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PubMed2004

Mental health knowledge in residential aged care: a descriptive review of the literature.

Health care staff knowledge of mental health is vital in the provision of quality care for older people in residential aged care settings. This paper aims to describe mental health knowledge competence of health care staff in residential aged care through a review of existing literature and to explore the link between knowledge, attitudes and education about older people and mental health. A literature review was conducted using electronic databases and library catalogues to identify articles published in English during the period 1982-2002. There is insufficient evidence within the literature to draw conclusions about staff knowledge levels in relation to mental health, however, the literature identified a link between continuing education, knowledge levels and staff attitudes to older people with mental health disorders. Future studies are needed to investigate existing levels of mental health knowledge among health care staff in residential aged care and to identify and evaluate strategies to enhance their ability to provide care for this population.

Aged↗
PubMed2000

Knowledge of and attitudes to pharmacotherapy in medical inpatients.

OBJECTIVE: To analyze different aspects of patients' knowledge and attitudes to pharmacotherapy in medical inpatients. PATIENTS: 183 patients hospitalized in the Department of Medicine of University Hospital "Merkur", Zagreb, Croatia were investigated. METHODS: A questionnaire was designed to investigate patients' knowledge of drugs they were taking before admission to the hospital and drugs they are receiving during hospitalization. Patients were asked to give drug names, dosage and reasons for their prescription. Patients' rating of the importance of some drug characteristics (dosage, indication, precautions, side-effects, mode of action) was evaluated. RESULTS: A representative group of patients (mean age 55.5 years, range 17-86, SD 16.1; 89 men, 94 women; 50 hematological, 44 cardiological, 50 gastroenterological and 39 nephrological patients) showed a significantly better (p < 0.000001) overall knowledge of drugs taken prior to admission compared to the knowledge of drugs that they were receiving during hospitalization. Overall drug knowledge did not differ significantly between groups of patients stratified according to gender, ward, number of drugs they were taking or duration of treatment. In older patients (p < 0.0001) and in those with lower education (p < 0.001) a significantly worse overall knowledge was observed. On a 1-5 semiquantitative scale patients rated dosage as the most important and mode of action as the least important drug characteristic (average 3.62 and 2.08, respectively). Of all patients, 94.5% pointed out physicians as one of their sources of drug information, written drug information followed in 40.4% and pharmacists in only 11.5% of patients. CONCLUSIONS: Our results agree with the results of the few similar studies published to date. A need for better health education of patients is underlined and possible ways of providing drug information for patients are discussed. The need for improvement of physician-patient transfer of drug information as well as the need for written drug information tailored according to patients' needs is underlined.

Adolescent↗
PubMedDate not supplied

Breast cancer knowledge and beliefs in subpopulations of African American and Caribbean women.

OBJECTIVE: To examine breast cancer belief and knowledge deficits among previously unstudied African and Caribbean subpopulations and to consider the particular knowledge and belief components that are most lacking in each group. METHODS: 1,364 African American, US-born white, English-speaking Caribbean, Haitian, Dominican, and Eastern European women were recruiting via stratified-cluster sampling. Participants provided demographics and measures of beliefs and knowledge. RESULTS: There were between-group differences in cancer knowledge and beliefs and within-group variation in terms of which particular knowledge and belief items varied. CONCLUSIONS: Studying how cognitive factors relate to screening in well-defined minority groups will capacitate interventions suited to the knowledge and belief deficits that characterize populations of diverse women.

Black or African American↗
PubMed1998

Knowledge and beliefs of breast cancer among elderly Puerto Rican women: validation process of scales.

This paper presents the results of the validation process to determine the concepts for knowledge and beliefs about breast cancer early detection practices among Puerto Rican elderly women. An initial questionnaire was designed based on the scientific literature review and focus group experiences. To determine its reliability and validity, 50 elderly women, stratified by type of profession and place of residence, were interviewed twice. Consistency of the questionnaire was analyzed using binomial test, matched t-test, Pearson correlation coefficient, and Cronbach's coefficient effect. Factor analysis (FA) was the statistical technique used to analyze the grouping of the knowledge and beliefs statements. FA indicated that three scales for knowledge and one for beliefs can be constructed. The purpose of the scales was to identify differences among groups, according to breast cancer early detection practices. Construct validity was performed to determine the number of statistical associations between the scales and these practices. The results showed that beliefs scales was associated with practice of mammogram (p < 0.05), and visit to the gynecologist (p < 0.05) while the knowledge scale for early-detection was associated with the clinical breast examination (p < 0.05). The beliefs scale had better consistency than the knowledge scale. The Cronbach's alpha was 0.75 for the beliefs' scale and 0.30, 0.41 and 0.43 for each defined knowledge scale, respectively.

Age Factors↗
PubMed1999

Knowledge of HIV/AIDS among health care workers in China.

This study was designed to assess knowledge of AIDS among health professionals in China via a cross-sectional survey. A self-administered questionnaire requesting demographic characteristics and basic AIDS knowledge was given to health professionals in 11 provinces, cities, and autonomous regions. Questionnaires were completed by 1,400 of 1,500 (93%) health professionals surveyed. The percentages of correct answers ranged from 3% to 68%. Findings included that public health workers had more knowledge than clinicians; having attended training workshops was not associated with an adequate levels of knowledge; and knowledge differed by professional level and by the geographic region in which they worked. Although most health professionals questioned knew that AIDS is caused by an infectious agents, their knowledge of transmission routes, the "window period" and the length of the incubation period is still inadequate. Thus, health professionals in China urgently need both more training and more effective training. The effectiveness of future HIV/AIDS workshops should be evaluated.

Acquired Immunodeficiency Syndrome↗
PubMed1999

An electronic study form to support collaborating agents in the management of clinical knowledge.

When dealing with biological organisms, one has to take into account some peculiarities which significantly affect the representation of knowledge about them. These are complemented by the limitations in the representation of propositional knowledge, i.e. the majority of clinical knowledge, by artificial agents. Thus, the opportunities to automate the management of clinical knowledge are widely restricted to closed contexts and to procedural knowledge. Therefore, in dynamic and complex real-world settings such as health care provision to HIV-infected patients human and artificial agents must collaborate in order to optimize the time/quality antinomy of services provided. If applied to the implementation level, the overall requirement ensues that the language used to model clinical contexts should be both human- and machine-interpretable. The eXtensible Markup Language (XML), which is used to develop an electronic study form, is evaluated against this requirement, and its contribution to collaboration of human and artificial agents in the management of clinical knowledge is analyzed.

Artificial Intelligence↗
PubMed1999

Analysis of pill knowledge amongst oral contraceptive users in Scotland according to client characteristics.

OBJECTIVES: The primary objective of this study was to investigate the relationship between various client characteristics and knowledge of oral contraceptives amongst pill users. METHOD: This was a subanalysis of the data from the national audit of Scottish family planning clinics. RESULTS: There were significant differences in knowledge about many different criteria according to the characteristics of the client group. Low educational attainment, unemployment and more rural residence produced greater significant differences in contraception knowledge than social deprivation according to postcode (zipcode). Age and duration of use affected different criteria to varying degrees, but teenagers scored relatively poorly compared to the general population and knowledge did not significantly improve overall with duration of use. CONCLUSION: Client characteristics do affect levels of pill knowledge. Clinicians must reflect on how to communicate more effectively with all types of pill users. They should take the opportunity of clinic visits for repeat pill prescriptions to improve knowledge levels.

Adolescent↗
PubMed1999

Dental hygienists' knowledge of menopause and its potential oral manifestations.

PURPOSE: The purpose of this study was to assess dental hygienists' general knowledge of menopause and its possible oral manifestations. Demographic descriptors, including education level, course work, and menopausal status, were examined to determine their influence on knowledge levels. METHOD: A 27-item, self-administered survey was mailed to a random sample of Connecticut dental hygienists. Frequency distributions and inferential statistics (ANOVA, t-test) were used for data analysis. RESULTS: Fifty-four percent of respondents scored 75 percent or higher in general knowledge about menopause. Seven percent scored the same about its oral effects. Educational level and dental hygiene college curricula influenced the oral effect scores. Dental hygienists with bachelor degrees exhibited more knowledge than those with certificate/associate degrees. Those who had taken a college course on the oral effects of menopause had more knowledge than those who had not. CONCLUSION: The findings suggest that dental hygienists need more education about menopause and its related oral conditions. Those with additional knowledge might be more able to provide comprehensive care to menopausal and post-menopausal dental patients. Future research using larger sample sizes may enhance the education of dental hygienists in this area.

Analysis of Variance↗
PubMed1999

Sociodemographic determinants of management behaviour of diabetic patients. Part II. Diabetics' knowledge of the disease and their management behaviour.

We aimed to: describe the level of knowledge of diabetic patients about the disease, show the relationship between demographic variables (age, sex and education) and level of knowledge and reveal the relationship between knowledge and management-related behaviour of diabetics. We found that a majority of diabetic patients (90.0%) had poor knowledge about the disease, 83.7% had poor knowledge about the complications associated with diabetes and 96.3% had poor awareness of how to control the disease. The poor level of knowledge that diabetics have about their disease suggests that health care providers need to be trained in the areas of information, education and communication.

Age Factors↗
PubMed2000

Knowledge and habits of tobacco among ice-hockey-playing boys. An intervention study.

The aim of this study was to investigate tobacco habits among ice-hockey-playing boys in three clubs in the County of Värmland, Sweden and to analyse whether health information about the harmful effects of tobacco could change the players' tobacco habits. In addition, the issue of whether there is any correlation between knowledge of tobacco and its harmful effects with tobacco habits was studied. Ice-hockey-players from three ice-hockey clubs were represented and one of the clubs acted as a control group. A total of 252 male ice-hockey-players, 12-19 years old participated. A specially designed questionnaire containing 33 questions on background, socioeconomics, behaviour, and knowledge was used. The boys answered the questionnaire on three occasions. The first and second examinations took place on the same occasion with the intervention occurring between the examinations. The third examination was carried out after 3-5 weeks. The study showed that the use of snuff played a more important role among the ice-hockey-players than did smoking and that they had tried using snuff at the age of 12. The baseline investigation showed that there were no significant differences between the clubs in tobacco habits and knowledge of the harmful effects of tobacco. After the health information, the boys' knowledge of tobacco and its harmful effects increased significantly (p<0.001), but regardless, no change in their use of tobacco was found after 3-5 weeks. Knowledge also increased significantly among the boys in the control group (p<0.001), but no change in the use of tobacco was found here either. No significant difference could be demonstrated between the group of boys who used snuff and the non-users with regard to their knowledge of the harmful effects of tobacco.

Adolescent↗
PubMed2000

Short and long-term impact of a structured educational program on the patient's knowledge of hypertension.

BACKGROUND: It has been generally accepted that educational programs can be beneficial in the treatment of a number of chronic diseases such as diabetes mellitus as well as of cardiovascular risk factors and hypertension. We organized a structured educational intervention aimed at 1) assessing the patient's baseline knowledge of hypertension, 2) verifying the short and long-term impact of this initiative on patient's education. METHODS: We invited 174 consecutive patients referred to our hypertension outpatient clinic to participate in an educational meeting on hypertension. For organizational reasons, patients were divided into two groups, each attending a single meeting. Each meeting included four sessions: 1) in the first session a multiple choice questionnaire (nine questions, with answers collected by an interactive electronic system) was administered in order to evaluate patients' baseline knowledge of hypertension, 2) a traditional teaching session, 3) an interactive phase aimed at assessing the improvement of knowledge in which the same questions as in the first session were assessed again, 4) a general discussion session. At the end of the meeting a booklet on principal issues related to hypertension was given to each patient. In order to evaluate the long-term impact of this initiative on the patient's knowledge, 6 months later we invited the patients to answer to the same questions in a questionnaire sent to their home address. RESULTS: One hundred thirty-three patients of the 174 invited attended the meeting and 111 (57 males, 54 females, mean age 53 +/- 13 years) completed the questionnaire after 6 months. The answers to the questions in the initial session were correct in a percentage ranging from 60 to 80% (mean 68%) and immediately after the teaching session this rate increased significantly (range 75-98%, mean 90%, p < 0.05 at least, in all questions). A similar good level of knowledge was maintained in the long term (percentage of exact answers ranging from 78 to 97%, mean 88%, p < 0.05 or p < 0.01 compared to baseline). CONCLUSIONS: The findings of the present study show a positive short and long-term impact of a structured educational intervention on the patient's knowledge of issues related to arterial hypertension. The beneficial role on clinical outcomes such as blood pressure control and cardiovascular events will need future controlled trials.

Adult↗
PubMed2001

Introducing T-shaped managers. Knowledge management's next generation.

Most companies do a poor job of capitalizing on the wealth of expertise scattered across their organizations. That's because they tend to rely on centralized knowledge-management systems and technologies. But such systems are really only good at distributing explicit knowledge, the kind that can be captured and codified for general use. They're not very good at transferring implicit knowledge, the kind needed to generate new insights and creative ways of tackling business problems or opportunities. The authors suggest another approach, something they call T-shaped management, which requires executives to share knowledge freely across their organization (the horizontal part of the "T"), while remaining fiercely committed to their individual business unit's performance (the vertical part). A few companies are starting to use this approach, and one--BP Amoco--has been especially successful. From BP's experience, the authors have gleaned five ways that T-shaped managers help companies capitalize on their inherent knowledge. They increase efficiency by transferring best practices. They improve the quality of decision making companywide. They grow revenues through shared expertise. They develop new business opportunities through the cross-pollination of ideas. And they make bold strategic moves possible by delivering well-coordinated implementation. All that takes time, and BP's managers have had to learn how to balance that time against the attention they must pay to their own units. The authors suggest, however, that it's worth the effort to find such a balance to more fully realize the immense value of the knowledge lying idle within so many companies.

Administrative Personnel↗
PubMed2001

[Knowledge, behavior, and attitudes toward sex among adolescent students at a junior/high school in Cote d'Ivoire].

OBJECTIVES: To be able to provide appropriate information about sex to adolescent students in the Cote D'Ivoire, we conducted a study to determine knowledge, behavior, and attitudes toward sex. METHODS: We conducted a cross-sectional study at a junior/high school using a self-administered questionnaire which contained students' characteristics (age, sex, grade, tribe, region), their knowledge about sex, sexual behavior (including experience of sex and contraception), and attitudes toward sex. Knowledge about sex and proportions employing contraception were compared between males and females and between the lower and the upper grades. We also examined associations between attitudes toward sex and contraception. RESULTS: A total of 695 (males: 278, females: 417) students filled in our questionnaire (response rate: 33.1%). The proportion of the students who had experienced sex was 84.2% for males, 46.5% for females, and the average age of the first sex was 14.3 and 15.6 years in males and females, respectively the proportions using contraception was 49.6% and 46.9%. In students of the lower grades, males had greater knowledge than females, but this difference was reduced with progression through the upper grades. The proportion using contraception in the upper grades was also higher and an association between attitude toward sex and contraception was clear. CONCLUSION: Adolescent students' knowledge, behavior, and attitudes toward sex could be relatively easily investigated at a junior/high school of Cote D'Ivoire. The majority of males and half of the females in this setting already had experience of sexual intercourse. The study showed that difference in sexual knowledge between males and females shrunk with increase in school grade. We also showed an association between attitude toward sex and contraception.

Adolescent↗
PubMedDate not supplied

Dollar$ & $en$e. Part VI: Knowledge management: the state of the art.

In Part I of this series, I introduced the concept of memes (1). Memes are ideas or concepts--the information world equivalent of genes. The goal of this series of articles is to infect you with memes so you will assimilate, translate, and express them. No matter what our area of expertise or "-ology," we all are in the information business. Our goal is to be in the wisdom business. In the previous articles in this series, I showed that when we convert raw data into wisdom, we are moving along a value chain. Each step in the chain adds a different amount of value to the final product: timely, relevant, accurate, and precise knowledge that then can be applied to create the ultimate product in the value chain--wisdom. In part II of this series, I introduced a set of memes for measuring the cost of adding value (2). In part III of this series, I presented a new set of memes for measuring the added value of knowledge, i.e., intellectual capital (3). In part IV of this series, I discussed practical knowledge management tools for measuring the value of people, structural, and customer capital (4). In part V of this series, I applied intellectual capital and knowledge management concepts at the individual level, to help answer a fundamental question: what is my added value (5)? In the final part of this series, I will review the state of intellectual capital and knowledge management development to date and outline the direction of current knowledge management initiatives and research projects.

Administrative Personnel↗
PubMed2001

[Does knowledge hurt?].

The rate of production of medical knowledge is high and increasing, and medical practitioners find it hard to keep up. Still, production of new knowledge is normally considered to be unambiguously desirable. This paper is a philosophical reflection upon this assumption of desirability. It is noted that the health sector appears to be subject to the law of diminishing returns; this implies that more doctors and more medical technology may at some level do more harm than good. We argue that Bacon's legitimization of knowledge (knowledge is power) is less forceful in the face of biological and psychosomatic complexity. Medical research may lead to unintended harm through at least two mechanisms. First, biomedical knowledge is reified through the introduction of new medical technology whose effects are not fully known, and may lead to uncontrollable adverse effects on a clinical and societal level. Second, exaggerated attention paid to the production and implementation of biomedical factual knowledge may prevent the development and teaching of personal clinical skills, including phronesis, the individual judgemental powers that enable us to judge which goals are worth striving for, and which are not.

Humans↗
PubMed2001

[Knowledge, attitudes and behavior regarding organ transplantation: the impact of the first transplantation from a brain-dead donor under the organ transplantation act].

OBJECTIVE: To investigate knowledge, attitudes and behavior regarding organ transplantation, and to estimate the impact of the first organ transplantation from a brain-dead donor under the Organ Transplantation Act. SUBJECTS AND METHODS: A telephone survey was made using the Random Digit Dialing method in May 1999. People living in the Tokyo Metropolitan area ages 20 years or over were asked about their knowledge, attitudes and behavior regarding organ transplantation, and their opinions on the first organ transplantation conduced in February 1999. The results were compared with an opinion poll made 7 months previously to estimate the impact of this first case. RESULTS: The number of respondents was 489 (response rate: 46.0%). 1) Knowledge of organ transplantation: most people knew that organ donation from brain-dead donors was possible under the act, and that written consent on a form and family member's agreement were necessary before donating. More people knew about donor cards. 2) Organ transplantation: more people were willing to donate their organs when they die, and to agree to donation when a family member died who had wanted to donate his/her organs on their death. In the poll 7 months before, fewer people were willing to donate their organs or to agree to donate their family member's organs after brain death compared with after heart arrest. However, no such difference between brain death and heart arrest was found in this later study, suggesting that the distinction between the two was no longer considered to be so important. 3) Respondents themselves having donor cards constituted 15.2%, showing a marked increase from 7 months earlier. Another 39.7% wished to carry a donor card; the most common reason for not carrying one was they did not know how to acquire it. 4) The first transplantation was considered to have contributed to the increase in knowledge, and a favorable change in attitudes and behavior toward organ transplantation. 5) Respondents who agreed to that organ donation from children aged under 15 should be possible constituted 46.4%, of the to be this not being allowed at the present time. 6) The majority of respondents considered that the brain death was diagnosed properly in the first case and that the donation was made voluntarily, concluding that the transplantation was made fairly. 7) Respondents who considered that the privacy of the donor and the recipients was violated were 46.2% and 36.1%, respectively. The attitude of the mass media toward the first transplantation was criticized by 56.9% of the respondents. 8) Respondents who had a favorable impression of the organ transplantation were 61.9%. Such people are likely to donate their organs, to agree to a family member's donation, and to have a donor card than people who had not gained a favorable impression. The two groups exhibited no difference in their knowledge concerning organ transplantation. CONCLUSIONS: An increase in knowledge and a favorable change in attitudes and behavior regarding organ transplantation was confirmed in this survey, as compared with results 7 months earlier, probably because the first transplantation took place. The majority of the respondents considered that the first transplantation was made fairly, although they criticized the attitude of the mass media invading the privacy of the donor and the recipients. Further studies should be made to facilitate effective delivery of donor cards to people who want to carry them, and to change the rules on organ donation from children.

Adult↗
PubMed2001

HIV/AIDS knowledge, attitudes and beliefs based prediction models for practices in prison inmates, Sindh, Pakistan.

This study was conducted on prison inmates in Sindh to determine whether HIV/AIDS related knowledge, attitudes and beliefs can predict their practices which risk HIV infection. A pre-designed questionnaire was administered in this cross-sectional study to collect the data on HIV/AIDS related knowledge, attitudes, beliefs, practices and demographic variables in a systematic sample of 3,395 prison inmates during July 1994. The data on responses of inmates to HIV/AIDS related knowledge, attitudes, and beliefs were analyzed and a clear interpretable factor structure emerged for each set of questions labeled as knowledge, attitude and beliefs. Similarly based on responses of inmates to practice questions, three factors emerged and were labeled as heterosexuality, homosexuality and drugs. The standardized factor scores of inmates for each of these six factors were computed and used in further analyses. Multiple linear regression analyses were carried out separately using heterosexuality, homosexuality and drugs factors score as dependent variables to identify if any of the independent variables (demographic variables, knowledge beliefs and attitude) predict these practice factors. The model for heterosexuality explained 23% of the variance and included HIV/AIDS related knowledge, beliefs, age, ethnicity and marital status and duration of imprisonment (F = 84.33, p < 0.001; R2= 23.0). The predictors in the model for homosexuality together explained 10% of the variance and included significant contribution by belief, martial status, ethnicity, education, age and duration of imprisonment (F = 24.76, p < 0.001; R2= 0.10). The model for drugs had significant contributions from HIV/AIDS related beliefs, marital status and ethnicity (F = 20.10, p < 0.001; R2= 0.03). Implications of prevention program based on these results are considered.

Adult↗
PubMed2001

Clinical sensitivity: the inseparability of ethical perceptiveness and clinical knowledge.

This article argues that there is an important connection between ethical sensitivity and clinical competency in nursing. This is more than a defense for ethical attitudes and virtues in clinical practice, however. I will show in what way ethical sensitivity is important not only to moral judgment, but to professional clinical knowledge and judgment as well. Drawing on central insights from continental philosophy, Husserl, Heidegger, Levinas and Foucault, as well as classical virtue theory, the article elucidates the inseparability of ethical sensitivity and clinical knowledge in nursing. Ethical sensitivity has bearing upon clinical knowledge and awareness in two important ways. First, what we consider relevant clinical knowledge and therapeutic measures frequently encounter the realities of clinical conditions, realities which embody certain moral qualities and appeal to moral values. In clinical nursing, it is important to understand how this encounter between professional knowledge and moral values informs clinical action, making it morally as well as professionally proper. Second, sensitivity to vulnerability qualifies clinical knowledge in the way that it alerts clinical sensitivity altogether. Perception of morally salient features informs the nurse about significant changes in the patient's pathological condition. The ability to be touched morally by the patient's condition, his or her vulnerability or vitality and positive experience is epistemologically and prognostically significant.

Attitude of Health Personnel↗