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PubMedDate not supplied

The influence of knowledge of mammography findings on the accuracy of breast ultrasound in symptomatic women.

Breast ultrasound is generally interpreted with knowledge of the mammographic examination. This study examined the influence of knowledge of mammography findings on the accuracy of ultrasound in women with breast symptoms. Subjects were sampled from all women 25-55 years of age consecutively attending a breast clinic. This included all 240 women shown to have breast cancer and 240 age-matched women shown not to have cancer. Ultrasound films were prospectively reviewed and reported by two radiologists independent of each other and in a blinded manner. A two-phase design was used. In the first phase, the radiologists provided an opinion on the ultrasound films. In the second phase, the ultrasound films were reread with consideration of the corresponding mammographic examination. The accuracy of reading the ultrasound with and without knowledge of the findings on mammography was compared using sensitivity and specificity, and receiver operating characteristics (ROC) curves. Reporting the ultrasound with knowledge of mammography (compared to without mammography) improved sensitivity and reduced specificity for both radiologists. For one reader, sensitivity increased from 77.5% to 86.7% (p = 0.0002) and specificity decreased from 89.7% to 85.4% (p = 0.04). For the other reader, sensitivity increased from 81.3% to 87.5% (p = 0.0023) and specificity decreased from 87.1% to 85.0% (p = 0.27). ROC curves for both radiologists showed that reporting ultrasound with knowledge of mammography resulted in small (about 3%), but significant improvement in the area under the ROC curve. Our study indicates that knowledge of the findings of mammography improves the interpretation of breast ultrasound in symptomatic women.

Adult↗

PubMedDate not supplied

Illness experience and related knowledge amongst children with asthma.

Forty-nine children with asthma (aged 7-16 years) completed a questionnaire concerned with (1) general knowledge about the body and how it works, and (2) specific knowledge about the cause and prognosis of asthma, knowledge of allergens and self-care behaviours. Compared with a matched group of healthy children, they were less well-informed about general knowledge of the body. Knowledge of asthma was also poor. Few children made any specific attempts to avoid situations known to precipitate attacks. There was no significant increase with age in knowledge of allergens or awareness of how to control attacks. The results indicate a need to make asthmatic children more aware of their illness, particularly with regard to self-care.

Adolescent↗

PubMed1979

Genetic knowledge possessed by American nurses and nursing students.

As diseases of genetic origin have increased their impact on society's health, nursing's role has also increased. Nurses may not be referring those needing it for genetic counselling or prenatal diagnosis and may be inadvertently giving patients erroneous information based on lack of knowledge. A questionnaire was used to examine the overall adequacy and specific knowledge in the more commonly encountered genetic disorders such as sickle cell disease, Rh disease and Down's syndrome. It also included interpretation of risk and basic knowledge. The sample consisted of 366 senior nursing students and 114 practising nurses. Student programme type was consistently related to score. Age was also important in the degree of knowledge manifested. Only 19 (4.2%) of the respondents demonstrated over-all adequate knowledge. These results indicate a need to raise the consciousness and knowledge of nurses about human genetic disorders before serious repercussions result from inappropriate and inadequate counselling, health teaching and referrals.

Adult↗

PubMed1996

A quasi-experimental research to investigate the retention of basic cardiopulmonary resuscitation skills and knowledge by qualified nurses following a course in professional development.

The research was undertaken with the intention of testing six null hypotheses regarding the retention of basic cardiopulmonary resuscitation (CPR) skills and knowledge of registered nurses. The hypotheses were formulated from the broad aims of the research, which were to investigate conclusions reached by other researchers highlighting the speed with which retention of CPR skills and knowledge deteriorates, and to investigate the need for regular updating in CPR. The research was quasi-experimental in nature. The 19 nurses participating in the research were qualified staff undertaking the English National Board (ENB) 923 course in Professional Development, which included a refresher on basic CPR skills and included some discussion regarding advanced techniques. The latest guidelines issued by the Resuscitation Council (1993) were used, which also aided in the design and use of the two research tools, namely an eight-point skills-testing observation tool and a 26-point knowledge-testing questionnaire. While a 3-hour update in CPR skills revealed an initial improvement, the decrease in retention of skills 10 weeks later was significant (P = 0.0000). The update in CPR knowledge also revealed an initial improvement but the decrease in retention of knowledge 10 weeks later was significant (P = 0.0000). The findings of the research reflect similar results to previous research undertaken and discussed in the literature review, suggesting that retention of skills and knowledge quickly deteriorates if not used or updated regularly. Therefore this research supports the importance of CPR refresher courses on a regular basis.

Adult↗

PubMed2004

Knowledge acquisition, synthesis, and validation: a model for decision support systems.

BACKGROUND: Decision tools such as clinical decision support systems must be built on a solid foundation of nursing knowledge. However, current methods to determine the best evidence do not include a broad range of knowledge sources. As clinical decision support systems will be designed to assist nurses when making critical decisions, methods need to be devised to glean the best possible knowledge. AIMS: This paper presents a comprehensive knowledge development process to develop a nursing clinical decision support system. DISCUSSION: The Nurse Computer Decision Support Project (N-CODES) is developing a prototype for a prospective decision support system. The prototype is being constructed on rules and cases generated by the best available evidence. To accommodate the range of decisions made in practice, different types of evidence are necessary. The process incorporates procedures to uncover, evaluate, and assimilate information to develop the knowledge domain for a clinical decision support systems. Both formal and practice-based knowledge are included. The model contains several innovative approaches including the use of clinical experts and a network of practicing clinicians. CONCLUSION: These strategies will assist scientists and practitioners interested in determining the best evidence to support clinical decision support systems.

Decision Making↗

PubMed2004

Emergency care and narrative knowledge.

BACKGROUND: Nursing knowledge is a composite of many influences. In an attempt to strengthen nursing knowledge and practice, there have been significant developments in the codification of nursing knowledge as part of the evidence-based practice movement. Using established research techniques; this has the capacity to enhance clinical practice. However, not all knowledge can be incorporated into this type of academic discourse, and there is growing interest in narrative knowledge. This paper contributes to this sometimes implicit and sometimes explicit critique of dominant paradigms. AIM: The aim of this paper is to examine the usefulness of narrative as a means of exploring the world of emergency nursing practice and its contribution to the emotional lifeworld of clinicians. METHOD: A discourse analysis of nursing narratives in their natural settings was carried out. This involved exploration of stories that were not produced for the purposes of research. FINDINGS: Narratives can open up social worlds, which escape or be deliberately erased by more formal methods. Contingent and subversive knowledge can contribute to understanding the emotional impact of emergency care. CONCLUSION: These narratives have their own 'truth', which should be incorporated into an understanding of what constitutes the lifeworld of emergency nurses.

Adaptation, Psychological↗

PubMed2006

Caring for patients living with AIDS: knowledge, attitude and global level of comfort.

AIMS: This paper reports a study that aimed to determine Nigerian nurses' knowledge, attitudes and overall level of comfort in giving nursing care to acquired immune deficiency syndrome patients; determine the relationship between these variables; and identify the sociodemographic variables that influence nurses' attitudes and how comfortable they are giving nursing care to patients with acquired immune deficiency syndrome. BACKGROUND: There is little information on sub-Saharan African nurses' knowledge, attitude and feeling of comfort in providing care to patients living with acquired immune deficiency syndrome. METHODS: Two hundred and seventy-seven nurses in two teaching hospitals and two general hospitals in Nigeria were surveyed in 2003. The survey questionnaire had two parts. Part I elicited demographic information and information on previous encounters with acquired immune deficiency syndrome patients and Part II consisted of three subscales assessing knowledge, attitude and level of comfort administering certain nursing procedures to acquired immune deficiency syndrome patients. RESULTS: Respondents demonstrated low levels of knowledge and poor attitudes towards people with acquired immune deficiency syndrome. Attitudes appeared to be influenced by the nurse's speciality, rank, prior education and experience with patients with acquired immune deficiency syndrome. The responding nurses showed low levels of comfort in giving care to patients with acquired immune deficiency syndrome. CONCLUSIONS: The findings suggest that Nigerian nurses will hesitate to care for patients with acquired immune deficiency syndrome, and that there is potential for avoidance behaviour towards them. Periodic continuing education and curriculum enhancement to include clinical clerkship, structured experience, guided discussion on ethical scenarios and attitude exploration are suggested in order to achieve and maintain adequate knowledge and a positive attitude. University-based professional and postprofessional nursing education, which could enhance acquisition of a broad knowledge base, therefore represents the future direction.

Acquired Immunodeficiency Syndrome↗

PubMed1993

Personality, clinical performance and knowledge in paediatric residents.

This study examines the relationship between personality, knowledge and teachers' evaluations of paediatric residents at a large, urban teaching hospital. All residents (n = 30) were graduates of foreign medical schools. Each resident completed the Myers-Briggs Type Indicator (MBTI) as a measure of personality and was rated (on a scale of 1-7) by teachers on each of 35 items representing 14 different aspects of clinical performance. These data were correlated with performance on the American Board of Pediatrics In-training Examination (ABPITE), and with demographic data. Ratings of knowledge were directly associated with scores on the ABPITE (r = 0.51, P < 0.01) and with the MBTI continuous score for extraversion (r = 0.51, P < 0.01), but inversely associated with age (r = -0.41, P < 0.01). ABPITE scores were also associated directly with MBTI Extraversion (r = 0.44, P < 0.01) and inversely with age (r = -0.56, P < 0.001). Age and MBTI Extraversion were independently significant predictors of ABPITE (Multiple R = 0.64, P < 0.01) and ratings of knowledge (Multiple R = 0.59, P < 0.01). Results suggest that teachers' evaluations of knowledge have validity, and that age and introversion/extroversion play a significant role in both subjective and objective evaluations of paediatric knowledge. Demographic and personality variables may be predictive of knowledge acquisition, but are unrelated to many dimensions of clinical performance.

Clinical Competence↗

PubMed2004

Growth of knowledge in psychiatry and behavioural sciences in a problem-based learning curriculum.

PURPOSE: To evaluate the effectiveness of undergraduate medical education in the domains of psychiatry and behavioural sciences, we examined the growth of knowledge in those disciplines in a 6-year, problem-based learning (PBL) curriculum. Psychiatry and behavioural sciences are taught in the 4 preclinical years and in the psychiatric clerkship. The integrative nature of this PBL curriculum led us to hypothesise that the knowledge growth curves for these disciplines are similar and show a steady upward trend throughout the curriculum. METHODS: All items pertaining to psychiatry and behavioural sciences in the progress tests administered in the period from September 1993 through May 2001 were identified. For those items, the percentage of correct scores in the 6 year groups were considered a multivariate observation reflecting knowledge growth across the 6-year programme. RESULTS: Knowledge growth for psychiatry and behavioural sciences increased significantly, from 12% to 59% and from 28% to 60%, respectively, between Year 1 and the end of Year 6. Apparently, students know more about behavioural sciences than about psychiatry when they enter medical school, but this difference vanishes in the last 2 years of training. Moreover, the growth curves for psychiatry and behavioural sciences started to level off after Years 3 and 4, respectively, with no additional significant growth in any of the later years. CONCLUSIONS: Psychiatry and behavioural sciences showed different patterns of knowledge growth and the 2 growth curves levelled off in Years 5 through 6. Because a student-centred, horizontally and vertically integrated PBL curriculum is aimed at effecting steady growth in knowledge in all disciplines, the slowdown in growth in the later years was among the reasons for initiating a major curricular innovation in 2001.

Behavioral Sciences↗

PubMedDate not supplied

Knowledge profile and control in diabetic patients.

Knowledge about diabetes was assessed using a previously described interactive computer-based questionnaire in 79 patients with insulin-dependent (IDDM) and 72 with non-insulin-dependent (NIDDM) diabetes mellitus routinely attending a single diabetic clinic. Simple linear correlation of total knowledge score with glycosylated haemoglobin (HbA1c) showed no significant relationship for either IDDM (r = 0.12: p = 0.18) or NIDDM (r = 0.15: p = 0.1). However, quintile grouping of knowledge scores showed the mean HbA1c to be significantly higher in the lowest scoring NIDDM quintile (10.6 +/- 0.5: +/- SE) with respect to the pooled mean of all the higher scoring quintiles (9.0 +/- 0.3) (p = 0.027). Mean HbA1c (9.6 +/- 0.5) was also higher in the least knowledgeable IDDM quintile than any other quintile group (range 8.8-9.0) but this was not significant with respect to the pooled mean of higher scoring patients (p greater than 0.1). The mean age of the lowest scoring IDDM quintile group (60.5 +/- 13.9 years) was significantly higher (p less than 0.01) than higher scoring IDDM groups (mean age range 36.5-43.3 years) but age was not significantly related to HbA1c in IDDM subjects. IDDM showed greater knowledge of diabetes than NIDDM but ignorance in key areas was unacceptably high in both diabetic subtypes, indicating that regular knowledge assessment and educational reinforcement may be essential for good diabetic control as well as patient safety, particularly in older IDDM patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed2005

Teachers' knowledge about adolescents: an interview study.

This paper presents the results of an interview study of twelve high school teachers to ascertain their general knowledge about adolescents, as well as their knowledge of issues important to adolescents. The results were as follows: (a) teachers lacked knowledge about what adolescents in previous studies have referred to as important issues in their lives; (b) teachers' general knowledge about adolescents was mainly based on experiential, as opposed to theoretical, knowledge; and (c) teachers were not interested in theoretical knowledge about normal adolescent development. These results are discussed in relationship to the Swedish school system, as well as their relationship to teacher training, which traditionally has focused on the what and how aspects of teaching, not on the aspect of whom one is teaching.

Adolescent↗

PubMedDate not supplied

Social support, knowledge of infant development, and maternal confidence among adolescent and adult mothers.

OBJECTIVE: To explore the influence of social support and knowledge of infant development on maternal confidence in performing infant care tasks among adolescents and adults. DESIGN: Descriptive, exploratory. SETTING: A large urban teaching hospital in the midwestern United States. PARTICIPANTS: 116 adolescent mothers (ages 13 to 19 years); 101 adult mothers (ages 20 to 41 years). MAIN OUTCOME MEASURES: Adult mothers reported higher levels of knowledge about infant development than did adolescent mothers. For both adolescent and adult mothers, social support and knowledge of infant development were significantly correlated with confidence in providing infant care. For adolescents, knowledge of infant development explained 15% of the variance in maternal confidence scores, and the number of people in the adolescent's household explained an additional 5%. For adults, parity explained 10%, social support explained 9%, and knowledge of infant development explained 4% of the variance in maternal confidence scores. CONCLUSIONS: An adolescent's knowledge of infant development significantly affects her confidence in providing infant care. Given the learning needs of new mothers and the time constraints for in-hospital postpartum teaching, nurses may need to adjust content and teaching methods for all new mothers, but especially to meet the needs of adolescent mothers.

Adolescent↗

PubMed1989

Guttman scale analysis of dental health attitudes and knowledge.

Indexes on attitudes and knowledge are very often used in community dentistry research. However, such indexes are seldom evaluated with respect to validity. In the social sciences, complicated and advanced scaling methods are widely used. One of the methods, The Guttman scaling, is a means of analyzing the underlying characteristics of several items in order to determine whether the scale is unidimensional and cumulative. The purpose of the present study was to develop and evaluate two Guttman scales: 1) attitudes to prevention of dental diseases and 2) knowledge about sugar and caries. The scales were evaluated on the basis of survey data on health behavior, dental attitudes and knowledge among parents of Danish children 6 years of age. A total of 193 parents (71% of original sample) responded to a postal questionnaire including questions on attitudes to prevention of dental diseases and knowledge about sugar and caries. In the analyses, the scales were evaluated according to standard criteria of scalability: Coefficient of Reproducibility, Minimal Marginal Reproducibility, and Coefficient of Scalability. The analyses showed that unidimensional and cumulative scale was indicated for attitudes to prevention while the scale on knowledge about sugar and caries failed on the criteria of validity. In community dentistry, future studies ought to be more concerned with the construction and testing of scaling models in order to provide valid analyses of dental health attitudes and knowledge.

Adult↗

PubMed1994

Specialized Travel Consultation Part I: Travelers' Prior Knowledge.

Studies have shown that more than one third of all travelers to tropical countries experience an illness while abroad. Naiveté about diseases, such as malaria, travelers' diarrhea, cholera, and HIV infections, appears to be the most crucial factor determining travel-related morbidity rates. A study was designed both to evaluate the level of disease-related, pretravel knowledge prior to a specialized travel clinic consultation as well as to correlate the level of knowledge with demographic and travel variables and previous travel experience. Using a self-administered questionnaire, data were collected from 167 clients who attended the Hospital for Tropical Diseases Travel Clinic, London, England, in June 1991. The questionnaire evaluated clients' knowledge and attitudes of travel-related diseases, their prevention and treatment, and the scores were analyzed using the Statistical Analysis System software, Version 5. Predictors for increased knowledge scores were examined by a one-way layout model comparing disease knowledge scores with variables such as sex, age, socioeconomic class, ethnic background, previous travel experience, type and duration of travel, destination, accommodation quality, and health insurance coverage. A step-down regression model was constructed to control for the effects of the many mutually confounding factors. Travelers' diarrhea and malaria risk at destination were acknowledged by more than 85% of the respondents, and 60% of the questions on travelers' diarrhea prevention, compared to 81% of those on malaria prevention, were answered correctly. Significantly, however, only one half of the respondents indicated that they would take appropriate measures concerning diarrhea while abroad. Stepwise regression identified previous travel experience, pretravel advice, traveling for work purposes, and using backpack overland tours as significant predictors of high knowledge. This study points out the necessity of pretravel education and that it should focus not only on malaria but also on other travel-related diseases like travelers' diarrhea. As well, target groups for whom more detailed information should be provided are identified, including inexperienced travelers, those using organized tours and sleeping indoors, those planning to visit friends or relatives, and those who have not received sufficient pretravel health advice.

Journal Article↗

PubMed1999

Knowledge of travel medicine providers: analysis from a continuing education course.

BACKGROUND: With millions of international travelers, there has been an increase in the scope and variability of travel medicine providers. A study was conducted to measure the baseline knowledge of providers, determine factors affecting this knowledge, and assess acquisition of knowledge after a continuing education course. METHODS: A one-day continuing medical education course was held for health care professionals interested in travel medicine. Prior to the course, attendees completed a test determining knowledge in malaria chemoprophylaxis, traveler's diarrhea management, vaccines, jet lag, the returned traveler, and other areas. An identical test was given after completion of the course. Performance on the test was analyzed by profession, area of specialty training, and experience in travel medicine. RESULTS: Seventy-seven attendees completed the precourse test. Forty-eight percent were physicians and 47% were nurses; 29% specialized in infectious diseases, 22% in occupational medicine and student health, and 18% in family or internal medicine; 60% had >/= 1 year of travel medicine experience while 20% had no experience. The precourse test score for all participants was 62.7% 6 6.5 (sd). Analysis by profession found that physicians scored the highest (71%). Providers with >/= 1 year of travel medicine experience scored higher than those with no experience (67% vs 53%, p <.01). Statistically significant correlations were found between precourse exam results and profession (+.432, p <.001) and travel medicine experience (+.365, p =.002). No significant correlation was found between precourse exam and area of specialty training. Combined mean score on the postcourse exam improved to 81.8% 6 4.5, an increase of 17.2% over the precourse score for those who took both tests (p <.001). CONCLUSIONS: The profession of the provider and the duration of experience in travel medicine were the most important correlations of baseline knowledge in travel medicine. All groups improved their knowledge following the course.

Clinical Competence↗

PubMed1984

Students' knowledge of child health and development: effects on approaches to discipline.

Unrealistic developmental and behavioral expectations of children, which are associated with child abuse, are related to a lack of knowledge about child development and child rearing. The Iowa Child Development Test (ICDT) was administered to college students to determine their knowledge of child health and development and effects on disciplinary approaches. The results indicated that college students had inadequate knowledge and those who most frequently chose harsh disciplinary methods in simulated child management situations were least knowledgeable. This finding is similar to that reported in an earlier study of high school seniors. College men knew less than college women about child development and health, and more frequently selected harsh punishment. Although noneducation and education majors did not differ with regard to level of knowledge on the ICDT, noneducation majors more frequently chose punish and abuse responses. The findings suggest a need to provide broad-based programs in child rearing education prior to parenthood to reduce the potentiating effects of inadequate knowledge of child health and development on the incidence of child abuse.

Adolescent↗

PubMed1987

Cancer knowledge and acceptance of children with cancer.

In this study, a Cancer Knowledge Questionnaire (CKQ) for elementary schoolchildren was developed and the relationship of cancer knowledge to attitudinal predispositions to accept and interact with children with cancer was assessed. CKQ includes 21 yes-no items that assess general cancer knowledge and knowledge of cancer's effects on social and emotional functioning. A sample of 478 children, ages six-12, completed CKQ, and a separate sample of 41 children completed it on two occasions separated by a one-week interval. Adequate internal consistency and test-retest reliability were obtained. Children's knowledge of cancer increased with age but generally was limited across all age groups. Knowledge of cancer was associated positively with previous experiences with cancer, lower fear of cancer, less worry about children with cancer, and attitudinal predispositions to accept and interact with children having cancer.

Age Factors↗

PubMed1997

General practitioners' knowledge of their patients' psychosocial problems: multipractice questionnaire survey.

OBJECTIVES: To evaluate general practitioners' knowledge of a range of psychosocial problems among their patients and to explore whether doctors' recognition of psychosocial problems depends on previous general knowledge about the patient or the type of problem or on certain characteristics of the doctor or the patient. DESIGN: Multipractice survey of consecutive adult patients consulting general practitioners. Doctors and patients answered written questions. SETTING: Buskerud county, Norway. SUBJECTS: 1401 adults attending 89 general practitioners during one regular working day in March 1995. MAIN OUTCOME MEASURES: Doctors' knowledge of nine predefined psychosocial problems in patients; these problems were assessed by the patients as affecting their health on the day of consultation; odds ratios for the doctor's recognition of each problem, adjusted for characteristics of patients, doctors, and practices; and the doctor's assessment of previous general knowledge about the patient. RESULTS: Doctors' knowledge of the problems ranged from 53% (108/203) of "stressful working conditions" to 19% (12/63) of a history of "violence or threats." Good previous knowledge of the patient increased the odds for the doctor's recognition of "sorrow," "violence or threats," "substance misuse in close friend or relative," and "difficult conflict with close friend or relative." Age and sex of doctor and patient, patient's educational level and living situation, and location of practice influenced the doctor's awareness. CONCLUSIONS: Variation in the patients' communication abilities, the need for confidence in the doctor-patient relationship before revealing intimate problems, and a tendency for the doctors to be entrapped by their expectations may explain these findings.

Adolescent↗