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Adolescent sexuality and sexually transmitted diseases: attitudes, beliefs, knowledge, and values.

This study described rural adolescents' attitudes, beliefs, knowledge, and values with regard to sexuality and sexually transmitted diseases (STDs). Rotter's Social Learning Theory (1954) provided the theoretical framework for this descriptive, correlational design. The convenience sample consisted of 170 students from one rural high school. Consistent with past studies, results included the following: participants had more correct than incorrect knowledge related to sexual intercourse and STDs; the majority had positive attitudes toward condom use and believed it was OK for peers to have sex with a "steady;" the value of an exciting life correlated positively with attitudes toward sex; knowledge of sexual intercourse correlated positively with attitudes toward condom use; and the value health correlated positively with knowledge of sex and attitudes toward condom use, and negatively with attitudes toward sex. The findings in this study suggest the need for ongoing research with adolescents in the area of sexuality and STDs. Additionally, the findings support past studies, which revealed that knowledge of sexual intercourse and STDs has little impact on attitudes toward sexual intercourse. With the serious nature of some of the undesired consequences of adolescent sexual behavior, current and accurate information on this population is needed to assist health educators in developing interventions in this area.

Adolescent↗

Nutrition knowledge, attitude and practice among primary care physicians in Taiwan.

OBJECTIVE: To investigate nutritional knowledge, attitude and practices among primary care physicians in the Taiwan area. METHOD: A closed-end questionnaire containing 26 knowledge questions, 12 attitude statements and 12 practice statements was mailed to physicians on the mailing list of the National Health Administration (NHA). RESULTS: The data reported are based on the responses of 27% of the total 1210 primary care physicians in the Taiwan area. Physicians answered 59% of the total knowledge questions correctly, with a tendency to score higher on general knowledge than clinical nutrition. The majority of physicians tended to agree with the positive-attitude statements and disagree with the negative-attitude statements. The performance of physicians regarding personal practices was less than that for job-related practices. CONCLUSIONS: This nationwide survey of nutrition-related knowledge and practices demonstrates the need for nutrition education for physicians. The questionnaire may be a useful instrument for future educational strategies in Taiwan.

Adult↗

Using a knowledge, attitudes and practices survey to supplement findings of an outbreak investigation: cholera prevention measures during the 1991 epidemic in Peru.

BACKGROUND: To assess the effectiveness of the cholera prevention activities of the Peruvian Ministry of Health, we conducted a knowledge, attitudes, and practices (KAP) survey in urban and rural Amazon communities during the cholera epidemic in 1991. METHODS: We surveyed heads of 67 urban and 61 rural households to determine diarrhoea rates, sources of cholera prevention information, and knowledge, attitudes, and practices regarding ten cholera prevention measures. RESULTS: Twenty-five per cent of 482 urban and 11% of 454 rural household members had diarrhoea during the first 3-4 months of the epidemic. Exposure to mass media education was greater in urban areas, and education through interpersonal communication was more prevalent in rural villages. Ninety-three per cent of rural and 67% of urban respondents believed they could prevent cholera. The mean numbers of correct responses to ten knowledge questions were 7.8 for urban and 8.2 for rural respondents. Practices lagged behind knowledge and attitudes (mean correct response to ten possible: urban 4.9, rural 4.6). Seventy-five per cent of respondents drank untreated water and 91% ate unwashed produce, both of which were identified as cholera risk factors in a concurrently conducted case-control study. CONCLUSIONS: The cholera prevention campaign successfully educated respondents, but did not cause many to adopt preventive behaviours. Direct interpersonal education by community-based personnel may enhance the likelihood of translating education into changes in health behaviours. Knowledge, attitudes, and practices surveys conducted with case-control studies during an epidemic can be an effective method of refining education/control programmes.

Adolescent↗

AIDS knowledge, risk behaviors, and factors related to condom use among male commercial sex workers and male tourist clients in Bali, Indonesia.

OBJECTIVES: To describe the AIDS/sexually transmitted diseases (STD) knowledge and risk behaviors, and to determine factors related to condom use among male commercial sex workers (CSW) and male tourist clients in Bali, Indonesia. DESIGN: Individual survey interviews were conducted with a sample of 80 male CSW and 100 tourist clients in the Kuta area of Bali. METHODS: Survey interviews included detailed questions on AIDS/STD knowledge, sexual behavior, and psychosocial measures related to risk taking. RESULTS: Most of the male CSW had heard about AIDS and other STD, although some misconceptions about transmission and risks of different sexual practices remained. Both oral and anal intercourse with tourists were common and condom use was far from consistent. Factors related to condom use for anal intercourse with tourist clients were condom beliefs, self efficacy, susceptibility to STD infection, and STD knowledge. Tourist clients were mainly from Australia and Europe and many had paid for sex in other parts of Indonesia as well as in high prevalence countries. Knowledge of AIDS/STD was very good among the tourists and previous experience with STD was common. Factors related to condom use with male CSW were condom beliefs and self efficacy. CONCLUSION: There is a very active and mobile group of male CSW and tourist clients present in Bali. Interventions with these men are needed due to the low level of knowledge about AIDS among CSW, their experience with STD and STD symptoms, and their level of risky sexual behavior.

Acquired Immunodeficiency Syndrome↗

Certification and education: do they affect pressure ulcer knowledge in nursing?

OBJECTIVE: To determine whether wound care certification and education affect nursing knowledge. This study examined pressure ulcer knowledge among registered nurses who were (1) certified in wound care, (2) certified in specialty areas other than wound care, or (3) not certified in any specialty area. DESIGN: A convenience sample of 460 nurses, located in both urban and rural areas, provided demographic information and completed a standardized pressure ulcer knowledge test using (Pieper Pressure Ulcer Knowledge Tool). RESULTS: The mean standardized test score for the total sample was 78%, with nurses certified in wound care scoring 89%, nurses certified in specialties other than wound care scoring 78%, and nurses receiving no certification scoring 76.5%. CONCLUSION: Wound care certification and education significantly affect nursing knowledge.

Adult↗

How can everyday practical knowledge be understood with inspiration from philosophy?

Many nursing scholars are inspired by philosophy when investigating phenomena within nursing. This paper focuses on the everyday practical knowledge of nurses. Based on an empirical project carried out in a surgical ward the authors make an attempt, with help from philosophy, at identifying and conceptualizing elements of knowledge in everyday practice. With reference to texts by Heidegger and Wittgenstein the authors investigate two dimensions of nursing knowledge: a dimension of doing and a dimension of being. These dimensions are further developed and concretized in the paper. The doing dimension is emphasized through the concepts of adapting and exploring. The being dimension has its basis in being understanding and being connected. These two dimensions constitute a form of knowledge which is mobile and flexible. This knowledge is in place in everyday situations and it works where it is supposed to work.

Adaptation, Psychological↗

A comparison of AIDS and STD knowledge between sexually active alcohol consumers and abstainers.

Effective curricula should influence knowledge levels of all students, including high-risk populations. In this study, a modified version of the National Adolescent Student Health Survey was administered to a group of eighth and 10th grade students (N = 3,803) exposed to a curriculum designed to improve AIDS and STD knowledge levels. The analysis examined the influence of gender, ethnicity, alcohol use, and sexual activity as they related to AIDS and STD knowledge. Findings indicated poor knowledge scores on STD items, with no significant differences on group comparisons. Comparisons of AIDS knowledge scores indicated significant differences based on gender, ethnicity, and behavior. Females scored higher than males, whites scored higher than blacks, and abstainers from sexual activity and alcohol scored higher than their active counterparts. Results suggest current educational efforts are not equally effective. Future educational initiatives should be sensitive to group membership.

Acquired Immunodeficiency Syndrome↗

Sexual promiscuity: knowledge of dangers in institutions of higher learning.

Knowledge of dangers of sexual promiscuity was assessed in 2 institutions of higher learning. The objectives were to find out the knowledge of medical and social consequences as well as the factors responsible for sexual promiscuity among Nigerian youths. The study also assessed the discrepancies in societal concept of sex norms for males and females. The result was used as an index to determine the need for sex education for Nigerian youths. A total of 200 students (100 from each school) was assessed by random selection and use of a questionnaire. The result showed that students had a fair knowledge of sexual promiscuity, although in terms of medical consequences the knowledge was low for both groups. On social consequences, the knowledge was fair for both groups. Students agreed that lack of financial support and of supervision from parents and teachers were among the causes of sexual promiscuity. Recommendations were made for Health Education in these areas in institutions of higher learning. Also, recommendations were made for parental education on how to bring up, and care for, their adolescents to reduce the problems of sexual promiscuity. It was also recommended that a compulsory course on sexual promiscuity should be included in the syllabus in institutions of higher learning.

Educational Status↗

Effects of bone density feedback and group education on osteoporosis knowledge and osteoporosis self-efficacy in premenopausal women: a randomized controlled trial.

In this 2-yr randomized controlled trial, we examined the effect of bone mineral density feedback and two different educational interventions (an osteoporosis information leaflet and group-based behavioral education [OPSMC]) on osteoporosis knowledge and self-efficacy in 470 women aged 25-44 yr. Osteoporosis knowledge increased across all intervention groups. Women receiving the OPSMC had a greater increase in both short (beta = +1.33, 95% confidence interval [CI] = 0.72-1.94) and long-term (beta = +0.64, 95% CI = 0.0034-1.25) osteoporosis knowledge, compared to those receiving the leaflet. In contrast, a low T-score was associated with a significant increase in long-term (beta = +0.66, 95% CI = 0.0034-1.25) but not short-term (beta = +0.57, 95% CI = -0.036 to 1.17) osteoporosis knowledge, compared to a normal T-score. Changes in osteoporosis self-efficacy were not associated with either low bone mineral density or receiving the OPSMC but were negatively associated with number of children (beta = -0.9, 95% CI = - 1.4 to -0.3) and working more than 20 h per week (beta = -2.7, 95% CI = -4.6 to -0.8). In conclusion, both the OPSMC and bone density feedback increased osteoporosis knowledge but not self-efficacy over 2 yr. Women with children or who worked full time have decreased osteoporosis self-efficacy, suggesting that this group should be a specific target for future interventional strategies.

Adult↗

Teenagers' knowledge of human sexuality and their views on teenage pregnancies.

There is concern about poor knowledge of human sexuality and a high rate of teenage pregnancies among Blacks. The primary aim of the study was to measure the knowledge that teenagers have on human sexuality and to identify the sources from which they obtain such knowledge. The secondary aim was to detect how teenagers perceive the teenage pregnancy problem and its consequences. A descriptive study was undertaken. Questionnaires were handed out and collected from 210 teenagers in two Senior Secondary Schools at a Black township near Empangeni. The study revealed that teenagers have reasonable knowledge about the anatomy and development of the reproductive organs at puberty but lacked sex counselling which resulted in their failure to understand the implications of sexual behaviour. The levels of knowledge an utilisation of the Youth Health Services was found to be low. The study also revealed a high level of awareness of the negative consequences of teenage pregnancies. The teenagers had numerous suggestions to make for the prevention of teenage pregnancies.

Adolescent↗

Emergency contraception: change in knowledge of women attending for termination of pregnancy from 1984 to 1996.

OBJECTIVE: To compare the knowledge of emergency contraception in women attending hospital for termination of pregnancy in 1984 and 1996. DESIGN: A questionnaire survey. SETTING: Ninewells Hospital, Dundee. SUBJECTS: Cohorts of 100 consecutive women undergoing termination of pregnancy in 1984 and 1996. RESULTS: Over this 12 year period, there has been a significant improvement in the knowledge of emergency contraception. Seventy three per cent had a good knowledge of the postcoital pill in 1996 compared to 12 per cent in 1984 (p=</=0.0001). There has been a significant rise in the use of condoms (60 per cent vs 32 per cent; p=</=0.001) and the number of conceptions due to condom accidents (38 per cent vs eight per cent; p=</=0.0001). Although most women in the 1996 cohort recognised a reason for contraceptive failure and had adequate knowledge of emergency contraception, only 17 per cent considered the possibility of pregnancy. CONCLUSION: Poor knowledge of postcoital contraception is no longer a major factor leading to the failure of women to obtain emergency contraception. Improved uptake in the use of emergency contraception is likely to result from a greater awareness of the possibility of condom failure and easier availability of the postcoital pill.

Abortion, Induced↗

Prevalence of gonorrhoea and knowledge of sexually transmitted infections in a farming community in Zimbabwe.

OBJECTIVE: To determine the prevalence of gonorrhoea and knowledge about sexually transmitted infections in a farming community. DESIGN: Cross sectional study. SETTING: Commercial farming area, Zimbabwe. SUBJECTS: 1,005 individuals aged between 15 and 60 years. MAIN OUTCOME MEASURES: Prevalence rates, knowledge of gonorrhoea and other sexually transmitted infections (STIs) by age and sex. RESULTS: Knowledge of gonorrhoea and other STIs was higher while knowledge of AIDS was lower among males than females. Frequency of past history of STIs in five years was significantly higher among males than females (OR 3.22; 95% CI 2.45 to 4.25). Physical examination revealed that 14% of males and 22% of females had other STIs besides gonorrhoea. The prevalence of gonorrhea was 18.4% (95% CI 16.0 to 20.8) and was higher among females than males (OR 2.77; 95% CI 1.97 to 3.90). Thirty one percent of the gonorrhoea infections were due to penicillinase producing Neisseria gonorrhoeae. CONCLUSIONS: Our findings emphasize the disparity between knowledge and practices with regards to STIs, and the importance of STIs as potential targets for and indices in the fight against human immunodeficiency virus (HIV) infection.

Adolescent↗

Knowledge about AIDS and follow-up compliance in patients attending a sexually transmitted disease clinic in the highlands of Papua New Guinea.

In a survey of 300 consecutive new attenders at the Porgera Health Centre Sexually Transmitted Disease Clinic information was obtained regarding knowledge about AIDS from male and female attenders. The differences between the sexes regarding a variety of socioeconomic variables, knowledge about AIDS and their compliance to follow-up appointments were studied as well as possible relationships between these social variables and the degrees of AIDS knowledge and compliance. Males tended to originate from further afield, be more educated, be either in salaried employment or not working at all, and be single as compared to females. They also admitted to more extramarital sexual contacts and received more adequate treatment. Knowledge about AIDS was also significantly higher amongst male attenders and in this group was correlated strongly with overall educational attainment and employment status but did not show any relationship with the number of extramarital contacts admitted to. Only 9% of the patients knew about condoms and their role in prevention. Follow-up compliance was generally poor, and not significantly higher in those with higher scores of knowledge about AIDS, but showed a relationship with the type of disease being treated and with the ultimate adequacy of treatment received.

Acquired Immunodeficiency Syndrome↗

Awareness, perception, and knowledge of heart disease risk and prevention among women in the United States. American Heart Association Women's Heart Disease and Stroke Campaign Task Force.

CONTEXT: One of 2 women in the United States dies of heart disease or stroke, yet women are underdiagnosed and undertreated for these diseases and their risk factors. Informed decisions to prevent heart disease and stroke depend on awareness of risk factors and knowledge of behaviors to prevent or detect these diseases. OBJECTIVE: Assess (1) knowledge of risks of heart disease and stroke and (2) perceptions of heart disease and its prevention among women in the United States. DESIGN AND SETTING: Telephone survey conducted in 1997 of US households, including an oversample of African American and Hispanic women. PARTICIPANTS: One thousand respondents 25 years or older; 65.8% white, 13.0% African American, and 12.6% Hispanic. MAIN OUTCOME MEASURES: Knowledge of heart disease and stroke risks, perceptions of heart disease, and knowledge of symptoms and preventive measures. RESULTS: Only 8% of the respondents identified heart disease and stroke as their greatest health concerns; less than 33% identified heart disease as the leading cause of death. More women aged 25 to 44 years identified breast cancer as the leading cause of death than women 65 years or older. Women aged 25 to 44 years indicated they were not well informed about heart disease and stroke. Although 90% of the women reported that they would like to discuss heart disease or risk reduction with their physicians, more than 70% reported that they had not. CONCLUSIONS: Most women do not perceive that heart disease is a substantial health concern and report that they are not well informed about their risk. Age influenced knowledge to a greater extent than ethnicity. Programs directed at young women that address the effects of lifestyle behaviors on long-term health are needed. Better communication between physicians and patients is also warranted.

Adult↗

Factors influencing knowledge of and adherence to self-care among patients with heart failure.

BACKGROUND: Patient education has been shown to be a key component in comprehensive heart failure management. Few data, however, are available regarding patients' knowledge of and adherence to self-care recommendations for the disease. OBJECTIVES: To assess the knowledge level of and adherence to self-care among patients with heart failure and to determine associated factors. METHODS: We conducted a needs-assessment survey among new patients visiting a heart failure clinic from April 1997 through June 1998. Multiple linear regression analysis was used to assess the factors predictive of patients' knowledge level and adherence behaviors. RESULTS: Of the 113 patients surveyed, 77% were referred by cardiologists and 60% had New York Heart Association class III or IV status. Two thirds of the patients reported receiving information or advice about self-care from health care providers. When asked how much they knew about congestive heart failure, however, 37% said "a little or nothing," 49% said "some," and only 14% said "a lot." Approximately 40% of the patients did not recognize the importance of weighing themselves daily and 27% weighed themselves twice a month or less often. Although 80% of the patients knew they should limit their salt intake, only one third always avoided salty foods. Additionally, 25% of the patients did not appreciate the risk of alcohol use and 36% believed they should drink a lot of fluids. The multiple linear regression analysis indicated that a higher knowledge score was associated with being married, prior hospitalization, and having received both advice and information about self-care from physicians or nurses. A poor adherence behavior score was associated with being unmarried, lower perceived self-efficacy, a lack of knowledge about self-care, and no prior hospitalization. CONCLUSIONS: We observed a gap between patients receiving and absorbing or retaining information on self-care for congestive heart failure supplied by health care providers. Self-care education needs to be directed to outpatients in addition to inpatients.

Adult↗

A survey of knowledge, attitudes, and beliefs of house staff physicians from various specialties concerning antimicrobial use and resistance.

BACKGROUND: Examination of knowledge, attitudes, and beliefs of house staff physicians will be important in developing interventions to improve antimicrobial use and prevent resistance. METHODS: A 75-item survey was distributed to house staff physicians on nonpediatric services in a university teaching hospital. Knowledge was assessed with a 10-question quiz. RESULTS: The survey was completed by 179 (67%) of 269 house staff physicians on 5 specialties. Outside and inside the intensive care unit, 21% and 25% of respondents, respectively, reported that they were using antibiotics optimally. Surgeons were significantly more likely than other physicians to report that they were regularly seeking input into antimicrobial selections (P<.001). Of the 170 physicians who completed the survey, 88% agreed antibiotics are overused in general and 72% also agreed this was the case at their institution (r = 0.56; P<.05); 96% agreed that hospitals in general face serious problems with antibiotic resistance and 93% agreed that their hospital faces these same problems (r = 0.57; P<.05); 97% agreed that better use of antibiotics would reduce resistance; 32% stated that they had not had formal teaching on antimicrobial agents in the last year (medicine residents reported significantly more formal teaching than others [P =.001]); and 90% wanted more education about antimicrobials and 67% wanted more feedback on antimicrobial selections. The mean antimicrobial quiz score was 28%, with medicine residents scoring significantly higher than others (P =.04). Upper-level residents did not perform better than interns. CONCLUSIONS: This survey (1) revealed that house staff are aware of the importance of antimicrobial resistance and believe better antimicrobial use will help this problem and (2) demonstrated differences between specialties with respect to antimicrobial use and knowledge. House staff at our hospital have suboptimal knowledge about antimicrobials, and this knowledge did not increase appreciably over the course of their training. Antimicrobial education is needed and is likely to be well received by house staff physicians in academic centers but may be more effective if it is tailored to specific specialties.

Anti-Bacterial Agents↗

Patterns and knowledge of nonmedical use of stimulants among college students.

OBJECTIVE: To determine patterns and knowledge of nonmedical use of stimulants among a sample of college students. DESIGN: Completion of an anonymous survey consisting of 23 questions designed to explore college student use of medications intended to treat attention-deficit/hyperactivity disorder. SETTING: A private liberal arts college in New England. PARTICIPANTS: Three hundred forty-seven undergraduate students. MAIN OUTCOME MEASURE: Nonmedical use of stimulants. RESULTS: Thirty-one students (9.2%) reported nonmedical stimulant use. Two hundred forty students (71.4%) had peers who used nonprescribed stimulants, 149 (44.3%) knew of peers who made stimulant medication-seeking visits to a physician although they did not believe that they had attention-deficit/hyperactivity disorder, and 178 (53.0%) knew of people who sold stimulants to students. Nonprescription users were significantly more knowledgeable about the effects of stimulants than nonusers, and nonusers whose peers used nonprescribed stimulants were more knowledgeable about the effects of stimulants than nonusers whose peers did not use nonprescribed stimulants. After controlling for age, race, and sex, the variables that predicted nonmedical use of stimulants were beliefs that stimulants help individuals study better, stay awake, and lose weight. CONCLUSIONS: A substantial proportion of college students in this sample were using nonprescribed stimulants. Among nonusers, those whose peers use nonprescribed stimulants were much more knowledgeable about the effects of stimulant use than those whose peers do not use stimulants. This knowledge may confer an increased risk of future nonmedical stimulant use if students become tempted to seek the beneficial effects experienced by their peers.

Adult↗

Childhood cancer survivors' knowledge about their past diagnosis and treatment: Childhood Cancer Survivor Study.

CONTEXT: Adult survivors of childhood cancer are at risk for adverse effects later in life but may have limited access to information about their diagnosis and treatment. This knowledge is necessary to motivate them to seek medical follow-up and to report essential history to health care professionals. OBJECTIVE: To assess knowledge of adult survivors of childhood cancer about their primary cancer diagnosis and associated therapies. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional survey of 635 consecutive survivors (approximately 5%) drawn from 12 156 participants 18 years or older participating in the Childhood Cancer Survivor Study (a multiinstitutional cohort of individuals diagnosed between January 1, 1970, and December 31,1986, at an age <21 years, who had survived 5 years from diagnosis). The survey assessed knowledge of their cancer diagnosis and associated therapies in a 3- to 5-minute telephone questionnaire. MAIN OUTCOME MEASURES: Responses were compared with medical record data for accuracy, sensitivity, specificity, and positive and negative predictive value. RESULTS: Overall, 72% accurately reported their diagnosis with precision and 19% were accurate but not precise. Individuals with central nervous system (CNS) cancer (odds ratio, 5.1; 95% confidence interval, 2.6-9.9) and neuroblastoma (OR, 4.2; 95% CI, 1.8-9.6) were more likely not to know their cancer diagnosis. Participants' accuracy rates for reporting their treatment history was 94% for chemotherapy, 89% for radiation, and 93% for splenectomy. Among those who received anthracyclines, only 30% recalled receiving daunorubicin therapy and 52% recalled receiving doxorubicin therapy, even after prompting with the drugs' names. Among those who received radiotherapy, 70% recalled the site of radiotherapy. History of receiving a written medical summary, attending a long-term follow-up clinic, and anxiety about late effects were not associated with greater knowledge. CONCLUSIONS: Important knowledge deficits exist among adult survivors of childhood cancer regarding basic aspects of their diagnosis and treatment. Such deficits could impair survivors' ability to seek and receive appropriate long-term follow-up care.

Adult↗