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Dietary status of lactating women. II. Relation of nutritional knowledge and attitudes to nutritional intake.

Dietary practices of sixty-one nursing mothers who had been breast-feeding their infants an average of four months were examined in relation to their knowledge of nutrition and their attitudes about nutrition, taking vitamin supplements, meal preparation, and meal planning. The women were fairly knowledgeable about nutrition, and most exhibited an attitude that "nutrition is important". Nutritional knowledge, as measured by performance on a reliable test instrument, correlated well with the attitude that "nutrition is important" and with education. Nutritional knowledge also correlated well with four dietary factors used as dependent variables. Associations between nutrition-related attitudes and dietary factors were much less strong. Path analysis was used to test the knowledge-to-attitudes-to-behavior paradigm. Results, using multiple regression analysis, indicated that this model was not supported by the data. Rather, path analysis supported the model of attitudes-to-knowledge-to-behavior. This research suggests that nutrition education programs should adopt, as a primary goal, that of instilling positive attitudes about nutrition and demonstrating to learners that "nutrition is important". Once such attitudes have been formulated, ability to learn and comprehend nutritional facts and concepts will be facilitated, thus resulting in improved dietary intake of crucial nutrients.

Adult↗

Hypertension knowledge in a Hispanic community.

Hypertension knowledge of 330 Hispanic subjects was assessed in a community study using a Hypertension Knowledge Interview Schedule (HKIS). Six areas of hypertension knowledge, including definition, etiology, diagnosis, risk factors, treatment, prognosis, and sequelae were assessed. Of the subjects, 64 percent had adequate knowledge and 34 percent inadequate knowledge of hypertension. Only 28 percent knew the correct definition; only 3 percent knew that the etiology was unknown. The Hispanic subjects were knowledgeable about risk factors and treatment. More than half the Hispanics were aware of the cardiovascular sequelae of hypertension.

Adolescent↗

Pediatric critical care nurses' knowledge of cardiac dysrhythmias.

OBJECTIVE: To describe pediatric critical care nurses' knowledge of dysrhythmias in critically ill pediatric patients and relate this knowledge level to certain demographic variables (education, nursing experience, certification, supplemental training, area of employment and geographic region of residence). DESIGN: A descriptive survey. SETTING: American Association of Critical-Care Nurses' 19 geographic regions of the United States. PARTICIPANTS: Of 1000 questionnaires mailed to pediatric critical care nurses who were members of the American Association of Critical-Care Nurses in 1991, 356 responses were received (a response rate of 36%). INTERVENTION: A criterion-referenced, self-administered test regarding pediatric dysrhythmias and a demographic sheet randomly mailed to 1000 pediatric critical care nurses. Test results were analyzed and compared with demographic variables. RESULTS: The mean total test score was 66%. Significantly higher total test scores and selected subtest scores were demonstrated in relationship to the following variables: increased age; certification in pediatric advanced life support, advanced cardiac life support or adult critical care; increased years of adult critical care experience; advanced dysrhythmia courses and dysrhythmia self-study; and perceived knowledge level above that of the advanced beginner. CONCLUSIONS: Pediatric critical care nurses' overall knowledge of dysrhythmias was low. Knowledge strengths included recognition of basic and life-threatening dysrhythmias and calculation of basic ECG measurements. Knowledge deficits included importance of sinus bradycardia in the neonate, appropriate intervention for life-threatening dysrhythmias and calculation of an irregular heart rate. These deficits should be considered when planning continuing education programs for pediatric critical care nurses.

Adult↗

[Clinical knowledge--facts or something more? Some theoretical views].

Origins, contents and validation procedures of medical knowledge are rarely discussed in medicine. Clinical knowledge is the core of medicine. Analysis of the procedures and strategies for seeking clinical knowledge, and the content of this knowledge, may enlighten the development of medical theory as well as constitute a basis for quality assurance of medical practice. The article presents epistemological challenges related to analysis of clinical knowledge, and delivers some theoretical frames of reference (postmodernism, pragmatism, practice theory and feminism) with a potential to provide a broader understanding of the medical field--acknowledged as living knowledge produced through human interaction.

Clinical Competence↗

Arden syntax and GALEN terminology support: a powerful combination to represent medical knowledge.

Arden syntax is an ASTM standard defined a few years ago to represent rule-based knowledge in the medical domain in an application- and implementation-independent way. Knowledge is expressed as Medical Logic Modules (MLMs). So far, it has mainly been used for providing critique and reminders in data driven, medical decision support systems, where typically rules are evoked by certain database operations (e.g., "store systolic blood pressure"). The syntax is an important step towards a general medical knowledge representation, with version control, maintenance information, arithmetic operations, logic rule syntax, and temporal operations, but it is not yet complete. The standard does not define how medical concepts (e.g., "systolic blood pressure") are to be referenced. Existing coding schemes such as SNOMED and ICD10 may be used for this, but they have generally failed to provide the required level of detail. The use of Arden syntax to transfer knowledge between centers in the form of MLMs has been shown to be non-trivial [1,2]. GALEN (Generalized Architecture for Languages, Encyclopedias, and Nomenclatures in Medicine) is an EC AIM project aiming at a machine-readable system to represent medical concepts in a semantic network. The network allows for the combination and specialization of concepts to the required level of detail. The project has resulted in a notation (GRAIL: GALEN Representation and Integration Language) and several tools, such as browsers for manipulating medical concepts. In a GALEN subproject, we are exploring the potential utility of combining Arden syntax with semantics from the GALEN terminology, and we are developing tools to facilitate the creation of MLMs with terminology support. Our impression is that the combination is very useful: GALEN tools allow a domain expert to express her knowledge in purely medical terms, independent of an actual or intended patient database structure and data representation. They can also help a knowledge engineer or quite possibly an automatic interpreter to translate a well defined medical concept (expressed in GRAIL) to actual database queries (in SQL or other notation). This translation can be facilitated by a Data Dictionary describing the local patient database.

Expert Systems↗

Assessment of the level of the actual and desirable levels of computer literacy, usage and expected knowledge of undergraduate students of nursing.

The aim of the study was to determine the perceptions of students entering nursing at the bachelors level, of their actual and desirable knowledge about computers and their applications relevant to nursing and health care. Within the health care system the use of computerized systems is increasing rapidly. In Australia, the NSW Health Department's Information Management Resource Consortium pilot project--to introduce the First Data Hospital Information System into NSW public hospitals--is a significant example of this trend. While the importance of computerized systems is fairly well recognized for the areas of management and research, they are becoming increasingly significant in the delivery of clinical care and quality assurance. It is important that nurses during their undergraduate education develop the computer literacy and awareness that will allow them access to the both the information and its management. To achieve this effectively it is essential to determine both the entry knowledge of students and what skills and knowledge are essential and desirable for their future roles as nurses. The research undertaken replicated an American study [2] and used their validated questionnaire. Both pre-registration(n=20) and post-registration (n=24) undergraduate students responded to a 21 item questionnaire. The issues addressed related to computer literacy, usage, and knowledge of clinical applications. Both groups desired more "hands on" experience and knowledge in the nurse's role in developing applications and using computers to help care for patients. These results were consistent with the Parks et. al. study. The significance of comparing actual and desirable levels of computer knowledge and awareness is in assisting educators to shape curriculum and course content to more effectively meet the educational needs of these groups in terms of Health Informatics.

Attitude to Computers↗

Effective domain-dependent reuse in medical knowledge bases.

Knowledge reuse is now a critical issue for most developers of medical knowledge-based systems. As a rule, reuse is addressed from an ambitious, knowledge-engineering perspective that focuses on reusable general purpose knowledge modules, concepts, and methods. However, such a general goal fails to take into account the specific aspects of medical practice. From the point of view of the knowledge engineer, whose goal is to capture the specific features and intricacies of a given domain, this approach addresses the wrong level of generality. In this paper, we adopt a more pragmatic viewpoint, introducing the less ambitious goal of "domain-dependent limited reuse" and suggesting effective means of achieving it in practice. In a knowledge representation framework combining objects and production rules, we propose three mechanisms emerging from the combination of object-oriented programming and rule-based programming. We show these mechanisms contribute to achieve limited reuse and to introduce useful limited variations in medical expertise.

Artificial Intelligence↗

Comparison of the genetic knowledge among nurses, students, and general public after ten years of implementation of genetic health program in Taiwan.

This study aims to explore the genetic knowledge of different health professional, and non-professional populations after ten years of implementation of genetic health program in Taiwan. A self-administered questionnaire was developed to test the genetic knowledge of 885 respondent who included 361 community health nurses, 74 maternal-child nurses, 364 college students, and 86 members of the general public. The questionnaire included 33 questions which were divided into 4 categories (1) basic genetic knowledge, (2) Mendel's Law and probability, (3) prenatal diagnosis, (4) identification of common genetic disorders. The responses were scored and analyzed statistically with ANOVA tests. Community health nurses had the highest scores of genetic knowledge. However, they need more practice in the application of Mendel's Law and probability. Maternal-child nurses should be involved in genetic education programs and improve their ability to identify common genetic disorders and thus increase their ability to identify cases and provide better information to patients and families. Compared to other groups, college students had lower scores in prenatal diagnosis and identification of common genetic disorders. Therefore, college curricula in genetics need to emphasize more on these subjects. From the study, it was concluded that community health nurses are effective and competent to continue the genetic education as supported by the government in the past ten years. Maternal-child nurses are inevitably involved in genetic service, and they should be provided with suitable continuing education programs. The general public should strengthen their knowledge of prenatal diagnosis and common genetic disorders. Prenatal diagnosis should be added in the school curriculum of college students to expand their knowledge. New genetic technology, such as DNA analysis, should be added in the content of genetic education programs.

Adult↗

Toddlers' acquisition of self/other knowledge: ecological and interpersonal aspects of self and other.

The complexity of toddlers' self-development was examined in the context of knowing others. Two studies were designed to test whether toddlers' self-knowledge was different from their knowledge of others (e.g., mother and inanimate object) or whether toddlers' knowledge of persons (e.g., self and mother) was different from their knowledge of objects. Knowledge of self, mother, and inanimate object was observed in developmentally sequenced tasks assessing agency and featural knowledge. When the inanimate object was perceptually different from humans, 12-month-old toddlers responded differently to all 3 versions. When the inanimate object was perceptually similar to humans, 24-month-olds distinguished self from other and did not distinguish between the 2 versions of "other:" mother and inanimate object. We concluded that 12-month-old infants were more sensitive to perceptual features of objects than were older toddlers. Data were interpreted according to Neisser's distinction between the ecological self and the interpersonal self.

Age Factors↗

The development of display rule knowledge: linkages with family expressiveness and social competence.

The development of display rule knowledge and its associations with family expressiveness (Study 1) and peer competence (Study 2) were investigated among elementary school children. In Study 1, the display rule knowledge of 121 kindergartners and third graders was assessed using validated hypothetical scenarios. There were significant grade differences in display rule knowledge such that third graders compared to kindergartners more frequently combined expression regulation with prosocial reasoning, norm-maintenance, and self-protective motives. Maternal reports of family emotional climates indicated that aspects of negative expressiveness were related positively to self-protective display rules and negatively to prosocial display rules. Study 2 included 93 third and fifth graders who reported on their display rule knowledge and on their emotional reactions and strategies to resolve peer conflict. Classmates and teachers provided ratings on social competence. Age differences for display rule knowledge were not documented, but prosocial display rules were most consistently related to hypothetical peer conflict responses and social competence. The findings confirm that display rule knowledge is related in consistent and systematic ways to what children learn within the family emotional context, how they propose to resolve peer conflict, and how they are perceived by peers and teachers.

Child↗

Knowledge about smoking, reasons for smoking, and reasons for wishing to quit in inner-city African Americans.

OBJECTIVE: To determine knowledge about smoking, reasons for smoking, and reasons for wishing to quit and the association of these variables with abstinence at ten weeks and six months. DESIGN: Descriptive study and longitudinal intervention. SETTING: Inner-city public hospital clinics. PARTICIPANTS: 410 African-American cigarette smokers interested in quitting were surveyed at baseline and subsequently enrolled into a double-blind, placebo-controlled, randomized trial of the transdermal nicotine patch. MAIN OUTCOME MEASURES: Descriptive information about smoking knowledge, reasons for smoking, and reasons for wishing to quit, and association of these variables with abstinence at 10 weeks and 6 months. RESULTS: Among the 410 patients randomized, mean age was 48 years, 61% were female, 41% had less than a high school education, 51% had an annual household income less than $8,000, and the average number of cigarettes smoked a day was twenty. The average number of questions answered correctly was nine out of eleven (84%). The most cited reason for smoking was relaxation/tension reduction and the least cited were stimulation and handling of the cigarette. Ninety-nine percent of patients stated they wished to quit for health reasons. Knowledge, reasons for smoking, and reasons for wishing to quit were not significantly associated with 10-week or 6-month abstinence. CONCLUSIONS: In this group of inner-city African-American smokers, knowledge about cigarette smoking was high. Reasons for smoking were related to relaxation, craving, and pleasure, and reasons for wishing to quit were largely health-related. Knowledge, reasons for smoking, and reasons for wishing to quit were not associated with 10 week or 6 month abstinence. Since knowledge about smoking is already high, future efforts should be directed at promoting cessation through proven behavioral and pharmacological approaches, rather than didactic patient education.

Administration, Cutaneous↗

Reproductive health in males with cystic fibrosis: knowledge, attitudes, and experiences of patients and parents.

Males with cystic fibrosis (CF) are generally infertile as a result of aberrant development of Wolffian duct derivitives. The personal significance of this and related reproductive and sexual health (RSH) issues is unknown. We set out to describe the knowledge, attitudes, and experiences regarding RSH in a group of adolescent and adult males with CF, as well as the knowledge and attitudes of parents. This descriptive study was based on a semi-structured interview utilizing in-depth interview techniques. Questions included aspects of knowledge, attitudes, and experiences. Adolescent (aged 14-17 years) and adult (at least 18 years) males attending the Children's Hospital Cystic Fibrosis Clinic, Boston, MA, USA, or hospitalized at the Children's Hospital over that period were eligible; the accompanying parent of the adolescent was also interviewed. Consecutive eligible males were interviewed over a 3 month period. Summary data are presented, attitudinal data are analyzed qualitatively, and a selection of representative transcript data are reported to describe the range of opinions. Fifty males (10 adolescents, 40 adults) participated; this constituted a consecutive sample of 44% of the eligible clinic population. Ninety percent of adults, 60% of adolescents, and 50% of parents knew of male infertility. The mean age (+/-SD) at which adults recalled first hearing this was 16.0 +/- 4.7 years and 13.9 +/- 1.6 years for those adolescents who knew of infertility. Nineteen (48%) of adults and 5 (83%) of adolescents first heard about infertility from their health care providers. Ninety percent reported no major distress upon first hearing about infertility during adolescence. Increasing significance of infertility with maturity was reported by 12 men (30%); only 4 adults (10%) reported that infertility was not a significant aspect of CF. Forty percent knew that males with CF have a small volume ejaculate, but none had been told this by a health care provider. Thirty percent of men had semen analysis performed and all were azoospermic. We conclude that the majority of males with CF know of likely infertility. The significance of this knowledge changes with time. Poor knowledge and confusion surround a range of RSH issues in males with CF.

Adolescent↗

Knowledge, attitudes and practices of Greek health professionals, in relation to AIDS.

In order to improve educational programmes directed at health care workers we investigated their knowledge, attitudes and practices in relation to HIV/AIDS. An anonymous self-administered questionnaires was distributed to 609 health care workers. Of these, 59.6% agreed to participate (42.4% of the medical doctors, 74.3% of the nurses and 79.6% of the laboratory technicians, health visitors and other health care workers). All studied groups believed that their knowledge of HIV modes of transmission (84.3%) was sufficient. In contrast, a relatively small percentage reported knowledge of the clinical spectrum of HIV infection (48.8%) and the diagnostic assays (57.6%). Nearly all the study participants believe (92.8%) that there is a risk of acquiring HIV infection during the hospitalization of HIV/AIDS patients. Obligatory screening of all patients was reported by nearly all participants (90.6%) as a chance to minimize their occupational risk. Although health care workers reported satisfactory knowledge of safety measures (87.0%), only 56.7% used gloves and 38.8% accept the hospitalization of HIV/AIDS patients. In spite of the educational programmes for AIDS in Greece, this study demonstrates that health professionals' knowledge and precautionary measures are not sufficient. As a result, a small percentage of them treat AIDS patients without discrimination. There is an urgent need to implement specific educational programmes for health professionals so that they will safely provide high quality care to people affected by HIV/AIDS.

Acquired Immunodeficiency Syndrome↗

The knowledge, attitudes and perceived support of Tanzanian nurses when caring for patients with AIDS.

In the literature on AIDS, much attention has been paid to the Western health care workers' knowledge of and attitudes toward AIDS. Little is known of the knowledge and attitudes of health care workers of developing countries. This study provides a descriptive and comparative examination of Tanzanian nurses' knowledge of, and attitudes towards AIDS and their perceived support when caring for patients with AIDS. A self-completing questionnaire was used to collect data. Questionnaires were completed and returned by 172 of the 180 nurses to whom they were distributed, a response rate of 95.5%. A random sample of 45 nurses was chosen from each hospital--two teaching and two regional hospitals. Data analysis included descriptive statistics, t-test, correlation coefficient, ANOVA and multiple regression. The research revealed that 96% of Tanzanian nurses appeared to have a satisfactory or passing level of knowledge about AIDS. However, they are overly cautious and have negative attitudes toward the care of patients with HIV/AIDS. They lacked knowledge regarding transmission and risk factors and indicated fear of contagion (AIDS-phobia). Most nurses indicated that they had a supportive working environment (informal support groups) in their working areas, but few formal supports and little in-service education. Further, they received support from their family and friends.

Acquired Immunodeficiency Syndrome↗

Attitudes, knowledge, and behavioral control regarding child abuse reporting in middle eastern nursing professionals: A systematic review and meta-analysis.

INTRODUCTION: Child abuse is critically underreported in the Middle East, with up to 90% of cases going unidentified. Nurses play a central role in child protection systems, yet factors influencing their reporting practices in this region have not been comprehensively synthesized. This study aims to review systematically and meta-analyze evidence on Middle Eastern nurses' knowledge, attitudes, and perceived behavioral control regarding child abuse reporting. METHODS: We conducted a systematic review and meta-analysis following PRISMA guidelines. Five databases (PubMed, Scopus, Web of Science, Embase, Cochrane Library) were searched through November 2025. Studies targeting nursing professionals or students in Middle Eastern countries assessing knowledge, attitudes, intention to report, subjective norms, or perceived behavioral control were included. Random-effects meta-analyses were performed with subgroup analyses comparing students and practicing nurses. RESULTS: Fourteen studies comprising 4018 participants across six countries met the inclusion criteria. The pooled knowledge score was 61.64% (95% CI: 50.14-73.14), with nursing students scoring higher than practicing nurses (75.28% vs. 54.79%, p = 0.03). The pooled attitude score was 60.69% (95% CI: 44.82-76.57). Educational interventions significantly improved knowledge (SMD = 1.54, 95% CI: 0.70-2.38, p = 0.0003). The pooled proportion of nurses intending to report suspected abuse was 75% (95% CI: 0.58-0.92). The pooled subjective norm score was 8.02 (95% CI: 7.75-8.29), and the pooled perceived behavioral control score was 24.34 (95% CI: 22.20-26.46). High heterogeneity (I2 > 95%) reflects substantial variability in educational and legal contexts across the region. CONCLUSIONS: Middle Eastern nurses show moderate knowledge and attitudes toward child abuse reporting, with notable gaps among practicing professionals. Educational interventions are effective but should be integrated with systemic reforms, including mandatory reporting legislation and clear protocols.

Humans↗

Female genital mutilation knowledge, attitudes and training needs among health professionals in non-practicing countries: A literature review.

BACKGROUND: With increasing globalization and migration, the number of women affected by female genital mutilation who reside in countries where the practice is not traditionally performed is constantly increasing. Healthcare providers in these settings are required to address the complex health needs of this vulnerable population. We aimed to synthesize recent literature on their knowledge, preparedness, and educational background. METHODS: We conducted a systematic review across PubMed, Scopus and Embase, identifying papers published from January 2015 onwards, examining providers' knowledge, education and attitudes toward female genital mutilation in non-practicing countries. Both quantitative and qualitative observational studies were eligible. Given heterogeneity in study populations, outcome definitions, and assessment tools, findings were synthesized narratively. The review protocol was registered with the International Prospective Register of Systematic Reviews (CRD420251044761). FINDINGS: 1046 records were screened by title and abstract, and 140 full-text articles were assessed for eligibility. 31 studies met the inclusion criteria (23 quantitative, 8 qualitative). Many providers reported clinical experience with women affected by female genital mutilation, yet substantial variability was observed in knowledge, training, and attitudes. Gaps were particularly evident regarding legislation, World Health Organization classification, clinical guidelines, referral pathways, workplace protocols. Midwives and younger professionals tended to demonstrate higher knowledge levels. Training exposure ranged from 5% to 91%, and many participants perceived it as insufficient. Qualitative findings echoed these patterns, highlighting challenges in female genital mutilation classification, legal awareness, documentation systems, the impact of providers' cultural beliefs on care delivery. CONCLUSION: Considerable efforts are needed to equip healthcare providers to deliver high-quality, culturally competent care to women affected by female genital mutilation. Research should develop validated tools to assess preparedness, adopt mixed-methods strategies to capture patient and provider perspectives, and guide standardized, up-to-date training programs, strengthening knowledge in managing female genital mutilation.

Humans↗

Biological and physiological knowledge and skills of graduating Finnish nursing students to practice in intensive care.

This study describes the basic biological and physiological knowledge and skills of graduating nurse students in Finland against the requirement of their being able to practice safely and effectively in intensive care. The study describes also their interest and willingness to work in intensive care. Measurements were based on the Basic Knowledge Assessment Tool (BKAT-5) developed by Toth in the United States. The sample consisted of 130 nursing students graduating in December 2001 and January 2002. The data were analysed statistically. The students were most knowledgeable in the areas of appropriate precautions, living will and medical calculation, followed by neurology and endocrinology. Scores were poorest for pulmonary, gastrointestinal and cardiovascular knowledge. Intensive care studies and the desire to work in intensive care correlated significantly with the respondents' basic intensive care knowledge. It is important for nursing education to concentrate on developing those areas of intensive care studies where the performance of students is weakest.

Adult↗

The influence of type of information, somatization, and locus of control on attitude, knowledge, and compliance with respect to the triphasic oral contraceptive Tri-Minulet.

The possibility of improving attitude, knowledge, and compliance with respect to the oral contraceptive (OC) Tri-Minulet (Wyeth, Hoofddorp, The Netherlands) by supplying brochures and information on audiotape was studied in 1239 healthy women, aged between 15 and 45. One group was orally informed, a second group additionally received brochures, and a third group received, in addition to the above two, information on audiotape. At baseline and after the first and third cycle, OC-attitude, missed pill handling, and compliance were assessed. Somatization and locus of control were also assessed. Knowledge of the medical advantages of the pill was increased by the audiotape and the compliance by the combination of brochures and audiotape. The brochures alone and in combination with tape improved the knowledge of how to handle missed pills. In somatizers and externals, who particularly showed a poor knowledge and a negative pill-attitude, this knowledge was increased by the combination of brochures and tape.

Adolescent↗