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The dental attitudes, knowledge and health practices of patients with Juvenile Idiopathic Arthritis.

AIM: To investigate the dental attitudes, knowledge and dental health practices of children and adults with a previous diagnosis of Juvenile Idiopathic Arthritis (JIA). STUDY DESIGN: A self-completion questionnaire. METHODS: Ninety-one children and 82 adults with JIA were age and gender matched with 152 healthy controls. For those below the age of 16 years, the parents' attitude, knowledge and dental health practices were investigated by the questionnaire. The adult subjects and controls completed an identical questionnaire assessing their own attitude, knowledge and dental health practices. RESULTS: Response rates of 84% and 75% were achieved for the subject and controls respectively. Both groups responded similarly to questions assessing perception of different medical conditions. The majority of respondents thought leukaemia was a very serious condition. Twenty-seven percent of subjects and 34% of controls felt dental decay was "slightly or not serious". Ninety percent of subjects and 93% of controls knew having sweet snacks during the day would harm teeth, but fewer were sure that eating sweet foods at mealtimes only would help reduce decay. The majority of respondents (63% and 56% respectively) did not know whether children should receive fluoride tablets but the majority of subjects in both groups had attended a dentist within the last year. STATISTICS: Descriptive analyses and chi-squared analysis were undertaken. A p-value of < or =0.01 was taken as strong evidence of a difference between groups. CONCLUSION: The perception of health and illness by both groups was appropriate. The questions investigating dental knowledge revealed understanding of the basic messages of prevention of dental disease, but finer detail appeared less well understood. Responses concerning dental health confirmed positive attitudes towards good dental health habits. The benefits of brushing with fluoride toothpaste were known, and the majority toothbrushed daily and received dental care within the previous year.

Adolescent↗

Health knowledge, attitudes, and practice (KAP)--a basis for health promotion policy in Israel.

OBJECTIVE: To review how health promotion policy can be based on research data. DATA SOURCES: The Department of Health Promotion, Ministry of Health, Israel, in collaboration with Midgam Research and Consultation Company and the Israel Center for Disease Control have conducted ongoing research on health knowledge, attitudes, and practice in Israel as a basis for health policy. MAIN FINDINGS: Based on data from 1995 to 2000: 1. There is a positive trend in healthy dietary habits. 2. There is no decrease in smoking rates. 3. There is an increase in drinking rates of wine. 4. There is an increase in aerobic exercise. More Israelis declare they eat healthy foods, but currently this is only for 50% of the population. There is a need for health promotion efforts to further increase positive dietary habits. There is an immediate need for extensive health promotion efforts to decrease smoking rates in Israel. Also, there is a need for health promotion campaigns to decrease drinking in Israel. Although more people are participating in aerobic physical exercise, there is a need to further increase this number. CONCLUSION: Data on health knowledge, attitudes, and practice is an important source for health promotion policy. By trends seen in a national survey of health knowledge, attitudes, and practice conducted every two years, additional health promotion policy can be shaped.

Adult↗

Reproductive health knowledge, attitudes and practices of Iranian college students.

To study reproductive health knowledge, attitudes and practices of youth in the Islamic Republic of Iran, 1111 university students completed a questionnaire with 43 closed questions. The overall mean knowledge score was 54%. Knowledge of males and females, and of married and single students, was similar. Of 664 students answering questions about reproductive health behaviour, 54 (8%) reported having sexual intercourse before marriage; 16% of males and 0.6% of females; 48% of them had used condoms. The majority of students believed that the risk of AIDS and other sexually transmitted infections was moderate but that youth had a low ability to practise healthy behaviour. The majority believed in the benefits of reproductive health knowledge for youth but felt that services were inadequate.

Attitude to Health↗

Dental attitudes, knowledge, and health practices of parents of children with congenital heart disease.

A total of 60 children with severe congenital cardiac disease from the Great Ormond Street Hospital for Children and Guy's Hospital children's department were matched for age, gender, social class, and ethnic origin with 60 healthy children from the trauma clinic of the Department of Orthodontics and Paediatric Dentistry at Guy's Dental Hospital, London. The parents' attitude, knowledge, and dental health practices were assessed by questionnaire. The cardiac group had significantly poorer dental health practices than the healthy group. Of the cardiac children 18% had never visited the dentist compared with only 3% for the healthy group. It is difficult to assess the importance of this in terms of a serious health hazard. Current practice of cardiac physicians is to recommend that children with heart disease seek out and attend a dentist, the advice usually being accompanied by the presentation of a 'heart card' detailing antibiotic prophylaxis regimens if extractions are required. The data presented here shows that this strategy has failed.

Adolescent↗

[Knowledge and attitudes of practice of health workers in Bizkaia health centers toward diet and cholesterol].

OBJECTIVE: Analyze the extent to which criteria and practice of the Sanitary Personnel approximate the recommendations of the Consensus on the Control of Hypercholesterolemia in Spain, find out how extensive their dietary knowledge in and how skillful they are to interview and counsel a patient with hyperlipidemia. DESIGN: Transversal study with simple aleatory sampling using a questionnaire. PARTICIPANTS AND LOCATION: 101 physicians and 95 nurses working in Primary Health Care Teams in Bizkaia, during the monthly of June 1991; deputies for periods inferior to 3 months were excluded. MEASUREMENTS AND MAIN RESULTS: 82% of physicians (P) counselled dietetic treatment for cholesterolemic levels coinciding with those set in the Consensus and 70% demanded excessive analytical controls for hypercholesterolemic patients under treatment already normalized; 37% (P) and 12% of nurses (N) knew that the polyunsaturated/saturated fat ratio is the main dietetic factor; various errors were detected in questions relating to olive oil, unsaturated fat in fish and fibre values of legume; accurate responses between 13-54% (N) and 23-77% (P). CONCLUSIONS: The "mediterranean diet" is not sufficiently known; our ability for the dietetic interview and personalized counsel needs to be improved. In the light of the above and taking into accounted the gaps and deviations existing between our practice and the Consensus and its applications, we consider a better diffusion of the cited document is necessary among Primary Health Care Teams.

Diet↗

Cold/flu knowledge, attitudes and health care practices: results of a two-city telephone survey.

The purpose of this paper is to describe knowledge, attitudes and practices of cold and flu self-care and health care utilization, and to identify the predictors of health care utilization for the cold and flu among residents of London and Windsor. Using a random digit dialing survey method, 417 residents were interviewed between November-December, 1993 and February-March, 1994. This survey revealed good knowledge about colds and flu and understanding of appropriate physician visits. Only seven percent reported a doctor visit for their last cold. Socio-demographic, health status, attitude and knowledge level variables were subjected to a logistic regression analysis to identify which variables predicted self-reported physician visits. Only attitudes and health status showed statistically significant log odds (3.6 and 1.5, respectively). In summary, consistent with other studies, attitude and health status, not knowledge, appear to be significant predictors of physician visits for colds/flu.

Adolescent↗

Chefs' attitudes toward healthful food preparation are more positive than their food science knowledge and practices.

OBJECTIVE: To determine if chefs' and student chefs' attitudes, knowledge, and practices regarding healthful food preparation are consistent with the Dietary Guidelines for Americans. DESIGN: An analytical survey questionnaire was distributed to 4 chef groups. Sections 1 and 2 of the survey measured chefs' food science knowledge (13 questions) and likelihood of using food preparation practices (15 questions) necessary to meet the 1990 Dietary Guidelines for Americans. Section 3 (22 questions) measured chefs' attitudes toward nutrition in general, toward the importance of healthful food preparation practices, and toward the US Dietary Guidelines. SAMPLE: Of 512 surveys distributed by mail, at culinary meetings, and in classes at 2 culinary schools, 447 (86%) were returned (158 from practicing chefs and 289 from student chefs). Practicing chefs included chef educators, foodservice chefs from a national corporation, and independent chef members of the American Culinary Federation of New York City. STATISTICAL ANALYSIS: Descriptive statistics included frequencies, means, and standard deviations of survey items and of individual survey sections. Reliability and validity were determined using alpha coefficients and principal components analysis. Analysis of variance was used to examine differences in practice, attitudes, and knowledge among chef groups. RESULTS: Both practicing chefs and student chefs answered more than 70% of the food science questions correctly; independent chefs scored significantly lower than educator and corporate chefs. More than two thirds of the chefs and student chefs correctly responded to questions about the nutrient composition of food and how cooking affects the nutrient content of food. All chef groups were confused about fat and cholesterol in food and in the body. Few healthful food preparation practices were likely to be used by any chef group more than two thirds of the time, although the subscale of the attitude toward the importance of these practices was very positive. The majority of practicing chefs thought that customers do not care about the US Dietary Guidelines and nutrition; student chefs thought that customers do care. Both groups strongly agreed that, as chefs, they are responsible for the nutritional content of the food they prepared. APPLICATION: Both chefs and student chefs are willing to learn about food science and recipe modification principles as they apply to healthful cooking practices. The opportunities are clear: Dietitians have the expertise to teach chefs healthful food preparation techniques, recipe modification, and food composition information.

Adolescent↗

Caries prevalence in Saudi primary schoolchildren of Riyadh and their teachers' oral health knowledge, attitude and practices.

OBJECTIVE: The purpose of the present study was to determine the caries prevalence and severity in primary school children Riyadh, Kingdom of Saudi Arabia, and to assess the oral health knowledge, attitude and practices of their teachers. METHODS: A random sample of primary schoolchildren was examined for dental caries utilizing World Health Organization criteria for diagnosis of caries. The information regarding oral health knowledge, attitude and practices in schoolteachers was collected through an especially designed self-administered questionnaire. RESULTS: The prevalence of caries among the sample was 94.4%. The mean decayed, missing and filled score for primary teeth of the sample was 6.3 (+3.5), with decay component of 4.9 (+3.1), missing component of 1.1 (+1.7) and filled component of 0.3 (+1.0). The mean decayed, missing and filled score for permanent teeth of the sample was 1.6 (+1.5) with decay component of 1.5 (+1.4) as the major component. All the teachers (100%) thought that good dental health was important for general health and that routine check up dental visits help in maintaining good dental health. All the teachers (100%) thought that tooth cleaning using brush or miswak was important for good dental health. Regarding the caries risk factors, the majority of teachers understood the main causes of dental caries such as poor oral hygiene (97.4%) and high sugar intake (97.4%). Almost all the teachers (97.4%) thought that dental health lectures were of great importance for their students but less than half (41%) actually spent time on teaching proper oral health care. CONCLUSION: The caries prevalence in Riyadh primary schoolchildren is very high. The teachers' knowledge regarding oral health is satisfactory and their attitude towards oral health is very positive.

Adolescent↗

Baby walkers--health visitors' current practice, attitudes and knowledge.

BACKGROUND: Baby walkers are a commonly used item of nursery equipment. Between 12% and 50% of parents whose infant uses a walker report that their child has suffered a walker-related injury. Health visitors' knowledge, attitudes and practice with regard to walkers and related health education has not been explored so far. AIM: The aim of the study was to describe health visitors' knowledge of walkers and walker-related injuries, their attitudes towards walkers and current practice with regard to walker health education, and to examine the relationship between knowledge and attitudes and knowledge and practice. METHOD: A survey was carried out with 64 health visitors prior to participation in a randomized controlled trial assessing the effectiveness of an educational package in reducing baby walker use. RESULTS: The response rate was 95%. Half of the health visitors always discussed walkers postnatally, most frequently at the 6-9 month check. Most did not usually discuss the frequency of walker-related injuries. Most had negative attitudes towards walkers, but believed that parents hold positive attitudes to them and that it is hard to persuade parents not to use them. Health visitors had a limited knowledge of walker use and walker-related injuries. Those giving advice on walkers most often had higher knowledge scores than those giving advice less often (P = 0.03). Those with higher knowledge scores held more negative attitudes towards walkers (rs = 0.29, P = 0.023) and believed parents to have more positive attitudes towards walkers (rs = -0.49, P < 0.001). Few health visitors had resources to discuss walkers. CONCLUSIONS: Health visitor advice regarding walkers needs to be given earlier in the postnatal period than is currently common practice, and they need more knowledge about walker use and related injuries. Education about baby walkers needs to be incorporated into undergraduate and in-service education, which may need to include the development of skills in exploring reasons why parents use walkers and in negotiating alternatives to their use. The provision of audio-visual aids for discussing walkers might also be helpful.

Accident Prevention↗

Nutrition and the health care agenda: a primary care perspective.

The current climate of prioritizing in the NHS brings into focus the debate surrounding efficient and effective management of conditions associated with the modern lifestyle. In any such debate, nutrition should be considered a primary issue as there is now international consensus regarding the optimum diet for the prevention of both coronary heart disease and cancer. Over recent years, government has stated that primary care is in an ideal setting to provide nutrition education to the public. However, we present the case that there currently is a mismatch between the attitude of the public, who appear willing to accept dietary advice from primary care professionals, and the reluctance on behalf of these professionals to fulfil this role. Dissatisfaction with the quality of nutrition education received by those working in primary care is often cited as a barrier to providing dietary advice to patients. With that in mind, we go on to discuss educational strategies that may motivate primary care staff to increase their involvement in providing dietary advice for their patients. The challenge to those involved in the delivery of nutrition training to primary care professionals is to convince them that dietary intervention is worthwhile and that they can make a positive contribution to dietary change within the current organization of primary care. Increasing motivation is an essential outcome of such training, along with providing the skills and knowledge to fulfil this role. The contribution which diet could make is significant and, in this time of questioning priorities, the role of nutrition needs to be put firmly on the health care agenda.

Attitude of Health Personnel↗

Reproductive health knowledge, attitude and practice among high school students in Bahir Dar, Ethiopia.

This study was carried out to investigate the reproductive health knowledge, attitude and practice of high school students in Bahir Dar, Ethiopia. Data were collected using self-administered questionnaire and focus group discussions. The study revealed that the students had high level knowledge of contraceptives and where to obtain contraceptive services; however, level of use was low. Some of the reasons given for not using contraceptives include lack of access to services, carelessness, unplanned sexual intercourse and pressure from sexual partner. The study indicates that young people engage in sexual relationships at an early age without protection or with unsafe non-conventional methods. There was no significant difference between the demographic variables and contraceptive use at first intercourse. Educational level of the respondents was the only demographic variable that had significant association with sexual experience (p < 0.05). We recommend improved access to family planning information and services and family life education programmes based on the needs and experience of these young people as a potential solution to alleviate their reproductive health problems.

Adolescent↗

Knowledge, attitude and practice of health workers in Keffi local government hospitals regarding Baby-Friendly Hospital Initiative (BFHI) practices.

OBJECTIVE: To assess the knowledge, attitude and practice of health workers towards Baby Friendly Hospital Initiative (BFHI) practices and thereafter plan an advocacy on BFHI training of the workers. DESIGN: A randomised cross-sectional study. SETING: Ten out of 16 health facilities reflecting all the levels of healthcare provision in Keffi Local Government Area in Nassarawa State, Nigeria, were selected. Staff of these health facilities had not received BFHI training, although breastfeeding is the norm in this population, exclusive breastfeeding is almost zero. SUBJECTS: A total of 250 health workers (six doctors, 160 nurses and 84 auxiliary staff) met in the health facilities at the time of interview. INTERVENTION: A structured questionnaire based on 10 steps to successful breastfeeding was administered by one of the authors and a Lactad nurse between July and October 1995. RESULTS: Fifty-two (20.8%) were aware of the need for initiating breastfeeding within 30 min of birth and 92 (36.8%) were aware of breastfeeding support groups. However, there were significant differences in the level of awareness among the doctors compared to the other categories of health staff (P<0.05). Also, 48 (19.2%) of the health workers believed that babies less than 6 months of age should not be given water (statistical difference (P<0.05) between doctors' attitude and that of the other health workers). Thirteen (5.22%) health workers could demonstrate correct positioning and attachment. CONCLUSION: There was general lack of awareness of some major recommended practices in the hospitals that will promote and sustain breastfeeding. There is therefore the need for policy changes and BFHI training for the staff of these health facilities to respond to the concern and growing need for proper infant/young child feeding.

Adult↗

Reasons for patient removals: results of a survey of 1005 GPs in Northern Ireland.

There has been considerable debate on the issue of general practitioners (GPs) removing patients from their lists. The second report of the Health Service Ombudsman addressed this area in some detail and, among other observations, commented on the lack of information available on this subject. This is a report on a questionnaire survey of GPs, aimed at finding out their reasons for removing patients and their feelings about the changes that have been proposed regarding their automatic right to remove patients without giving them a reason.

Attitude of Health Personnel↗

Oral health knowledge, attitudes, and practices of Chinese adults.

Only recently have behavioral aspects been taken into consideration in oral health studies in China; thus, relevant information on perceptions in adult Chinese about oral health care is inadequate. In 1996-97, a large-scale oral epidemiological study was conducted in Southern China. Among its objectives were to describe the oral health knowledge, attitudes, and practices of the urban and rural adults living in Southern China and to analyze the influence of selected demographic and socio-economic factors. From 8 urban and 8 rural communities in Guangdong Province, 1,573 35- to 44-year-olds and 1,515 65- to 74-year-olds were sampled. Specially trained interviewers from the staff of local government or hospitals conducted face-to-face structured interviews. Almost all of the middle-aged and more than 90% of the dentate elderly surveyed claimed that they brushed their teeth every day and used toothpaste during toothbrushing, but awareness about fluoride content was lacking. The respondents had poor oral health knowledge but positive attitudes toward oral health, providing a basis for more community-based oral health education programs, especially targeting adults who are less-well-educated and have fewer socio-economic advantages.

Adult↗

Physicians' attitudes toward managed care: assessment and potential effects on practice behaviors.

This study was designed to identify the key components of physicians' attitudes toward managed care and develop a tool to assess these components. We developed a questionnaire based on physicians' reactions to managed care, as reflected in the published literature. We mailed this questionnaire to a sample of 753 community physicians in the greater Sacramento area. A factor analysis of these data (n = 315) identified five unifactorial scales, which we labeled managed care quality, need to adapt to managed care, cost-containment effectiveness of managed care, personal knowledge of managed care, and inevitability of managed care. Physicians were most negative about the quality of managed care and most in agreement about the need to adapt to it. Correlations among these five scales, while statistically significant, were modest in size, suggesting that these physicians were quite discriminating in their evaluations. In comparison with medical/surgical specialists, primary care physicians rated the quality of managed care, their knowledge of it, and the inevitability of a national transition to managed care more positively. These measures predicted the physicians' intentions to alter their medical behaviors to comply with managed care practices.

Attitude of Health Personnel↗