In total, 1,621 people responded to our questionnaire. Nineteen individuals were excluded because they were not a dentist, dental student, medical doctor or a medical student. A further twenty-three individuals were excluded because they did not provide information regarding the country they were currently living or working in. Therefore, 1,579 responses were included in our final analysis. Table 1 outlines the demographic variables of the study population. Almost two-thirds of the respondents were female (64.4%) and the majority were less than 25 years old (67.2%). Dentists accounted for 12.6% of the total population. The clinical experience of the dentists in this group ranged from 0.25 to 52 years, with a median of 3 years (IQR 1 – 10 years). Medical doctors accounted for 24.5% of responses. The clinical experience of the medical doctors ranged from 0 to 50 years, with a median of 13 years (IQR 3 – 23 years). Among the dental students, 42.3% were in pre-clinical years and 57.7% were in clinical years of study. For the medical students, 57.5% were in pre-clinical years and 42.5% were in clinical years of study. Kuwait (44.5%), the Kingdom of Saudi Arabia (23.9%) and the Kingdom of Bahrain (19.2%) were the most represented countries in this survey with smaller numbers of respondents living in the United Arab Emirates (6.6%), Oman (3.8%) and Qatar (2%). Almost everyone (96.5%) had heard about COVID-19 at the time of the survey while just 60.2% had attended a discussion or lecture about the virus. Knowledge score of the responses of dentists, dental students, medical doctors, and medical students regarding knowledge of COVID-19 divided in satisfactory and unsatisfactory responses (Table 2). Detailed responses of dentists, dental students, medical doctors, and medical students to knowledge and perceptions of COVID-19 question can be seen in the supplementary tables S1 and S2).
DASS-21 and Knowledge Scores
Table 3 and Figure 1 outline the median (IQR) scores for depression, anxiety, stress in the DASS-21 according to satisfactory knowledge scores regarding COVID-19. It was observed that satisfactory knowledge regarding COVID-19 was associated with higher DASS depression and anxiety scores (p <0.001 and p = 0.001 respectively) but not with stress scores (p = 0.657). Those with satisfactory knowledge scores also scored higher in the DASS-21 questionnaire overall compared to those with unsatisfactory knowledge scores (p = 0.012).
Perceptions of COVID-19 did not appear to be associated with any of the DASS-21 sub-domains (Table 3). There was no difference observed between those who achieved satisfactory and unsatisfactory perception scores in the DASS depression (p = 0.190), anxiety (p = 0.394), or stress (p = 0.143) sub-domains. The median total DASS-21 score was greater in the satisfactory perception group, but the difference was not statistically significant (p = 0.180).
Satisfactory knowledge scores were examined using univariate and multivariate logistic regression. Increasing depression scores were associated with greater odds of having satisfactory knowledge of COVID-19, univariate OR 1.039 (95% CI 1.015 – 1.063, p = 0.001) and multivariate 1.047 (95% CI 1.021 – 1.073, p <0.001). Similarly, increasing anxiety scores were also associated with greater odds of having satisfactory knowledge of COVID-19, univariate OR 1.036 (95% CI 1.005 – 1.068, p = 0.022) and regression OR 1.055 (95% CI 1.019 – 1.091, p = 0.002).
However, stress scores were not associated with satisfactory knowledge of COVID-19 in univariate analysis (OR 1.015, 95% CI 0.994 – 1.037, p = 0.157) but was significantly associated with a higher odd of satisfactory knowledge in multivariate analysis (OR 1.035, 95% CI 1.010 – 1.060, p = 0.005). The total DASS-21 score was also associated with higher odds of satisfactory knowledge of COVID-19, univariate OR 1.011 (95% CI 1.003 – 1.020, p = 0.012) and multivariate OR 1.018 (95% CI 1.008 – 1.028, p = 0.001).
Differences between Countries
We also examined the DASS-21 scores broken down according to each country. Figure 2 displays box plots which shows the differences in DASS-depression, DASS-anxiety, DASS-stress scores for each country. In each category, the respondents from Qatar demonstrated the highest levels of depression, anxiety, and stress according to the DASS-21 (p <0.001, p<0.001, and p<0.001 respectively). Respondents from the Kingdom of Saudi Arabia scored lowest in the anxiety and stress sub-domains while those from the United Arab Emirates scored lowest in the depression subdomain.
Attitude Towards Outreach and Volunteering
Just one quarter (25.2%) of respondents had prior experience of getting involved in medical or dental outreach/ volunteering in a foreign country (Table 4). There were no significant differences in terms of prior outreach experience between dentists, dental students, medical doctors or medical students (p = 0.098). Among all the groups, medical doctors were the least worried about participating in outreach programs (25.1%), while dentists (40.2%) and medical students (41.1%) were most concerned (p <0.001). However, medical students indicated that they were most willing to participate in an outreach program within the next 12 months (p = 0.002).