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PubMedDate not supplied

Ethnic differences in knowledge and attitudes about BRCA1 testing in women at increased risk.

Informed consent for BRCA1 mutation testing will require adequate knowledge of patterns of inheritance of cancer and the benefits, limitations, and risks of DNA testing. This study examined knowledge about the inheritance of breast cancer and attitudes about genetic testing for breast-ovarian cancer susceptibility in women at increased risk. Knowledge and attitudes were measured in 407 African American and Caucasian women aged 18-75 who had at least one first-degree relative (FDR) with breast and/or ovarian cancer. The average knowledge score was 6.0 out of a total of 11 (S.D. = 2.15). Compared to Caucasian women, African American women had lower levels of knowledge and had more positive attitudes about the benefits of genetic testing. There were no significant ethnic differences in attitudes about the limitations and risks of testing, however, income was negatively associated with this outcome. Ethnic differences in knowledge and attitudes about genetic testing for breast-ovarian cancer risk may be attributable to differences in exposure to genetic information and referral by health care providers.

Adolescent↗
PubMed2003

Knowledge management in healthcare: what does it involve? How is it measured?

While knowledge exists in all healthcare organizations, it often remains in silos or on the sidelines, neither used to its maximum potential nor purposefully focused on strategic results. In order to facilitate the development of strategically valuable knowledge, this article outlines seven knowledge-building dimensions that create a solid knowledge-management lever within the organization. Additionally, the article helps readers to come to grips with accountability by suggesting strategic outcomes for knowledge management. A particular focus is on lead or forward-looking indicators that track the progress and success of knowledge management.

Canada↗
PubMed2000

A pain monitoring program for nurses: effects on nurses' pain knowledge and attitude.

One of the reasons for inadequate pain treatment in hospitalized patients is that nurses have insufficient knowledge about pain and pain management. To address this problem, a Pain Monitoring Program (PMP) for nurses was developed, implemented, and evaluated. The PMP consisted of two components: educating nurses about pain, pain assessment, and pain management, and implementing daily pain assessment by means of a numeric rating scale. The effects of the PMP were measured in a one-group pretest-post-test design. The results show that nurses have knowledge deficits and prejudices with regard to pain and pain management. Age and additional pain courses in pain partly predict nurses' pain knowledge. After nurses were educated, the average score on the Pain Knowledge Questionnaire increased from 69.1% (SD = 13.2) at pretest to 75.8% (SD = 11.5) at post-test (P < 0.001). Nurses' attitudes changed with regard to their level of knowledge and skills in relieving pain, willingness to assess pain on a daily basis, and attention to patients' pain complaints. It can be concluded that the PMP is effective in improving nurses' knowledge of pain management and focusing nurses' attention to patients' pain complaints.

Adult↗
PubMed2001

Knowledge and perceived competence of home care nurses in pain management: a national survey.

This national mail survey assessed pain-related knowledge and subjective competence of a random sample of home care nurses across the United States. Other study objectives were to examine the relationship between nurse characteristics, knowledge and perceived competence, and assess continuing education practices. On average, the 1236 nurses scored only 56% of the items correctly, demonstrating stronger knowledge in pain assessment than treatment. Respondents reported most confidence in patient and family communication, discussion of advance directives and pain assessment. The lowest competence was reported in sophisticated pain treatment techniques. The relationship between knowledge and subjective competence was found to be highly significant. Sixty-three percent of the sample displayed a realistic assessment of their pain management knowledge, while 37% under- or overestimated what they knew. It is challenging to engage the latter group who overestimate their competence but score low on pain management knowledge. Educational strategies need to differentiate these two groups and target the audience appropriately.

Advance Directives↗
PubMed1998

Knowledge of health insurance coverage by adolescents and young adults attending a hospital-based clinic.

PURPOSE: To describe adolescents' and young adults' knowledge about their health insurance, and to identify factors associated with correct knowledge of health insurance in this population. METHODS: Data were analyzed from a confidential questionnaire administered to 830 patients at a hospital-based adolescent medicine clinic. The questionnaire contained items pertaining to insurance type, demographics, health status, and health-risk behaviors. Actual health insurance data and information regarding utilization of health services were obtained from the hospital billing data-base. Predictors of health insurance knowledge were determined through bivariate analyses followed by stepwise logistic regression. RESULTS: A total of 50.7% of respondents correctly identified their type of health insurance. Those who correctly identified their insurance had a higher mean age. Only 48.5% of participants who were 11-18 years old could identify their insurance type, versus 53.1% of 19-21-year-olds and 64.7% of 22-24-year-olds (p = 0.02). Sixty-five percent of Medicaid patients and 76.3% of hospital free care patients knew how their medical bills were paid, versus 17.9% of self-pay patients and 47.3% of patients with private insurance (p < 0.01). Greater utilization of health services was associated with increased rates of insurance knowledge among 19-24-year-olds on bivariate analysis; however, this factor was not significant when controlling for other factors. Regression analysis revealed that older age and insurance type other than self-payment were independent predictors of health insurance knowledge in adolescents (11-18 years old), while female gender and insurance type other than self-payment were independent predictors of insurance knowledge in young adults (19-24 years old). CONCLUSIONS: Approximately half of adolescents and young adults do not know how their medical bills are paid. Validation of self-reported insurance data is, therefore, critical both in clinical practice and health services research.

Adolescent↗
PubMed2003

Physician knowledge and attitudes of Minnesota laws concerning adolescent health care.

STUDY OBJECTIVE: To determine physicians' knowledge and attitudes of medico-legal issues affecting adolescent health care. DESIGN, SETTING, PARTICIPANTS: A cross-sectional, mailed survey was distributed to 900 randomly selected primary care physicians in Minnesota, and all eligible physicians in Olmsted County. INTERVENTIONS: Physicians were mailed a survey with questions concerning Minnesota consent and confidentiality laws. MAIN OUTCOME MEASURES: Physician knowledge and attitudes of consent and confidentiality laws. RESULTS: A total of 317 (26%) surveys were returned. Olmsted county physicians achieved a median score of 37.5% and non-Olmsted physicians achieved a median score of 50% correct on a test of knowledge. Using a scoring scale where -1 signified "a bad law," 0 signified "neither a good nor bad law," and +1 signified "a good law," attitude regarding the laws was a median of +0.5 for both groups. In all, 41.1% of Olmsted physicians and 51.7% of non-Olmsted physicians felt that the laws had affected them or their practice. Olmsted physicians were compared to a cohort of Olmsted parents previously reported, with statistically significant differences noted. CONCLUSIONS: Results suggest that primary care physicians are not knowledgeable of Minnesota laws affecting adolescent health care. Opinion of these laws was positive, with notable exceptions. Physicians lack a sense of impact of laws affecting adolescent health care. Physicians were more knowledgeable and felt more positively about the laws than did parents of adolescents. Lack of knowledge and the presence of certain attitudes identify areas where physicians could benefit from greater understanding.

Adolescent↗
PubMed2000

Health and hygiene knowledge, attitudes and behaviour.

The aim of this study was to develop and test measures of health and hygiene knowledge, attitudes and behaviour. A questionnaire was administered to 240 women: 80 from a squatter camp, 80 from an informal settlement and 80 from a formal township. Reliability of the knowledge scale was 0.73. Coefficient alpha was 0.87 for the attitude and behaviour scales. The knowledge, attitude and behaviour scales were significantly related (P<0.001). Factor analysis confirmed that domestic and personal hygiene were core components of the attitude scale, whereas the emphasis for behaviour was on personal hygiene. Stepwise regression showed that age explained 23% of the variance in knowledge and 18% in behaviour. Waste management significantly affected knowledge, attitudes and behaviour, suggesting that dustbin ownership was an important public health measure. It was concluded that these scales were useful measures of health and hygiene knowledge, attitudes and behaviour; provided baseline information for planning health promotion programmes; and could be used to evaluate the effectiveness of such programmes.

Adult↗
PubMed2003

Instruments to measure acceptability of information and acquisition of knowledge in patients with heart failure.

BACKGROUND: Patients with heart failure suffer from poor health outcomes and require combinations of medications to treat their disease. Providing patients with knowledge through education is one mechanism to help them improve compliance with complicated treatment regimens. METHODS: We developed and tested two instruments. The first instrument, which we call the measure of educational material acceptability (EMA), was designed to help us differentiate between written educational materials according to patients' subjective responses. The second instrument, the knowledge acquisition questionnaire (KAQ), which measures knowledge gained, was designed to determine whether patients understand the rationale and mechanics of their heart failure management. We explored the measurement properties of both instruments. RESULTS: The internal consistency of the EMA was 0.79 (Cronbach's alpha). The internal consistency of the KAQ was 0.61 and its responsiveness, measured using change scores of knowledge before and after an educational intervention, was 0.75. CONCLUSIONS: We have developed instruments that measure acceptability and knowledge acquisition, and that clinicians and investigators involved in heart failure programs may find useful in developing educational material and measuring the impact of their interventions on patients' knowledge.

Aged↗
PubMed2004

Human papilloma virus testing knowledge and attitudes among women attending colposcopy clinic with ASCUS/LGSIL pap smears.

OBJECTIVE: To study women's knowledge regarding the role of human papilloma virus (HPV) in cervical intraepithelial neoplasia and their attitudes toward the integration of HPV testing as part of routine follow-up of atypical squamous cell of uncertain significance/low-grade squamous intraepithelial lesion (ASCUS/LGSIL) abnormalities. METHODS: Over a 12-month period, all women attending the University of Ottawa colposcopy clinic for evaluation and follow-up of ASCUS/LGSIL Pap smears were recruited. Demographic data included age, nature of the Pap smear abnormality, gravidity, parity, occupation and education level, smoking history, previous history of abnormal smears, colposcopic examination and treatment, and current method of contraception. The women were asked to rate their level of concern over their Pap smear abnormality, from 0 (not concerned) to 10 (very concerned). Women's knowledge regarding the role of HPV in cervical intraepithelial neoplasia and the rationale behind the use of HPV testing was assessed by the clinic nurse as being minimal, moderate, or good, as defined by pre-specified criteria. Upon explanation by the nurses of the results of the recent ALTS (ASCUS/LGSIL Triage Study) trial, the women were asked to state whether they preferred to continue with regular colposcopic surveillance every 6 months, or to use the results of the HPV test, if negative, to reduce the number of colposcopy examinations to one annually. Descriptive statistics and logistic regression analysis were used to identify significant demographic factors associated with the women's preference for incorporation of HPV testing in their follow-up. All P values less than.10 were considered to be statistically significant, due to the exploratory nature of the study. RESULTS: Of the 100 women who participated in the study, 42% presented with ASCUS. The mean age (+/- SD) of the women was 33.63 +/- 11.25 years (range, 18-75 years); 66% were office workers with at least a community college degree, 86% reported previous abnormal Pap smears, and 67% had previously been seen for colposcopy. Fifty-eight percent of the women rated their concern level as being 6 or more, while 15% ranked their concerns as maximal at 10. In terms of knowledge about HPV, 75% of the women had no or very minimal knowledge of the role of HPV in cervical intraepithelial neoplasia. With regard to HPV testing, 84% of the study group had either never heard of the test or had only a minimal knowledge of HPV testing. After being informed of the ALTS results, 64% of the women chose to use HPV testing to help in triaging the needs for frequent colposcopy. Logistic regression modelling showed that a college level education (odds ratio [OR], 2.27; 95% confidence interval [CI], 0.95-;5.45; P =.06) and history of previous treatment for abnormal Pap smears (OR, 3.31; CI, 0.88- 12.46; P =.07) were closely associated with the adoption of HPV testing in clinical management. CONCLUSION: There exists a significant lack of knowledge about HPV and its role in the pathogenesis of cervical intraepithelial neoplasia. Women who have received previous treatments for cervical intraepithelial neoplasia and those with college-level educations were more likely to adopt this new technology as part of their care.

Adolescent↗
PubMed2006

HIV/AIDS knowledge, women's education, epidemic severity and protective sexual behaviour in low- and middle-income countries.

A fundamental public health strategy to reduce the risk of HIV/AIDS is to increase levels of awareness and knowledge about the disease. Although knowledge about HIV/AIDS and protective sexual behaviour are linked theoretically, relatively little is known about their empirical relationship. Using Demographic and Health Survey data from 23 low- and middle-income countries, this study used multilevel logistic regression models: to examine cross-national variability in the relationship between HIV/AIDS knowledge and protective behaviour (condom use and restricted sex); to investigate the moderating influences of women's educational attainment on this relationship; and to test the extent to which severity of the HIV/AIDS epidemic accounts for cross-national variability in the association between HIV/AIDS knowledge and protective behaviour. There was an association between increased knowledge of HIV/AIDS and condom use that varied in strength and form cross-nationally. This cross-national variation was accounted for partially by the socioeconomic characteristics of women resident in the study countries and between-country differences in the severity of the HIV epidemic. While education modified the association between HIV/AIDS knowledge and protective behaviour--stronger associations at lower levels of education--epidemic severity exerted a stronger influence on behaviour than any other characteristic. Finally, this study indicates that protective sexual practices are disturbingly low. In eight of 23 countries, overall levels of condom use to prevent STDs and HIV/AIDS were less than 5.0%. Waiting for the spread of HIV/AIDS infection to change sexual practices in low- and middle-income countries will result in dramatic unnecessary suffering.

Acquired Immunodeficiency Syndrome↗
PubMed1999

A theory of implicit and explicit knowledge.

The implicit-explicit distinction is applied to knowledge representations. Knowledge is taken to be an attitude towards a proposition which is true. The proposition itself predicates a property to some entity. A number of ways in which knowledge can be implicit or explicit emerge. If a higher aspect is known explicitly then each lower one must also be known explicitly. This partial hierarchy reduces the number of ways in which knowledge can be explicit. In the most important type of implicit knowledge, representations merely reflect the property of objects or events without predicating them of any particular entity. The clearest cases of explicit knowledge of a fact are representations of one's own attitude of knowing that fact. These distinctions are discussed in their relationship to similar distinctions such as procedural-declarative, conscious-unconscious, verbalizable-nonverbalizable, direct-indirect tests, and automatic-voluntary control. This is followed by an outline of how these distinctions can be used to integrate and relate the often divergent uses of the implicit-explicit distinction in different research areas. We illustrate this for visual perception, memory, cognitive development, and artificial grammar learning.

Cognition↗
PubMed2004

Knowledge, quality of life, and use of complementary and alternative medicine and therapies in inflammatory bowel disease: a comparison of Chinese and Caucasian patients.

Inflammatory bowel disease is rare in the Chinese population, which may result in limited support, misinformation, and unalleviated fears and adversely affect quality of life (QOL). This study compared the inflammatory bowel disease (IBD)-related knowledge, QOL, and use of complementary and alternative medicines and therapies (CAMT) in two contrasting IBD populations. Chinese and Caucasian IBD patients completed a questionnaire on IBD knowledge and CAMT usage. QOL was evaluated using the validated Inflammatory Bowel Disease Questionnaire. One hundred sixty-two IBD patients were recruited, 81 Chinese and 81 Caucasian. The IBD knowledge score was higher in Caucasian than in Chinese IBD patients (median difference, 6.5; P = 0.001) and was independent of education and occupation. Twenty-one-percent of Chinese subjects incorrectly identified their IBD type (0% in the Caucasian group; P < 0.001). QOL was higher in the Chinese than the Caucasian group, but not significantly different after adjusting for disease activity. QOL was unassociated with IBD knowledge. The overall use of CAMT was similar in both groups (33% of Chinese and 37% of Caucasian patients) and similar for Crohn's disease and ulcerative colitis. IBD-related knowledge was inferior in Chinese compared to Caucasian IBD patients. Health-related QOL is unlikely to be greatly influenced by disease-related knowledge or education. A high proportion of Chinese and Caucasian IBD patients uses CAMT.

Adolescent↗
PubMed2002

Oral health care education and its effect on caregivers' knowledge and attitudes: a randomised controlled trial.

OBJECTIVES: The effect of an oral health care education programme (OHCE) upon nursing home caregivers was assessed in a randomised controlled trial. METHODS: A self-administered questionnaire assessed oral health care knowledge and attitudes at baseline among 369 caregivers working in 22 nursing homes. Homes were randomly allocated to two groups. The intervention was a workplace OHCE. Caregivers assessed the value of the presentations. Questionnaires were re-administered 1 month (time 2) and 6 months (time 3) after the OHCE was delivered. The knowledge and attitude score means of the groups were compared. Open-ended questions solicited qualitative data. RESULTS: Questionnaire response rates at the three time points ranged from 76.3% to 85.4%. Two-thirds of caregivers employed at the time of the intervention attended the presentations. The OHCE was favourably assessed in 79% of responses. The intervention group significantly improved their scores over the control group at times 2 and 3 for knowledge (P<0.003) and attitude (P<0.001). Analysed across both arms at baseline, the main predictors for knowledge and attitude scores were age and dental attendance pattern. Qualitative responses showed an acceptance of caregivers' roles in oral health care and criticism of existing provision within homes. CONCLUSIONS: The OHCE was well received and resulted in improved oral health care knowledge and attitudes. When viewed with separately reported trial results of clients' oral health status, knowledge and attitude score improvements coincided with improved delivery of oral health care.

Adolescent↗
PubMed1995

Prior knowledge and functionally relevant features in concept learning.

Empirical learning models have typically focused on statistical aspects of features (e.g., cue and category validity). In general, these models do not address the contact between people's prior knowledge that lies outside the category and their experiences of the category. A variety of extensions to these models are examined, which combine prior knowledge with empirical learning. Predictions of these models were compared in 4 experiments. These studies contrasted the cue and category validity of features with people's prior knowledge about the relevance of features to the functions of novel artifacts. The findings suggest that the influences of knowledge and experience are more tightly integrated than some models would predict. Furthermore, relatively straightforward ways of incorporating knowledge into an empirical learning algorithm appear insufficient (e.g., use of knowledge to weight features by general relevance or to individually weight features). Other extensions to these models are suggested that focus on the importance of intermediary features, coherence, and conceptual roles.

Adult↗
PubMed2006

Partial knowledge of abstract words in patients with cortical degenerative conditions.

Partial knowledge is a common but rarely studied consequence of damage to conceptual representations and is characterized by the retained ability to retrieve crude, superordinate information but not specific, detailed information about a conceptual entity. Previous studies have described partial knowledge for concrete items particularly following semantic dementia (SD). The present study was designed to investigate the occurrence of partial knowledge effects in the conceptual domain of abstract words. A novel 3-level synonym comprehension test was administered to 9 patients with SD, 20 patients with probable Alzheimer's disease (AD), and 40 healthy control subjects. All subject groups showed weaker performance on tasks requiring a fine specification of word meaning compared with those for which a broad sense of meaning or valence was necessary. However, this gradient of partial knowledge was significantly greater for SD and AD subjects than for controls. These results demonstrate that partial knowledge is a general property of a degraded knowledge base and is not restricted to the concrete word domain. It constitutes a normal phenomenon that is exacerbated in the context of neurodegenerative disease.

Aged↗
PubMed2004

College students' memory for vocabulary in their majors: evidence for a nonlinear relation between knowledge and memory.

The effect of domain knowledge on students' memory for vocabulary terms was investigated. Participants were 142 college students (94 education majors and 48 business majors). The measure of domain knowledge was the number of courses completed in the major. Students recalled three different lists (control, education, and business) of 20 words. Knowledge effects were estimated controlling for academic aptitude, academic achievement, and general memory ability. Domain-specific knowledge consistently predicted recall, above and beyond the effect of these control variables. Moreover, nonlinear models better represented the relation between knowledge and memory, with very similar functions predicting recall in both knowledge domains. Specifically, early in the majors more classes corresponded with increased memory performance, but a plateau period, when more classes did not result in higher recall, was evident for both majors. Longitudinal research is needed to explore at what point in learning novices' performance begins to resemble experts' performance.

Adolescent↗
PubMed2002

Hepatitis-associated knowledge is low and risks are high among HIV-aware injection drug users in three US cities.

AIMS: Injection drug use is a major risk factor for HIV and hepatitis infections. Whereas programs to prevent new infections have focused on HIV, they have generally neglected hepatitis B and C. This study was designed to examine the interrelationships among HIV and hepatitis knowledge, risky drug preparation and injection practices, and participation in syringe exchange programs (SEPs). DESIGN: Surveys of injection drug users (IDUs) collected data on socio-demographics, medical history, drug use and injection practices, and HIV- and hepatitis-related knowledge. SETTING: Inner-city US neighborhoods in Chicago, IL, Hartford, CT and Oakland, CA. PARTICIPANTS: The study population was a convenience sample of 493 IDUs recruited using street outreach and snowball sampling strategies. MEASUREMENTS: HIV and hepatitis knowledge, injection-related risks for virus transmission, associations between the two, and with SEP use. FINDINGS: HIV knowledge was significantly higher than hepatitis knowledge among SEP customers and non-customers alike. Elevated hepatitis knowledge was associated with a history of substance abuse treatment, hepatitis infection, hepatitis B vaccination and injection practices that reduced contact with contaminated blood or water but not with SEP use. SEP customers were consistently less likely to engage in risk behaviors, with the notable exception of safely staunching blood postinjection. CONCLUSION: Increased hepatitis awareness among IDUs is necessary for reducing hepatitis transmissions. Although SEPs continue to effectively disseminate HIV prevention messages-as evidenced by lowered risk behaviors among their customers-they must do more to prevent hepatitis transmissions.

Adult↗
PubMed1993

The effects of comprehensive guidelines for the care of sickle-cell patients in crisis on the nurses' knowledge base and job satisfaction for care given.

The primary purpose of this study was to determine the effects of comprehensive nursing guidelines for sickle-cell patients in crisis on the nurses' knowledge base and job satisfaction for nursing care given. This study was carried out through the use of a single-group pretest-posttest design. A total of 18 subjects participated in the study. At the pretesting, each subject completed an Individual Information Questionnaire for the collection of background data, a Knowledge Base tool and a Job Satisfaction tool. Afterwards, all subjects attended 10.5 hours of educational programmes on sickle-cell disease, treatment, interventions and relaxation training. Following this, the comprehensive guidelines for the care of sickle-cell patients were instituted. At 3 months and 6 months after the guidelines had been in effect, subjects were again asked to complete the Knowledge Base and Job Satisfaction tools. The results of the tools were then measured comparing the three time intervals for any differences in knowledge and job satisfaction using independent measure t-tests. t-Tests were also performed for each question on the Job Satisfaction tool comparing the three time intervals. The results of the analyses demonstrated that there was a statistically significant increase in knowledge between the pretest and 6 month time interval. The findings also showed that there was no statistically significant increase in overall job satisfaction. However, the t-test results from the individual questions demonstrated a statistically significant increase in job satisfaction in the areas of nurse/physician collaboration and having a broad knowledge base of sickle-cell disease.

Acute Disease↗