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PubMedDate not supplied

Developing clinical practice environments supporting the knowledge work of nurses.

Registered nurses represent the largest group of healthcare knowledge workers. They accomplish their knowledge work by engaging in the roles of data gatherer, information user, knowledge user, and knowledge builder. To successfully implement these roles, nurses rely on healthcare settings to provide supportive clinical practice environments that recognize their information and knowledge management needs. The authors describe the various knowledge-worker roles, delineate computerized mechanisms that can support these roles, and examine the ability of current healthcare settings to provide an environment conducive to successful knowledge-worker role performance. The article concludes with specific recommendations for development of clinical practice environments supportive of nurses' knowledge work.

Decision Making, Computer-Assisted↗
PubMed1999

Adolescent and Young Adult Male Hockey Players: Nutrition Knowledge and Education.

Athletes often have inadequate nutrition knowledge and poor nutritional habits, which can have a negative impact on athletic performance. This study assessed the nutrition knowledge of competitive adolescent and young adult male hockey players, and examined the impact of a nutrition intervention program, Sport Nutrition for the Athletes of Canada (SNAC). Before the intervention, nutrition knowledge was tested in 175 adolescent and young adult male hockey players. The intervention was provided as part of a hockey camp curriculum and was based on the SNAC workbook, which emphasizes achieving a balanced diet with adequate energy and fluid intake. After the intervention, nutrition knowledge was assessed in a subgroup of 33 hockey players. The pre-intervention nutrition knowledge score was 45% (n = 175), which suggests this population had little sport nutrition knowledge. Nutrition knowledge scores two weeks after the intervention showed no meaningful improvement in the subgroup. The results of this study suggest that the SNAC nutrition intervention program offered under the conditions of this study, did not effectively improve nutrition knowledge in adolescent and young adult male hockey players.

Journal Article↗
PubMed2002

[Knowledge on hypertension and the effect of management on hypertension in patients attending hospital clinics].

OBJECTIVE: To estimate the current knowledge on hypertension and the effect of management on hypertension in patients attending hospital clinics. METHODS: A cross-sectional survey was used in the outpatients over the age of 35 years in 18 general hospitals (provincial, district and community) which represented the different levels of medical care in 8 major cities covering Northern and Southern China including an interview with two blood pressure measurements and one questionnaire in one clinical visit. RESULTS: A total of 9 703 subjects participated in this project, who were similarly distributed by gender and age in the hospitals at different levels. Of all the 9 703 subjects, 4 510 (46.5%) were found to be hypertensive. 6.4%, 12.1%, 25.5%, 41.1% and 14.6% of all the participants were categorized into knowledge on hypertension grade 0, 1, 2, 3, 4 respectively. The classification was based on the number of correct answers to four questions about knowledge of hypertension. The higher the grade of hypertension knowledge the more response to higher rate of awareness, treatment, and control in this hypertensive population was noticed. There was significantly positive correlation between the grade of hypertension knowledge and treatment compliance. The major cause of poor treatment compliance was due to lack of hypertension knowledge. CONCLUSION: There was poor knowledge on hypertension in the investigated participants, which would influence on the management of hypertension. Data suggested that health education on the knowledge of hypertension in the population needs to be improved.

Adult↗
PubMed1992

Reuse of knowledge represented in the Arden syntax.

Knowledge Data Systems is building a medical expert system for monitoring clinical events. This system uses the Arden syntax as a knowledge representation. Having encoded may different types of rules in the Arden syntax, we have noticed a number of shortcomings of the syntax. Many of these shortcomings originate from Arden's procedural orientation, from its failure to separate factual medical knowledge from knowledge of how the medical facts should be applied to a particular clinical situation. The absence of this separation leads to redundancy of knowledge and to difficulties in knowledge reuse. We suggest that standards for representing medical logic preserve this separation to engender knowledge reuse. We propose a general framework for representing medical logic which supports both knowledge sharing and reuse.

Diagnosis, Computer-Assisted↗
PubMed2005

Integrating genomic knowledge sources through an anatomy ontology.

Modern genomic research has access to a plethora of knowledge sources. Often, it is imperative that researchers combine and integrate knowledge from multiple perspectives. Although some technology exists for connecting data and knowledge bases, these methods are only just beginning to be successfully applied to research in modem cell biology. In this paper, we argue that one way to integrate multiple knowledge sources is through anatomy--both generic cellular anatomy, as well as anatomic knowledge about the tissues and organs that may be studied via microarray gene expression experiments. We present two examples where we have combined a large ontology of human anatomy (the FMA) with other genomic knowledge sources: the gene ontology (GO) and the mouse genomic databases (MGD) of the Jackson Labs. These two initial examples of knowledge integration provide a proof of concept that anatomy can act as a hub through which we can usefully combine a variety of genomic knowledge and data.

Anatomy↗
PubMed1992

Evolving a blueprint for certification: the responsibilities and knowledge comprising American professional oncology nursing practice.

Ensuring adequate content validity of a certification examination is a major concern in the development and administration of a test. To establish content validity of the Oncology Nursing Certification Corporation (ONCC) certification exam, a job analysis study was conducted to provide empirical data about the responsibilities and knowledge areas required for practice at the level of the newly certified oncology nurse. The study involved The Profession of Oncology Nursing: An Inventory of Responsibilities and Knowledge (IRKPON), a questionnaire that was developed based on a review of the literature, professional practice information, interviews with oncology nurses, the original ONCC certification exam table of specifications, and evaluations undertaken by two advisory committees. The IRKPON consisted of three parts: 56 responsibilities clustered into eight job dimensions, 217 knowledge areas grouped into seven knowledge dimensions, and demographic information. The IRKPON was sent to a stratified random sample of 3,000 oncology nurses in the United States, who were asked to rate both the responsibilities and knowledge areas by level of importance. The 1,297 (43%) responding nurses rated 45 of 56 responsibilities (80.4%) as "very important" and 8 of 56 responsibilities (14.3%) as "extremely important"; they also rated 163 of 217 knowledge areas (75.1%) as "very important" and 41 of 217 knowledge areas (18.9%) as "extremely important." These findings identified the specific responsibilities most important to the oncology nurse role at the level of the newly certified nurse, as well as the knowledge areas necessary for competent performance. Subsequent ONCC certification examinations were modified; the test blueprint that guides the construction of the examination was revised, and the passing score was adjusted.

Adult↗
PubMedDate not supplied

Effect of a PDA-assisted evidence-based medicine course on knowledge of common clinical problems.

BACKGROUND AND OBJECTIVES: It is not yet known if personal digital assistant (PDA)-assisted evidence-based medicine (EBM) courses in postgraduate training enhance knowledge of common clinical problems. This study's objective was to determine if PDA-assisted EBM training would improve clinical knowledge. METHODS: In a controlled trial, intervention group residents received InfoRetriever on a PDA coupled with an EBM course integrated within clinical rotations in family medicine. The effect of the intervention and the rate of use of InfoRetriever on a written test of knowledge were evaluated after adjusting for baseline knowledge scores. The test measured knowledge of primary care management of hypertension and diabetes as well as estimation of disease probability. RESULTS: There was no effect on first posttest knowledge scores of the intervention overall or of the rate with which participants had used InfoRetriever during the intervention. However, when intervention group residents retook the test with access to InfoRetriever while taking the knowledge test, scores increased 7.4% (+2.4 correct test questions). Access to InfoRetriever Clinical Prediction Rules on a PDA, however, had an unclear effect on residents' ability to estimate disease probability. CONCLUSIONS: There was no effect of a PDA-assisted EBM course on knowledge test scores, although using the PDA during the test results in higher scores. It is unclear if using PDA Clinical Prediction Rules can improve residents' estimates of disease probability.

Adult↗
PubMed1991

1990 Federal Nursing Service Award winner. Mental health care and illness knowledge among chronic schizophrenics.

This study examined perceived and actual knowledge about mental health care and illness among chronic schizophrenics, the relationship between their perceived and actual knowledge, and the relationship of knowledge to subject characteristics. Perceived knowledge was assessed with a self-administered 18-item Likert format questionnaire. Actual knowledge was assessed with an interview of open-ended questions paralleling items of perceived knowledge instrument. Perceived and actual knowledge were moderate. Half the parallel items correlated significantly, with weak to moderate positive correlations. Except for age and number of years ill, subject characteristics did not correlate significantly with knowledge. This study has nursing implications for formal and informal patient education.

Adult↗
PubMed1987

[Development of a knowledge-based system for aiding therapeutic decision in breast cancer].

The SENEX project has been initiated at the fondation Bergonié in 1985 and is intended for providing physicians in general hospitals with knowledge based systems for the management of cancer treatment protocols. The design and building of a knowledge-based system for the management of breast cancer protocols (SENEX) was the first goal of this project. SENEX has been developed using a commercially available development tool (Personal Consultant Plus, Texas-instruments) derived from EMYCIN. It runs on IBM and compatible microcomputers. The knowledge base embeds the formal knowledge contained in the breast cancer protocols currently in use at the fondation Bergonié, and some judgmental knowledge acquired form breast cancer experts. Production rules and frames allowed us to adequately represent and structure this knowledge and the problem solving processes related to the management of breast cancer. A preliminary informal evaluation of the system has shown that it performs at the expert-level in giving advice for patients included in formal protocols. Its use and acceptability are good. However, we have to add judgmental knowledge into the knowledge base and to interface the system with a temporal data base management system to improve the overall performances of SENEX. Moreover the effectiveness of the system remains to be demonstrated before one can anticipate is routine use in clinical practice.

Breast Neoplasms↗
PubMed1981

Notes on the desire for knowledge.

The desire for knowledge, which was much discussed by Freud, Abraham and Melanie Klein, had for many years scarcely been mentioned in the analytical literature until it was taken up again by Bion, but from a different point of view. For Freud the desire for knowledge was related to the sexual instinct-it was even called an epistemological instinct although it was never considered to be an instinct in the narrow sense of the word. Abraham and Klein followed Freud, but in her later writings Klein understood the desire for knowledge as part of the defence against anxiety dur to fantasied damage done by the aggressive instincts. In this paper I discussed Bion's contribution to the psychoanalysis of knowledge in detail and illustrated it by clinical examples. Bion restricts the concept of knowledge to what is knowable and knowledge can only be an approximation to the truth. Interpretations make the truth knowable. The desire for knowledge of the truth is for Bion elementary and necessary for mental health. This view, although different from, is not dissimilar to, Freud's who described the compelling nature of the desire for knowledge as an epistemological instinct.

Cognition↗
PubMed1994

A model for structured data entry based on explicit descriptional knowledge.

Clinical narratives in patient records are usually recorded in free text, limiting the use of this information for research, quality assessment, and decision support. This study focuses on the capture of clinical narratives in a structured format by supporting physicans with structured data entry (SDE). We analyzed and made explicit which requirements SDE should meet to be acceptable for the physician on the one hand, and generate unambiguous patient data on the other. Starting from these requirements, we found that in order to support SDE, the knowledge on which it is based needs to be made explicit: we refer to this knowledge as descriptional knowledge. We articulate the nature of this knowledge, and propose a model in which it can be formally represented. The model allows the construction of specific knowledge bases, each representing the knowledge needed to support SDE within a circumscribed domain. Data entry is made possible through a general entry program, of which the behavior is determined by a combination of user input and the content of the applicable domain knowledge base. We clarify how descriptional knowledge is represented, modeled, and used for data entry to achieve SDE, which meets the proposed requirements.

Artificial Intelligence↗
PubMed1995

Terminological reference of a knowledge-based system: the data dictionary.

The development of open and integrated knowledge bases makes new demands on the definition of the used terminology. The definition should be realized in a data dictionary separated from the knowledge base. Within the works done at a reference model of medical knowledge, a data dictionary has been developed and used in different applications: a term definition shell, a documentation tool and a knowledge base. The data dictionary includes that part of terminology, which is largely independent of a certain knowledge model. For that reason, the data dictionary can be used as a basis for integrating knowledge bases into information systems, for knowledge sharing and reuse and for modular development of knowledge-based systems.

Artificial Intelligence↗
PubMed1996

Maternal nutritional knowledge and the nutritional status of preschool children in a Nairobi slum.

Most nutrition education programmes in Kenya operate on the premise that nutritional knowledge can have an impact on children's nutritional status. It has, however, been argued that nutritional knowledge among low income groups is unlikely to have an impact, hence, the need to establish whether there is a relationship between nutritional status and maternal nutritional knowledge. In a cross-sectional survey carried out in a Nairobi slum (Kibera), nutritional status of 363 children aged six to 24 months was measured and nutritional knowledge of their mothers assessed. Makina village was randomly selected as the study site and all consenting households were involved in the study. The study established that most mothers (97.5%) have access to nutrition education. Prevalence of stunting (86.2%) and underweight (58.4%) was high but that of wasting (1.9%) was low. There was no significant relationship between the nutritional status of children and overall nutritional knowledge. Unexpectedly, a negative relationship was found between nutritional status and mothers' ability to recognise clinical signs of malnutrition, knowledge in the weaning process and dietary management during sickness. Knowledge on frequency of feeding was, however, positively related to nutritional states. In conclusion, nutritional knowledge alone is inadequate in ensuring young children's nutrition security and, hence, for nutrition education programmes to have a positive impact, facilitational strategies must be incorporated.

Adult↗
PubMed1996

Knowledge acquisition for temporal abstraction.

Temporal abstraction is the task of detecting relevant patterns in data over time. The knowledge-based temporal-abstraction method uses knowledge about a clinical domain's contexts, external events, and parameters to create meaningful interval-based abstractions from raw time-stamped clinical data. In this paper, we describe the acquisition and maintenance of domain-specific temporal-abstraction knowledge. Using the PROTEGE-II framework, we have designed a graphical tool for acquiring temporal knowledge directly from expert physicians, maintaining the knowledge in a sharable form, and converting the knowledge into a suitable format for use by an appropriate problem-solving method. In initial tests, the tool offered significant gains in our ability to rapidly acquire temporal knowledge and to use that knowledge to perform automated temporal reasoning.

Artificial Intelligence↗
PubMed1998

Automated knowledge extraction from the UMLS.

This paper presents our work in extracting disease-chemical relationship knowledge from the UMLS Co-occurrence table (MRCOC) using an automated method. We evaluated the quality of the knowledge from UMLS MRCOC by comparing it with knowledge from other sources: For disease-lab chemical relationships, knowledge was obtained from a decision support system (DXplain) and our own knowledge base of medical terminology (MED) through automated processes. For disease-drug chemical relationships, knowledge was manually acquired from the medical literature. Evaluations showed that the UMLS MRCOC knowledge has good sensitivity, especially regarding disease-drug relationships. We are using this knowledge to produce disease-specific views of patients' electronic patient record.

Decision Support Systems, Clinical↗
PubMed2002

Sociospatial knowledge networks: appraising community as place.

This article introduces a new theory of geographical analysis, sociospatial knowledge networks, for examining and understanding the spatial aspects of health knowledge (i.e., exactly where health beliefs and knowledge coincide with other support in the community). We present an overview of the theory of sociospatial knowledge networks and an example of how it is being used to guide an ongoing ethnographic study of health beliefs, knowledge, and knowledge networks in a rural community of African Americans, Latinos, and European Americans at high risk for, but not diagnosed with, type 2 diabetes mellitus. We believe that the geographical approach to understanding health beliefs and knowledge and how people acquire health information presented here is one that could serve other communities and community health practitioners working to improve chronic disease outcomes in diverse local environments.

Adolescent↗
PubMed1999

Psychosocial care in oncology nursing: a study of social knowledge.

A combination of focus group and individual interviews aimed to examine psychosocial aspects of nursing within a social context and social knowledge held by two teams of ward-based oncology nurses. Five core categories of knowledge emerged: knowledge of how to care, knowledge of the patient, knowledge of the ward, knowledge of nurses coping, and knowledge of involvement. Involvement or emotional closeness was seen as a necessary, inevitable and potentially stressful feature of psychosocial care. The authors conclude that interpersonal and professional aspects of nursing must be balanced in order to provide effective psychosocial care.

Adaptation, Psychological↗
PubMed1992

Knowledge about developmental screening in mothers attending a maternal and child health clinic in Singapore.

A study of knowledge about Developmental Screening in mothers was done among 200 Singapore mothers attending a Maternal and Child Health Clinic from February to March 1990. They were requested to answer a set of questions pertaining to their knowledge on the Developmental Screening session and their reason for attending the session. They were also asked whether they had attended any health education talks given by the nurses in the clinic. Seventy-three out of 200 (36.9%) knew what the appointment given was for. Mothers with secondary education were almost three times and mothers with tertiary education were five-and-a-half times more likely to possess the correct knowledge than a mother with primary education. Wives of husbands from Social Classes I and II were more knowledgeable (83% and 54%) than those in lower social classes (32% and 25%). Mothers with older children were more knowledgeable than those with children age six weeks. Mothers of one child four-and-a-half years old were more knowledgeable than those with one child age six weeks. Twelve out of 27 (44%) of mothers of one child age six weeks did not know what Developmental Screening was about whereas all mothers with four-and-a-half year old children knew what Developmental Screening was about. Only 88 (44%) mothers had attended health education talks. There was no discernible difference in knowledge of Developmental Screening between those mothers who attended talks and those who did not (35% vs 40%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗