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PubMed2003

Effects of knowledge, personal attribution and perception of ecosystem health on depreciative behaviors in the intertidal zone of Pacific Rim National Park and Reserve.

Human activities levy a biological cost on ecosystems as resources are accessed and utilized at rates which are often incompatible with inherent ecosystem processes and structures. The recreational impact of humans upon intertidal zones and particularly fucoid algal assemblages is one major threat facing coastal ecosystems. The effect of human values, knowledge and perception in effecting biologically costly behaviors has rarely been examined. We hypothesize that with respect to intertidal zones: (1) Personal attribution and perception of ecosystem resiliency are more important than knowledge in determining the extent of depreciative behaviors individuals engage in, and; (2) Individuals who are uncertain about ecosystem resiliency will behave in a manner consistent with the 'precautionary principle'. We measured the depreciative behavior, and the attitudes and perceptions to ecosystem resilience, of visitors to Wick Headland in Pacific Rim National Park, British Columbia. Attitudes, knowledge, perceptions, and personal attribution were measured using questionnaire survey and structured interviews undertaken in situ. Depreciative behaviors of visitors were discreetly observed and correlated to the questionnaire survey and interview responses. We show that visitors who recorded greater knowledge of intertidal ecology engaged in more depreciative behaviors than visitors recording less knowledge. Visitors who perceived high ecosystem resilience in the intertidal zone engaged in significantly more behaviors eliciting biological cost than those who perceived low ecosystem resilience. Visitors who recorded uncertainty regarding ecosystem resilience engaged in significantly more depreciative behaviors than those who perceived low ecosystem resilience but slightly fewer depreciative behaviors than those who perceived high ecosystem resilience. Personal attribution was inversely correlated to the mean number of depreciative behaviors. We discuss the relevance of these results to the management of intertidal zones and marine protected areas, to multiple use management, the management of visitor impact, and natural resource use.

Adolescent↗
PubMed2000

Hormone replacement therapy: knowledge, attitudes, self-reported use - and sales figures in Nordic women.

OBJECTIVES: To evaluate knowledge about, attitudes towards and use of hormone replacement therapy (HRT) in Norwegian women - and to compare self-reported use with sales statistics of HRT in the Nordic countries during recent years. MATERIAL AND METHODS: Random samples of Norwegian women age 16-79 were interviewed by the Central Bureau of Statistics in 1994 (n=737), in 1996 (n=665) and in 1998 (n=680). Statistics on the sale of estrogen were provided by the Norwegian Medical Depot and Nordic Council on Medicines. RESULTS: One in three women had received information about HRT during the last 2 years (1994), mainly through weekly magazines and physicians. The proportion answering in accordance with the prevailing view of HRT's effects ('correct knowledge') varied from 36.4 to 47.2%. Those informed by a physician possessed correct knowledge, had positive attitudes towards HRT and were willing to use HRT more often than women informed through other channels. Women with a high level of education had received information and had correct knowledge more often than others, but they were still less willing to use HRT and did not use HRT more often than the less educated. In the age group 45-69 years the use of HRT was 16.3% in 1994, 19.1% in 1996 and 19. 1% in 1998 (P=0.421, trend). In addition to received information, attitudes towards and knowledge about estrogen were the most important factors predicting use of HRT after adjusting for other variables. According to sales figures, the use of systemic estrogen in Norway has increased more than 360% since 1990. Although no other Nordic country has experienced a corresponding increase, Iceland had the highest sales figures in 1997. CONCLUSIONS: Based on the limited proportion of women receiving information on HRT and the ambivalence found in groups of educated women, we suggest that more and better information should be given middle-aged women to make them better able to make informed choices regarding use of HRT.

Adolescent↗
PubMed2001

Knowledge and attitudes of high school pupils towards peers' attention deficit and learning disabilities.

The purpose of this study was to investigate pupils' knowledge and attitudes in the areas of attention deficit and hyperactivity (ADHD) and learning disabilities (LD). One hundred and four high school pupils in Holon (Israel) were interviewed and anonymously completed a questionnaire on these conditions. Pupils' knowledge on the topic of ADHD was low (62%); they showed a better knowledge about LD (75%). They showed a partially tolerant attitude (62.7%) towards pupils suffering from ADHD; on the other hand, they had a somewhat more positive and perceptive attitude (74.1%) towards peers diagnosed as learning disabled. Pupils' attitudes became more perceptive with increasing age. There was no correlation between pupils' knowledge and attitude. Pupils had learned about these two handicapped conditions from various sources; TV (66.3%), newspapers (63.5%) and school (53.8%), while physicians and nurses occupied the 5th and last place. Information about these two disabilities (ADHD and LD) should be added to the curriculum and be taught by qualified specialists, as there is an obvious statistically deficient knowledge in these areas.

Adolescent↗
PubMed2001

The effects of a pharmacy-based intervention on the knowledge and attitudes of asthma patients.

The effects of a pharmacy-based intervention on the knowledge and attitudes of asthma patients was studied with a small convenience sample in four Finnish community pharmacies. The intervention consisted of patient education, counselling and outcomes monitoring according to Therapeutic Outcomes Monitoring (TOM) concept. Twenty-eight patients aged 20-64 years suffering from asthma and having problems in asthma management were involved. Measurements were done at baseline, immediately after the intervention (12 months) and 1 year after the intervention (24 months) using a pre/post-test design, with the patients being their own controls. Both knowledge about and attitudes towards asthma as a disease improved significantly during the intervention. Also knowledge about medication improved significantly during the intervention, though the patients' attitudes towards the medication remained unchanged. The negative correlation between knowledge about and attitudes towards asthma (-0.35) at baseline disappeared after the intervention (0.21). There was a positive correlation between knowledge about and attitudes towards medication at 12 months (0.40, P=0.04) which was still significant 1 year after the intervention (0.40, P=0.04).

Adult↗
PubMed2000

Physicians' knowledge and attitudes toward the use of analgesics for cancer pain management: a survey of two medical centers in Taiwan.

The purposes of this study were to examine the attitudes of physicians regarding the optimal use of analgesics for cancer pain management (CPM), to evaluate their knowledge and attitudes toward opioid prescribing, and to comprehend their perceptions of the barriers to optimal CPM. A survey was conducted on 356 physicians with cancer patient care responsibilities practicing in two medical centers in Taiwan. A total of 204 (57%) physicians responded, including internists (28%), surgeons (27%), oncologists (11%), anesthesiologists (10%), and other specialties (24%). The majority of physicians displayed significantly inadequate knowledge and negative attitudes toward the optimal use of analgesics and opioid prescribing. Multivariate analyses showed that the following six categories of physicians would be inclined to have inadequate knowledge of opioid prescribing: 1) those with perception of good medical school training in CPM, 2) those with perception of poor residency or fellowship training in CPM, 3) those with a medical specialty in surgery, medicine, or oncology (vs. anesthesiology), 4) those with limited clinical experience in cancer patient care (number of patients less than 30), 5) those with a limited aim of pain relief, and 6) those with an underestimation of analgesic effect. Additionally, physicians with inadequate knowledge of opioid prescribing and with hesitation to intervene earlier with maximal dose of analgesia would be inclined to have reluctant attitudes toward opioid prescribing. The most important barriers to optimal CPM identified by physicians themselves were physician-related problems, such as inadequate guidance from a pain specialist, inadequate knowledge of CPM, and inadequate pain assessment. The results of this study suggest that active analgesic education programs are urgently needed in Taiwan.

Adult↗
PubMed2001

Nurses' knowledge of pain in the elderly.

The purpose of this study was to investigate nurses' knowledge of pain and pain management with respect to elderly persons. Registered nurses at several general hospitals and nursing homes were surveyed by questionnaire concerning their knowledge of pain management in the elderly. The findings indicated a significant knowledge deficit in this area. There were also significant differences in knowledge levels between general hospital nurses and those working in nursing homes. We conclude that more education about pain management in elderly patients is needed for nurses. This deficit needs to be addressed in both undergraduate nursing programs and hospital in-service courses. Presently, the majority of patients entering hospitals are aged 65 years and over. Hence, nurses in all areas of care, not just specifically those working in aged care facilities, need a sound knowledge of pain management of the elderly to facilitate compassionate and effective nursing care.

Aged↗
PubMed1997

Assessment and knowledge in palliative care in second year family medicine residents.

Inadequate physician knowledge, particularly in areas of pain assessment and use of analgesics, has been identified as a major factor contributing to poor pain management in cancer patients. In most medical schools, teaching in Palliative Care at both the undergraduate and postgraduate levels is limited or nonexistent. Baseline knowledge and changes in knowledge in areas relevant to Palliative Care were assessed by the use of 2 16-question examinations (Exams A and B) in 78 second-year Family Medicine Residents from the University of Alberta Family Medicine Residency Program. The residents participated in a two-week rotation on the Acute Palliative Care Unit at the Edmonton General Hospital or Grey Nuns Community Health Centre between September 1991 and February 1996. The residents were randomly assigned on their first day (Time 1) to complete either Exam A or B and were subsequently crossed over on their final day of the rotation to complete the alternate Exam (Time 2). Six domains were represented in the Exams as follows: pain assessment, opioid use, adjuvant medications, delirium, urinary catheterization, and hydration. Improvements were noted in the mean percentage results in Time 2 compared with Time 1 for Exams A, B, and A and B combined. Mean global percentage results were 53 +/- 15 versus 73 +/- 13 (p < 0.001) at Times 1 and 2, respectively. There were significant improvements for domains in Time 2 compared to Time 1 (p < or = 0.05) for combined A and B Exam except for urinary catheterization. Despite these documented improvements in scores, serious deficiencies were identified particularly in the areas of pain assessment and opioid use, namely opioid sude effects and issues involving dependence, addiction, and tolerance. Examinations, such as the two used in this study, can be a useful aid in assessing physician knowledge in addition to structuring teaching in Palliative Care. Examination content will require updating as knowledge in Palliative Care evolves.

Evaluation Studies as Topic↗
PubMedDate not supplied

Parent's behaviors, knowledge, and beliefs related to unintentional firearm injuries among children and youth in the southwest.

INTRODUCTION: The purpose of this research study was to describe parents' behaviors, knowledge, and beliefs related to unintentional firearm injuries among children and youth. METHOD: A convenience sample of 80 parents whose children were attending one of six Kindercare Learning Centers in a Southwestern city was surveyed during the summer of 1995 to learn about their behaviors, knowledge and beliefs about unintentional firearm injuries among children and youth. Data on demographic characteristics, behaviors, knowledge, and beliefs, were collected with a questionnaire. RESULTS: Men and parents who had grown up with a gun in the house were more likely to be gun owners. Forty-eight percent of parents kept at least one gun in the home. Twenty-six percent of gun owners reported that the gun was loaded at all times, and 18% reported that a gun was kept within reach of a child. The most common reason given by parents for having a gun was for protection (61%). Only 8% of parents reported having discussed firearm safety with a health care worker. None of the parents had discussed firearm safety with a pediatrician. A test of knowledge about firearm injuries revealed some gaps in knowledge, with no significant differences between men and women or gun owners and non-gun owners. DISCUSSION: Results suggest that firearms in the home continue to pose a significant risk to children. Anticipatory guidance from NPs and pediatricians is needed to protect children from unintentional firearm injuries.

Adult↗
PubMed2003

Development and validation of a knowledge test for health professionals regarding lifestyle modification.

OBJECTIVES: We wanted to develop and validate a test that assesses the knowledge and practices of health professionals (HPs) with regard to the role of nutrition, physical activity, and smoking cessation (lifestyle modification) in chronic diseases of lifestyle. METHODS: A descriptive cross-sectional validation study was carried out. The validation design consisted of two phases, namely 1) test planning and development and 2) test evaluation. The study sample consisted of five groups of HPs: dietitians, dietetic interns, general practitioners, medical students, and nurses. The overall response rate was 58%, resulting in a sample size of 186 participants. A test was designed to evaluate the knowledge and practices of HPs. The test was first evaluated by an expert group to ensure content, construct, and face validity. Thereafter, the questionnaire was tested on five groups of HPs to test for criterion validity. Internal consistency was evaluated by Cronbach's alpha. RESULTS: An expert panel ensured content, construct, and face validity of the test. Groups with the most training and exposure to nutrition (dietitians and dietetic interns) had the highest group mean score, ranging from 61% to 88%, whereas those with limited nutrition training (general practitioners, medical students, and nurses) had significantly lower scores, ranging from 26% to 80%. This result demonstrated criterion validity. Internal consistency of the overall test demonstrated a Cronbach's alpha of 0.99. Most HPs identified the mass media as their main source of information on lifestyle modification. These HPs also identified lack of time, lack of patient compliance, and lack of knowledge as barriers that prevent them from providing counseling on lifestyle modification. CONCLUSIONS: The results of this study showed that this test instrument identifies groups of health professionals with adequate training (knowledge) in lifestyle modification and those who require further training (knowledge).

Chronic Disease↗
PubMed2002

A critical analysis of the philosophy, knowledge and theory underpinning mouth care practice for the intensive care unit patient.

In the provision of high quality mouth care practice for the intensive care unit (ICU) patient, the nurse draws on philosophy, knowledge and theory. The complexity of mouth care for the ICU patient is compounded by their medical or surgical condition and the psychological effects of mouth care problems. Effective mouth care practice includes proactive prediction and prevention of complications, and prompt and skilled intervention in the problems arising. Therefore, critical analysis of the philosophy, knowledge and theory relevant to mouth care practice is important. The philosophical approach to mouth care requires the nurse to view the practice from different perspectives. Nursing knowledge has inextricable links with nursing practice that challenges the nurse in her/his everyday work. This application of knowledge to practice is conceptualised as ways of thinking, which is also based on what the nurse might know. Therefore, the judicious use of theory and the necessary skills are essential to provide high quality and effective mouth care practice. The purpose of this paper is to illustrate the ways in which philosophy, knowledge and theory all have an impact on the practice of mouth care for the ICU patient.

Humans↗
PubMedDate not supplied

Knowledge and risk behaviors of people seeking HIV antibody testing at a community site.

People seeking HIV antibody testing at a community-based AIDS service organization (N = 342) were asked to complete a self-report questionnaire to determine knowledge of HIV transmission, source(s) of HIV-related knowledge, and recent risk behaviors. The overall knowledge level of risk for transmitting HIV associated with 16 related behaviors was relatively high. Yet, 69% of the participants reported engaging in unsafe sex during the previous six months. Poorly informed subjects tended to overestimate their level of knowledge. In a multiple regression analysis, knowledge, age, and gender were the only significantly predictors of engaging in unsafe sex in this cohort. Nurses must be on the forefront in developing (1) strategies to reach people at high risk for HIV infection and HIV transmission, (2) culturally relevant and sensitive education, and (3) interventions that will enable people to make appropriate choices concerning high-risk behaviors.

Adolescent↗
PubMed2003

Patient's perspective on epilepsy: self-knowledge among Omanis.

Improving patients' knowledge has been suggested to improve their symptoms and prognosis. Very little is known about epileptic patient's knowledge of their illness in cross-cultural settings. This pilot study investigated what Omani patients know about their disorder. Patients attending a tertiary hospital completed a structured knowledge questionnaire to elicit information pertaining to aetiology, safety, compliance with medication regimes, legal and employment issues concerning epilepsy.Although correctly endorsing issues related to their medication, this cross-cultural sample was found to have limited knowledge about their condition. In particular, most patients were unable to give accurate indications of epilepsy, neither were they able to give correct responses to questions pertaining to safety and compliance. There is a need for improving patient's knowledge. As with other chronic disorders, people with epilepsy in Oman should receive systematic health education about how to manage the condition most effectively.

Adolescent↗
PubMed2003

Knowledge and practice of dust mite control by specialty care.

BACKGROUND: Dust mites are the primary indoor allergen risk for increasing asthma attacks and morbidity. Adherence to allergen avoidance recommendations decreases bronchial reactivity and asthma morbidity. OBJECTIVE: This study compared the knowledge and practice of environmental control advice of families of children with asthma seen by an allergist or a pediatrician. Studies suggest that knowledge and practice of environmental control recommendations is inconsistent. METHODS: Subjects were aged 6 to 17 years, diagnosed with asthma, and had positive skin test to dust mites. There were 114 eligible pediatric patients, and 69 had also seen an allergist before the study. An in-home evaluation was completed during which parents were asked about environmental control knowledge and practice. An environmental technician then completed a walk-through evaluation to observe which recommendations were implemented in the home. RESULTS: Families who saw an allergist demonstrated significantly greater awareness of environmental control recommendations for dust mite allergens than those who had not. Knowledge and placement of allergen-proof mattress and pillow covers was significantly higher in these families. However, 30% of families who saw an allergist reported no knowledge of any environmental control recommendations for dust mites. Less than half of the allergist families (48%) who were advised to use mattress encasements actually had encasements on their children's beds. CONCLUSIONS: The parents of dust mite-sensitive, asthmatic children who saw an allergist were more aware of dust mite allergen control recommendations and made more indoor environmental changes.

Adolescent↗
PubMed2005

Knowledge about preconception care in French women with type 1 diabetes.

OBJECTIVE: To assess the knowledge about preconception care among women with type 1 diabetes of childbearing age and to identify factors that may be associated with the absence of preconception care. RESEARCH DESIGN AND METHODS: All women of childbearing age with type 1 diabetes who were seen in 11 Diabetes Centers between December 1 and 12, 2003 were included. An anonymous dual questionnaire was proposed to these women and their consulting diabetologists. RESULTS: One hundred and thirty-eight women were included in the study. The main reported sources of information about pregnancy were the diabetologist (78%) and/or specific leaflets (42%). Although 85% of the women declared having received information about preconception care, 48% were unaware of the risk of congenital malformations and 41% feared for neonatal diabetes. However, 82% of the women thought that a level of HbA1c below 7% was a target to achieve before conception. In multivariate analysis, onset of diabetes before the age of 15 was associated with the knowledge that diabetes may be associated with complications during pregnancy; the use of contraception was associated with knowledge about preconception care; a high educational level was associated with knowledge that complications are avoidable and that good glycemic control is mandatory before conception. CONCLUSIONS: French women with type 1 diabetes, although followed by diabetologists, have major knowledge defects concerning the risks associated with pregnancy. This is the first step towards decreasing the rate of unplanned pregnancies in women with type 1 diabetes.

Adolescent↗
PubMed2000

Primary care physicians' knowledge and attitudes towards genetic testing for breast-ovarian cancer predisposition.

BACKGROUND: Primary health care providers are expected to be directly involved in the genetic testing for cancer susceptibility. This study assessed physicians' knowledge, attitude and perception of their role towards testing for hereditary breast ovarian cancer. DESIGN: A mail-in survey was sent to all general practitioners, internists, obstetrician-gynecologists and oncologists in private practice in Geneva county, Switzerland. Questions included socio-demographic variables, knowledge about hereditary breast ovarian cancer, attitude towards testing and assessment of their role in the pre- and post-test procedure. RESULTS: Two hundred fifty-nine (65%) of four hundred questionnaires were returned of which two hundred forty-three (61%) were analysed. Response rates were similar between specialties; women answered more frequently. The majority of the respondents (87%) approved of genetic susceptibility testing. The most common objection to testing was the absence of approved strategies for the prevention and detection of early breast cancer. Most physicians felt they had an active part to play in the pre-test procedure, the disclosure of results, and especially the consultants' long-term care and support (99%). Physicians correctly answered a third (32%) of the knowledge questions. The abstention rate for individual items ranged from 13% to 60%. Scores varied by specialty. Oncologists were more knowledgeable than gynecologists, internists and general practitioners. CONCLUSIONS: The majority of the primary care physicians in this study have a favourable attitude and are ready to play a prominent role in genetic counseling and testing for breast ovarian cancer predisposition. Defective knowledge scores, however, underline the need for targeted educational programs.

Attitude of Health Personnel↗
PubMed2003

HIV knowledge among a sample of Puerto Rican and Mexican men and women.

This study assessed levels of HIV knowledge and identified factors associated with HIV knowledge among a sample of heterosexual Puerto Rican and Mexican men and women, ages 18 to 45. The sample consisted of 144 men and women living in San Diego County, California, who self-identified as being of Mexican ethnicity and 209 men and women living in Cuyahoga County, Ohio, who self-identified as Puerto Rican. Interviews were conducted by trained, bilingual interviewers. Data were collected on demographic variables, attitudes towards decision-making in relationships, and HIV knowledge and risk behaviors. Puerto Rican individuals were significantly more likely than Mexican individuals to respond correctly to almost one-half of the 12 HIV knowledge items. Multiple logistic regression analysis indicated that higher levels of education, greater U.S. acculturation, legal status and birth in the United States, a self-focused locus of control in relationships, and being male were predictors of higher knowledge.

Adolescent↗
PubMed2003

HIV/AIDS knowledge and attitudes of STD clinic attendees in St. Petersburg, Russia.

Over the last several years, Russia has experienced dramatic increases in rates of HIV and other sexually transmitted disease (STDs). This study examined HIV/AIDS knowledge, attitudes toward condoms, and sources of information about HIV in a sample of 200 male and 200 female Russian STD clinic patients. Study participants displayed substantial knowledge deficits concerning AIDS and HIV transmission. Superior knowledge was associated with younger age, greater education, positive attitudes toward condoms, having more sources of information about HIV/AIDS, and believing that the government is telling the truth about AIDS. More-positive attitudes toward condoms were associated with having a larger number of information sources, greater HIV/AIDS knowledge, and not being in a steady relationship. Many participants reported not trusting government and media sources of information concerning AIDS. Participants also reported concerns regarding the low quality and high cost of condoms in Russia. Results of the study suggest that interventions designed to increase knowledge and awareness of AIDS among Russians at high risk for HIV are urgently needed.

Adolescent↗
PubMed2000

Oral hygiene knowledge of high-risk Grade One children: an evaluation of two methods of dental health education.

The effectiveness of two methods of dental health education (DHE) for improving oral hygiene knowledge among high-risk Grade One students was evaluated. Fifty elementary schools in the former City of North York, Canada were assigned to one of two groups. In one group, students received a classroom-based DHE lesson which was reinforced by two small-group sessions (n=243). In the other group, students received only a single classroom-based DHE lesson (n=206). After DHE interventions, students in both groups displayed improved knowledge for most oral hygiene questions (e.g., when should you throw your toothbrush away?). However, for several questions, a significantly higher proportion of "classroom plus small-group sessions" students displayed improved knowledge compared to students receiving only a classroom lesson. These items included: awareness that cavity prevention and removal of germs are two purposes of oral hygiene; and knowledge that teeth help people to eat and talk. Results suggest a classroom-based lesson combined with small-group sessions is a more effective method of improving oral hygiene knowledge among high-risk Grade One students compared to a single classroom-based lesson.

Child↗