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PubMed1999

The importance of AIDS-related knowledge for mid-life and older women.

Although the AIDS epidemic has had a major impact on the lives of women throughout the world, there is little knowledge regarding risk factors, transmission factors, prevention methods, and results of prevention efforts for older women, even though almost 10% of all AIDS cases in the United States are among those 50 years and older. This article reports results on AIDS knowledge and risks from the Massachusetts Women's Health Study, a longitudinal community-based study of middle-aged women. AIDS-related questions were asked of this sample at their last study interview, which occurred in 1995 when the women were aged 58-67. Results indicate that this sample of older, predominantly Caucasian women are quite knowledgeable about transmission factors but are less knowledgeable about early interventions and their own risk status. Many are also likely to know someone with HIV or AIDS. Even though these women are generally at low risk, they may be at higher risk than they perceive. They may also be significant disseminators of knowledge to friends and relatives who may be at risk, and thus could represent an important target group for AIDS educational programs.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Lymphedema prevention and management knowledge in women treated for breast cancer.

PURPOSE/OBJECTIVES: To describe what women treated for breast cancer know about upper extremity lymphedema, what they recall being told to help prevent lymphedema, what preventive strategies they used, and, if lymphedema occurred, factors related to its occurrence and strategies they used to manage it. DESIGN: Descriptive, correlational survey. SETTING: Survivor-established Breast Cancer Resource Center. SAMPLE: 72 women with breast cancer who returned a mailed questionnaire that was enclosed with a quarterly newsletter. METHODS: A survey instrument, the Lymphedema Knowledge Scale, developed from National-Lymphedema Network guidelines to prevent upper extremity lymphedema. Data that was analyzed using descriptive statistics, chi square, and t-tests. MAIN RESEARCH VARIABLES: Lymphedema knowledge, lymphedema occurrence, and lymphedema prevention and management strategies. FINDINGS: Although many respondents were aware of their risk for lymphedema, their knowledge and use of prevention strategies were poor. Most knowledge was obtained from surgeons, reading materials, and breast cancer survivors. Occurrence of lymphedema was significantly associated only with radiation therapy to breast and axilla and use of any prevention strategy. The 27 women experiencing lymphedema used several management strategies to control the condition. CONCLUSIONS: The few women who had knowledge of most of the recommended guidelines for lymphedema prevention and management did not recall nurses as resources. Research in a larger sample is needed to better examine the association between preventive practices and lymphedema occurrence. IMPLICATIONS FOR NURSING PRACTICE: Nurses could do more to inform patients before and during breast cancer treatment about their risk for lymphedema and the need for prompt diagnosis and treatment of the condition. Until strategies for lymphedema prevention are researched further, nurses should be cautious in counseling about lymphedema prevention.

Breast Neoplasms↗
PubMed1999

Differences in knowledge of hepatitis B among Vietnamese, African-American, Hispanic, and white adolescents in Worcester, Massachusetts.

OBJECTIVE: To assess the level of knowledge about hepatitis B of Vietnamese adolescents, a group at high risk for hepatitis B, and compare it to the knowledge of adolescents of other races and ethnicities. METHODS: A sample of 2816 adolescents was surveyed in 1993 in 2 middle schools and 2 high schools in Worcester, Massachusetts, using a self-administered multilingual questionnaire. RESULTS: Knowledge of hepatitis B was low overall. Vietnamese respondents were more likely than were other students to know that hepatitis B affects the liver (35.6% vs 22.6%). However, they were much less likely than were other students to correctly identify sex with an infected person as a risk factor for infection (13.7% vs 32. 8%). Independent predictors of this knowledge were: white race; older age; attending high school versus middle school; having been taught about hepatitis B in school; knowing the definition of hepatitis B; reporting better grades; having a family member with hepatitis B; and being more highly acculturated. CONCLUSIONS: Adolescent knowledge about risk of infection was low in this study. Attention should be directed at providing health education on hepatitis B to adolescents, particularly to Vietnamese. Health care providers, community health educators, and others engaged in the effort to control and eradicate hepatitis B should be sensitive to the unique educational and cultural needs of high-risk southeast Asian adolescent populations.

Adolescent↗
PubMed1999

The use of physician domain knowledge to improve the learning of rule-based models for decision-support.

This paper describes a study testing the hypothesis that the learning of a decision-support model by a computer learning algorithm from clinical data can be improved by the addition of domain knowledge from practicing physicians. The domain of the experiment is community-acquired pneumonia. The overall design of the study compares a computer learning algorithm given clinical data to one given clinical data plus domain knowledge added by physician subjects. This study showed that the performance of the computer-generated models augmented with knowledge added by physician subjects were significantly better than the computer-generated models generated without added knowledge using a two-stage rule induction algorithm in the domain of community-acquired pneumonia. This result was highly significant and shows that the addition of domain knowledge may be beneficial to the learning of clinical decision-support models, especially in domains where data is limited.

Algorithms↗
PubMed2000

The associations among pediatricians' knowledge, attitudes, and practices regarding emergency contraception.

OBJECTIVES: To quantify practitioner administration of the emergency contraceptive pill (ECP) among adolescent patients, and to determine if such administration is associated with physician knowledge and attitudes regarding efficacy, side effects, and appropriate use. DESIGN: Survey of pediatricians. SETTING: The survey address list was generated from a database of active Fellows of the American Academy of Pediatrics in the District of Columbia metropolitan area. MAIN OUTCOMES MEASURES: Prescription of the ECP in the previous 12 months, or counseling of an adolescent patient about the ECP. RESULTS: Of the 236 questionnaires distributed, 143 (61%) were returned and 121 (51%) were usable. Twenty-four pediatricians (20%) reported prescribing the ECP, and 29 (24%) had counseled adolescent patients about the ECP. Of the practice-related variables surveyed, both the number of adolescents seen per week and the practice setting were significantly associated with these outcomes. Of the knowledge-related variables surveyed, knowledge of the timing and the Food and Drug Administration-labeled status of the ECP were significantly associated with outcomes. None of the attitude-related variables surveyed were associated with outcomes. CONCLUSIONS: This study demonstrates that knowledge deficits, not attitude-related variables, are significantly associated with the low level of ECP administration and counseling among District of Columbia pediatricians. Because knowledge deficits are amenable to educational interventions, our data suggest that informing pediatricians about the ECP may increase its administration among their adolescent patients.emergency contraceptive pill, pediatricians, adolescents.

Adult↗
PubMed2000

Attitudes and knowledge about transplantation in dialyzed patients requesting a cadaveric kidney graft.

AIM: Eighty-two patients answered a multiple choice questionnaire aimed at identifying their presumed and actual knowledge regarding transplantation, given immediately before evaluation by our transplant team for inclusion on our kidney transplant waiting list. SUBJECTS, METHODS AND RESULTS: A total of 78% stated that they had no or incomplete knowledge of transplantation and 22% were very well informed. The mean score for technical knowledge of transplantation (duration, requirement for removal of native kidneys, possibility of obtaining a second transplant, duration of immunosuppressive therapy and duration of the risk of rejection) was 3.1 +/- 0.15 SEM (maximal possible score 5), that for risk knowledge (risks of infections, unpleasant side effects, hypertension, diabetes mellitus, viral infections and cancer) was 1.4 +/- 0.15 (maximal possible score 6). A total of 23% knew that the spouse could donate a kidney, 74% stated that only a blood relative could and 3% that living donation was impossible. CONCLUSIONS: There is scarce knowledge about transplantation, especially with regard to the risks and living donation.

Adult↗
PubMed1998

Maternal knowledge on risk behavioural practices and it's association with diarrhoea in a rural community of West Bengal, India.

Knowledge of rural mothers related to five diarrhoeagenic risk behaviours, identified in an earlier study, was ascertained. A high proportion of mothers (67%-79%) had knowledge about risk of bottle feeding, non-use of soap for cleaning feeding containers, storage of drinking water in wide-mouthed vessels and indiscriminate disposal of children's faeces. However, only around 31% of mothers were aware about danger of using pond water for cleaning feeding containers. Risk behavioural practices were less amongst mothers who had knowledge about them. Risk of diarrhoea amongst children of mothers having risk practice without knowledge as compared to those who utilised their knowledge to avoid risk practice was found significantly higher (p < or = 0.005) except for bottle feeding (p = 0.330). The results of this study indicate that children can be protected significantly from diarrhoea if mothers' diarrhoeagenic behaviours can be altered through educational intervention.

Adult↗
PubMed2000

Demographic factors associated with knowledge of colorectal cancer symptoms in a UK population-based survey.

Greater public awareness of colorectal cancer symptoms might result in earlier presentation with improved cure by available treatments, but little is known about the extent of public knowledge of colorectal cancer symptoms. We asked a sample of the general population about knowledge of colorectal cancer symptoms and assessed demographic characteristics associated with differences in knowledge. A population-based telephone enquiry into knowledge of colorectal cancer-associated symptoms was conducted by a commercial telephone market-research company. Persons called were asked if they knew any symptom of colorectal cancer. Those who answered 'yes' were asked to state any symptom. The ability to state a colorectal cancer-associated symptom was correlated with demographic characteristics, and the strength of the relation between stating a colorectal cancer associated and unassociated symptom (discrimination) was also assessed. 1019 persons (respondents) from an age, sex, and social class-balanced general population sample were questioned. 328 (31%) of respondents stated a colorectal cancer-associated symptom. Regression analysis identified older age, female sex and higher social class as being significantly associated with ability to state a colorectal cancer-associated symptom. There was a weak trend (P = 0.054) towards a relationship between ability to state an associated symptom and stating fewer unassociated symptoms. These results reveal a total ignorance of colorectal cancer symptoms in the majority of respondents and suggest a need for improved public education about colorectal cancer. Public education should be directed at population groups with higher risk and the least knowledge of colorectal cancer.

Adolescent↗
PubMed2000

Attitudes, behaviour and knowledge on sexuality among female adolescents in Zagreb, Croatia.

The aim of this study was to estimate the level of knowledge about sexuality, attitudes and sexual behaviour of female adolescents. The study included 194 female students, 117 from Medical High School (MHS) and 77 from General High School (GHS) in Zagreb. Data was collected using an anonymous self-administered questionnaire. In addition to items on personal data (age, parental education etc.), the participants were asked to define terms about sexuality (e.g. menstruation, puberty) the definitions of which are found in biology textbooks for the fifth and eighth grade of primary school. The aim of the third part of the survey was to collect information about attitudes and behaviour of female adolescents. The results showed a low level of knowledge in students of both schools. General High School students showed a higher level of knowledge than their Medical High School peers. One fifth of General High School students and 1/3 of Medical High School students were unable to define the term "menstruation". The majority of adolescents talk about sexuality with their friends, 92.1% of General High School and 81.2% of Medical High School students. Almost 50% of students of both schools would like to talk about sexuality with their school doctor. 6.9% of Medical High School students had at least one sexual intercourse while none of the General High School students had been sexually active at the time of the survey. As the majority of students were not sexually active and results showed a rather low level of knowledge, this seems to be the ideal period for the implementation of educational programs aimed at increasing the level of knowledge, and thus preventing unwanted consequences (STD, pregnancy, abortion, infertility).

Adolescent↗
PubMedDate not supplied

Hospice and hospital oncology unit nurses: a comparative survey of knowledge and attitudes about cancer pain.

PURPOSE/OBJECTIVES: To identify knowledge strengths and weaknesses and misperceptions about cancer pain management between two groups of registered nurses in different settings. DESIGN: Descriptive, comparative survey. SETTING: 11 community-based hospices and 7 inpatient hospital oncology units within an urban county. SAMPLE: A convenience sample of 30 hospice and 34 hospital oncology unit nurses. Sample criteria included registered nurses who had worked for at least the preceding six months exclusively in either a hospice or hospital oncology unit. METHODS: The North Carolina Cancer Pain Initiative survey and a demographic survey were distributed to the work mailboxes of nurses in the participating facilities who met the inclusion criteria. MAIN RESEARCH VARIABLES: Hospice and hospital oncology unit nurses' knowledge and attitudes about basic pharmacologic cancer pain management. FINDINGS: Hospice nurses scored significantly higher than hospital oncology unit nurses regarding overall pain management knowledge, opioids, scheduling, and liberalness. Hospice nurses also reported more pain education and a higher frequency of pain guideline review requirements than hospital oncology unit nurses. CONCLUSIONS: The most prevalent knowledge deficits concerned opioids. Practice setting and pain education may influence knowledge, as well as attitudes, about pain. IMPLICATIONS FOR NURSING PRACTICE: Further research is needed regarding nurses' pain management behavior and outcomes of pain management education in various settings.

Adult↗
PubMed2000

[Knowledge about hypertension and blood pressure level].

BACKGROUND: The improvement of efficacy of the hypertension prevention and patient education largely depend on determination of the hypertension risk factors and increase in knowledge about hypertension. The aim of this study was to assess correlation between the environmental factors and knowledge about hypertension and occasionally measured blood pressure values. MATERIALS AND METHODS: The studied group consisted of 485 subjects, who voluntarily participated in the street-based hypertension screening program in Cracow (summer 1997). All subjects were asked to fill out a questionnaire concerning their health behaviours (i.e. stress, smoking and drinking habits) and a test to evaluate their knowledge about hypertension and its risk factors. The blood pressure measurement were taken using semiautomatic device (Digital Blood Pressure UA-702), in the sitting position, after a rest minimum five minutes. The study group consisted of persons with negative history of hypertension (n = 440), and untreated hypertensive patients (n = 45). In order to assess the influence of different factors on blood pressure level, the subjects were divided into two groups according to the presence or absence of a particular risk factor. In the statistical analysis Student's t-test, chi 2 and linear regression analysis with adjustment for possible confuses were used. All values were presented as mean +/- SD. RESULTS: The mean age was 37.1 +/- 17.8 years. Participants were well educated (75.9% had finished college or high school), and there were more women than men in the study group (57.5% vs 42.5%). 24.1% of participants had blood pressure values exceeding 140/90 mmHg. Multiple linear regression demonstrated that age, body mass index and knowledge about hypertension significantly influenced the level of systolic blood pressure; while only body mass index was among the factors determining diastolic blood pressure. CONCLUSIONS: This study confirms the influence of age, male gender, body mass index, alcohol consumption, stress and the snoring on the blood pressure level. The association between the knowledge about hypertension risk factors or hypertension and occasionally measured blood pressure values has been demonstrated.

Adult↗
PubMed2000

Rethinking knowledge and pedagogy in dental education.

Dentistry as a profession has often been considered both art and science. Traditional dental education has attempted to address both; however, in many places only the science of dentistry is emphasized. The move toward competency-based curricula in dental education requires an expansion of what constitutes meaningful knowledge in the curriculum and what pedagogies best support that curriculum. The scientific and technical knowledge considered foundational to clinical practice is not sufficient to teach competencies associated with the art of dentistry. Habermas, a social scientist, offers a way of looking beyond technical knowledge to consider two other forms of knowledge: practical and emancipatory. Pedagogy that supports development of practical and emancipatory knowledge includes problem-based learning and case methods, heuristics, reflective practica, journals, storytelling, and performance-based assessment methods. These important teaching strategies are being integrated into various dental curricula including a new competency-based dental curriculum at Marquette University's School of Dentistry. It will be critical for dental educators to continue developing these methods to provide efficient and effective education for future practitioners in both the art and science of dentistry.

Clinical Clerkship↗
PubMedDate not supplied

Influence of education and occupation on knowledge about diabetes control.

BACKGROUND: A global epidemic of diabetes has been predicted during the first quarter of the twenty-first century, with a substantial increase in its prevalence in India. Good management of diabetes is a necessary step towards its control and blood glucose testing forms an integral part of this. This study was undertaken to assess the importance of education and occupation in relation to knowledge about good control of diabetes. METHODS: Perception patterns regarding methods for testing blood glucose and metabolic control were assessed by the direct interview method in 793 patients with type 2 diabetes. Patients' knowledge levels were compared for different educational and occupational categories using the Normal test (z-test) and the Student's t-test. RESULTS: The difference between the mean ages of men and women diabetics was not significant (p > 0.1). It was found that 46.7% of the subjects were aware of the importance of blood glucose testing. Awareness regarding the importance of microalbuminuria, lipid profile and glycosylated haemoglobin was observed in 24.1%, 15.5% and 7.6% of patients, respectively. A positive impact of education on overall knowledge levels was observed. However, no definite relationship was found between knowledge and occupation. CONCLUSION: There was a total lack of knowledge regarding self-care of diabetes in all educational and occupational categories (including patients who were qualified doctors). This calls for an urgent need to create greater public awareness. This study may serve as a guideline for developing an educational package for different subsections of the community.

Blood Glucose↗
PubMed2000

Learning and knowledge-production for public health: a review of approaches to evidence-based public health.

Public health needs to be evidence-based if it is to be done correctly, which means that learning and knowledge-production for public health must be comprehensive and include knowledge from four different domains: distribution of health, determinants or causal web, consequences, and intervention methods. Specification of development trends in cardiovascular prevention points at four generations of preventive programs; these include a clinical, a bioepidemiological, a socioepidemiological, and an environmental and policy-oriented generation. Generations differ in focus and strategy, in knowledge base--the art of making an impact--and evaluation. Comprehensive public health programs often comprise components from different generations, leading to the need for an expanded model for research and evaluation. There is an urgent need for learning and knowledge-production using both quantitative and qualitative approaches for developing the evidence base for public health action. In addition, epidemiological knowledge is necessary for making appropriate priorities.

Cardiovascular Diseases↗
PubMed2001

Knowledge integration: insight through the E-portal.

Data become information when they can be summarized and organized into logical patterns; information becomes knowledge when it can be manipulated for actionable decision making; knowledge becomes insight when contextually relevant and temporarily appropriate. This article describes how information technology can now be used to provide clinicians with access to both insight and information that is context- and event-sensitive. Collaboration between the American College of Physicians, medical knowledge experts, Oregon Health Sciences University (OHSU), and shared medical systems for framework and infrastructure combine to create the ideal environment of complementary and synergistic competencies. This article describes the research that is under way at OHSU to determine how to deploy medical knowledge derived from these sources and integrate it into the clinical workflow; it also examines a vision of how medical knowledge can be integrated in the future.

Education, Medical, Continuing↗
PubMedDate not supplied

College students' knowledge of human papillomavirus and effectiveness of a brief educational intervention.

BACKGROUND: Human papillomavirus (HPV) is the most prevalent sexually transmitted disease in the United States and is associated with considerable morbidity and cost. Several surveys of college students have found, however, a paucity of knowledge of HPV. Sexually transmitted disease education focused on human immunodeficiency virus infection has been found to be effective at improving knowledge and safe-sex behaviors, at least in the short term. The purpose of this study was to evaluate the effectiveness of a brief HPV-focused, educational intervention on college students' knowledge of HPV. METHODS: Sixty physician's assistant and psychology students were administered a questionnaire that elicited their knowledge of HPV, including prevalence, symptomatology, and complications. The participants then underwent a brief HPV-focused educational intervention. Three months later, the cohorts were reevaluated with the same questionnaires. RESULTS: Before the intervention, only 45% of the HPV questions were answered correctly, compared with 87% of the non-HPV items. After the intervention, 79% of the HPV questions were answered appropriately. Physician's assistant students performed significantly better than the psychology students on the HPV questions, but not statistically significantly better on the non-HPV related items. Women performed better than men on the non-HPV questions, but scored similarly for the HPV-related items. CONCLUSION: Despite the high prevalence and serious complications associated with HPV infection, most college students know very little about HPV. Brief HPV-focused educational interventions, which could be readily implemented in the family physician's office at a routine visit, were found to be effective at improving HPV knowledge, at least in the short term. More HPV education is needed, particularly for young adults. Further studies should be undertaken to evaluate the effectiveness of HPV education on improving safe-sex behaviors.

Adult↗
PubMedDate not supplied

[Children's knowledge of sex behavior and contraception].

INTRODUCTION: Adolescent sexuality is not a new phenomenon, but it has been accepted differently at various times and societies. In modern times, adolescents start sexual life early, not well educated and not prepared for possible consequences. The period between the first sexual relationship, marriage and having children is prolonged with a greater possibility of having artificial abortions or sexually transmitted diseases (STD). It is of great importance to work on proper education of children and adolescents on sexual life and contraception. MATERIAL AND METHODS: An inquiry into the knowledge of sex and contraception was performed in an elementary school in Novi Sad, comprising 134 children from VII and VIII grade (aged 13-14, 77 girls and 57 boys) in order to prepare a lecture on these topics. RESULTS: Most of the knowledge on these topics children aged 13 and 14 got watching TV and reading magazines (44.15% girls and 70.17% boys) and from their friends (42.1%). Communication about sex and contraception exists mostly among friends (51.95% girls and 82.46% boys). One third of girls talk with parents and one quarter got knowledge from them. Only four boys (2.98%) had sexual intercourse without complications: artificial abortion or STD. Almost every child (96.95%) knows about AIDS and 89.25% children know about at least one method of contraception (mostly condom). Three quarters claim artificial abortion is harmful. 50% of children want more education about sex and contraception. DISCUSSION AND CONCLUSIONS: Most of the knowledge on sexual life and contraception children get from various forms of mass-media and from one another which is unreliable and incomplete. Unfortunately, parents and teachers play a minor role in sex education of children. In order to prevent spreading of sexually transmitted diseases and to decrease the percentage of adolescent pregnancy and artificial abortions, it is of great importance to investigate knowledge, attitudes and practice of children and adolescents in regard to sexual life and contraception and to prepare acceptable and efficient programs for education on these topics. However, not only education is important, but also acceptance and behavior of children and adolescents resulting from these programs.

Adolescent↗
PubMed2001

Breast cancer detection: knowledge, attitudes, and behaviors of women from Pennsylvania.

PURPOSE/OBJECTIVES: To assess relationships among breast cancer detection behaviors and selected variables in healthy women. DESIGN: Correlational study. SETTING/SAMPLE: A sample of 1,000 women was selected randomly from the 16,500 members of the General Federation of Women's Clubs of Pennsylvania. Respondents (N = 538; 54% response rate) were predominately white, well educated, lived in urban areas, and had an average age of 60 years. METHODS: Mailed packets with a professionally designed, scannable survey instrument that included questions related to detection behaviors, a risk index, health behaviors, attitudes, and knowledge. MAIN RESEARCH VARIABLES: Breast cancer detection behaviors: mammography, clinical breast examination (CBE), breast self-examination (BSE). Structural/demographic variables: age, education, residence, knowledge of breast cancer and detection methods, teaching history, encouragement, and risk index (family/medical history). Predisposing variables: susceptibility, benefits/barriers, confidence, social norms and influence, and general health motivation. FINDINGS: Women reported moderate/high adherence to recommendations for early detection of breast cancer. Mammography behavior was predicted by older age, being encouraged by a doctor or nurse, and greater risk. CBE predictors were greater knowledge and risk along with greater benefits, social norms, and health motivation. BSE behavior was predicted by having had BSE technique checked, greater knowledge, greater risk, decreased barriers to BSE, and higher health motivation. CONCLUSIONS: Common predictors of breast screening behaviors include risk (family/medical history), knowledge, and general health motivation. IMPLICATIONS FOR NURSING PRACTICE: Educational efforts can be designed specifically to influence variables related to compliance with early breast cancer detection behaviors.

Adult↗