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PubMed1998

Pediatric primary care provider's knowledge of HIV/AIDS care.

To respond to the difficulties that community-based providers face in keeping abreast of the rapid changes in HIV-related care, an intensive pediatric HIV mentoring program (Pediatric HIV Miniresidency [MR]) was developed, linking a regional AIDS Education and Training Center (AETC) with an urban children's hospital HIV outpatient care site. The purpose of this study was to evaluate HIV-related knowledge and perceived skills, abilities, and willingness of community-based primary care pediatric providers and providers completing the MR. A convenience sample of community-based primary pediatric practitioners and those participants in the MR program completed a three-part mailed survey. The survey assessed practice characteristics, knowledge of pediatric HIV clinical care, and perceived skills, ability, and willingness (PSAW) to provide HIV-related care. The main outcome measures were overall knowledge and PSAW scores. One hundred nineteen community-based practitioners (NMRs), 20% of those surveyed, completed the instrument, as did 19 of 20 MR participants. NMRs exhibited low knowledge scores in key areas relating to the identification and evaluation of HIV-exposed children. Fewer than half of these respondents correctly answered questions related to HIV antibody incidence in HIV-exposed newborns and recommended diagnostic testing of such infants. Providers completing the MR scored significantly higher on the knowledge survey (15.2 vs. 8.8, p < 0.001), and had higher PSAW scores (45.8 vs. 33.9, p < 0.001). Although the generalizability of our study is limited by the low response rate, community-based physicians completing the survey demonstrated a lack of knowledge we believe necessary to provide pediatric HIV-related care (as defined by Public Health Service practice guidelines). Physicians completing the MR program had substantial HIV-related knowledge and expressed a willingness to provide care to HIV-exposed/infected children. An effective MR program provides a mechanism for developing a network of dedicated community-based physicians who are willing and capable of providing care to HIV-infected or exposed infants and children.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Genital human papillomavirus infections: knowledge, perception of risk, and actual risk in a nonclinic population of young women.

The purpose of this study was to assess knowledge, beliefs, and attitudes about genital human papillomavirus (HPV) infections in a group of young women in a nonclinic setting and to examine the association between perception of risk and actual risk. One hundred ten women attending a state university participated in the study and were asked to complete a self-administered questionnaire about knowledge and perceptions of risk. They were then offered testing for the virus using a self-administered vaginal method. The mean age was 20 +/- 1.2 years. Ninety (82%) were sexually experienced (SE), with a mean number of lifetime partners of 5.1 +/- 4.3. The mean knowledge score was less than the 68th percentile, reflecting low levels of knowledge about genital HPV infections. The SE group had a higher knowledge score than the sexually inexperienced (p < .02), but there were no differences in knowledge between those who chose to be tested and those who refused testing. The majority of women attributed negative emotion to being hypothetically tested positive for HPV. Emotions selected by > 50% of the group included feeling scared, angry, guilty, anxious, confused, dirty, regretful, and panicky. A greater negative emotion score was associated with refusing HPV testing (p < .002). Of the SE women, 58% (51) perceived themselves at risk, and, of this group, 71% (36) agreed to be tested. Of the women who agreed to HPV testing, 36% who perceived themselves at risk and 35% who did not perceive themselves at risk were, in fact, positive for HPV (p = ns). The majority of women have little knowledge of HPV infections and have attributed many negative emotions associated with infectivity. These negative attributes appear to influence women's decision making concerning HPV testing. The risk of HPV infection in this nonclinic group was substantial, suggesting that even in a nonclinic group, the prevalence of HPV is quite high. Perception of risk was unrelated to actual risk (HPV positive test), reflecting the lack of self-identified risk.

Adolescent↗
PubMed2001

Unwanted pregnancy and contraceptive knowledge: identifying vulnerable groups from a randomized controlled trial of educational interventions.

OBJECTIVES: The aim of this study was to identify predictors of contraceptive pill knowledge and their relationship to educational interventions. METHODS: A total of 636 women attending for a follow-up appointment for repeat prescription of the combined oral contraceptive pill with a GP or practice nurse were randomized to receive leaflets (simple summary leaflet or FPA leaflet), advice or neither. Sociodemographic details and contraceptive knowledge were determined using a validated contraceptive knowledge questionnaire sent after 3 months by post. The main outcomes were sociodemographic, contraceptive, attitudinal and educational predictors of knowledge. RESULTS: A total of 522 (82%) had complete questionnaires. After controlling for educational intervention and other confounding variables, independent predictors of knowledge were further education (adjusted odds ratio 2.98, 95% confidence interval 1.78-4.99); number of years on the pill (0-5, 6-10, >10 years) 1.0, 0.56 (0.33-0.95) and 0.34 (0.19-0.59), respectively; past emergency contraception (1.87, 1.18-2.97); and importance attached to not falling pregnant (1.83, 1.02-3.29). These predictors are less powerful than the impact of most educational interventions (range of odds ratios for interventions: 1.85-6.81), and there was no evidence of a separate effect of educational intervention in any subgroup, except that leaflets have a larger effect in women who have needed emergency contraception in the past (no past use or simple summary and FPA leaflets, 1.74 and 0.90, respectively; with past use, 3.47 and 3.83; interaction term chi-square 6.92, P = 0.03). CONCLUSION: Educational interventions are as important as sociodemographic features in determining knowledge. With limited time for full educational interventions in practice, priorities for intervention should be women who have used emergency contraception in the past-who will benefit most-and those on the pill for >5 years or with no further education who are at highest risk due to poor knowledge.

Adult↗
PubMed2004

Improving nursing home staff knowledge and attitudes about pain.

PURPOSE: Effective pain management remains a serious problem in the nursing home setting. Barriers to achieving optimal pain practices include staff knowledge deficits, biases, and attitudes that influence assessment and management of the residents' pain. DESIGN AND METHODS: Twelve nursing homes participated in this intervention study: six treatment homes and six control homes, divided evenly between urban and rural locations. Three hundred licensed and unlicensed nursing home staff members completed written knowledge and attitude surveys at baseline, and 378 staff members completed the surveys after intervention implementation. RESULTS: Baseline results revealed notable knowledge deficits in the areas of pharmacology, drug addiction and dependence, side effect management, and nonpharmacologic management-strategy effectiveness. Significant differences were noted by job title (registered nurse/licensed practical nurse/certified nursing assistant). Case studies displayed a knowledge application problem, with nurses often filtering resident pain reports through observed resident behaviors. The intervention led to significant improvement in knowledge scores in some, but not all, the treatment homes. Perceived barriers to effective pain management showed a significant decline across all study nursing homes. IMPLICATIONS: Knowledge deficits related to pain management persist in nursing homes. An interactive multifaceted educational program was only partially successful in improving knowledge across settings and job categories. Attitudes and beliefs appear more difficult to change, whereas environmental and contextual factors appeared to be reducing perceived barriers to effective pain management across all participating nursing homes.

Adult↗
PubMed2004

HIV/AIDS knowledge and the implications for health promotion programs among Chinese college students: geographic, gender and age differences.

Data were collected in 2000 from 1081 students from eight colleges in China to assess the overall level of AIDS knowledge, and to explore regional, gender and grade differences in AIDS knowledge. The data indicate an inconsistent level of AIDS knowledge among students, with a significant gender and grade difference. More than one-third of the students perceived themselves as having limited knowledge of AIDS. While the students could identify transmission modes, they were less knowledgeable about symptoms, activities that did not transmit the virus, treatment and preventive measures. The majority of the students reported having discussed AIDS issues with their peers and friends, but few of them had done so with their parents or teachers. AIDS knowledge varied among students by site of residence, with the highest knowledge among students from the urban areas and the lowest among those from rural areas. The data underscore the urgent need for HIV/AIDS-related health promotion and prevention efforts targeting college students as well as younger age groups in China.

Acquired Immunodeficiency Syndrome↗
PubMed1989

The relationship between knowledge about acquired immunodeficiency syndrome and the implementation of universal precautions by registered nurses.

The relationship between the level of knowledge of registered nurses (RNs) concerning acquired immunodeficiency syndrome (AIDS)-related issues and the practical observance of universal precautions was studied. It was hypothesized that the more knowledge a nurse has concerning AIDS the more likely he or she is to implement universal precautions. All registered nurses who have direct patient contact (N = 400) and are employed at a Northeastern teaching medical center, were provided a packet of three questionnaires and encouraged to participate. Two hundred thirteen (53%) RNs returned completed questionnaires. Subgroups were examined for trends relating such parameters as age and the amount of AIDS knowledge, using analysis of variance. The major hypothesis was tested by correlating the overall scores for AIDS knowledge and the implementation score. Results indicated no relationship between knowledge and the implementation of universal precautions (r = -0.12). When evaluating scores according to work areas, those subjects with higher knowledge scores had lower practice scores. Other demographic variables showed no influence on either knowledge or implementation scores as measured by this study. Further study is needed to understand what factors will motivate RNs to implement universal precautions.

Acquired Immunodeficiency Syndrome↗
PubMed2001

Correlates of actual and perceived knowledge of prostate cancer among African Americans.

While digital rectal examination, prostate-specific antigen, and transrectal ultrasound have been identified as effective means of early detection of prostate cancer, African American men tend to underuse these services as compared to white men. Using a nonrandom sample of 108 African American men, the authors conducted an exploratory investigation of the effects of education, income, age, and health insurance coverage on actual and perceived knowledge of prostate cancer. The extent to which the use of prostate cancer screening services may be attributed to actual and perceived knowledge of prostate cancer was also explored. Respondents demonstrated a poor knowledge of prostate cancer and less than 40% reported having had prostate cancer screening as part of their annual physical examination. The results of the study also revealed that (a) there was a moderately strong correlation between actual and perceived knowledge of prostate cancer, (b) use of prostate cancer screening service was positively associated with actual and perceived knowledge of the disease, (c) actual knowledge of prostate cancer was negatively correlated with education, age, and income, and (d) actual and perceived knowledge of prostate cancer were both correlated with having health insurance coverage.

Adult↗
PubMedDate not supplied

Breast cancer knowledge assessment in female Chinese immigrants in New York.

The purpose of this study was to examine the relationships between acculturation level and perceptions of health access, Chinese health beliefs, Chinese health practices, and knowledge of breast cancer risk. This descriptive, correlational cross-sectional study used a survey approach. The sample included 135 Chinese women from the New York City metropolitan area. Data were analyzed using correlational techniques and polytomous regression. There were no significant relationships between acculturation and health access, Chinese health beliefs, Chinese health practices, and breast cancer risk knowledge. Only "years of education," "marital status," and "household income" significantly predicted breast cancer risk knowledge level. The data indicate that women with a better knowledge of breast cancer risk are twice as likely to have higher income and have more education. The most knowledgeable women are less likely to be married and less likely to have partners compared to least knowledgeable group. Providers need to promote health knowledge and provide information about as well as access to preventive health practices to the immigrant population, given that acculturation to the new dominant society is inevitable.

Acculturation↗
PubMedDate not supplied

Deficiency of knowledge of genetics and genetic tests among general practitioners, gynecologists, and pediatricians: a global problem.

PURPOSE: The objective of this study was to assess knowledge of genetics and awareness of genetic tests among Dutch general practitioners (GPs), gynecologists (GYNs), and pediatricians (PEDs), as well as factors influencing their knowledge and awareness. METHODS: An anonymous questionnaire inquiry was used, validated with a sample of 52 clinical geneticists (CGs). The study was carried out in primary care (general practice) and secondary care (general and university hospitals) in The Netherlands. A random sample of 200 GPs, 300 GYNs, and 265 PEDs received a questionnaire. In addition, all registered CGs (58) received a questionnaire for validation. In total, 122 GPs, 187 GYNs, 164 PEDs, and 52 CGs returned a completed questionnaire. The main outcome measures were differences in knowledge scores between physicians working in different disciplines and factors influencing these scores. RESULTS: Knowledge scores of GPs (mean 64% correct answers, 61%-66% [95% confidence interval]), GYNs (mean 75% correct answers, 73%-76% [95% confidence interval]), and PEDs (mean 81% correct answers, 79%-82% [95% confidence interval]) were lower than those in the CG validation group (mean 95% correct answers, 94%-96% [95% confidence interval]). The 5th percentile of GPs, GYNs, and PEDs was at approximately 40%, 52% and 62% correct answers, respectively. There was a specific lack of knowledge about DNA testing. In addition to specialty, important factors positively associated with the knowledge scores of nongeneticists are more recent graduation, having taken an elective course in genetics, and providing genetic counseling in their own practice. CONCLUSION: The overall knowledge levels of genetics in many nongeneticist health care providers show clear deficiencies. This is in line with reports from other countries, showing that these deficiencies are a global problem.

Genetic Testing↗
PubMed2004

Student nurses' knowledge, attitude, and behavior toward chinese medicine and related factors.

The purposes of this study were (1) to understand student nurses' knowledge, attitude, and behavior toward Chinese medicine and (2) to explore the related factors. This study was based on a structured questionnaire survey. The subjects of the study were students from the nursing department of one technical university in southern Taiwan. The sampling methods of this study were stratified sampling and cluster sampling. After getting the agreement of the student nurses, the researcher gave out 518 questionnaires to do the test. There were 496 valid questionnaires and the retrieval ratio was 96%. The results were: (1) The highest mean score was for the basic concepts of Chinese medicine and the lowest mean score was for the basic concepts of Chinese herbal medicine. The average correctness rate of knowledge about Chinese medicine was 67.42%. (2) The student nurses had a positive attitude toward Chinese medicine. (3) As for the frequency of seeking Chinese medical treatment, most of the student nurses used common folk tonics of Chinese medicine to recuperate their health. As for the medical treatment of general diseases, muscular and skeletal diseases were the most. (4) The significant common related factors for student nurses' knowledge, attitude, and behavior toward Chinese medicine were " have ever studied the literature of Chinese medicine or Chinese medicine nursing" and " have sources of knowledge on Chinese medicine". The factors "have ever studied the credit points of Chinese medicine", and " all credit points of Chinese medicine that have ever studied" also significantly influenced student nurses' knowledge and attitude toward Chinese medicine. Additionally, there were significantly positive pairwise correlations between student nurses' knowledge, attitude, and behavior toward Chinese medicine. The results of this study suggest that nursing schools should arrange curricula in Chinese medicine as required credits in the education of student nurses and provide student nurses with information on Chinese medicine by various kinds of formal and informal methods to promote the Chinese medicine knowledge, attitude, and behavior of student nurses and to accelerate the personnel cultivation of Chinese medicine nursing in order to meet the needs of society.

Adolescent↗
PubMed2005

Effects of nursing instruction on asthma knowledge and quality of life in schoolchildren with asthma.

The issue of whether nursing instruction efforts could improve asthma knowledge and quality of life among schoolchildren was investigated using a quasi-experimental design. The key instruments were the Asthmatic Knowledge Questionnaire and the Childhood Asthma Questionnaire-Form B. Asthmatic knowledge increased among children who received instruction from nurses (Meanpre/post=22.20/31.87, p<.05). These children also experienced significant improvements in their active quality of life (Meanpre/post=27.53/30.20, p<.05), and decreased distress (Meanpre/post=24.04/10.86, p<.05) and asthma severity (Meanpre/post=13.27/8.3, p<.05). This study finds nursing instruction helpful in improving asthma knowledge. However, in terms of quality of life, elevated knowledge has a marked (negative) correlation only with levels of distress and severity. It shows no detectable relationship with active or passive life quality. Therefore, though nursing instruction can improve schoolchildren's knowledge about asthma, the improvement in knowledge only relates to reducing distress and severity and thus improving quality of life. This result can provide guidance for nursing personnel in developing nursing instruction to improve active quality of life in child patients.

Ambulatory Care↗
PubMed2004

Evolutionary model with genetics, aging, and knowledge.

We represent a process of learning by using bit strings, where 1 bits represent the knowledge acquired by individuals. Two ways of learning are considered: individual learning by trial and error, and social learning by copying knowledge from other individuals or from parents in the case of species with parental care. The age-structured bit string allows us to study how knowledge is accumulated during life and its influence over the genetic pool of a population after many generations. We use the Penna model to represent the genetic inheritance of each individual. In order to study how the accumulated knowledge influences the survival process, we include it to help individuals to avoid the various death situations. Modifications in the Verhulst factor do not show any special feature due to its random nature. However, by adding years to life as a function of the accumulated knowledge, we observe an improvement of the survival rates while the genetic fitness of the population becomes worse. In this latter case, knowledge becomes more important in the last years of life where individuals are threatened by diseases. Effects of offspring overprotection and differences between individual and social learning can also be observed. Sexual selection as a function of knowledge shows some effects when fidelity is imposed.

Aging↗
PubMed2004

Patients with advanced cancer and family caregivers' knowledge of health and community services: a longitudinal study.

The present study examines the knowledge of health and community services reported by patients with advanced cancer and their family caregivers, and compares patient-stated use with their knowledge of availability. A longitudinal study of the quality of life of patients with advanced cancer was conducted out of the cancer services of The Canberra Hospital, a teaching service, in Canberra, Australian Capital Territory, Australia. Some 317 subjects were recruited sequentially, comprising patients (n = 181) and their nominated family caregivers (n = 136). Patients were more aware of the available health and community support services compared with their caregivers, and differences were significant for most allied professional services, as well as some key supportive care institutions and community programmes. Knowledge of community support services was variable and low for those specifically associated with terminal care. While congruence of knowledge for dyads was quite low in some areas, overall household knowledge was high. The identified sources were mainly non-medical. Nurses, social workers and alternative practitioners, as well as family, friends and commercial sources were the main categories which were identified. No statistically significant changes in knowledge or sources of information occurred over time. Further longitudinal research would assist healthcare teams to understand the role of health and community services in the advanced cancer setting. The identification of systemic and regional weaknesses in communication may assist in improving family knowledge and improve timely access to important supports in the advanced cancer setting.

Adult↗
PubMed2006

Exploring knowledge work and leadership in online midwifery communication.

AIM: This paper reports a study to answer the following question: if given a user-friendly online system, that enabled communication across the practice community, would midwives function as knowledge workers? BACKGROUND: Globally, the demand for quality-led and innovative service delivery requires that nurses and midwives shift from being 'information workers', or passive receivers of managerial and organizational decisions, to become 'knowledge workers' who are able to create, lead and communicate service innovation and practice development. New communication technologies may offer a means for healthcare professionals to interact as knowledge workers and develop supportive communities of practice. METHODS: An online discussion forum was implemented as a low-cost technological intervention, deploying existing hardware and a standard hospital intranet. The evaluation of the forum was constructed as case-study organizational research. The totality of online communication, both traffic and content, was analysed over a 3-month period (193 messages downloaded 2003/2004), and 15 in-depth interviews were undertaken with forum users. FINDINGS: Given simple, facilitative, innovative technology, supported by a positive working culture and guided by effective leadership, midwives could function as 'knowledge workers', critically reflecting upon their practice and translating knowledge into action designed to achieve change in practice. Participation occurred across all staff grades, and midwives were predominantly supportive and facilitative towards the contributions made by colleagues. CONCLUSION; Midwives may be well placed to exemplify the 'ideal' characteristics of the knowledge worker being demanded of modern healthcare professionals. The deployment of online interactive technologies as part of strategic vision to enhance knowledge work among healthcare professionals should be given attention within health systems.

Attitude of Health Personnel↗
PubMed2007

Improving paediatric nurses' knowledge and attitudes in childhood fever management.

AIM: This paper reports an evaluation of the effectiveness of a peer education programme in developing paediatric nurses' evidence-based knowledge and attitudes towards fever management and the sustainability of these changes. BACKGROUND: In general, paediatric nurses' fever management knowledge seems to be mediocre. They believe fever to be harmful, causing febrile convulsions and brain damage. Antipyretics are administered to prevent febrile convulsions and alternate antipyretics are given when temperatures are not reduced. METHOD: A quasi-experiment was conducted from August 2002 to March 2003. An experimental group of Registered Nurses received the peer education programme and peer support and education were promoted for those unable to attend the sessions. A control group continued its normal practices. Seventy-seven nurses were eligible to attend the programme; 74.0% attended at least one session, 52% two or more. Questionnaire data were collected 1 month before and 1 and 4 months after the peer education programme from 56.3% to 77.8% of eligible experimental and 40.9% to 51.6% of eligible control group nurses. FINDINGS: Interaction effects between group and time were found in overall knowledge (P = 0.01), specifically knowledge of the physiology of fever (P = 0.001), and attitudes towards evidence-based fever management (P = 0.05). In addition, experimental group nurses demonstrated statistically significantly more knowledge of general fever management principles at 4 months after the intervention than control group nurses (P = 0.01), and compared with their own knowledge at baseline (P < 0.001). CONCLUSIONS: Educational programmes targeting practice change must be theoretically based and target knowledge, attitudes and barriers to change. The programme tested here, which incorporated peer education and support and facilitated group change, is adaptable to other practices, groups and settings.

Adult↗
PubMed1995

Parental asthma knowledge: its association with readmission of children to hospital.

OBJECTIVE: To assess whether poor parental knowledge about asthma was a risk factor for readmission of their children to hospital. METHODOLOGY: Parents of children who were admitted to the paediatric facility at Newcastle Mater and John Hunter Hospitals were administered a previously validated asthma knowledge questionnaire with a maximum possible score of 31. RESULTS: The mean parental knowledge scores for three groups of children were determined: those with a previous diagnosis of asthma being readmitted to hospital (170 children, mean score 18.3); those with a previous diagnosis of asthma being admitted for the first time (114 children, mean score 17.2); and children being admitted with their first attack of asthma (65 children, mean score 15.6). There was a significant difference in parental asthma knowledge between the first and third group (P < 0.001) but not between the first and second group. A linear regression model with knowledge score as an outcome found that increased knowledge was associated with previously diagnosed asthma, higher parental occupation and no smoker in the home. CONCLUSIONS: Knowledge was poor in all groups. Readmission rate was related to the severity of the child's asthma.

Adolescent↗
PubMed2006

Exclusive versus everyday forms of professional knowledge: legitimacy claims in conventional and alternative medicine.

In this paper I present a model of professional knowledge forms that accounts for the different, and sometimes contradictory, ways in which medical doctors (MDs) and various complementary and alternative medicine (CAM) practitioners define their competencies and make legitimacy claims. The first section provides a schema for problematising knowledge and its relationship to legitimacy by distinguishing between the context, form and content of professional knowledge. I draw particularly upon Jamous and Peloille's (1970) distinction between the technical or indeterminate forms of professional knowledge. I argue that their characterisation might be enriched by attending to dimensions of 'exclusive' versus 'everyday' knowledge forms. In particular, I point out that both technical and indeterminate forms are amenable to exclusion, or conversely can be made accessible as everyday knowledge. Both forms can thus be employed in attempts to legitimate professional practice. In the final section, I map the current context of CAM and biomedicine onto this expanded professional knowledge map.

Attitude of Health Personnel↗
PubMed2005

Managing knowledge to support the patient journey in NHS Scotland: strategic vision and practical reality.

BACKGROUND: The strategy for NHS Scotland Knowledge Services is set in the context of a global transition to a networked model of management within health services. OBJECTIVES: Development planning for NHS Scotland aims to establish strategic vision and operational delivery systems which meet the needs of this changing health environment. METHODS: Analysis of knowledge needs at strategic organizational level and through consultation with healthcare staff form the basis of a vision of seamless knowledge support throughout all stages of the patient journey, based on a hybrid model of complementary human- and technology-based knowledge networks. RESULTS: The central role of the NHS Scotland e-library as a system-wide technology infrastructure facilitating management of both explicit and tacit knowledge is described. The implementation pathway and approaches to evaluation are outlined, based on practical steps to translate the concept of knowledge networks into a working reality. CONCLUSIONS: The model emerging is that of a knowledge matrix, with the primary delivery system comprising inter-dependent human, organizational and technology-based networks focused on the overriding common purpose of improving patient care.

Computer Communication Networks↗