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PubMed1993

Women's knowledge about breast cancer. Dimensions of knowledge and scale development.

Evidence suggests that knowledge about breast cancer may influence secondary prevention, care-seeking behavior, and participation in treatment decision-making. Yet few standardized measures of breast cancer knowledge are in existence. Using factor analysis, this paper describes the structure of women's knowledge about breast cancer and uses that structure to develop a measurement scale. Principal axis factoring and varimax rotation yielded a nine factor solution, which accounted for 59.3% of the common variance. Interpretation of the conceptual structure of these factors suggests that knowledge is organized around breast cancer treatment, misconceptions, risk factors, symptoms, menstruation, and prevalence. Considering only those items with factor loadings of .35 and greater, and including only those factors containing three or more items, a 16-item scale, which included four factor-based subscales covering knowledge about breast cancer treatment, misconceptions, risks, and symptoms was developed. Internal consistency reliability of the total scale and of the four subscales was high (alphas = .76-.95). Using chi square analysis, it was found that levels of knowledge on the total scale and on the treatment and symptom subscales are associated with age, education, income, and history of breast cancer. Knowledge on the misconceptions subscale was associated with age, education, and income. Knowledge on the risks subscale was associated with age and education. Issues of reliability and validity of the scale as well as directions for future research in this area are discussed.

Adult↗
PubMed2004

Disciplinary knowledge of K-3 teachers and their knowledge calibration in the domain of early literacy.

Recently, investigators have begun to pay increasing attention to the role of teachers' domain specific knowledge in the area of reading, and its implications for both classroom practice and student learning. The aims of the present study were to assess kindergarten to third-grade teachers' actual and perceived reading-related subject matter knowledge, and to investigate the extent to which teachers calibrate their reading related subject matter knowledge by examining relationships between actual and perceived knowledge. Results indicated that while teachers demonstrated limited knowledge of children's literature, phoneme awareness, and phonics, the majority of these same teachers evaluated their knowledge levels quite positively. Teachers demonstrated some ability to calibrate their own knowledge levels in the area of children's literature, yet they were poorly calibrated in the domains of phoneme awareness and phonics. These findings suggest that teachers tend to overestimate their reading related subject matter knowledge and are often unaware of what they know and do not know. Implications for the design of teacher education at both the preservice and inservice levels are discussed.

Adult↗
PubMed2005

The effects of different knowledge-dissemination interventions on the mastitis knowledge of Tanzanian smallholder dairy farmers.

We developed three different knowledge-dissemination methods for educating Tanzanian smallholder farmers about mastitis in their dairy cattle. The effectiveness of these methods (and their combinations) was evaluated and quantified using a randomised controlled trial and multilevel statistical modelling. To our knowledge, this is the first study that has used such techniques to evaluate the effectiveness of different knowledge-dissemination interventions for adult learning in developing countries. Five different combinations of knowledge-dissemination method were compared: 'diagrammatic handout' ('HO'), 'village meeting' ('VM'), 'village meeting and video' ('VM+V'), 'village meeting and diagrammatic handout' ('VM+HO') and 'village meeting, video and diagrammatic handout' ('VM+V+HO'). Smallholder dairy farmers were exposed to only one of these interventions, and the effectiveness of each was compared to a control ('C') group, who received no intervention. The mastitis knowledge of each farmer (n=256) was evaluated by questionnaire both pre- and post-dissemination. Generalised linear mixed models were used to evaluate the effectiveness of the different interventions. The outcome variable considered was the probability of volunteering correct responses to mastitis questions post-dissemination, with 'village' and 'farmer' considered as random effects in the model. Results showed that all five interventions, 'HO' (odds ratio (OR)=3.50, 95% confidence intervals (CI)=3.10, 3.96), 'VM+V+HO' (OR=3.34, 95% CI=2.94, 3.78), 'VM+HO' (OR=3.28, 95% CI=2.90, 3.71), 'VM+V' (OR=3.22, 95% CI=2.84, 3.64) and 'VM' (OR=2.61, 95% CI=2.31, 2.95), were significantly (p<0.0001) more effective at disseminating mastitis knowledge than no intervention. In addition, the 'VM' method was less effective at disseminating mastitis knowledge than other interventions. Combinations of methods showed no advantage over the diagrammatic handout alone. Other explanatory variables with significant positive associations on mastitis knowledge included education to secondary school level or higher, and having previously learned about mastitis by reading pamphlets or attendance at an animal-health course.

Animals↗
PubMed1990

A research-knowledge system (ARKS) for storing, managing, and modeling knowledge from the scientific literature.

Nursing knowledge and nursing data are the foundation for nursing practice. Domain knowledge that is stored in the literature of nursing and related disciplines, if not in memory, needs to be available to nurses during the process of clinical decision making. Although the electromechanical technology for delivering knowledge is available, conceptual technology lags far behind. An informatics solution to the conceptual problem is provided by knowledge engineering, the branch of informatics that addresses such problems by developing methods for restructuring knowledge from one form into a form that is more useful. The purpose of this article is to describe a research program for engineering nursing knowledge that has resulted in the development of such a tool, a prototype computer system for storing, managing, and modeling research-knowledge. The system is called ARKS, acronym for A Research-Knowledge System.

Computer Simulation↗
PubMed1998

Cooperative knowledge evolution: a construction-integration approach to knowledge discovery in medicine.

In this paper, we perform a cognitive analysis of knowledge discovery processes. As a result of this analysis, the construction-integration theory is proposed as a general framework for developing cooperative knowledge evolution systems. We thus suggest that for the acquisition of new domain knowledge in medicine, one should first construct pluralistic views on a given topic which may contain inconsistencies as well as redundancies. Only thereafter does this knowledge become consolidated into a situation-specific circumscription and the early inconsistencies become eliminated. As a proof for the viability of such knowledge acquisition processes in medicine, we present the IDEAS system, which can be used for the intelligent documentation of adverse events in clinical studies. This system provides a better documentation of the side-effects of medical drugs. Thereby, knowledge evolution occurs by achieving consistent explanations in increasingly larger contexts (i.e., more cases and more pharmaceutical substrates). Finally, it is shown how prototypes, model-based approaches and cooperative knowledge evolution systems can be distinguished as different classes of knowledge-based systems.

Artificial Intelligence↗
PubMed1993

The development of a questionnaire to assess knowledge of epilepsy: 1--General knowledge of epilepsy.

It is well documented that knowledge is a vital factor in the ability to cope successfully with epilepsy. Misconceptions and deficits in knowledge have implications not only for psychosocial well-being but also for medical compliance. However, at present there is no commonly accepted objective measure of knowledge of epilepsy. The development of the Epilepsy Knowledge Profile--General (E.K.P.--G) is presented in this paper. Fifty-five true/false items (34 medical knowledge items, 21 social knowledge items) were selected by a range of experts in the field of epilepsy. A clinical trial of the questionnaire was then completed by 82 people with epilepsy attending a city centre outpatient clinic. Results indicated that the scale has both good internal reliability and test-retest reliability. Also the range of scores indicates that it is sensitive to differences in knowledge. Potential uses of the questionnaire are discussed.

Adaptation, Psychological↗
PubMed2006

Understanding knowledge effects on attitude-behavior consistency: the role of relevance, complexity, and amount of knowledge.

The role of properties of attitude-relevant knowledge in attitude- behavior consistency was explored in 3 experiments. In Experiment 1, attitudes based on behaviorally relevant knowledge predicted behavior better than attitudes based on low-relevance knowledge, especially when people had time to deliberate. Relevance, complexity, and amount of knowledge were investigated in Experiment 2. It was found that complexity increased attitude- behavior consistency when knowledge was of low-behavioral relevance. Under high-behavioral relevance, attitudes predicted behavior well regardless of complexity. Amount of knowledge had no effect on attitude- behavior consistency. In Experiment 3, the findings of Experiment 2 were replicated, and the complexity effect was extended to behaviors of ambiguous relevance. Together, these experiments support an attitude inference perspective, which holds that under high deliberation conditions, people consider the behavioral relevance and dimensional complexity of knowledge underlying their attitudes before deciding to act on them.

Analysis of Variance↗
PubMed2006

Linking local knowledge with global action: examining the Global Fund to Fight AIDS, Tuberculosis and Malaria through a knowledge system lens.

New global public health institutions are increasingly emphasizing transparency in decision-making, developing-country ownership of projects and programmes, and merit- and performance-based funding. Such principles imply an institutional response to the challenge of bridging the "know-do gap", by basing decisions explicitly on results, evidence and best practice. Using a knowledge systems framework, we examine how the Global Fund to Fight AIDS, Tuberculosis and Malaria has affected the ways in which knowledge is used in efforts to combat these three diseases. We outline the formal knowledge system embedded in current rules and practices associated with the Global Fund's application process, and give three examples that illustrate the complexity of the knowledge system in action: human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) policy in China; successful applications from Haiti; and responses to changing research on malaria. These examples show that the Global Fund has created strong incentives for knowledge to flow to local implementers, but with little encouragement and few structures for the potentially valuable lessons from implementation to flow back to global best practice or research-based knowledge. The Global Fund could play an influential role in fostering much-needed learning from implementation. We suggest that three initial steps are required to start this process: acknowledging shared responsibility for learning across the knowledge system; analysing the Global Fund's existing data (and refining data collection over time); and supporting recipients and technical partners to invest resources in linking implementation with best practice and research.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Diet- and blood pressure-related knowledge, attitudes, and hypertension prevalence among African Americans: the KDBP Study. Knowledge of Diet and Blood Pressure.

Despite attempts to raise awareness of the effect lifestyle factors such as diet have on health, little is known about the results of such efforts among populations at highest risk for hypertension (HTN). The Knowledge of Diet and Blood Pressure (KDBP) Study investigated the relationship between diet- and blood pressure-related knowledge and HTN prevalence, and attitudes among a church-based population of African Americans. One hundred ninety-six adults were randomly selected from 6 churches in an urban area of North Carolina. After study criteria and missing data exclusions, the study sample comprised 179 individuals. A knowledge index assessed awareness of: the definition of HTN; its risk and prognostic factors; risk-preventing and risk-promoting nutrition; and related nutritional recommendations (score range: 0-100, 100 = most knowledgeable). Health attitudes were assessed primarily through Likert-type questions. HTN was defined as SBP > or = 140 mm Hg, DBP > or = 90 mm Hg, or anti hypertensive medication use. The mean SBP and DBP were 135.4 +/- 21.6 mm Hg and 78.8 +/- 15.7 mm Hg, respectively, and 55.9% of participants had HTN. The mean knowledge score was 76.1 (+/- 10.6). There was no statistically significant difference in mean knowledge score by HTN status (known HTN: 76.9 [+/- 11.31); unknown HTN (ie, the participant was unaware of the presence of HTN): 76.1 (+/- 9.3); no HTN: 75.3 (+/- 10.4), P = .665). Attitudes were not significantly related to knowledge and HTN prevalence, despite apparent trends. However, logistic regression analyses revealed that age, occupation, and church site were significant correlates of this relationship. Further exploration of attitudes and socioeconomic factors in assessing health awareness and HTN prevalence in this population is recommended.

Adult↗
PubMed1995

Knowledge, implicit knowledge and metaknowledge in visual agnosia and pure alexia.

Residual or implicit knowledge has been observed in patients with object agnosia, optic aphasia and pure alexia. Previous investigators have considered implicit knowledge in these patients to be dissociated from awareness on the basis of intact semantic capabilities that are consistent with right hemisphere processing. The absence of explicit verbal identification is presumably dependent upon damaged left hemisphere systems. We describe a 72-year-old woman with a left occipital infarction, object agnosia and pure alexia who was unable to explicitly identify visual stimuli (objects and words), but was able to make reliable judgements of her residual knowledge on forced-choice matching tasks. While the patient could not consistently demonstrate awareness of knowledge prior to stimulus matching ('Do you know what this is?'), she was able to reliably demonstrate awareness of knowledge for response accuracy ('Are you sure?') assessed after stimulus matching. Further, the extent of the patient's metaknowledge corresponded to her degree of preserved knowledge. We propose that this pattern of performance suggests limited or partial access to preserved semantic knowledge which, though degraded, is not 'non-conscious'.

Aged↗
PubMed2001

Does eye gaze indicate implicit knowledge of false belief? Charting transitions in knowledge.

Three-year-olds sometimes look to the correct location but give an incorrect verbal answer in a false belief task. We examined whether correct eye gaze among 3- to 5-year-old children indexed unconscious knowledge or low confidence conscious knowledge. Children "bet" counters on where they thought a story character would go. If children were conscious of the knowledge conveyed by their eye gaze then they should have bet modestly on their explicit answer (i.e., been unsure whether this answer or the answer conveyed through eye direction was correct). We found that children bet very highly on the location consistent with their explicit answer, suggesting that they were not aware of the knowledge conveyed through their eye gaze. This result was supported by a number of conditions that showed that betting was a sensitive measure of even small degrees of uncertainty. The results shed light on false-belief understanding, the implicit-explicit distinction, and transitional knowledge. We argue that the transition to a full understanding of false belief is marked by periods of implicit knowledge and explicit understanding with low confidence.

Child Development↗
PubMed1996

The gap between back pain patients' prior knowledge and scientific knowledge and its evolution after a back school teaching programme: a quantitative evaluation.

This study presents a method for quantitative evaluation of the congruence between patients' representations and teachers' scientific knowledge, which is used as the standard of assessment. First, the patients' knowledge and the teachers' scientific concepts before a back school (BS) programme were compared (T0). Then the evolution of patients' knowledge at 1 month (T1) and 1 year (T2) after the teaching was evaluated. Patients' knowledge was assessed blind by a multidisciplinary panel of nine independent judges. Mean scores were computed for each set of data (T0,T1,T2); these scores were then submitted to an analysis of variance. The results showed an important gap between patients and teachers before BS with an improvement after the teaching. Knowledge referring to know-how and/or attitudes evolved differently when compared to theoretical knowledge.

Adolescent↗
PubMedDate not supplied

Development of children's body knowledge, using knowledge of the lungs as an exemplar.

When teaching young children about health care procedures, health care professionals must assess what children already know about human anatomy and physiology, otherwise known as "body knowledge," to correct misconceptions and expand children's knowledge of their bodies. This article summarizes studies published between 1935 and 2000 that were related to the development and assessment of children's body knowledge, using knowledge of the lungs as an exemplar of body knowledge. Types of instruments used to measure body knowledge are described, and suggestions for future studies are provided.

Adolescent↗
PubMedDate not supplied

Does knowledge make a difference? The association between knowledge about genes and attitudes toward gene tests.

A survey was conducted (n = 1,216) to evaluate the level of knowledge about basic facts of genetics and attitudes toward gene tests among the Finnish population. Our results show that a majority of the Finnish population generally approved of gene tests. Well over half of the respondents believed that genetic testing will have positive consequences, but many also had worries related to the development of gene tests. We showed that there was an association between knowledge and attitudes, but better knowledge did not simply lead to unambiguous acceptance. Among those with the highest level of knowledge there was in many respects both more enthusiasm and more skepticism than among those with the lowest level of knowledge. Those with a low level of knowledge had more difficulties in taking a stance toward attitude statements. In general, steps should be taken, first, to increase citizens' capabilities to seek and understand information about genetics and specific diseases when faced with a need for it. Second, steps should be taken to provide citizens with tools to perceive and discuss potential ethical and social problems, which development of gene technology, genetic testing, and screening bring along. Sites for these enterprises could be the biology school curriculum, genetic counseling, media, as well as health education and health communication in general.

Data Collection↗
PubMed2006

Patient knowledge and misconceptions of osteoarthritis assessed by a validated self-completed knowledge questionnaire (PKQ-OA).

OBJECTIVES: To design and validate an osteoarthritis (OA) patient knowledge questionnaire (PKQ-OA) and to use it to assess the patients' level of knowledge of their disease, treatments and appropriate management techniques. METHODS: The PKQ-OA comprises 16 multiple choice questions with 30 correct answers. It was developed in two phases and tested for face validity, readability (Flesch Reading Index) and understanding, reliability (Kuder-Richardson Formula 20) and reproducibility (test/retest). The questionnaire was then used to assess knowledge of disease and management of OA in a cohort of 83 patients with established disease. RESULTS: The PKQ was found to be fairly easy to read, reliable (r = 0.75) and reproducible (r = 0.81; P < 0.01). The overall median score for the PKQ-OA was 19 ranging from 8 to 26. There was a highly significant association between the scores obtained and the number of years patients had spent in formal education, higher scores equating with greater length of education (P < 0.005). The majority of patients was knowledgeable about the symptoms of OA and exercise, but confused joint protection and energy conservation. The most worrying finding was the lack of knowledge regarding analgesics and some aspects of non-steroidal anti-inflammatory drug (NSAID) therapy. Less than a third of patients knew that analgesics could be taken prophylactically and 70% did not know that they should be taken when pain starts to build. Among the patients 34% did not know that NSAIDs should be taken with or following food. CONCLUSIONS: The PKQ-OA is a readable, reliable and reproducible questionnaire. It is quick to complete and score and could be used in out patient clinics or GP surgeries to assess knowledge of patients with OA.

Adult↗
PubMed2005

Unity of knowledge in the advancement of nursing knowledge.

During the past 20 years, we have witnessed an explosion in nursing knowledge providing the discipline with diverse and multifaceted theoretical frameworks and paradigms. One knowledge theme that pervades the dialogue in the scholarly literature is that of multiple ways of knowing. With the acknowledgement that the fundamental nature of nursing knowledge is grounded in the understanding of human nature and its response to its environment, comes an imperative for a consilience of knowledge. The purpose of this article is to present such a unified worldview by articulating a vision of nursing knowledge, a meaning of unity of knowledge, and a challenge to the discipline to embrace inclusive rather than exclusive ways of knowing.

Attitude of Health Personnel↗
PubMed2003

The design of a valid and reliable questionnaire to measure osteoporosis knowledge in women: the Osteoporosis Knowledge Assessment Tool (OKAT).

BACKGROUND: Osteoporosis knowledge is an important contributor to improving exercise and calcium intake behaviour. However, there are few validated instruments for measuring osteoporosis knowledge levels. The aim of this study was to design a valid and reliable instrument to measure osteoporosis knowledge in Australian women. METHODS: A 20 item instrument with true, false and don't know responses was drafted, based on the Osteoporosis Australia Osteoporosis Prevention and Self-management course and the information leaflet "Understanding Osteoporosis". The scoring range was 1 to 20. This was administered to a 467 randomly-selected, healthy women aged 25-44 years. Questionnaire performance was assessed by Flesch reading ease, index of difficulty, Ferguson's sigma, inter-item and item-total correlations, Cronbach's alpha and principal component factor analysis. RESULTS: Flesch reading ease was higher than desirable at 45, but this was due to the use of the word osteoporosis in many items. Of the individual items 17 had an index of difficulty less than 0.75. The questionnaire had a Ferguson's sigma of 0.96, a Cronbach's alpha of 0.70 and factor analysis consistent with only one factor (osteoporosis knowledge) being measured. Levels of osteoporosis knowledge were low with a mean score of 8.8 out of 20 which suggests the OKAT may be sensitive to change. CONCLUSIONS: The OKAT for measuring osteoporosis knowledge has good psychometric properties in Australian 25-44 year old females. While it should be applicable to other Caucasian populations, this will require confirmation by further research.

Adult↗
PubMed2000

Relationship between patient practice-oriented knowledge and metabolic control in intensively treated Type 1 diabetic patients: results of the validation of the Knowledge and Practices Diabetes Questionnaire.

AIMS: To validate a newly developed questionnaire for the measurement of patients' knowledge and practices, with particular attention to its ability in predicting HbA1c levels. RESEARCH DESIGN AND METHODS: The Knowledge and Practices Diabetes Questionnaire (KPDQ) is a questionnaire composed of two scales, investigating patient knowledge and practices. Twenty-two questions, 12 dealing with patients' knowledge and 10 relative to patients' practices, were initially identified. Factor analysis and reliability analysis were used to validate the questionnaire. The ability of the two scales in predicting metabolic control was then evaluated. The questionnaire was administered to a population of Type 1 diabetic subjects intensively treated and regularly attending the diabetes outpatient clinic of Pescara General Hospital. The mean of all HbA1c measurements performed after patients were taken in charge by the clinic was used as an indicator of metabolic control. RESULTS: Out of 133 Type 1 patients identified, 77 (58 %) filled in the questionnaire. Respondents had a mean age (+/- SD) of 37 +/- 13 years and a mean diabetes duration of 13 +/- 9 years. The application of factor and reliability analyses led to the definition of two final scales composed of 10 (Knowledge Score, KS) and 5 items (Practice Score, PS), respectively. Item-scale correlation was > or = 0.40 for all the items investigated. Cronbach's alpha coefficient exceeded the value of 0.70 for both scales. The mean number of HbA1c determinations during a median period of observation of 4 years was of 11 +/- 5. The mean HbA1c value for the whole population was of 7.0% +/- 1.4, while the proportion of patients with values < or = 7.0% was of 57%. After adjusting for clinical and patient-related characteristics, the KS was the only independent predictor of metabolic control. Patients in the lowest quartile of the KS showed a more than 20-fold increased risk of having mean HbA1c values > or = 7.0% as opposed to those in the highest quartile (odds ratio, OR=23.3;p=0.009). No association emerged between metabolic control and PS. CONCLUSIONS: The KPDQ presents excellent psychometric properties. The KS also shows a very impressive association with the mean HbA1c values over a period of 4 years. These findings are particularly remarkable in that many studies have failed in documenting such a relationship. The KS can thus be considered as a quick and efficient screening tool to be used in an ambulatory setting to monitor the level of practice-oriented knowledge of patients with Type 1 diabetes as well as to identify those subjects who need individualized educational interventions.

Adult↗