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PubMed1993

HIV infection and Norwegian general practitioners: does fear affect knowledge?

The objective was to study the dimensionality of knowledge among general practitioners in Norway about transmission of HIV and what factors influence the degree of knowledge. Data were collected by a mailed questionnaire. Independent variables were experience of HIV, acquisition of knowledge and confidence in information on HIV from the central authorities and perception of own knowledge, skills of practice and fear of oneself or one's family contracting the HIV infection. Analysis of variance and multiple classification analysis were applied to measure the effect of independent variables on knowledge about transmission of HIV. The general practitioners in three counties (Oslo, Møre og Romsdal and Troms), constituting one-quarter of the Norwegian general practitioner population were selected (n = 578). The response rate was 65%, and the results are assumed to be representative of Norwegian general practitioners. Four dimensions of knowledge about transmission of HIV were identified by factor analysis. The two most important, transmission through 'body fluids' and transmission by 'needle sticks', were subsequently converted into sum scores and used as dependent variables. Forty-five per cent of the respondents were uncertain about ways in which HIV is not transmitted through 'body fluids'. There was an association between knowledge about transmission through 'body fluids' and the variables county background, confidence in the information about HIV and fear of contracting HIV. In the multiple classification analysis these three variables explained 11% of the variation in knowledge about transmission through 'body fluids'. Only confidence and fear significantly predicted the degree of knowledge, and among the 11% who had no confidence in the information received the effect of fear on knowledge increased significantly.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude of Health Personnel↗

PubMedDate not supplied

Knowledge utilization among experienced staff nurses.

The purpose of this descriptive exploratory study was to describe the processes staff nurses use to select and transfer new knowledge to practice. Eleven experienced staff nurses shared 29 examples in which gaining new knowledge resulted in changes in thinking or acting in a clinical situation. Findings indicated that knowledge utilization originated with the nurse who was active in selecting and using new knowledge. Nurses used multiple knowledge utilization processes primarily involving factual knowledge and instrumental utilization. Often, the decision to move knowledge to practice was based on comparison by similarity. There were no variations in utilization processes as nurses floated across units. Sources of new knowledge were primarily informal and unit based. Implications for staff development focus on developing unit-based resources and resource personnel, using innovative ways to introduce new knowledge on the unit, and providing time in formal classes for exchange of ideas on using new knowledge in practice.

Clinical Competence↗

PubMed1994

Dental health knowledge and attitudes among the middle-aged and the elderly in Hong Kong.

Previous studies on adult Hong Kong Chinese have indicated that their level of knowledge of and attitudes toward dental health might be a potential barrier to effective oral preventive efforts. The knowledge and attitudes of elderly Chinese have not previously been studied. The objectives of this study were to describe Hong Kong adults' knowledge of the causes of the two main oral diseases, caries and periodontal disease, and possible preventive measures, and to analyse possible relationships between knowledge and attitudes and selected sociodemographic and utilization variables. Two populations aged 35-44 yr (n = 398) and 65-74 yr (n = 559) were selected for the study, which was conducted as structured interviews. A knowledge score was constructed from questions on caries and periodontal disease development and prevention. Attitudes were measured in the younger group by beliefs and evaluations of those beliefs according to the theory of reasoned action (the higher the score, the more positive the attitude). Knowledge scores were almost normally distributed in the younger respondents, but were heavily skewed toward 0 in the older group. In both age groups, increased level of education and regularity or recency of dental visits were strongly associated with dental knowledge. Women, regular dental care users, and prevention-oriented respondents had higher attitude scores. There was no correlation between knowledge and attitudes. Some improvement in knowledge seems to have taken place, especially on the cause of caries, with fewer 35-44-yr-old respondents claiming lack of knowledge of the causes of caries and gum disease than in a previous study.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed2004

Knowledge on gingivitis and oral hygiene practices among secondary school adolescents in rural and urban Morogoro, Tanzania.

OBJECTIVES: To assess and compare knowledge on gingivitis and oral hygiene practices among rural and urban secondary school students. DESIGN: A cross-section descriptive study involving secondary school students aged between 13 and 17 years in Morogoro rural and urban districts. METHODS: Questionnaire was used to collect information about knowledge on causes, signs, symptoms, complications, treatment modalities and prevention of gingivitis, as well as on oral hygiene practices. RESULTS: A total of 196 students participated in this study, of which 58.7% were females, and 52% were from urban schools. The responses were graded into three criteria namely 'lack of knowledge', 'partial knowledge' and 'total or full knowledge'. There was a partial knowledge about gingivitis and full knowledge of the basic oral hygiene measures among secondary school teenagers. The difference between rural and urban residence on the level of understanding was statistically significant in relation to tooth brushing practices (P = 0.0088), necessity of using toothpaste (P = 0.0204), reasons for using toothpaste (P = 0.0057), signs and symptoms of gingivitis (P = 0.0261) and treatment of gingivitis (P = 0.0106). However, there were no statistically significant differences in distribution of study participants, understanding of tooth brushing practices, reasons for tooth brushing, causes, prevention and complications of gingivitis. CONCLUSION: Secondary school teenagers have partial knowledge about gingivitis and a good knowledge of the basic oral hygiene measures necessary to maintain proper oral health. A small difference on knowledge in specific areas was noted among rural and urban respondents.

Adolescent↗

PubMed2006

Factors behind change in knowledge after a mass media campaign targeting periodontitis.

The aim of this study was to investigate changes in knowledge before and after a mass media campaign, in relation to social attributes, care system attributes and oral health aspects. The study was based on a questionnaire in a cohort design, sent out to 900 randomly sampled people aged 50-75 in Sweden. The response rate to the questionnaire before and after the campaign was 70% and 65% respectively. Sixty-four percent answered both questionnaires. Two questions addressed knowledge, while 10 questions aimed to measure social attributes, care system attributes and oral health aspects. Data were analysed for bivariate relations as to change in knowledge and social attributes, care system attributes and oral health aspects. Data were also analysed in multiple regression analysis with knowledge before, knowledge after and knowledge differences as dependent variables. The results showed that there were a number of independent variables with influence on the dependent variables. Of the social attributes, secondary education gave almost 10% (P < 0.001) better knowledge both before and after the campaign. Among care system attributes, high care utilization was related to knowledge both before and after the campaign. The most important factors for knowledge about periodontitis were education, care utilization and perceived importance of oral health. In conclusion, this study demonstrates that mass media might increase knowledge about periodontitis as a health promotion strategy.

Aged↗

PubMed2004

A survey of food hygiene knowledge and attitudes among Chinese food handlers in Fong Song Tong district.

The purpose of this study was to find out the knowledge and attitudes concerning food hygiene among Chinese food handlers in Fong Song Tong district, and to analyze the impact of variables on the degree of knowledge and attitudes. Face-to-face interviews were conducted within Chinese food handlers in Fong Song Tong district using a self-designed questionnaire, which contained food hygiene knowledge and attitudes. Main knowledge outcome measures included food handling, personal hygiene and legislation issues. Questionnaires were completed by 580 (72.0%) Chinese food handlers from 91% premises of the district. 71.2% Chinese food handlers could respond correctly to eight or more out of 11 knowledge questions and 1.4% respondents only achieved full scores of knowledge. Fully correct response of personal hygiene knowledge was statistically and significantly higher than food handling knowledge (p<0.05). 79.0% of respondents showed their need of more food hygiene education. Male respondents, age less than 30, secondary education or above, five years or more of working experience, or who had previously attended a health training within the last two years, generally performed better on the knowledge of food hygiene. Chinese food handlers working in the kitchen and owners' beliefs on 'cleaning the kitchen before getting off duty' was reasonable. Those with secondary education at least, or who had prior participation in a health training within the last two years would need more food hygiene knowledge than the people aged over 30 or who were the owners. It would be more motivated by changing the traditional training model, community-based education in an optimum situation, additional authoritative information, attitudes and intentions of learning on food hygiene.

Adult↗

PubMed2005

Sources of practice knowledge among nurses.

Several studies have been published listing sources of practice knowledge used by nurses. However, the authors located no studies that asked clinicians to describe comprehensively and categorize the kinds of knowledge needed to practice or in which the researchers attempted to understand how clinicians privilege various knowledge sources. In this article, the authors report findings from two large ethnographic case studies in which sources of practice knowledge was a subsidiary theme. They draw on data from individual and card sort interviews, as well as participant observations, to identify nurses' sources of practice knowledge. Their findings demonstrate that nurses categorize their sources of practice knowledge into four broad groupings: social interactions, experiential knowledge, documents, and a priori knowledge. The insights gained add new understanding about sources of knowledge used by nurses and challenge the disproportionate weight that proponents of the evidence-based movement ascribe to research knowledge.

Adult↗

PubMed1986

The role of health belief attitudes, sex education, and demographics in predicting adolescents' sexuality knowledge.

As part of a pretest-posttest design to evaluate a 15-hour Health Belief Model (HBM)-based sex education program, we interviewed 203 teenagers (aged 13-17) of both genders regarding their preintervention sexual and contraceptive knowledge, attitudes toward pregnancy and contraception, and prior sex education and sexual activity experiences. A multiitem sexual and contraceptive knowledge measure yielded several specific topic area scales and a total knowledge score, and a multiitem attitudes measure also yielded five reliable HBM-based scales. A series of regression analyses that used teenagers' previous sexuality-related experiences, demographic information, and attitudes predicted knowledge scores well (R2 = 0.22-0.54). Across specific knowledge areas, HBM-based attitudes (e.g., perceived serious consequences of teen pregnancy) were consistently significant predictors. Interestingly, neither previous sex education nor personal sexual experiences were significantly associated with specific knowledge areas (e.g., venereal disease), although they were related to total knowledge scores. Similarly, age and gender were poor predictors of specific areas of knowledge, but minority ethnic status was consistently associated with less sexual and contraceptive knowledge. Our model was highly successful in accounting for a substantial portion of the variance in total knowledge scores (R2 = 0.54). Results are discussed in terms of their implications for designing sex education programs that focus on motivation for pregnancy avoidance and contraception as well as factual information for teenagers.

Adolescent↗

PubMed2005

Cardiovascular health knowledge and behavior in patient attendants at four tertiary care hospitals in Pakistan--a cause for concern.

BACKGROUND: Knowledge about coronary heart disease (CHD) and its risk factors is an important pre-requisite for an individual to implement behavioral changes leading towards CHD prevention. There is scant data on the status of knowledge about CHD in the general population of Pakistan. The objective of this study was to assess knowledge of CHD in a broad Pakistani population and identify the factors associated with knowledge. METHODS: Cross sectional study was carried out at four tertiary care hospitals in Pakistan using convenience sampling. Standard questionnaire was used to interview 792 patient attendants (persons accompanying patients). Knowledge was computed as a continuous variable based on correct answers to fifteen questions. Multivariable linear regression was conducted to determine the factors independently associated with knowledge. RESULTS: The mean age was 38.1 (+/- 13) years. 27.1% had received no formal education. The median knowledge score was 3.0 out of a possible maximum of 15. Only 14% were able to correctly describe CHD as a condition involving limitation in blood flow to the heart. Majority of respondents could identify only up to two risk factors for CHD. Most commonly identified risk factors were stress (43.4%), dietary fat (39.1%), smoking (31.9%) and lack of exercise (17.4%). About 20% were not able to identify even a single risk factor for CHD. Factors significantly associated with knowledge included age (p = 0.023), income (p < 0.001), education level (p < 0.001), residence (p < 0.001), a family history of CHD (p < 0.001) and a past history of diabetes (p = 0.004). Preventive practices were significantly lacking; 35%, 65.3% and 84.6% had never undergone assessment of blood pressure, glucose or cholesterol respectively. Only a minority felt that they would modify their diet, stop smoking or start exercising if a family member was to develop CHD. CONCLUSION: This is the first study assessing the state of CHD knowledge in a relatively diverse non-patient population in Pakistan. There are striking gaps in knowledge about CHD, its risk factors and symptoms. These translate to inadequate preventive behavior patterns. Educational programs are urgently required to improve the level of understanding of CHD in the Pakistani population.

Adult↗

PubMed2003

'Best practice' development and transfer in the NHS: the importance of process as well as product knowledge.

A core prescription from the knowledge management movement is that the successful management of organizational knowledge will prevent firms from 'reinventing the wheel', in particular through the transfer of 'best practices'. Our findings challenge this logic. They suggest instead that knowledge is emergent and enacted in practice, and that normally those involved in a given practice have only a partial understanding of the overall practice. Generating knowledge about current practice is therefore a precursor to changing that practice. In this sense, knowledge transfer does not occur independently of or in sequence to knowledge generation, but instead the process of knowledge generation and its transfer are inexorably intertwined. Thus, rather than transferring 'product' knowledge about the new 'best practice' per se, our analysis suggests that it is more useful to transfer 'process' knowledge about effective ways to generate the knowledge of existing practice, which is the essential starting point for attempts to change that practice.

Benchmarking↗

PubMed2005

The incidental orgasm: the presence of clitoral knowledge and the absence of orgasm for women.

Women report anorgasmia and other difficulties achieving orgasm. One approach to alleviating this problem is to teach women about the clitoris. This assumes that women lack information about the clitoris and that knowledge about the clitoris is correlated with orgasm. Using a non-random sample of 833 undergraduate students, our study investigates both assumptions. First, we test the amount of knowledge about the clitoris, the reported sources of this knowledge, and the correlation between citing a source and actual knowledge. Second, we measure the correlation between clitoral knowledge and orgasm in both masturbation and partnered sex. Among a sample of undergraduate students, the most frequently cited sources of clitoral knowledge (school and friends) were associated with the least amount of tested knowledge. The source most likely to correlate with clitoral knowledge (self-exploration) was among the most rarely cited. Despite this, respondents correctly answered, on average, three of the five clitoral knowledge measures. Knowledge correlated significantly with the frequency of women's orgasm in masturbation but not partnered sex. Our results are discussed in light of gender inequality and a social construction of sexuality, endorsed by both men and women, that privileges men's sexual pleasure over women's, such that orgasm for women is pleasing, but ultimately incidental.

Clitoris↗

PubMed1999

Knowledge of fetal alcohol syndrome (FAS) among natives in Northern Manitoba.

OBJECTIVE: To investigate knowledge about fetal alcohol syndrome (FAS) among Natives in northern Manitoba. A second objective was to determine if there are age or gender differences in level of knowledge. A third objective was to examine the relationship between knowledge about FAS and reported frequency of drug and alcohol use during pregnancy. METHOD: A nonrandom sample of 466 Natives from northern Manitoba was interviewed about drug and alcohol use during pregnancy and knowledge of FAS. The sample was proportionately representative of the 26 northern reserves, with an approximately equal number of male and female subjects ranging in age from 13 to 71 years. RESULTS: Northern Manitoban Natives have lower levels of FAS knowledge than the general public. Of this sample, 80% believed drinking alcohol could adversely affect the unborn baby and 36% had heard of FAS, compared to 90% and 64%, respectively, in the general U.S. population. Natives in their 20s and 30s were more knowledgeable than Natives in their 50s and 60s. Females tended to be more knowledgeable than males. Drug and alcohol use during pregnancy is high (51% of women report drinking during one or more pregnancies) and the relationship between FAS knowledge and drug use during pregnancy appears weak. Young people were the most knowledgeable about FAS but also the most likely to report having used drugs or alcohol during pregnancy. CONCLUSIONS: The low levels of knowledge about FAS among the Native population supports the need for continued education. However, the results also suggest that education by itself may be insufficient to make dramatic changes in behavior.

Adolescent↗

PubMed2004

Knowledge and utilization of Information Technology among health care professionals and students in Ile-Ife, Nigeria: a case study of a university teaching hospital.

BACKGROUND: The computer revolution and Information Technology (IT) have transformed modern health care systems in the areas of communication, teaching, storage and retrieval of medical information. These developments have positively impacted patient management and the training and retraining of healthcare providers. Little information is available on the level of training and utilization of IT among health care professionals in developing countries. OBJECTIVES: To assess the knowledge and utilization pattern of information technology among health care professionals and medical students in a university teaching hospital in Nigeria. METHODS: Self-structured pretested questionnaires that probe into the knowledge, attitudes and utilization of computers and IT were administered to a randomly selected group of 180 health care professionals and medical students. Descriptive statistics on their knowledge, attitude and utilization patterns were calculated. RESULTS: A total of 148 participants (82%) responded, which included 60 medical students, 41 medical doctors and 47 health records staff. Their ages ranged between 22 and 54 years. Eighty respondents (54%) reportedly had received some form of computer training while the remaining 68 (46%) had no training. Only 39 respondents (26%) owned a computer while the remaining 109 (74%) had no computer. In spite of this a total of 28 respondents (18.9%) demonstrated a good knowledge of computers while 87 (58.8%) had average knowledge. Only 33 (22.3%) showed poor knowledge. Fifty-nine respondents (39.9%) demonstrated a good attitude and good utilization habits, while in 50 respondents (33.8%) attitude and utilization habits were average and in 39 (26.4%) they were poor. While 25% of students and 27% of doctors had good computer knowledge (P=.006), only 4.3% of the records officers demonstrated a good knowledge. Forty percent of the medical students, 54% of the doctors and 27.7% of the health records officers showed good utilization habits and attitudes (P=.01) CONCLUSION: Only 26% of the respondents possess a computer, and only a small percentage of the respondents demonstrated good knowledge of computers and IT, hence the suboptimal utilization pattern. The fact that the health records officers by virtue of their profession had better training opportunities did not translate into better knowledge and utilization habits, hence the need for a more structured training, one which would form part of the curriculum. This would likely have more impact on the target population than ad hoc arrangements.

Adult↗

PubMed1992

The influence of general practitioners' knowledge about their patients on the clinical decision-making process.

Continuity of care is claimed to be an important and integral part of general practice. A main result of continuity is the doctor's accumulated knowledge about his or her patients. The objective of the present study was to evaluate the modifying effects of this knowledge on the decision-making process that takes place in consultations, as experienced by practitioners. A representative sample of 133 Norwegian general practitioners evaluated a total of 3,918 of their own consultations. The main independent variable was the doctor's own subjectively evaluated knowledge about the patient's medical history, while the major outcome measures included the perceived influence of accumulated knowledge on the consultation process in general, and on the diagnostic and management decisions in particular. In two-thirds of all consultations, or in three out of four in which the doctor had previous knowledge about the patient, this knowledge was considered to be clinically useful. In more than one-third of all consultations with previously unknown patients, this lack of information was felt to be a hindrance. Among patients with new medical problems and when the doctor had prior knowledge about the patient, this knowledge was felt to have significantly more therapeutic than diagnostic impact. Accumulated knowledge was generally felt to be of most help in consultations due to psycho-social problems, and was of special diagnostic value in patients presenting new, unspecific problems such as fatigue, fever, and generalized pain. This study indicates that accumulated knowledge about the patient is felt by the general practitioners to play an important and integral part in their clinical decision-making process.

Continuity of Patient Care↗

PubMed2002

Just-in-time delivery comes to knowledge management.

Like all primary care physicians, Dr. Bob Goldszer must stay on top of approximately 10,000 different diseases and syndromes, 3,000 medications, 1,100 laboratory tests, and many of the 400,000 articles added each year to the biomedical literature. That's no easy task. And it is, quite literally, a matter of life and death. The Institute of Medicine's 1999 report, To Err Is Human, suggests that more than a million injuries, and 90,000 deaths are attributable to medical errors annually. Something like 5% of hospital patients have adverse reactions to drugs, another study reports, and of those, 43% are serious, life threatening, or fatal. Many knowledge workers have problems similar to Dr. Goldszer's (though they're usually less life threatening). No matter what the field, many people simply can't keep up with all they need to know. In the early years of knowledge management, companies established knowledge networks and communities of practice, built knowledge repositories, and attempted to motivate people to share knowledge. But each of these activities involved a great deal of additional labor for knowledge workers. A better approach, say the authors, is to bake specialized knowledge into the jobs of highly skilled workers. Partners HealthCare has started to embed knowledge into the technology that doctors use in their jobs so that consulting it is no longer a separate activity. Now when Dr. Goldszer orders medicine or a lab test, the order-entry system automatically checks his decision against a massive clinical database as well as the patient's own medical record. Knowledge workers in other fields could likewise benefit from a just-in-time knowledge-management system tailored to deliver the right supporting information for the job at hand.

Benchmarking↗

PubMed2005

[Knowledge management in health organizations].

BACKGROUND: In 2002 the head of the Israel Defense Forces (IDF) Technology and Logistics Command took a strategic decision to manage knowledge across the organization. The IDF Medical Corps was one of the initiation sites selected. Insights from the process of establishment of a knowledge management (KM) system in the IDF Medical Corps as a health organization (HO) are described. METHODS: IDF's medical services were identified, mapped and their participants interviewed, as were KM personnel in Israeli HOs. Information analysis pointed to the medical rendezvous (MR) as the central process for initiation of KM. The knowledge challenges were identified, and knowledge services and administrative interventions were planned. RESULTS INCLUDING KM CHALLENGES AND RESPONSE: The MR was found to be the process in which most of the clinically and administratively significant decisions in HO's were taken. Practitioners had large clinical and administrative knowledge gaps. Medical and administrative knowledge originated from various sources, in many formats. It could not be retrieved either easily or completely, was usually presented in an inconvenient form for assimilation, and was not always updated. Therefore, the MR was selected as the initial intervention point. Optimally, a comprehensive solution providing access to high quality knowledge can be a knowledge portal, including diagnostic indexing as a key for retrieval of information. Furthermore, indexed clinical, administrative, services list, quality assurance, risk management, and continuing medical education knowledge services, as well as a collegial and administrative feedback, link all entities involved into a knowledge community. This may increase the opportunity for optimal and efficient managed care.

Health Knowledge, Attitudes, Practice↗

PubMedDate not supplied

HIV/AIDS and STI related knowledge, attitude and practice among high school students in Kathmandu valley.

OBJECTIVE: To assess the knowledge, attitude and practice of high school students regarding HIV/ AIDS and STI and to determine if a school education programme would bring about statistically significant positive change in the knowledge, attitude and practice regarding HIV/AIDS and STI. METHODS: The study was conducted among 1012 students of various schools in Kathmandu Valley (Kathmandu, Bhaktapur and Lalitpur). The tool for assessment was confidentially administered closed questionnaire both before and after the education programme of 45 minutes single class, standardized education package. RESULTS: Knowledge on some aspect of the disease was quite low in the study group. 45.8% had prior knowledge of HIV, 65.2% knew that HIV/AIDS could be transmitted by sharing same needle, 46.2% knew that vaccine is not yet available for HIV/AIDS. Knowledge about STI was also quite low, 41.5% knew that pus in the urine is a symptom of STI and 41.7% knew that STI is curable. 4.2% of the study group had previous sexual intercourse, 64.2% had sexual intercourse with friend and 35.17% had sexual intercourse with commercial sex workers. 1.8% would commit suicide if they contracted HIV/AIDS. According to sex wise distribution of the sample, female's knowledge about HIV was low 43.2% as compared to male 48%, male's knowledge about transmission of HIV/AIDS from pregnant mother to child was low; 89.7% as compared to female's knowledge 94.2%. Female's knowledge about commercial sex worker as high risk group was low (87.8%) as compared to male's knowledge 90.6%.

Adolescent↗

PubMed1991

Gender differences in adults' knowledge about fat and cholesterol.

Cognitive learning theories suggest that an individual's prior knowledge is a major factor for determining what can be learned. The objectives of this study were to compare the organization of knowledge about fat and cholesterol in adult, middle-class men and women and changes in that knowledge after reading an educational bulletin. Forty men and 48 women participated in two semistructured interviews to assess their knowledge; half received a US Department of Agriculture bulletin on fat and cholesterol at the end of the first interview. Concept maps (two-dimensional representations of an individual's cognitive knowledge structure) were made from the interview transcripts to assess knowledge organization. Both genders had limited knowledge, scoring less than 25% of the maximum possible score at interview 1. Overall, known and not known concepts were similar in men and women; however, women had slightly more integrated knowledge and more misconceptions than men. Both groups receiving the bulletin made significant gains in knowledge at interview 2, but knowledge gains were twice as great in men as in women. Our findings indicate that practitioners need not create separate materials about fat and cholesterol for middle-class men and women.

Adult↗