Due to the scarcity of studies that study students' awareness of anticoagulants locally and globally, this study aimed to know the awareness of Syrian private university students about anticoagulants (types, mechanism of action, indications, and side effects).
Methods
The research design is an observational descriptive study of the cross-sectional study type. This type of study is easy and quick to implement and can be used to evaluate several exposures and outcomes and allows for determining the burden of disease in society. In addition, it allows for descriptive analyses and hypotheses to be established. Since the sample of this research is a random sample selected from the community, the results extracted from this research are generalizable and reflect the general situation of the community from which the sample was taken.
Study Group
Samples were collected at the Syrian Private University and samples were collected daily during official working hours in the period between 6/1/2024 and 6/7/2024. Since the questionnaires will be distributed randomly to the students of the Syrian Private University, the sampling method is convenience sampling. Our required sample size was 267 participants who met the inclusion and exclusion criteria. Since the research design is a cross-sectional study, the sample size was determined taking into account the margin of error ± 5% and the confidence interval 95%.
Exclusion Criteria
Students who did not provide us with sufficient or illogical information were excluded, and students from other colleges at the university were excluded.
Inclusion Criteria
Medical students at the Syrian Private University of all ages, regardless of their standard of living and academic year. Males and females were included, and all ages were included without excluding anyone.
Sampling Difficulties
There was difficulty in delivering the electronic questionnaires to the participants, so we had to interview the students individually in order to obtain sufficient information for the study.
The questionnaire was developed by the researchers under the supervision of the supervisor based on the objectives of the study and after reviewing the literature of previous studies, a committee of 3 professors evaluated the questionnaire to ensure its suitability and accuracy, in addition to being asked to critique the content of the questionnaire.
To ensure the validity of the questionnaire, it was administered to a sample of 30 students selected from medical colleges and were from different academic years. Since the results of the pilot questionnaires were not included in the analysis, a reliability scale evaluation was conducted to estimate the internal consistency of the items and a good Cronbach's alpha score (α = 0.74) was achieved.
The questionnaire was divided into 6 sections with a total of 46 questions and most of the questions were closed-ended. The first section covered demographic characteristics, including college, age, gender and academic year.
The second section included students' knowledge of blood thinners and the answer items were "yes", "no" and "not sure".
Section Three: included questions about knowledge of the indications for the management of anticoagulants, and the response options for the knowledge items included "yes", "no", and "not sure".
Section Four: included questions about knowledge of contraindications for anticoagulants, and the response options for the knowledge items included "yes", "no", and "not sure".
Section Five: included questions about knowledge of the mechanism of action of warfarin and apixaban, and the response options for the knowledge items included "yes", "no", and "not sure".
Section Six: included questions about knowledge of the side effects of using anticoagulants, and the response options for the knowledge items included "yes", "no", and "not sure".
Correct answers were recorded as 1, while incorrect answers and "I'm not sure" were recorded as 0, and the percentage of those who answered correctly less than 50% (less than 20 questions) was considered to have poor knowledge, those who answered correctly 50–70% (20 to 35 questions) were considered to have average knowledge, and those who answered correctly more than 70% (more than 35 questions) were considered to have good knowledge.
Mechanism of action
The method used to collect data is a personal interview and electronic questionnaire administration, where in addition to conducting interviews, the electronic questionnaire was sent to medical student groups, where the questionnaire was placed in the social media groups of medical students, along with the part for conducting personal interviews. The answers to the questionnaire questions were taken by the research team, and the data collection process was carried out during the period from 2/15/2024 to 5/31/2024, and then the data was entered and analyzed using the SPSS statistics V26 program.
Informed Consent
and Voluntary Participation
Approval was obtained from the Faculty of Medicine Council at the Syrian Private University and the questionnaire included an "information sheet" that the study subjects had to read before answering the questionnaire. This sheet included items including
¬ Emphasis on the privacy and confidentiality of data and participants.
¬ A brief overview that gives students a general idea about the study.
¬ Freedom to withdraw from participation at any time during data collection and that their information will be ignored if they withdraw.
¬ The study does not cause any material, psychological or social harm to any of the students, and does not require them to disclose any information of a sensitive nature and the participants did not receive any payments for participating in the questionnaire.
Each questionnaire was given a numerical code and the questionnaires were stored with the researchers in special folders.
Statistical Analysis
The data collected through the Google form were recoded and after adding the data collected through the personal interview, they were entered and processed using the statistical package SPSS-26, to describe the basic features of the data in the study through frequencies and percentages, the Chi-square test (χ2) was used to find the relationship between the level of knowledge (weak - average - good) and the socio-demographic variables, P-value < 0.05 was adopted as a significant value