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[Guideline-adequate knowledge in internists and general practitioners about the diagnosis and treatment of arterial hypertension].

Only a small proportion of patients with arterial hypertension are adequately treated. Although a possible cause for this fact may be the deficient knowledge of physicians about diagnosis and treatment of arterial hypertension, to date no studies have addressed this important problem in Germany. Therefore, we have reviewed the knowledge of internists and general practitioners about diagnosis and treatment of arterial hypertension using a questionnaire. The guidelines of the German Hypertension Society were used as the reference standard. The questionnaire was sent out in December 1999 to all internists (n = 15,952) and to a random sample of general practitioners (n = 8947) who work as statutory health insurance physicians. A total of 11,547 questionnaires were sent back and could be analysed. Adequate guideline knowledge was assumed if five out of eight questions were correctly answered; the correct answers had to include the correct definition of arterial hypertension (> 140/90 mmHg). The correct definition of arterial hypertension was known by 4103/11,547 participants (36%). An adequate guideline knowledge was found in 18.8% of the general practitioners and in 26.6% of the internists. There were no relevant regional differences. The level of awareness about diagnosis and treatment of arterial hypertension is insufficient among internists and general practitioners. This insufficient knowledge may in part explain the inadequate care for patients with arterial hypertension. Thus, the implementation and evaluation of new information and training strategies are mandatory to improve the care for patients with arterial hypertension.

Family Practice↗

Changes in economically disadvantaged adolescents' knowledge and beliefs about HIV/AIDS.

PURPOSE: The purpose of this study was to compare HIV/AIDS related knowledge and beliefs in two cohorts of economically disadvantaged adolescents (n = 132). Participants were between 15 and 21 years old, predominately African-American and Hispanic, and participants in a Job Training Partnership Act (JTPA) summer program. The hypothesis was that adolescent HIV/AIDS-related knowledge would be higher in 1999 than in 1994. METHODS: A cohort of sixty-six (66) adolescents were surveyed in 1994 and another cohort of 66 adolescents was surveyed again in 1999, all participating in the JTPA program. Participants' knowledge and beliefs were assessed using the National Adolescent Student Health Survey. RESULTS: A statistically significant increase in overall HIV/AIDS knowledge occurred between the two measurements. Fifty-five percent (55.6%) of the 1999 cohort believed that HIV could be contracted by donating blood, compared to 47.5% of the 1994 cohort. Belief that it is more likely to become infected with the AIDS virus through male to male sex was higher in 1999 by 2% and was 10% higher for female to female sex. CONCLUSIONS: Adolescent misconceptions/misinformation, gender-based lack of knowledge, increased perception of immunity from HIV infection, and a reported reduction in health education courses were all factors in the adolescents' continued engagement in risky sexual activities. Given these findings, and that AIDS is predicted to be one of the top five causes of death among young people, increased gender- and ethnic-specific HIV intervention programs are recommended.

Adolescent↗

A framework for addressing Māori knowledge in research, science and technology.

This paper seeks to identify and discuss some of the issues for Māori research and in doing so presents a framework for considering the range of research activities which attempt to provide or develop Māori knowledge. The paper goes on to discuss kaupapa Māori research in depth as the particular approach of the Research, Science and Technology sector that is most likely to consistently develop Māori knowledge. According to Treaty of Waitangi analysis, the special relationship between tangata whenua and the Crown acknowledges the right of a distinct position based on the Māori view of knowledge as a taonga. Secondly, there is the clear acknowledgment of the undermining of the Māori knowledge base since the signing of the Treaty and that supporting kaupapa Māori research can in part offer redress in terms of re-establishing lost knowledge. The framework provided here may be used to reorient the balance of the research purchase. First, the framework allows the identification of the location of specific projects and enables an 'audit-map' of research purchase/investment over time. Secondly, research purchasers need to operate systems of assessment and performance monitoring which can respond to the range of 'Māori' research. Third, the development of methods and methodologies for Māori-centred and kaupapa Māori approaches is an area of active investment and complements the effort to develop a skilled Māori research workforce.

Attitude to Health↗

[Information in the fight against HIV infection and AIDS: results of a knowledge survey among general practice physicians, journalists, and users of the AIDS Green Line].

This work presents the outcomes of the study "Evaluation of the role of social communication in the fight against HIV infection and AIDS" carried out by some researchers of the Istituto Superiore di Sanità (ISS) and financed within the 2nd Social Research Project on AIDS. Through an accurate survey, the study aimed to evaluate the standard of knowledge on HIV/AIDS in two most important sources of information frequently contacted by citizens: general practitioners and journalists. It also sounded out the knowledge in a random sample of users of the AIDS Help-Line of the ISS. We could find out a generally low standard of knowledge of HIV/AIDS among journalists. As far as general practitioners are concerned, the differences found in the standard of knowledge are inversely proportioned to age and number of patients. A fairly good standard of knowledge is found out among the users the AIDS Help-Line. Of course, the same outcomes cannot be valid also for the general population; on the contrary, the outcomes concerning general practitioners and journalists could be generalized. Information gathered from data collection could make easier the planning of more specific interventions and the drawing up of appropriate guidelines.

Acquired Immunodeficiency Syndrome↗

Folic acid. Preconception knowledge and use by infertile women.

OBJECTIVE: To assess knowledge of preconception folic acid intake (PFAI) and its use by infertile women and to compare it to results from a national survey of reproductive-age women. STUDY DESIGN: New patients presenting to a reproductive medicine practice were surveyed regarding their knowledge and use of PFAI. Results were compared to those of a national survey of reproductive age women. RESULTS: Eighty-six women were surveyed. Infertile women were more aware of the benefits of PFAI than the control population (65% vs. 13%) and used it more frequently (52% vs. 29%). Although infertile women knowledgeable about PFAI were more likely to take folic acid (chi 2 = 24.90, P < .001), 30% of women who were aware of the benefits of PFAI did not take it. CONCLUSION: Preconception folic acid knowledge and use were higher among infertility patients presenting to a reproductive medicine practice than in the general population. Nonetheless, in this highly motivated population, only half were taking folic acid, and knowledge alone did not ensure usage. To effectively decrease the incidence of neural tube defects, food fortification may be more effective than education focusing on vitamin supplementation.

Adult↗

Women's interest in genetic testing for breast cancer risk: the influence of sociodemographics and knowledge.

The objective of this study was to assess women's interest in genetic testing for breast cancer risk. Randomly selected samples of 761 women without breast cancer from the general population of British Columbia, Canada, and 260 women with breast cancer from the provincial cancer registry participated in a telephone survey that assessed interest in genetic testing for breast cancer risk, knowledge of hereditary breast cancer and genetic testing, and sociodemographics. Women with breast cancer did not possess superior knowledge of breast cancer genetics compared with women from the general population. Of the women with breast cancer, 30.8% reported interest in testing or had been tested, compared with 28.5% of women without breast cancer. Controlling for differences in age, education, personal history of breast cancer, and knowledge of genetics, women with at least one relative with breast cancer were 2.3 times more likely to express interest in genetic testing for breast cancer risk than those with no family history. There were significant interactions between breast cancer status and education and between age and knowledge of breast cancer genetics. Women without breast cancer and with a positive family history, who were between 20 and 40 years of age, were most likely to be interested in testing. The women with breast cancer who were interested in testing tended to be approximately 50 years of age, had a positive family history, and had more years of education. Women with a family history of breast cancer, well-educated women with breast cancer, and younger women, particularly those with knowledge of genetic testing, are important target audiences for community-based education on genetic testing for breast cancer risk.

Adult↗

Asthma: knowledge and practice patterns of Louisiana family physicians.

BACKGROUND: This study examines the practice patterns of Louisiana family physicians in managing asthma with attention to National Asthma Education Program (NAEP) guidelines. METHODS: A confidential two-page, multiple choice, 24-question survey was faxed to the 550 active members of the Louisiana Academy of Family Practitioners. It included questions related to the use of peak flow meters and pulse oximetry, nedocromil, theophylline, beta 2 agonists, suppressive antibiotics, inhaled steroids, as well as knowledge of published guidelines for classifying and treating asthma. RESULTS: Most of those who participated have an appropriate knowledge of asthma classification, but a sharp drop in the knowledge of the correct management of step 4 asthma was seen. A minority of respondents claimed knowledge of the NIH guidelines, but their management patterns for adult step 1, 2, and 3 asthma were largely in agreement with the guidelines. CONCLUSIONS: Unlike previous studies in the literature, this one shows good knowledge and reported practice compliance with the NAEP guidelines by Louisiana family physicians.

Adult↗

[Knowledge, attitude and practices of health personnel with regard to HIV/AIDS in Tamatave (Madagascar)].

BACKGROUND: Health care workers are key players in the prevention and management of HIV-infection. We surveyed HIV/AIDS-related knowledge, attitudes and practices of health care workers in Tamatave (Madagascar), to assess the feasibility of voluntary counselling and testing for HIV infection in antenatal care. MATERIALS AND METHOD: A Knowledge Attitude and Practice study was conducted during July 2000 in the antenatal health care centres and the hospital of Tamatave. The health workers completed a self-administrated questionnaire on HIV transmission, attitudes and practices regarding AIDS testing and counselling, HIV risk perception and attitudes regarding patients with HIV disease. RESULTS: A 90% response rate was obtained, with completed questionnaires from 45 health care workers. The sample included physicians, midwives, nurses, medical students and nursing auxiliaries. Scientific knowledge about transmissibility of HIV infection was poor: transmission was believed possible by living together without having sex (7%), by breastfeeding a HIV-positive child (9%), by using toilets after a HIV-positive patient (13%) and by blood donation (76%). 73% of the health staff believed a child born of an HIV-positive woman would systematically be infected and interventions to reduce this risk were unknown. Sixty one per cent of the health-workers reported never having advised patients to be tested and less then 10% mentioned correct counselling precautions. Seventy nine percent believed that they were at risk of acquiring AIDS, mainly through occupational exposure. Negative attitudes towards HIV-positive patients were also noted: twenty per cent of the health workers mentioned that AIDS patients should be isolated in quarantine. Physicians and paramedical staff differed only in their better knowledge about transmissibility of HIV. Physicians had the same restrictive attitude towards patients with HIV as paramedical health workers and did not differ by their counselling practice. CONCLUSIONS: Our study revealed gaps in the knowledge of health care workers about HIV infection. Before implementing voluntary counselling and testing in antenatal care, additional HIV/AIDS training for health staff seems necessary.

AIDS Serodiagnosis↗

[Present-conditions of nutritional knowledge of clinical doctors].

Nutritional knowledge of 184 clinical doctors was investigated by questionnaires. The results showed that clinical doctors did not have enough nutritional knowledge to meet the demands of their work. The doctors grasped fundamental nutritional knowledge better than clinical nutritional knowledge (P < 0.01). There was no significant difference between the doctors in different groups with different academic degrees, professional titles, work histories, and departments (P > 0.05). Therefore, we suggest that the class hours of nutrition science can be added, the course of clinical nutrition can be offered in medical university, and the nutritional knowledge of clinical doctors can be improved by conducting nutritional science training course.

Adult↗

An educational project to improve knowledge related to pulse oximetry.

BACKGROUND: Pulse oximetry is a frequently used, noninvasive monitoring tool for assessing arterial blood oxygenation. Physicians, registered nurses, and respiratory therapists are responsible for the accurate interpretation of pulse oximetry data as part of the evaluation and management of acutely and critically ill patients. OBJECTIVES: (1) To evaluate the extent of current knowledge about pulse oximetry and (2) to increase clinicians' knowledge of research-based practices related to the appropriate use of pulse oximetry and interpretation of its results. METHODS: A test/survey of 17 true-false questions based on the research-based practice protocol of the American Association of Critical-Care Nurses was developed to evaluate current knowledge of pulse oximetry. A convenience sample of medical, nursing, and respiratory therapy staff was invited to complete the test/survey before and several months after an educational program to improve staff members' knowledge of pulse oximetry. The program included educational forums, policy changes, competency checklists, and verification of inclusion of research-based principles in orientation programs. RESULTS: A total of 442 staff members completed the test/survey given before the educational program: 331 nurses, 82 physicians, and 29 respiratory therapists. The overall mean percentage of correct answers was 66%. Differences between disciplines were significant: respiratory therapists scored slightly higher (76%) than did nurses (64%) and physicians (66%) (P = .01). The scores on the test/survey given after the educational program increased significantly, from 66% to 82% (P < .01). CONCLUSIONS: This educational project improved staff members' knowledge of pulse oximetry monitoring.

Clinical Competence↗

Knowledge on, and attitude toward, HIV/AIDS among staff of an international organization in Bangladesh.

Two hundred and ninety-three randomly-selected members of the staff of ICDDR,B: Centre for Health and Population Research were surveyed anonymously in June 1998, using a pre-tested and self-administered questionnaire, to assess their knowledge on, and attitude toward, human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). All except 4 (1.4%) heard of AIDS. Main sources of information were radio and television (93%), newspapers and magazines (84.8%), posters and leaflets (70.2%), and friends (59.2%). About 94% of the respondents believed that HIV might spread in Bangladesh. Only 61.6% knew about the causative agent for AIDS. More than 96% had knowledge that HIV could be detected through blood test. The respondents were aware that unprotected sexual intercourse (92%), transfusion of blood and blood components (93.8%), sharing unsterile needles for injections (94.1%), and delivery of babies by infected mothers (82.7%) could transmit HIV. Similarly, the respondents had the knowledge that HIV infection could be prevented by using condom during sexual intercourse (85.5%), having sex only with an HIV-negative faithful partner (87.2%), avoiding transfusion of blood not screened for HIV (88.9%), and taking injections with sterile needles (86.5%). However, only 33.0% had the knowledge that HIV-infected persons can look healthy, and 56.4% were unaware of transmission through breastmilk. Most members of the staff, particularly at lower level, had misconceptions about transmission and prevention of HIV/AIDS. More than 40% of the respondents had the attitude that HIV-infected persons should not be allowed to work, while another 10% did not have any idea about it. The findings of the study suggest that the members of the Centre's staff have a satisfactory level of essential knowledge on HIV/AIDS, although half of them have poor attitudes toward persons with HIV/AIDS. Therefore, preventive strategy for the staff should be directed toward behaviour change communication.

Acquired Immunodeficiency Syndrome↗

Previous BFHI training and nurses' knowledge, attitudes and practices regarding exclusive breastfeeding.

The UNICEF/WHO Baby Friendly Hospital Initiative (BFHI) programme was developed to train health workers and equip them with the required knowledge and skills to protect, promote and support breastfeeding among mothers through the implementation of the "Ten Steps to Successful Breastfeeding". This study was conducted to assess the effect of BFHI training on knowledge, attitudes and support practices of nurses with regards to exclusive breastfeeding. A total of 298 nurses in maternal and child health care units were interviewed, of these 113 (37.1%) had participated in the BFHI training workshop. Significantly higher proportions of the BFHI trained nurses had the correct knowledge regarding the causes and management of common breastfeeding problems. The overall knowledge scores of the BFHI trained nurses was significantly higher than that of the untrained (11.9 +/- 1.8 versus 10.7 +/- 2.4 P < 0.01). Higher proportions of BFHI trained nurses reported correct support practices for the initiation and establishment of exclusive breastfeeding among mothers. The findings show that nurses who had participated in the BFHI training workshop were significantly more knowledgeable about some aspects of exclusive breastfeeding, they had more positive attitudes and were more likely to employ correct practices for the promotion of exclusive breastfeeding.

Attitude of Health Personnel↗

[Impact of a 10-year nation-wide campaign on knowledge of sensible drinking limits in Denmark].

INTRODUCTION: In Great Britain and in Denmark, strong efforts have been made to influence knowledge on the upper threshold of hazardous drinking. In Denmark, a campaign has been repeated every week 40 from 1990 to 2001 with information on the sensible drinking limits of 21 drinks per week for men and 14 drinks per week for women. The aim of this study was to examine the effect of this ongoing campaign on the level of knowledge of sensible drinking limits for men and women. MATERIAL AND METHODS: Every year from 1994 to 1999, random representative samples of 1,030 adult Danes were interviewed on the telephone. RESULTS: Our main finding was that the level of knowledge of sensible drinking limits for own sex increased in all subsets of the population throughout the period. However, at the end of the study period (1999), a total of 80% of highly educated young (18-25 years of age) men knew sensible drinking limits for own sex, while only 35% of uneducated older (more than 65 years old) men had knowledge on sensible drinking limits. The proportions were similar among women: Subjects admitting an intake higher than sensible for own sex, i.e. 21 and 14 drinks per week, respectively, had the highest knowledge of these drinking limits. DISCUSSION: We conclude that public health campaigns, such as the sensible drinking limit campaign, certainly has an impact on the level of awareness in the general population. Furthermore, those drinking more than 21 and 14 drinks per week, respectively, are reached by these campaigns.

Adult↗

[Knowledge of coronary heart disease risk factors among students of Warsaw universities].

Prevention of coronary heart disease (CHD) is the most effective way in fighting with epidemic of this illness in our country. Risk factors of CHD are divided into modifying and non-modifying. General knowledge of cardiac risk factors in young population is the most important point in prophylactic. Our aim was to elucidate knowledge of cardiovascular disease risk factors in students. We distributed a questionnaire to 544 students (264 women and 280 men) of 3 Universities in Warsaw in the middle age 22 +/- 0.79. The survey contained 22 answers: general risk factors (obesity--O, high cholesterol level--Ch, smoking--S. hypertension--HA, wrong diet--D, family history--F, life style--S, age--A, diabetes--DM, male--M, down limbs arteriosclerosis--DLA, myocardial infarction in family under 55 years old-MI) and wrong answers (allergic, female, mobile phone...). Data were taken under analyze. Right risk factors were mentioned by the following number of students: O--92%, Ch--89%, S--85%, HA--75.8%, D--71%, F--65.2%, DM--50.4%, M--49.3%. DLA--36.9%, MI--36.0%. General knowledge of modifying cardiac risk factors, not including diabetes, is high among polish students. However, the knowledge is poor about non-modifying factors, like gender, age, early MI in family. The results of our study let us hope that the students will correctly use their knowledge to reduce risk of CHD in their families.

Adult↗

Herbs and other dietary supplements: healthcare professionals' knowledge, attitudes, and practices.

CONTEXT: Herbs and other dietary supplements (H/DS) are frequently used by the public. They have significant health implications, yet little is known about health professionals' knowledge, attitudes, or clinical practices related to H/DS. DESIGN: Cross-sectional survey of clinicians prior to participation in an Internet-based educational program on herbs and dietary supplements. PARTICIPANTS: The 537 participants included 111 physicians (MD), 30 advanced practice nurses (RN), 46 pharmacists (PharmD), and 350 dietitians (RD). In addition to demographic information, participants were asked about their knowledge, attitudes, and practices related to H/DS. RESULTS: Most participants were involved in direct patient care (85%), in practice or on faculty (84%), and from outside our local institutions (76%); 66% reported receiving professional education about H/DS in the past year. There were statistically significant differences between professional groups, with RDs scoring better than others, but even their average scores were less than 60% of possible. The average score on knowledge questions was 10/20; the average confidence score was 4 out of 10 possible, and the average communication score was 1.4 out of 4 possible. Most respondents knew the most common clinical uses of echinacea and St. John's wort, and felt confident that they knew more than their colleagues about H/DS. Key deficits were in knowledge about adverse effects, confidence in reporting side effects, routinely communicating with patients about H/DS, and recording H/DS information in the medical record. CONCLUSIONS: Despite significant interest and previous training in H/DS, these clinicians had substantial room for improvement in knowledge, attitudes, and clinical practices about H/DS. Educational interventions and institutional policies are needed to improve the quality of patient care regarding H/DS, and such interventions should be rigorously evaluated to ensure that continuous improvements occur.

Adult↗

Knowledge, attitude and practice about sexually transmitted diseases among university students in Kampala.

BACKGROUND: Sexually transmitted diseases (STDs) remain an important cause of morbidity and mortality among women in the child-bearing age. In order to institute appropriate preventive measures there is need to establish the profile of knowledge of the predisposing factors and causation of STDs, attitude to sexual practice and sexual patterns among the susceptible young people, such as university students. STUDY POPULATION: Non medical university students, Makerere University. DESIGN: Descriptive cross sectional study. METHODS: A detailed questionnaire identifying socio-demographic characteristics, sexual patterns, knowledge of STDs as well as attitudes towards prevention of STDs was administered to 400 non medical university students of Makerere University. RESULTS: Knowledge of the clinical features of gonorrhoea and AIDS was high; most knew the predisposing factors for STDs (multiple sexual partners 90%; unprotected sexual intercourse 93%; rape 81%; sex outside marriage 78%, and sex under the influence of alcohol 73%) but not so for syphilis. Males were three times more likely to contract STDs (27%) than their female (9%) counterparts. Whereas knowledge on methods of prevention was high (>90%) it was not followed by appropriate behavioural patterns. More female (33.5%) students had heard about Trichomonas vaginalis than males (23%); (((2) = 17.1; < 0.0001). This study has shown that more female than male students got information from their parents (((2) = 25.3; p < 0.001) while more male students had their source of information from previous sexual intercourse (((2) = 12.9; p = 0.001). CONCLUSION: The level of knowledge about STDs and their prevention is not matched by sexual behavioural patterns, and male students undertake more risky sexual behaviour. Sexual education should be introduced at the university as a means of increasing students' awareness about the problem and prevention of sexually transmitted diseases including HIV/AIDS.

Adolescent↗

Arizona providers' use and knowledge of fluoride supplements.

Dietary fluoride supplements are recommended for dental caries prevention in children without access to optimally fluoridated water. Previous studies have shown deficiencies in dentists' and physicians' knowledge about dietary fluoride supplementation. Data were collected from dentists, physicians and other healthcare provider groups to assess dietary fluoride supplement knowledge and practices. Pediatricians and dentists were found to be the most knowledgeable concerning the recommended prescribing protocols. Substantial proportions of all practitioner groups had insufficient knowledge about the recommended dosages of dietary fluoride supplements by age, fluoride levels in local water supplies, and the effectiveness of fluoride delivery methods. Baseline knowledge and practices were determined for healthcare provider groups within Arizona.

Arizona↗

[Oral hygiene knowledge of caregivers in a psycho-geriatric home].

Several studies have shown that there is a close relation between bad oral hygiene, general well-being and general health among elderly people living in nursing homes. It is therefore important that dentists have the necessary knowledge to care for these people in collaboration with other professionals in the health sector. It is the nursing staff in these homes who look after the daily oral hygiene of the residents. Studies show that these professionals meet several barriers which prevent them from carrying out their work successfully for example the lack of knowledge and technical know-how of the nursing staff as well as difficult collaboration with the residents and the lack of time and interest on the part of nursing management. This study shows that in a chosen nursing home with the presence of a dentist the knowledge to enable staff to carry out daily oral hygiene is probably sufficient. However, basic knowledge of dentistry is lacking especially when taking care of unwilling patients. The nursing staff has shown a great interest in furthering their knowledge of dental care. The administrator has pointed out the difficulty in prioritising care among residents. Up until now the concern about dental health has only played a small part in the organisation of nursing homes and therefore in the care programme itself. For the administrator, therefore, there is some sensitive and negotiable work to be done so as to include dental care in the general care of patients.

Administrative Personnel↗