, collecting information regarding healthcare workers’ sources of knowledge, their attitude and experience during the COVID-19 pandemic, and accessibility to the PPE is important to assess and maintain the healthcare workers’ efficiency and to protect the health of their workforce and the patients they serve. Findings retrieved from such information could help decision-makers find weaknesses and strengths in order to improve the services provided to the patients. To the authors’ knowledge, no studies have assessed such information among physical therapists working in the Saudi healthcare system. Thus, the purpose of this study is to assess and report the sources of knowledge, attitude, experience and accessibility of PPE for physical therapists working in Saudi Arabia. Methods Design This study implemented a cross-sectional design that was based on an online questionnaire to survey physiotherapists in Saudi Arabia in September 2020 during the COVID-19 pandemic. We surveyed the participants’ sources of knowledge, attitude, experience, and accessibility of PPE during the pandemic. Ethics This study was approved by the Institutional Review Board of the Prince Sultan Military College of Health Sciences, Saudi Arabia (IRB No: IRB-2020-PT-032). Written informed consent was obtained from all participants before proceeding to the survey by providing it at the cover letter and having each participant accepting it by clicking start to proceed to the survey. Anonymity of the participants was ensured and no personal identifier was obtained. Study settings and participants Physical therapy practitioners working in the Saudi healthcare system (including governmental and private sectors hospitals and clinics) were invited through emails and professional social media groups to fill an anonymous web-based questionnaire. Data were collected during September 2020 by sending the survey to professional physiotherapy groups on social media channels to cover the five geographical regions of Saudi Arabia. Social network channels used were Twitter, Facebook, WhatsApp, Instagram, LinkedIn, and Snapchat. Using the Raosoft calculator, a sample size of 257 therapists was targeted. This was based on an estimated population size of 5000 licensed physical therapists, according to the data available through the World Physiotherapy website, 21 and using a confidence level of 90%, and P- value of 0.05. The inclusion criteria were licensed physical therapy practitioners working inside Saudi Arabia only. Participants were excluded if they were not working in Saudi Arabia, or if they were any health care providers other than physical therapy practitioners. Instrument This study used a web-based survey ( QuestionPro ) comprised of 22 questions. It covered the participant’s demographic data and the following areas: sources of knowledge regarding the pandemic, experience, and attitude of the therapists during the pandemic, and accessibility to the PPE. The survey tool was developed by the authors in accordance with the guidelines of the World Physiotherapy regarding the physical therapy services during the COVID-19 pandemic, 22 and based on a questionnaire for spine surgeons, 23 and a study that assessed the physical therapy practice during the pandemic. 24 The sources of knowledge about the COVID-19 pandemic was assessed by one question that had four answer categories including news, social media, official websites (e.g. World Health Organization ), and family and friends. Each category had a 4-point Likert scale (least used to most used). The attitude topic was assessed by two questions concerned with the type of precautionary measures implemented at home, and willingness of participants to treat a positive COVID-19 patient. Regarding the topic of experience, nine questions were developed to assess training of the participants during the pandemic, their involvement in pandemic management teams, actual treatment of positive cases, and their feedback about the efficacy of the treatment they provided for those cases. Accessibility to the PPE was assessed by one question with six answer categories in order to identify accessibility. The questionnaire can be found as Extended data. 52 Procedures The authors reviewed and confirmed the face and content validity of the questionnaire items. Then, the questionnaire was pilot tested by ten respondents who volunteered to take part of the survey that was announced through professional social networks. They completed the questionnaire online, and their comments about the questions and the cover letter were recorded. Then, the respondents were interviewed via phone and requested to provide responses to the survey items that were rephrased using alternative wording. Their responses were checked against what they provided in the web-based questionnaire. Afterwards, the questionnaire was amended accordingly based on the pilot study results. The formal questionnaire was constructed using QuestionPro software and disseminated during September 2020 through emails and social media. We used various professional social media groups through Twitter, Facebook, WhatsApp, Instagram, LinkedIn, and Snapchat. Data analysis Data were analyzed using SPSS version 26 (SPSS, Chicago, IL). Completed responses for each variable were examined. Descriptive statistics were performed for all the variables in the form of frequency (percentages) distribution. Univariable analyses were performed to examine the significant differences between the defined parameters among different demographic characteristics. Chi-square test was used for the categorical parameters. The significance level (α) was set at P ≤0.05. Variables with significant univariable effects were further processed using multivariable analysis. Logistic regression was performed to estimate the association between the demographic characteristics and study parameters. Results Demographic characteristics Of the 2021 subjects who viewed the survey, 795 participants started it. A total of 425 physical therapy practitioners completed the knowledge and attitude sections, and only 352 (83%) participants completed the entire survey including the PPE. 52 The demographic data are presented in Table 1 . Table 1. Demographic characteristics of participants. PT=physical therapist. n % Age (years) ≤30 287 67.5% Above 30 138 32.5% Gender Male 162 38.1% Female 263 61.9% Nationality Saudi 394 92.7% Non-Saudi 31 7.3% Work Region Eastern 163 38.4% Central 111 26.1% Western 78 18.4% Northern 24 5.6% Southern 49 11.5% Professional rank Assistant PT 34 8.0% Junior PT 204 48.0% Senior PT 150 35.3% Consultant 19 4.5% Assistant to Head of Department 7 1.6% Head of Department 11 2.6% Subspecialty Musculoskeletal PT 70 16.5% Pediatric PT 46 10.8% Neurological PT 9 2.1% Sports PT 25 5.9% Cardiopulmonary PT 16 3.8% Women Health PT 9 2.1% Rehabilitation PT 28 6.6% General PT 207 48.7% Other 15 3.5% Education Diploma 12 2.8% Bachelor degree 338 79.5% Master degree 54 12.7% Doctoral degree 21 4.9% Years of experience ≤5 268 63.1% >5 157 36.9% Type of employer Governmental institution 259 60.9% Non-governmental institution 166 39.1% Sources of knowledge about the COVID-19 pandemic The participants reported that the sources of knowledge they used the most were the official governmental websites e.g. Ministry of Health (n=165, 39%), followed by the social media including Twitter, Facebook, WhatsApp, and Snapchat (n=113, 26.7%). Knowledge obtained through colleagues and family members were the least used (n=16, 3.8%). Although not being the most used source of knowledge (n=69, 16.3%), print and broadcast media were significantly associated with age ( P =0.016) and years of experience ( P =0.043), as older (n=28, 20.4%) and more-experienced (n=32, 20.5%) participants reported using it as the most used source of knowledge, more than their younger (n=41, 14.3%) and less-experienced (n=37, 13.8%) counterparts ( Table 2 ). Table 2. Sources of knowledge about the (COVID-19) pandemic. Values indicate the number (%) of participants who reported the sources of knowledge they used the most (n=363). Age (y) Gender Experience (y) Institution ≤30 >30 Male Female ≤5 >5 Govern. Private Print and broadcast media n=69 (16.3%) 41 (14.3%) 28 (20.4%) 25 (15.4%) 44 (16.8%) 37 (13.8%) 32 (20.5%) 47 (18.2%) 22 (13.3%) Social Media n=113 (26.7%) 72 (25.2%) 41 (29.7%) 43 (26.5%) 70 (26.6%) 64 (23.9%) 49 (31.2%) 70 (27.0%) 43 (25.9%) Official Governmental websites n=165 (39%) 110 (38.5%) 55 (39.9%) 64 (39.5%) 101 (38.4%) 103 (38.4%) 62 (39.5%) 104 (40.2%) 61 (36.7%) colleagues and family n=16 (3.8%) 13 (4.5%) 3 (2.2%) 7 (4.3%) 9 (3.4%) 12 (4.5%) 4 (2.5%) 10 (3.9%) 6 (3.6%) Attitude of participants during the COVID-19 pandemic Hand sanitization and washing clothes were the most commonly implemented precautionary measures reported by 81.1% and 80.9% of participants, respectively. Self-isolation was implemented by 26.8% of participants, and 8.0% reported implementing other additional measures, which were implemented by women more than men ( P =0.037) ( Table 3 ). Table 3. Precautions implemented by participants at home due to the coronavirus disease 2019 (COVID-19) pandemic. Values indicate number (%) of participants who reported implementing those precautionary measures (n=425). Age (y) Gender Experience (y) Institution ≤30 >30 Male Female ≤5 >5 Govern. Private Self-isolation n= 114(26.8%) 85(29.6%) 29 (21.0%) 42 (25.9%) 72 (27.4%) 76 (28.4%) 38 (24.2%) 66 (25.5%) 48 (28.9%) Hand sanitization n= 344(81.1%) 232 (80.8%) 113 (81.9%) 126 (77.8%) 218 (82.9%) 219 (81.7%) 125 (79.6%) 215 (83.0%) 129 (77.7%) Washing cloths n= 343(80.7%) 228 (79.4%) 116 (84.1%) 129 (79.6%) 214 (81.4%) 215 (80.2%) 128 (81.5%) 215 (83.0%) 128 (77.1%) Other measures n= 34(8.0%) 19 (6.6%) 15 (10.9%) 7 (4.3%) 26 (9.9%) 17 (6.3%) 16 (10.2%) 19 (7.3%) 14 (8.4%) Furthermore, about half of the participants (52.1%) reported their willingness to manage and treat COVID-19 patients. This positive attitude towards the COVID-19 patients was significantly associated with gender ( P <0.001) and experience ( P =0.027). Male and more-experienced therapists were more willing to manage positive COVID-19 patients than their female and less-experienced counterparts ( Table 4 ). Table 4. Attitude and experience of participants during the coronavirus disease 2019 (COVID-19) pandemic. Values indicate number (%) of participants who answered “yes” to the questions (n=425). Age (y) Gender Experience (y) Institution ≤30 >30 Male Female ≤5 >5 Govern. Private Willingness to manage a COVID-19 patient? n=222 (52.2%) 149 (51.9%) 73 (52.9%) 102 (63.0%) 120 (45.6%) 129 (48.1%) 93 (59.2%) 137 (52.9%) 85 (51.2%) Involvement in COVID-19 management teams n=132 (31.1%) 80 (27.9%) 52 (37.7%) 68 (42.0%) 64 (24.3%) 66 (24.6%) 66 (42.0%) 99 (38.2%) 33 (19.9%) COVID-19 training n=134 (31.5%) 92 (32.2%) 42 (30.4%) 60 (37.0%) 74 (28.1%) 79 (29.5%) 55 (35.0%) 88 (34.0%) 46 (27.7%) Diagnosed as a COVID-19 patient n=46 (10.8%) 32 (11.2%) 14 (10.2%) 20 (12.4%) 26 (9.9%) 26 (9.7%) 20 (12.8%) 23 (8.9%) 23 (13.9%) Treated a COVID-19 patient n=99 (23.3%) 59 (20.8%) 40 (29.4%) 49 (30.6%) 50 (19.2%) 49 (18.4%) 50 (32.5%) 75 (29.2%) 24 (14.6%) Managing consequences of prolonged ventilation and immobilization n=116 (27.3%) 81 (29.6%) 35 (26.5%) 52 (33.1%) 64 (25.7%) 73 (28.3%) 43 (29.1%) 78 (31.6%) 38 (23.9%) Positive impact of physical therapy on patient’s condition n=115 (27.05%) 76 (89.4%) 39 (95.1%) 58 (96.7%) 57 (86.4%) 64 (87.7%) 51 (96.2%) 80 (90.9%) 35 (92.1%) Experience of participants during the COVID-19 pandemic At the institutional level, participants reported that they were involved in management teams of the COVID-19 pandemic (30.9%). However, this was associated with age ( P =0.036), gender ( P <0.001), experience ( P <0.001), and type of institution ( P <0.001). The results revealed that older and more experienced male therapists working in governmental institutions were more involved in the pandemic management teams. Unexpectedly, only 134 participants (31.6%) received training to deal with the pandemic ( Table 4 ). In total, 99 participants (23.6%) reported treating positive COVID-19 patients. Managing infected patients was significantly associated with gender ( P =0.007), experience ( P <0.001) and type of the institution ( P <0.001). 47.8% of participants who treated infected patients handled five or less patients, while 63.3% treated more than ten patients. The number of COVID-19 cases treated by participants was associated with gender ( P =0.008) as male therapists reported managing more infected patients than female therapists. Only 7% of them felt unconfident treating COVID-19 patients ( Table 5 ). 28.4% of participants treated the complications of prolonged ventilation and immobilization associated with the COVID-19 infection, and 91.2% of them reported a positive impact on the patient’s condition. The reported data regarding the impact of the physical therapy treatment were associated with the participant’s gender ( P =0.041). Table 5. Management of coronavirus disease 2019 (COVID-19) patients. Values indicate number (%) of participants who reported treating COVID-19 patients (n=91). Age (y) Gender Experience (y) Institution ≤30 >30 Male Female ≤5 >5 Govern. Private Number of COVID-19 patient managed 1-5 n=43(47.3%) 26 (47.3%) 17 (47.2%) 18 (38.3%) 25 (56.8%) 24 (52.2%) 19 (42.2%) 32 (46.4%) 11 (50.0%) 6-10 n=15(16.5%) 10 (18.2%) 5 (13.9%) 5 (10.6%) 10 (22.7%) 9 (19.6%) 6 (13.3%) 13 (18.8%) 2 (9.1%) >10 n=33(36.3%) 19 (34.5%) 14 (38.9%) 24 (51.1%) 9 (20.5%) 13 (28.3%) 20 (44.4%) 24 (34.8%) 9 (40.9%) Level of confidence dealing with a COVID-19 patient Very confident n=43(47.3%) 24 (43.6%) 19 (52.8%) 26 (55.3%) 17 (38.6%) 17 (37.0%) 26 (57.8%) 32 (46.4%) 11 (50.0%) Somewhat confident n=41(45.1%) 24 (43.6%) 17 (47.2%) 18 (38.3%) 23 (52.3%) 24 (52.2%) 17 (37.8%) 32 (46.4%) 9 (40.9%) Not confident n=7 (7.7%) 7 (12.7%) 0 (0.0%) 3 (6.4%) 4 (9.1%) 5 (10.9%) 2 (4.4%) 5 (7.2%) 2 (9.1%) Accessibility to PPE Participants reported that accessibility to most of the protective equipment and sanitization supplies was not problematic during the pandemic. Availability of hand sanitizer, gloves, surgical masks, and gowns was of no or little problem for 93.5%, 93.5%, 89.8%, and 87.2% of participants, respectively. However, accessibility to respiratory masks and face shields/goggles was a huge problem for 23.3%, and 16.8% of participants, respectively ( Table 6 ). Table 6. Accessibility to personal protective equipment (PPE). Values indicate number (%) of participants (n=352). Age (y) Gender Experience (y) Institution ≤30 n=235 >30 n=117 Male n=139 Female n=213 ≤5 n=221 >5 n=131 Govern. n=219 Private n=133 Respiratory mask (N95, KN95, or other) No problem n=126 80 (22.7%) 46 (13.1%) 57 (16.2%) 69 (19.6%) 78 (22.2%) 48 (13.6%) 78 (22.2%) 48 (13.6%) Little problem n=144 95 (27.0%) 49 (13.9%) 51 (14.5%) 93 (26.4%) 91 (25.9%) 53 (15.1%) 93 (26.4%) 51 (14.5%) Huge problem n=82 60 (17.1%) 22 (6.2%) 31 (8.8%) 51 (14.5%) 52 (14.8%) 30 (8.5%) 48 (13.6%) 34 (9.7%) Surgical mask No problem n=241 158 (44.9%) 83 (23.6%) 93 (26.4%) 148 (42.1%) 149 (42.3%) 92 (26.1%) 152 (43.2%) 89 (25.3%) Little problem n=75 52 (14.8%) 23 (6.5%) 34 (9.7%) 41 (11.6%) 49 (13.9%) 26 (7.4%) 41 (11.6%) 34 (9.7%) Huge problem n=36 25 (7.1%) 11 (3.1%) 12 (3.4%) 24 (6.8%) 23 (6.5%) 13 (3.7%) 26 (7.4%) 10 (2.8%) Face shield/goggles No problem n=201 131 (37.2%) 70 (19.9%) 80 (22.7%) 121 (34.4%) 128 (36.4%) 73 (20.7%) 127 (36.1%) 74 (21.0%) Little problem n=92 66 (18.8%) 26 (7.4%) 40 (11.4%) 52 (14.8%) 58 (16.5%) 34 (9.7%) 51 (14.5%) 41 (11.6%) Huge problem n=59 38 (10.8%) 21 (6.0%) 19 (5.4%) 40 (11.4%) 35 (9.9%) 24 (6.8%) 41 (11.6%) 18 (5.1%) Gloves No problem n=288 192 (54.5%) 96 (27.3%) 110 (31.3%) 178 (50.6%) 182 (51.7%) 106 (30.1%) 174 (49.4%) 114 (32.4%) Little problem n=41 27 (7.7%) 14 (4.0%) 16 (4.5%) 25 (7.1%) 26 (7.4%) 15 (4.3%) 31 (8.8%) 10 (2.8%) Huge problem n=23 16 (4.5%) 7 (2.0%) 13 (3.7%) 10 (2.8%) 13 (3.7%) 10 (2.8%) 14 (4.0%) 9 (2.6%) Gowns No problem n=246 168 (47.7%) 78 (22.2%) 91 (25.9%) 155 (44.0%) 156 (44.3%) 90 (25.6%) 153 (43.5%) 93 (26.4%) Little problem n=61 38 (10.8%) 23 (6.5%) 28 (8.0%) 33 (9.4%) 35 (9.9%) 26 (7.4%) 39 (11.1%) 22 (6.2%) Huge problem n=45 29 (8.2%) 16 (4.5%) 20 (5.7%) 25 (7.1%) 30 (8.5%) 15 (4.3%) 27 (7.7%) 18 (5.1%) Hand sanitizer No problem n=289 190 (54.0%) 99 (28.1%) 112 (31.8%) 177 (50.3%) 174 (49.4%) 115 (32.7%) 181 (51.4%) 108 (30.7%) Little problem n=40 28 (8.0%) 12 (3.4%) 15 (4.3%) 25 (7.1%) 34 (9.7%) 6 (1.7%) 24 (6.8%) 16 (4.5%) Huge problem n=23 17 (4.8%) 6 (1.7%) 12 (3.4%) 11 (3.1%) 13 (3.7%) 10 (2.8%) 14 (4.0%) 9 (2.6%) Discussion During the past year, several studies examined how the healthcare practitioners handled the COVID-19 pandemic. 9 , 15 , 25 – 30 However, studies focusing on the physical therapy profession were scarce. 24 , 31 – 33 Physical therapists typically spend extended periods of time treating patients through prolonged and direct physical interaction with patients. 20 In the current pandemic, physical therapists play an important role providing respiratory support and active mobilization to COVID-19 patients both inside and out of an acute care setting. 18 , 19 , 34 , 35 The COVID-19 pandemic is an unprecedented medical situation that has been associated with extreme measures imposed worldwide. Accordingly, it was essential to assess the knowledge of physical therapists about the new viral infection. Our results showed that nearly 40% of the physical therapists were responsible enough to seek knowledge about the new pandemic from trusted sources such as the official websites. Meanwhile, more than one quarter (26.7%) of the participants used social media as their main source of information. This may suggest that the physical therapists may have developed misconceptions about the pandemic because of the invalid information about how the virus spreads and any myths about the virus symptoms through the social media. 16 , 36 Other studies investigated the community knowledge about the pandemic and found a significant knowledge gap among the public 37 , 38 and healthcare providers. 15 The current results indicate commitment from most of the physical therapists to apply the recommended precautionary measures. More than 80% of the participants reported using hand sanitizers and washing clothes once they return home. Previous reports revealed an increased anxiety among healthcare providers in Saudi Arabia during April 2020 because of the pandemic. 28 One of the main reasons for increased anxiety was the fear of contracting the infection and transmitting it to family and friends. 15 , 39 In the current study, women were more inclined than men to apply additional precautionary measures, which reflects a greater protective attitude. This is in accordance with previous studies that showed hygienic practices were positively associated with women, 37 , 40 and they were more compliant than men with the imposed public policy measures while dealing with COVID-19 pandemic as mandating the use of face masks, quarantine the infected cases, etc. 41 In the current study, physical therapists showed a positive attitude towards managing COVID-19 positive cases. Despite of the documented concern and anxiety among healthcare providers regarding the pandemic, 15 , 39 more than half of the participants were willing to treat a COVID-19 patient. Physical therapy services by nature require extended and direct physical interaction between the therapist and the patient, which would potentially significantly increase the risk of contracting a highly contagious infection such as COVID-19. Thus, it is expected that physical therapists might be hesitant to manage a positive case, which was reported by almost half of the study participants. Meanwhile, men as well as more experienced therapists, were more motivated to treat COVID-19 patients. This finding is counterintuitive considering the reported fact that older adults and males are more likely to be at greater risk of serious morbidity and higher mortality. 42 – 44 However, this interesting finding could be explained by reports of the gender-based differences regarding attitude and risk perception during the COVID-19 pandemic. Women reported greater fear and health-related negative expectations than men. 41 , 45 Additionally, experienced therapists are commonly assigned to higher administrative positions that limit direct interaction with patients. Furthermore, they are typically older than less experienced therapists. Therefore, they are considered amongst the high-risk group for contracting infection and experiencing serious health consequences. Thus, they had limited or no interaction with patients, which may explain their positive attitude and limited concern regarding treating patients diagnosed with COVID-19. Unfortunately, only about one third of the participants (30.9% and 31.6%, respectively) reported being involved in management and planning teams of the pandemic or receiving training to deal with the pandemic. This surprisingly low percentage indicating the need to provide more training programs for rehabilitation professionals by the governing authorities. However, it could be justified by the fact that COVID-19 is a life-threatening disease for which, the first line of treatment is medical rather than rehabilitative. Thus, it is reasonable that physicians and nurses become the focus group for treatment planning and training efforts during the pandemic. This should not underestimate the valuable role physical therapists have in acute settings for treating COVID-19 patients. 19 Our findings also indicate that involvement in management teams was positively associated with male, older and more experienced therapists working in governmental institutions. This further corroborates the finding discussed here above regarding gender-based differences about worries, fear and negative expectations toward the pandemic that are more associated with women. This could potentially be a barrier for female therapists to participate in management and planning teams. Additionally, the measures imposed by the Saudi Ministry of Health targeted primarily the governmental medical institutions that are more capable to accommodate the increased number of COVID-19 cases. 46 This may explain the interesting finding favoring therapists working in governmental institutions. This argument is supported by the reported data regarding actual treatment of positive cases. The majority of therapists who reported treating COVID-19 cases were mostly working in governmental institutions, and male therapists treated higher numbers of patients compared with female therapists. The results revealed that accessibility to the PPE was not a problem for the majority of the participants. This indicates the preparedness of the Saudi healthcare system to face the pandemic and equip the healthcare providers with the necessary protective equipment. 46 This is particularly important considering that more than 60% of the participants work in governmental institutions. Protection of healthcare providers during a pandemic is crucial for the quality and efficiency of the service provided. Reports have shown a significant shortage of PPE in some healthcare systems. In Italy, only 13% of physicians reported to have access to PPE every time they needed to. 47 Another study in Ethiopia identified a critical shortage of PPE that is significantly associated with high levels of dissatisfaction amongst healthcare workers. 48 This should be a warning to the governing authorities to continuously provide sufficient supplies of PPE and avoid shortage using different resources, 49 , 50 given the findings revealing that limited access to or shortage of PPE is significantly associated with increased risk of contracting the COVID-19 infection and increased severity of symptoms among the health care workers. 17 The current study has some limitations that should be noted. The data collection process was not carried out at the time of the lockdown during the peak of the COVID-19 pandemic during March to June 2020. 51 Therefore, the data obtained were collected retrospectively. Thus, it may likely suffer the recall bias inherent with retrospective self-reported data. The five geographical regions of Saudi Arabia were not equally represented, which may limit the generalizability of the obtained findings. However, successfully recruiting participants more than the required minimal sample size could provide credible data. In conclusion, the current study showed that physical therapists were knowledgeable about best hygienic practices. Furthermore, sufficient supplies of PPE were available through the Saudi healthcare system, which indicates appropriate planning by the authorities. Physical therapists showed a positive attitude towards COVID-19 patients. Yet, this could be improved significantly by implementing a stringent plan to educate physical therapy practitioners about misleading information on social media as a source of information and involving them more in management planning teams. Developing better physical therapists’ awareness about the COVID-19 pandemic would help establish more efficient management strategies during pandemics. In doing so, appropriate and immediate responses could be implemented to ensure the continuity of service provision and limit economic burden. Data availability Underlying data Open Science Framework: COVID-19 influence on rehabilitation service providers in Saudi Arabia. https://doi.org/10.17605/OSF.IO/4M7GV . 52 This project contains the following underlying data: • Raw Data with codebook.csv (dataset) • CodeBook-Raw Data.csv (codebook) Extended data Open Science Framework: COVID-19 influence on rehabilitation service providers in Saudi Arabia. https://doi.org/10.17605/OSF.IO/4M7GV . 52 This project contains the following extended data: • Questionnaire.pdf Data are available under the terms of the Creative Commons Zero “No rights reserved” data waiver (CC0 1.0 Public domain dedication). 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Publisher Full Text Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 10 Aug 2022 ADD YOUR COMMENT Comment Author details Author details 1 Department of Physical Therapy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia 2 Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia 3 Basic Science Department, Faculty of Physical Therapy, Cairo University, Cairo, Egypt Walaa Elsayed Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Supervision, Validation, Writing – Original Draft Preparation, Writing – Review & Editing Faisal Albagmi Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Writing – Original Draft Preparation, Writing – Review & Editing Mohammed Alghamdi Roles: Data Curation, Investigation, Project Administration, Resources, Software Ahmed Farrag Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Writing – Original Draft Preparation, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (2) version 2 Revised Published: 18 Sep 2024, 11:918 https://doi.org/10.12688/f1000research.110204.2 version 1 Published: 10 Aug 2022, 11:918 https://doi.org/10.12688/f1000research.110204.1 Copyright © 2024 Elsayed W et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Elsayed W, Albagmi F, Alghamdi M and Farrag A. Physical therapists’ use of personal protective equipment during the COVID-19 pandemic: a cross-sectional study in Saudi Arabia [version 2; peer review: 1 approved with reservations] . F1000Research 2024, 11 :918 ( https://doi.org/10.12688/f1000research.110204.2 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 1 VERSION 1 PUBLISHED 10 Aug 2022 Views 0 Cite How to cite this report: Hyland MR. Reviewer Report For: Physical therapists’ use of personal protective equipment during the COVID-19 pandemic: a cross-sectional study in Saudi Arabia [version 2; peer review: 1 approved with reservations] . F1000Research 2024, 11 :918 ( https://doi.org/10.5256/f1000research.121782.r293151 ) The direct URL for this report is: https://f1000research.com/articles/11-918/v1#referee-response-293151 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 12 Jul 2024 Matthew R. Hyland , Department of Psychology, Center for Behavioral Teratology, San Diego State University, San Diego, California, USA Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.121782.r293151 It is interesting the authors chose not to site any published research in the United States during that period when the Northeast was the epicentre at that time. In the abstract and in the manuscript, ... Continue reading READ ALL It is interesting the authors chose not to site any published research in the United States during that period when the Northeast was the epicentre at that time. In the abstract and in the manuscript, they reference physical therapy services with the abbreviation PT. PT is a licensed designation for physical therapists or physiotherapists not for the profession. I suggest these changes be made throughout. In the abstract and early in the manuscript the authors identify “experience” as a domain. It is not clear until much later in the manuscript that they are referring to experience as years in the profession, not experience in working with COVID-19 patients. I would state that earlier on. When reporting statistics it should be a fact, 83%, not “around 83%.” In the introductions the authors state, “Therefore, collecting information regarding healthcare workers’ sources of knowledge and their attitude and experience during the COVID-19 pandemic and accessibility to the PPE is important to assess and maintain the efficiency of healthcare systems” I think it is important to add, after healthcare systems, “and to protect the health of their workforce and patients they serve.” I don’t think this research is about the healthcare systems, rather the healthcare workers and patients they serve. Big distinction in my opinion. Significant at the end of the section of “study settings and participants.” Under results “Sources of knowledge about the COVID-19 Pandemic” I would suggest an associated table. Enhancing the conclusion would add to the manuscript such as what does this mean for the future, if another pandemic hits, why is the research important. Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Partly Competing Interests: No competing interests were disclosed. Reviewer Expertise: Impacts on the profession of physical therapy that are not directly intervention based (ie impacts of COVID-19, health policy such as predicting outcomes of care, injuries in physical therapists. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Hyland MR. Reviewer Report For: Physical therapists’ use of personal protective equipment during the COVID-19 pandemic: a cross-sectional study in Saudi Arabia [version 2; peer review: 1 approved with reservations] . F1000Research 2024, 11 :918 ( https://doi.org/10.5256/f1000research.121782.r293151 ) The direct URL for this report is: https://f1000research.com/articles/11-918/v1#referee-response-293151 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 18 Sep 2024 Faisal Albagmi , Department of Physical Therapy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia 18 Sep 2024 Author Response We would like to thank the reviewer for their thoughtful comments and suggestions. Below is a detailed response to each of the issues raised, along with the corresponding corrections made ... Continue reading We would like to thank the reviewer for their thoughtful comments and suggestions. Below is a detailed response to each of the issues raised, along with the corresponding corrections made in the manuscript: Citing Published Research in the United States Comment: It is interesting that the authors chose not to cite any published research in the United States during that period when the Northeast was the epicenter at that time. Response: We have cited the work of Miller et al. (2020) in reference no. 7 to address this concern. Please see page 2 for the citation. Use of "PT" for Physical Therapy Comment: PT is a licensed designation for physical therapists or physiotherapists, not for the profession. I suggest these changes be made throughout. Response: We have corrected this issue throughout the manuscript. PT is now used to refer to "physical therapist" and not "physical therapy." Please see pages 3, 5, and 7 for the changes. Clarifying "Experience" Comment: In the abstract and early in the manuscript, the authors identify “experience” as a domain. It is not clear that they are referring to years in the profession, not experience in working with COVID-19 patients. Response: We have clarified this in the abstract by adding “years in the profession.” Please refer to page 1, fifth line in the abstract, and throughout the manuscript for consistency. Accuracy in Reporting Statistics Comment: When reporting statistics, it should be a fact (83%) not “around 83%.” Response: This issue has been corrected. We have used the precise figure “83%” in both the abstract and results sections. Please see page 1 (abstract) and page 6 (results section). Revision to Introduction Comment: The introduction should focus more on the healthcare workers and the patients they serve, not just healthcare systems. Response: We revised the last paragraph of the introduction to reflect this distinction by adding: “and to protect the health of their workforce and the patients they serve.” Please see page 4. Typo Correction Comment: Significant at the end of the section of "study settings and participants." Response: The typo has been corrected to "therapy practitioners." Please refer to page 5. Table Addition for "Sources of Knowledge" Comment: Under results, a table is suggested for “Sources of knowledge about the COVID-19 Pandemic.” Response: We have added Table 2 to represent the sources of knowledge about the COVID-19 pandemic. Please see page 8 for the new table. Enhancing the Conclusion Comment: Enhancing the conclusion would strengthen the manuscript, discussing what this means for the future if another pandemic hits. Response: We have enhanced the conclusion by stating: “Developing better physical therapists’ awareness about the COVID-19 pandemic would help establish more efficient management strategies during pandemics. In doing so, appropriate and immediate responses could be implemented to ensure the continuity of service provision and limit economic burden.” Please refer to page 10. We believe these revisions have significantly improved the clarity and impact of the manuscript, and we appreciate your feedback. Thank you for your careful review. We would like to thank the reviewer for their thoughtful comments and suggestions. Below is a detailed response to each of the issues raised, along with the corresponding corrections made in the manuscript: Citing Published Research in the United States Comment: It is interesting that the authors chose not to cite any published research in the United States during that period when the Northeast was the epicenter at that time. Response: We have cited the work of Miller et al. (2020) in reference no. 7 to address this concern. Please see page 2 for the citation. Use of "PT" for Physical Therapy Comment: PT is a licensed designation for physical therapists or physiotherapists, not for the profession. I suggest these changes be made throughout. Response: We have corrected this issue throughout the manuscript. PT is now used to refer to "physical therapist" and not "physical therapy." Please see pages 3, 5, and 7 for the changes. Clarifying "Experience" Comment: In the abstract and early in the manuscript, the authors identify “experience” as a domain. It is not clear that they are referring to years in the profession, not experience in working with COVID-19 patients. Response: We have clarified this in the abstract by adding “years in the profession.” Please refer to page 1, fifth line in the abstract, and throughout the manuscript for consistency. Accuracy in Reporting Statistics Comment: When reporting statistics, it should be a fact (83%) not “around 83%.” Response: This issue has been corrected. We have used the precise figure “83%” in both the abstract and results sections. Please see page 1 (abstract) and page 6 (results section). Revision to Introduction Comment: The introduction should focus more on the healthcare workers and the patients they serve, not just healthcare systems. Response: We revised the last paragraph of the introduction to reflect this distinction by adding: “and to protect the health of their workforce and the patients they serve.” Please see page 4. Typo Correction Comment: Significant at the end of the section of "study settings and participants." Response: The typo has been corrected to "therapy practitioners." Please refer to page 5. Table Addition for "Sources of Knowledge" Comment: Under results, a table is suggested for “Sources of knowledge about the COVID-19 Pandemic.” Response: We have added Table 2 to represent the sources of knowledge about the COVID-19 pandemic. Please see page 8 for the new table. Enhancing the Conclusion Comment: Enhancing the conclusion would strengthen the manuscript, discussing what this means for the future if another pandemic hits. Response: We have enhanced the conclusion by stating: “Developing better physical therapists’ awareness about the COVID-19 pandemic would help establish more efficient management strategies during pandemics. In doing so, appropriate and immediate responses could be implemented to ensure the continuity of service provision and limit economic burden.” Please refer to page 10. We believe these revisions have significantly improved the clarity and impact of the manuscript, and we appreciate your feedback. Thank you for your careful review. Competing Interests: No competing interests were disclosed. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 18 Sep 2024 Faisal Albagmi , Department of Physical Therapy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia 18 Sep 2024 Author Response We would like to thank the reviewer for their thoughtful comments and suggestions. Below is a detailed response to each of the issues raised, along with the corresponding corrections made ... Continue reading We would like to thank the reviewer for their thoughtful comments and suggestions. Below is a detailed response to each of the issues raised, along with the corresponding corrections made in the manuscript: Citing Published Research in the United States Comment: It is interesting that the authors chose not to cite any published research in the United States during that period when the Northeast was the epicenter at that time. Response: We have cited the work of Miller et al. (2020) in reference no. 7 to address this concern. Please see page 2 for the citation. Use of "PT" for Physical Therapy Comment: PT is a licensed designation for physical therapists or physiotherapists, not for the profession. I suggest these changes be made throughout. Response: We have corrected this issue throughout the manuscript. PT is now used to refer to "physical therapist" and not "physical therapy." Please see pages 3, 5, and 7 for the changes. Clarifying "Experience" Comment: In the abstract and early in the manuscript, the authors identify “experience” as a domain. It is not clear that they are referring to years in the profession, not experience in working with COVID-19 patients. Response: We have clarified this in the abstract by adding “years in the profession.” Please refer to page 1, fifth line in the abstract, and throughout the manuscript for consistency. Accuracy in Reporting Statistics Comment: When reporting statistics, it should be a fact (83%) not “around 83%.” Response: This issue has been corrected. We have used the precise figure “83%” in both the abstract and results sections. Please see page 1 (abstract) and page 6 (results section). Revision to Introduction Comment: The introduction should focus more on the healthcare workers and the patients they serve, not just healthcare systems. Response: We revised the last paragraph of the introduction to reflect this distinction by adding: “and to protect the health of their workforce and the patients they serve.” Please see page 4. Typo Correction Comment: Significant at the end of the section of "study settings and participants." Response: The typo has been corrected to "therapy practitioners." Please refer to page 5. Table Addition for "Sources of Knowledge" Comment: Under results, a table is suggested for “Sources of knowledge about the COVID-19 Pandemic.” Response: We have added Table 2 to represent the sources of knowledge about the COVID-19 pandemic. Please see page 8 for the new table. Enhancing the Conclusion Comment: Enhancing the conclusion would strengthen the manuscript, discussing what this means for the future if another pandemic hits. Response: We have enhanced the conclusion by stating: “Developing better physical therapists’ awareness about the COVID-19 pandemic would help establish more efficient management strategies during pandemics. In doing so, appropriate and immediate responses could be implemented to ensure the continuity of service provision and limit economic burden.” Please refer to page 10. We believe these revisions have significantly improved the clarity and impact of the manuscript, and we appreciate your feedback. Thank you for your careful review. We would like to thank the reviewer for their thoughtful comments and suggestions. Below is a detailed response to each of the issues raised, along with the corresponding corrections made in the manuscript: Citing Published Research in the United States Comment: It is interesting that the authors chose not to cite any published research in the United States during that period when the Northeast was the epicenter at that time. Response: We have cited the work of Miller et al. (2020) in reference no. 7 to address this concern. Please see page 2 for the citation. Use of "PT" for Physical Therapy Comment: PT is a licensed designation for physical therapists or physiotherapists, not for the profession. I suggest these changes be made throughout. Response: We have corrected this issue throughout the manuscript. PT is now used to refer to "physical therapist" and not "physical therapy." Please see pages 3, 5, and 7 for the changes. Clarifying "Experience" Comment: In the abstract and early in the manuscript, the authors identify “experience” as a domain. It is not clear that they are referring to years in the profession, not experience in working with COVID-19 patients. Response: We have clarified this in the abstract by adding “years in the profession.” Please refer to page 1, fifth line in the abstract, and throughout the manuscript for consistency. Accuracy in Reporting Statistics Comment: When reporting statistics, it should be a fact (83%) not “around 83%.” Response: This issue has been corrected. We have used the precise figure “83%” in both the abstract and results sections. Please see page 1 (abstract) and page 6 (results section). Revision to Introduction Comment: The introduction should focus more on the healthcare workers and the patients they serve, not just healthcare systems. Response: We revised the last paragraph of the introduction to reflect this distinction by adding: “and to protect the health of their workforce and the patients they serve.” Please see page 4. Typo Correction Comment: Significant at the end of the section of "study settings and participants." Response: The typo has been corrected to "therapy practitioners." Please refer to page 5. Table Addition for "Sources of Knowledge" Comment: Under results, a table is suggested for “Sources of knowledge about the COVID-19 Pandemic.” Response: We have added Table 2 to represent the sources of knowledge about the COVID-19 pandemic. Please see page 8 for the new table. Enhancing the Conclusion Comment: Enhancing the conclusion would strengthen the manuscript, discussing what this means for the future if another pandemic hits. Response: We have enhanced the conclusion by stating: “Developing better physical therapists’ awareness about the COVID-19 pandemic would help establish more efficient management strategies during pandemics. In doing so, appropriate and immediate responses could be implemented to ensure the continuity of service provision and limit economic burden.” Please refer to page 10. We believe these revisions have significantly improved the clarity and impact of the manuscript, and we appreciate your feedback. Thank you for your careful review. Competing Interests: No competing interests were disclosed. Close Report a concern COMMENT ON THIS REPORT Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 10 Aug 2022 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 Version 2 (revision) 18 Sep 24 Version 1 10 Aug 22 read Matthew R. Hyland , San Diego State University, San Diego, USA Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Hyland M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 12 Jul 2024 | for Version 1 Matthew R. Hyland , Department of Psychology, Center for Behavioral Teratology, San Diego State University, San Diego, California, USA 0 Views copyright © 2024 Hyland M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions It is interesting the authors chose not to site any published research in the United States during that period when the Northeast was the epicentre at that time. In the abstract and in the manuscript, they reference physical therapy services with the abbreviation PT. PT is a licensed designation for physical therapists or physiotherapists not for the profession. I suggest these changes be made throughout. In the abstract and early in the manuscript the authors identify “experience” as a domain. It is not clear until much later in the manuscript that they are referring to experience as years in the profession, not experience in working with COVID-19 patients. I would state that earlier on. When reporting statistics it should be a fact, 83%, not “around 83%.” In the introductions the authors state, “Therefore, collecting information regarding healthcare workers’ sources of knowledge and their attitude and experience during the COVID-19 pandemic and accessibility to the PPE is important to assess and maintain the efficiency of healthcare systems” I think it is important to add, after healthcare systems, “and to protect the health of their workforce and patients they serve.” I don’t think this research is about the healthcare systems, rather the healthcare workers and patients they serve. Big distinction in my opinion. Significant at the end of the section of “study settings and participants.” Under results “Sources of knowledge about the COVID-19 Pandemic” I would suggest an associated table. Enhancing the conclusion would add to the manuscript such as what does this mean for the future, if another pandemic hits, why is the research important. Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Partly Competing Interests No competing interests were disclosed. Reviewer Expertise Impacts on the profession of physical therapy that are not directly intervention based (ie impacts of COVID-19, health policy such as predicting outcomes of care, injuries in physical therapists. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (1) Author Response 18 Sep 2024 Faisal Albagmi, Department of Physical Therapy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia We would like to thank the reviewer for their thoughtful comments and suggestions. Below is a detailed response to each of the issues raised, along with the corresponding corrections made in the manuscript: Citing Published Research in the United States Comment: It is interesting that the authors chose not to cite any published research in the United States during that period when the Northeast was the epicenter at that time. Response: We have cited the work of Miller et al. (2020) in reference no. 7 to address this concern. Please see page 2 for the citation. Use of "PT" for Physical Therapy Comment: PT is a licensed designation for physical therapists or physiotherapists, not for the profession. I suggest these changes be made throughout. Response: We have corrected this issue throughout the manuscript. PT is now used to refer to "physical therapist" and not "physical therapy." Please see pages 3, 5, and 7 for the changes. Clarifying "Experience" Comment: In the abstract and early in the manuscript, the authors identify “experience” as a domain. It is not clear that they are referring to years in the profession, not experience in working with COVID-19 patients. Response: We have clarified this in the abstract by adding “years in the profession.” Please refer to page 1, fifth line in the abstract, and throughout the manuscript for consistency. Accuracy in Reporting Statistics Comment: When reporting statistics, it should be a fact (83%) not “around 83%.” Response: This issue has been corrected. We have used the precise figure “83%” in both the abstract and results sections. Please see page 1 (abstract) and page 6 (results section). Revision to Introduction Comment: The introduction should focus more on the healthcare workers and the patients they serve, not just healthcare systems. Response: We revised the last paragraph of the introduction to reflect this distinction by adding: “and to protect the health of their workforce and the patients they serve.” Please see page 4. Typo Correction Comment: Significant at the end of the section of "study settings and participants." Response: The typo has been corrected to "therapy practitioners." Please refer to page 5. Table Addition for "Sources of Knowledge" Comment: Under results, a table is suggested for “Sources of knowledge about the COVID-19 Pandemic.” Response: We have added Table 2 to represent the sources of knowledge about the COVID-19 pandemic. Please see page 8 for the new table. Enhancing the Conclusion Comment: Enhancing the conclusion would strengthen the manuscript, discussing what this means for the future if another pandemic hits. Response: We have enhanced the conclusion by stating: “Developing better physical therapists’ awareness about the COVID-19 pandemic would help establish more efficient management strategies during pandemics. In doing so, appropriate and immediate responses could be implemented to ensure the continuity of service provision and limit economic burden.” Please refer to page 10. We believe these revisions have significantly improved the clarity and impact of the manuscript, and we appreciate your feedback. Thank you for your careful review. View more View less Competing Interests No competing interests were disclosed. reply Respond Report a concern Hyland MR. Peer Review Report For: Physical therapists’ use of personal protective equipment during the COVID-19 pandemic: a cross-sectional study in Saudi Arabia [version 2; peer review: 1 approved with reservations] . F1000Research 2024, 11 :918 ( https://doi.org/10.5256/f1000research.121782.r293151) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/11-918/v1#referee-response-293151 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. 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