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PubMed2003

Students' perceptions of the acceptability of behaviour management techniques.

The aim of the present study was to determine the perceptions of dental students of the acceptability of different forms of behaviour management for children. The effect of client characteristics (typically developing or learning disabled), intervention method (relaxation training and reinforcement or physical restraint) and treatment outcome (good or poor) on acceptability ratings made by fourth year dental students was determined. Students rated the acceptability of treatments on the basis of written vignettes using a standardized measure of the acceptability of behavioural treatments (the Treatment Evaluation Inventory, TEI, Kazdin, French and Sherick 1981). The study had a full factorial design; all possible combinations of variables were represented in the vignettes. The results were analysed using ANOVA models. There were significant main effects of intervention method and treatment outcome, indicating that less restrictive methods and good intervention outcome were rated as more acceptable. Significant two- and three-way interactions were found, which suggested that the use of restrictive methods may be perceived as more acceptable for a child with learning disabilities even when the outcome was poor. The second order interactions revealed that the acceptability of restrictive techniques was improved less markedly by a good outcome. This study highlights the importance of empirically evaluating outcome and treatment restrictiveness when engaging in behaviour management during dental procedures.

Adult↗
PubMed2003

The acceptability of the use of sedation in the management of dental anxiety in children: views of dental students.

The aim of the present study was to determine the views of dental students concerning the acceptability of the use of sedation in the management of dentally anxious children. Dental students in Trinidad (n = 100) were asked to rate the acceptability of vignettes describing the management of a young teenager with dental anxiety. The vignettes varied systematically along two dimensions: nature of intervention for anxiety (sedation vs. the use of relaxation training and rewards) and outcome of the intervention (good vs. poor). Ratings of acceptability were made using a standardized questionnaire measure. The data were analysed using analysis of variance (ANOVA). There were significant main effects of nature of intervention (F = 5.54; P < 0.05) and outcome of intervention (F = 298.01; P < 0.001), though the students' year of study did not influence ratings. None of the interaction terms were significant. Sedation was viewed as a less acceptable intervention than relaxation and rewards. Interventions associated with good outcomes were seen as more acceptable than interventions associated with poor outcomes. It is concluded that dental students' perceptions of the acceptability of interventions for use with dentally anxious patients are related to the effectiveness of the intervention. Sedation, regardless of the outcome, is seen as less acceptable than the use of rewards and relaxation.

Adolescent↗
PubMed2002

Acceptability and availability of pharmacological interventions for substance misuse by British NHS treatment services.

AIMS: Despite their potential advantages, many of the pharmacological interventions available to treat substance misuse are controversial and their acceptability within the United Kingdom (and other countries) has only recently begun to be investigated. DESIGN: A questionnaire mailed to British National Health Service (NHS) alcohol and drug treatment services asked respondents to rate the acceptability and availability of 11 pharmacological interventions for substance misuse employed to relieve withdrawal, reduce the likelihood of relapse and opiate overdose and substitute pharmaceuticals for illicit drugs. PARTICIPANTS: A sample of NHS substance misuse services (n = 265) listed in one or more directories of services in England, Wales and Scotland. FINDINGS: Substitute methadone for opiate addiction, substitute benzodiazepines for benzodiazepine-dependent patients, lofexidine for opiate detoxification, naltrexone for opiate relapse prevention and acamprosate for alcohol relapse prevention were widely acceptable and available interventions. Another subset of medications-buprenorphine for opiate detoxification, take-home naloxone for overdose prevention and substitute prescribing of levo-alpha-acetyl-methadol (LAAM), heroin and dexamphetamine-garnered less support, but the majority of participants rated even these therapies as acceptable. Ultra-rapid detoxification under sedation was the intervention rated as least acceptable to, and was one of the two least frequently available from, responding NHS services. CONCLUSIONS: Differences among specific medications notwithstanding, a wide range of harm-reduction and abstinence-orientated interventions were acceptable to and available from NHS services. Acceptance and availability are probably limited by a combination of practical, economic, safety, efficacy and theoretical considerations.

Attitude of Health Personnel↗
PubMed2001

Persons with insulin-dependent diabetes mellitus: acceptance and coping ability.

AIMS: The purposes of this study were to describe how persons with insulin-dependent diabetes mellitus (IDDM) accept their disease and what sense of coherence they have, in order to determine whether a person's acceptance of the disease is related to his or her sense of coherence. Whether acceptance of the disease and sense of coherence are related to the disease duration, complications of the disease, metabolic control and demographic data would also be determined. DESIGN: One hundred and seven, randomly selected, insulin-dependent, diabetic subjects (47 men and 60 women) participated in the study. The Acceptance of Disability Scale Modified (ADM scale), the Sense of Coherence Scale (SOC scale), a study-specific questionnaire and the patients records were used to collect the data. BACKGROUND: IDDM implies a major change in way of life. Ingrained procedures and patterns of behaviour must be adapted to the disease and its treatment. RESULTS: The results of the present study show that educational level seems to be an important factor for how well a person accepts the disease and the sense of coherence. Persons with higher scores on the ADM and the SOC scales had higher levels of education. Moreover, they also had a better metabolic control. Individuals with a poor metabolic control had more disease-related complications. A significant correlation between the ADM and the SOC scores was found, indicating that persons with a high degree of acceptance of the IDDM also had a high coping capability. CONCLUSIONS: It is important to individualize the care of subjects with IDDM and to identify the persons with low acceptance of their disease and a low sense of coherence.

Adaptation, Psychological↗
PubMed1987

The effect of temperature and humidity levels in a protective mask on user acceptability during exercise.

Subjective and physiological responses were obtained from six subjects wearing a ventilated face mask while exercising (3.8 met) for 15 min on a bicycle ergometer. Different combinations of ambient air temperatures (7 degrees, 16 degrees, 25 degrees C) and mask air temperatures (22 degrees, 27 degrees, 33 degrees C) were studied together with two different air humidities inside the mask (61% and 86% RH). Control experiments were performed without the mask at the same ambient temperatures. Skin temperatures, heart rates and skin wettedness were monitored during exercise. The subject's acceptance of the mask and thermal environment, thermal sensation, sensations of discomfort, sweating and skin wettedness, and their judgment of the work of breathing were assessed at the end of the 15 min exercise period. The acceptance of both the ambient thermal environment and of the thermal microclimate in the mask primarily was determined by the ambient air temperature, but it was influenced by the air temperature and humidity inside the mask. At ambient temperatures of 7 degrees C and 25 degrees C, the acceptance of the thermal work conditions decreased. In the warm environment a mask air temperature less than or equal to 27 degrees C was 100% acceptable and increased the acceptance of thermal environment. In the cool environment, a mask air temperature greater than or equal to 27 degrees C was 100% acceptable. The humidity content of the mask air was only important when the mask air was warm. Warm humid air significantly decreased acceptance of the mask conditions.

Adult↗
PubMed2004

Acceptable rates of treatment failure in osteomyelitis involving the diabetic foot: a survey of infectious diseases consultants.

Shortening the duration of antibiotic therapy is an attractive strategy for delaying the emergence of antimicrobial resistance. The paucity of data about optimal treatment durations hinders adoption of this approach. This study used contingent valuation analysis to identify failure rates for treatment of diabetic foot osteomyelitis acceptable to infectious diseases consultants (IDCs). The Infectious Diseases Society of America's Emerging Infections Network (EIN) provided members with the case scenario and 1 of 10 failure rates; members were asked, assuming delivery of standard therapy, if they would accept or reject the given failure rate. The relationship between specific failure rates and the willingness of IDCs to accept them was analyzed. The median acceptable failure rate for EIN members was 18.1%; 75% of IDCs found a failure rate of 7.8% to be acceptable, and 25% found a rate of 28.4% to be acceptable. The methodology used in this study may prove useful in delineating acceptable treatment failure thresholds, an initial step in shortening durations of antimicrobial therapy.

Adult↗
PubMed2004

Acceptability of severe pain among hospitalized adults.

BACKGROUND: It is unclear why some hospitalized adults experiencing severe pain report that this degree of pain is acceptable to them. METHODS: A 25% random sample of cognitively intact patients admitted to nine medical/surgical units in a New York City hospital were enrolled. Patients were interviewed daily, Monday to Friday from April 1, 2001 through February 14, 2003, to collect information on the presence of pain, pain intensity, analgesic use, and acceptance of pain. Patients were asked to rate their current level of pain using a four-point scale. RESULTS: Three hundred ninety-two of 1254 patients ( 31%) experiencing severe pain reported that their pain was acceptable to them. Variables significantly associated with an episode of acceptable severe pain in multivariate analyses included resolution of the painful episode (odds ratio = 4.7; 95% confidence interval [CI], 3.54-6.17), recent surgery (odds ratio = 1.5; 95% CI, 1.11-1.99), African American compared to white (odds ratio = 0.7; 95% CI, 0.48-0.955), age (odds ratio = 0.985; 95% CI, 0.977-0.993), and patients taking analgesics (odds ratio = 0.7; 95% CI, 0.46-0.964 for nonsteroidal anti-inflammatory drugs [NSAIDs]/acetaminophen and odds ratio = 0.6; 95% CI, 0.46-0.85 for opioids). Overall, 86 of 252 (34%) reported the pain was acceptable because it had resolved, 47 (19%) believed the pain would eventually go away, and 47 (19%) reported they were able to tolerate the pain. CONCLUSIONS: A substantial percentage of patients reporting severe pain report this experience as acceptable. Given recent research linking high intensity pain to adverse outcomes, future studies directed at improving the management of pain need to target both pain intensity and patients' beliefs about the acceptability of severe pain.

Adolescent↗
PubMed1998

Patterns of allosensitization in allograft recipients: long-term cardiac allograft acceptance is associated with active alloantibody production in conjunction with active inhibition of alloreactive delayed-type hypersensitivity.

BACKGROUND: The immunologic characteristics of experimental allograft acceptance remain ill-defined. This study evaluates humoral and cell-mediated immunity in transiently immunosuppressed mice that have accepted cardiac allografts. METHODS: DBA/2-->C57BL/6 heterotopic cardiac allograft recipients were immunosuppressed with either GK1.5 monoclonal antibody or gallium nitrate and monitored for donor-reactive delayed-type hypersensitivity (DTH) assessed by ear challenge and for alloantibody production detected by flow cytometry. RESULTS: Cardiac allograft function continued for >90 days in approximately 50% of GK1.5-treated and 97% of gallium nitrate-treated transplant recipients. All nonsuppressed recipients lost graft function within 7 to 10 days. Among mice that accepted allografts, donor-reactive IgG was produced by about 50% of GK1.5 monoclonal antibody-treated mice and 80% of gallium nitrate-treated mice. None of the these mice exhibited donor-reactive DTH responses, and all could down-regulate third-party DTH responses in a donor alloantigen-dependent manner. This down-regulation is not found in nonsuppressed allograft recipients or in naive mice. Importantly, transfer into SCID mice of splenocytes from mice that accepted allografts, but not naive splenocytes, provided them with a similar ability to accept cardiac allografts, even if the grafts co-expressed third-party alloantigens. CONCLUSIONS: IgG alloantibody production by murine cardiac allograft recipients is not a precise indicator of allosensitization leading to either cardiac allograft rejection or acceptance. However, expression of alloreactive DTH is a reliable indicator of allosensitization leading to acute rejection, and the absence of DTH in association with active DTH down-regulatory mechanisms is a reliable indicator of allograft acceptance in this experimental model. Thus, DTH analysis may hold more promise than alloantibody detection for clinical assessment of posttransplant immune status.

Animals↗
PubMed2000

Determination of acceptable HLA mismatches in highly sensitized patients by soluble HLA class I ELISA inhibition.

BACKGROUND: Acceptable HLA mismatches for highly sensitized patients are determined so as to increase their chances of receiving transplants. The disadvantage of the current procedures is that the antibody reactivity of the patients' sera is tested against HLA antigens expressed on cells or HLA antigens isolated from cell lysates. Therefore, two (homozygous for HLA-A and -B) to four (heterozygous for HLA-A and -B) different HLA class I antigens are present in the test. This might cause reactivity toward nonacceptable mismatches to mask the determination of acceptable mismatches. METHODS: Recently we observed that the detection of soluble HLA class I antigens is inhibited by HLA-specific antibodies. In the present study, inhibition of soluble HLA-specific ELISAs (anti-soluble HLA-A2, -B7, -B12) was evaluated as a tool used to determine acceptable mismatches. The results were compared with current determination of acceptable mismatches (which is by complement-dependent cytotoxicity and/or fluorescence-activated cell sorter analysis). RESULTS: In the case of acceptable mismatches determined by conventional methods, sera from the patients were not interfering in these ELISAs, whereas in the case of nonacceptable mismatches (thus specific antibodies), significant inhibition was observed in most instances. Among the nonacceptable mismatches, the test showed significant inhibition in 20 of 24 cases, whereas among acceptable mismatches, no inhibition was observed (in eight of eight), indicating the lack of specific antibodies. CONCLUSIONS: In highly sensitized patients, the introduction of soluble HLA-specific ELISAs is of additional and confirmatory value for the determination of acceptable mismatches. The major advantage of this approach is that antibody reactivity is tested against single antigens only.

Antibodies↗
PubMed2004

Risk comparisons, conflict, and risk acceptability claims.

Despite many claims for and against the use of risk comparisons in risk communication, few empirical studies have explored their effect. Even fewer have examined the public's relative preferences among different kinds of risk comparisons. Two studies, published in this journal in 1990 and 2003, used seven measures of "acceptability" to examine public reaction to 14 examples of risk comparisons, as used by a hypothetical factory manager to explain risks of his ethylene oxide plant. This study examined the effect on preferences of scenarios involving low or high conflict between the factory manager and residents of the hypothetical town (as had the 2003 study), and inclusion of a claim that the comparison demonstrated the risks' acceptability. It also tested the Finucane et al. (2000) affect hypothesis that information emphasizing low risks-as in these risk comparisons-would raise benefits estimates without changing risk estimates. Using similar but revised scenarios, risk comparison examples (10 instead of 14), and evaluation measures, an opportunity sample of 303 New Jersey residents rated the comparisons, and the risks and benefits of the factory. On average, all comparisons received positive ratings on all evaluation measures in all conditions. Direct and indirect measures showed that the conflict manipulation worked; overall, No-Conflict and Conflict scenarios evoked scores that were not significantly different. The attachment to each risk comparison of a risk acceptability claim ("So our factory's risks should be acceptable to you.") did not worsen ratings relative to conditions lacking this claim. Readers who did or did not see this claim were equally likely to infer an attempt to persuade them to accept the risk from the comparison. As in the 2003 article, there was great individual variability in inferred rankings of the risk comparisons. However, exposure to the risk comparisons did not reduce risk estimates significantly (while raising benefit estimates), and Conflict-Claim respondents found the risk of the hypothetical factory less acceptable than No-Conflict respondents. Results suggest that neither risk comparisons nor risk acceptability claims are automatically anathema to audiences, but they may have tiny or unintended effects on audience judgments about risky situations.

Journal Article↗
PubMed2004

Major psychological factors affecting acceptance of gene-recombination technology.

The purpose of this study was to verify the validity of a causal model that was made to predict the acceptance of gene-recombination technology. A structural equation model was used as a causal model. First of all, based on preceding studies, the factors of perceived risk, perceived benefit, and trust were set up as important psychological factors determining acceptance of gene-recombination technology in the structural equation model. An additional factor, "sense of bioethics," which I consider to be important for acceptance of biotechnology, was added to the model. Based on previous studies, trust was set up to have an indirect influence on the acceptance of gene-recombination technology through perceived risk and perceived benefit in the model. Participants were 231 undergraduate students in Japan who answered a questionnaire with a 5-point bipolar scale. The results indicated that the proposed model fits the data well, and showed that acceptance of gene-recombination technology is explained largely by four factors, that is, perceived risk, perceived benefit, trust, and sense of bioethics, whether the technology is applied to plants, animals, or human beings. However, the relative importance of the four factors was found to vary depending on whether the gene-recombination technology was applied to plants, animals, or human beings. Specifically, the factor of sense of bioethics is the most important factor in acceptance of plant gene-recombination technology and animal gene-recombination technology, and the factors of trust and perceived risk are the most important factors in acceptance of human being gene-recombination technology.

Adolescent↗
PubMed1993

Acceptance of mementos of fetal and perinatal loss in a south Australian population.

A package of mementos of a fetal or perinatal loss has been shown to help with the grieving process. The level of acceptance and the factors influencing acceptance of these mementos in a South Australian population was examined over a 27-month period. Data were available on 447 women and the acceptance rate was 79.6%. Major influences on the acceptance of mementos were maternal age and gestational age. Mothers in the 20-30 year age group were more likely to accept mementos than younger and older mothers. This age-related effect was more noticeable among genetic terminations and neonatal deaths than among spontaneous abortions or stillbirths. Memento acceptance of miscarriages and stillbirths over 20 weeks' gestation was significantly greater than for younger gestation. These findings may have an impact on the psychosocial management of perinatal loss. The high level of acceptance of these mementos is encouraging and vindicates our current practice which we recommend to others involved in the management of perinatal loss.

Australia↗
PubMed1998

Acceptability for temporal modification of single vowel segments in isolated words.

Few perceptual studies of the temporal aspects of speech have investigated the influence of changes in segmental durations in terms of acceptability. Aiming to contribute to the assessment of rules for assigning segmental durations in speech synthesis, the current study measured the perceptual acceptability of changes in the segmental duration of vowels as a function of the segment attributes or context, such as base duration, temporal position in a word, vowel quality, and voicing of the following segment. Seven listeners estimated the acceptability of word stimuli in which one of the vowels was subjected to a temporal modification from -50 ms (for shortening) to +50 ms (for lengthening) in 5-ms steps. The temporal modification was applied to vowel segments in 70 word contexts; their durations ranged from 35-145 ms, the mora position in the word was first or third, the vowel quality was /a/ or /i/, and the following segment was a voiced or an unvoiced consonant. The experimental results showed that the listeners' acceptable range of durational modification was narrower for vowels in the first moraic position in the word than for those in the third moraic position. The acceptable range was also narrower for the vowel /a/ than for the vowel /i/, and similarly narrower for vowels followed by unvoiced consonants than for those followed by voiced consonants. The vowel that fell into the least vulnerable class (the third /i/, followed by a voiced consonant) required 140% of the modification of that which fell into the most vulnerable class (the first /a/, followed by an unvoiced consonant) to yield the same acceptability decrement. In contrast, the effect of the original vowel duration on the acceptability of temporal modifications was not significant despite its wide variation (35-145 ms).

Humans↗
PubMed2004

Topical adrenaline and cocaine gel for anaesthetising children's lacerations. An audit of acceptability and safety.

OBJECTIVES: (1) To assess the acceptability of a gel solution of adrenaline (epinephrine) (1 in 2000) and cocaine (5%) for anaesthetising children's facial lacerations to the child, parent, and operator. (2) To assess the safety of the current protocol. SETTING: The emergency unit of a large university hospital. METHODS: All patients who were treated with topical adrenaline and cocaine (topAC) gel over a six month period were entered into a prospective audit (n = 75). Patient details, the nature and cause of the injury, and any treatment carried out were all recorded. The acceptability to children over 3 years of age, was assessed by the use of the Wong Baker face scale, in which 0 represents "no hurt" and 5 represents "hurts worst". The acceptability to both the parent and the operator was assessed by the use of a 0 to 9 Likert scale, where 0 represented "very acceptable" and 9 represented "not at all" acceptable. RESULTS: (1) Children aged 3 years or older graded their pain during the procedure as having a mean value of 1.17 on the Wong Baker (0 to 5) scale. Parents graded acceptability on the Likert scale (0 to 9) with a mean score of 1.13. Operators using the same grading system, recorded a mean score of 1.75. (2) No toxic side effects were seen but the protocol was updated in line with evidence. CONCLUSIONS: Topical adrenaline and cocaine is an effective anaesthetic for suturing children's facial lacerations and is acceptable to child, parent, and operator alike.

Administration, Topical↗
PubMed2003

Opportunistic screening for genital chlamydial infection. I: acceptability of urine testing in primary and secondary healthcare settings.

OBJECTIVES: To determine the acceptability of opportunistic screening for Chlamydia trachomatis in young people in a range of healthcare settings. DESIGN: An opportunistic screening programme (1 September 1999 to 31 August 2000) using urine samples tested by ligase chain reaction (LCR). Data on uptake and testing were collected and in-depth interviews were used for programme evaluation. SETTING: General practice, family planning, genitourinary medicine clinics, adolescent sexual health clinics, termination of pregnancy clinics, and women's services in hospitals (antenatal, colposcopy, gynaecology and infertility clinics) in two health authorities (Wirral and Portsmouth and South East Hampshire). Main participants: Sexually active women aged between 16 and 24 years attending healthcare settings for any reason. MAIN OUTCOME MEASURES: Uptake data: proportion of women accepting a test by area, healthcare setting, and age; overall population coverage achieved in 1 year. Evaluation data: participants' attitudes and views towards opportunistic screening and urine testing. RESULTS: Acceptance of testing by women (16-24 years) was 76% in Portsmouth and 84% in Wirral. Acceptance was lower in younger women (Portsmouth only) and varied by healthcare setting within each site. 50% of the target female population were screened in Portsmouth and 39% in Wirral. Both the opportunistic offer of screening and the method of screening were universally acceptable. Major factors influencing a decision to accept screening were the non-invasive nature of testing and treatment, desire to protect future fertility, and the experimental nature of the screening programme. CONCLUSIONS: An opportunistic model of urine screening for chlamydial infection is a practical, universally acceptable method of screening.

Adolescent↗
PubMed2005

Influence of nasal resistance on initial acceptance of continuous positive airway pressure in treatment for obstructive sleep apnea syndrome.

BACKGROUND: Continuous positive airway pressure (CPAP) is considered as the standard therapy for obstructive sleep apnea syndrome (OSAS), but some patients with OSAS are unable to accept CPAP due to nasal obstruction and poor nasal airflow. OBJECTIVES: We assessed the influence of nasal resistance before beginning CPAP treatment on the initial acceptance of CPAP in OSAS patients. METHODS: The study subjects comprised 77 patients (74 males, 3 females) with primary OSAS, all of whom received CPAP treatment with nasal masks. Before trials, all subjects underwent overnight polysomnography, and nasal resistance was measured with active anterior rhinomanometry in the seated position on the first day of CPAP trial. RESULTS: The CPAP treatment was accepted by 56 patients after the initial trials with overnight polysomnography. Body mass index, the number of apnea/hypopnea episodes per hour (apnea/hypopnea index; AHI), and the number of episodes per hour with an oxygen desaturation of >3% (oxygen desaturation index) were significantly higher (p<0.01) and nasal resistance was lower (p=0.003) in patients who accepted CPAP than in those who did not. Logistic regression analysis, with patient age, body mass index, Epworth sleepiness scale score, AHI, oxygen desaturation index, and nasal resistance before CPAP treatment as explanatory variables, showed that nasal resistance (OR+0.1 Pa/cm3/s: 1.48; p=0.002) and AHI (OR+1 event/h: 0.93; p=0.003) were significant factors for CPAP non-acceptance. CONCLUSIONS: Nasal resistance before the beginning of CPAP treatment has a significant effect on the acceptance of CPAP in OSAS patients, and hence, could be a predictive parameter for the initial acceptance of CPAP.

Adult↗
PubMed2002

The contribution of chronic illness to acceptance of death in hospitalized patients.

This pilot study explored acceptance of death in the chronically ill. It was hypothesized that chronic illness would be a positive predictor of premature acceptance of death. Acceptance of death, if premature, may lead to untimely acquiescence to death, making people less likely to seek medical care and practice preventive health behaviors. A correlational design was used to explore the relationship between chronic illness and acceptance of death, controlling for age. Data were collected on death acceptance using the revised version of the Life Attitude Profile. Number of chronic illnesses was obtained from self-report and a review of the medical record in a sample of 76 hospitalized individuals. The number of chronic illnesses was significantly and positively associated with death acceptance, but age was not. The model explained only 5.2% of the variance in death acceptance, however. Chronic illness is clearly only one of many factors stimulating individuals to ponder death earlier than expected. Nurses need to be alert to the possibility that individuals with multiple chronic illnesses may be prematurely acquiescing to death. If acquiescence causes failure to participate in care, it could potentially exacerbate chronic conditions unnecessarily.

Attitude to Death↗
PubMed2005

A gap between acceptance and knowledge of herbal remedies by physicians: the need for educational intervention.

BACKGROUND: The unprecedented global increase in the use of herbal remedies is set to continue apace well into the foreseeable future. This raises important public health concerns, especially as it relates to safety issues including adverse effects and herb-drug interactions. Most Western-trained physicians are ignorant of the risks and benefits of this healthcare modality and assessment of acceptance and knowledge would identify appropriate intervention strategies to improve physician-patient communication in this area. METHODS: A cross-sectional survey was done using an interviewer-administered pilot tested de novo questionnaire at six public hospitals in Trinidad between May-July 2004. The questionnaire utilized weighed questions to quantify acceptance (maximum score = 14 points) and knowledge (maximum score = 52 points). Acceptance and knowledge scores were analyzed using the ANOVA and Tukey's tests. RESULTS: Of 192 physicians interviewed, most (60.4%) believed that herbal remedies were beneficial to health. Respondents had relatively high acceptance levels (mean = 5.69 +/- 0.29 points or 40% of total possible score) and poor knowledge (mean = 7.77 +/- 0.56 points or 15% of total possible score). Seventy-eight physicians (40.6%) admitted having used herbs in the past, and 60 of these (76.9%) were satisfied with the outcome. Although 52 physicians (27.1%) recommended the use of herbs to their patients only 29 (15.1%) were able to identify at least one known herb-drug interaction. CONCLUSION: The use of herbal remedies is relatively high in Trinidad, as throughout the world, and most patients self-medicate with or without the knowledge of their attending physician. Surprisingly, we demonstrated relatively high acceptance levels and use of herbs among physicians in Trinidad. This interesting scenario of high acceptance levels and poor knowledge creates a situation that demands urgent intervention. We recommend educational intervention to narrow the gap between acceptance and knowledge so that physicians would be adequately equipped to communicate with their patients on this modality. The integration of herbal medicine into the curriculum of medical schools, continuing education programs and the availability of reputable pharmacopoeias for referencing at public health institutions are useful instruments that can be used to close this gap and promote improved physician-patient communication.

Access to Information↗