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Results for “Health Knowledge, Attitudes, Practice”

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PubMed2005

Health professionals' knowledge, practice and opinions about fetal alcohol syndrome and alcohol consumption in pregnancy.

OBJECTIVE: To measure the knowledge, attitudes and practices of health professionals regarding fetal alcohol syndrome (FAS) and alcohol use during pregnancy. METHOD: A postal survey of a representative random sample of health professionals was conducted in Western Australia (WA) in 2002/03. 1,143 (79%) of 1,443 eligible health professionals completed the survey (87 Aboriginal Health Workers, 286 allied health professionals, 537 community nurses, 170 general practitioners and 63 obstetricians). RESULTS: Of 1,143 health professionals, 12% identified all four essential diagnostic features of FAS. Most (95%) had never diagnosed FAS. Although 82% believed that making a diagnosis of FAS might improve treatment plans and 85% agreed FAS was preventable, 53% said the diagnosis might be stigmatising. Only 2% felt very prepared to deal with FAS and most wanted information for themselves and their clients. Of the 659 health professionals caring for pregnant women, only 45% routinely ask about alcohol use in pregnancy, only 25% routinely provide information on the consequences of alcohol use in pregnancy and only 13% provide advice consistent with NHMRC guidelines on alcohol consumption in pregnancy. CONCLUSION: Health professionals have identified the need for educational materials for themselves and their clients. IMPLICATIONS: FAS is likely to be under-ascertained in Australia due to a lack of knowledge of FAS by health professionals. Until this lack of knowledge is addressed, opportunities for diagnosis and prevention of FAS will be limited.

Adult↗
PubMed2005

What do primary care patients think about generic drugs?

OBJECTIVE: To examine the attitude of patients towards generic drugs and prescriptions containing generic drugs as an alternative to brand-name products, with a special focus on information on patients attitude to generic drugs provided by their general practitioners (GPs). METHODS: A total of 804 patients in 31 general practices were surveyed using a self-questionnaire. The influence of age, sex, education, disease, knowledge of generic drugs, experience with generic substitution and information provided by the GP on patient attitudes towards generic drugs and substitutions were examined. RESULTS: Nearly two thirds of the patients (509/804) stated that they knew of the difference between brand-name drugs and generics; of these, one third were not satisfied with the information given by their GPs and 37% of patients expressed general skepticism towards generic drugs because of their lower price. This attitude was more frequent among those who felt that generic prescribing was "invented" to solve the financial crisis in the German health insurance system at their expense (odds ratio (OR): 6.2; 95% confidence interval: 4.0 - 9.8) and those who had not been confronted personally with a generic substitution (OR: 1.8; 1.3 3.0). Patients who had been skeptical when first confronted with a generic substitution were more frequently among those who considered inexpensive drugs to be inferior (OR: 4.5; 2.0 10.4) and they were frequently not satisfied with the information on substitution provided by their GP (OR: 2.7; 1.2 - 5.9). CONCLUSION: GPs are in an ideal position to inform their patients adequately about the equivalence of brand-name and generic drugs. However, the patient view that inexpensive drugs must be inferior may be difficult to rectify in the short term.

Drugs, Generic↗
PubMed2004

Implementing evidence-based practice: evaluation of an opinion leader strategy to improve breast-feeding rates.

OBJECTIVE: The objective was to evaluate the effectiveness of opinion leaders in raising breast-feeding rates. STUDY DESIGN: A randomized controlled trial of an opinion leader strategy in 18 hospitals in Central New York State compared mothers' intention to breast-feed during baseline and study years. Multivariate logistic regression with a mixed model analyzed the effects on breast-feeding exclusively and on breast- and formula-feeding combined. RESULTS: Obstetric clinicians had a high degree of knowledge about breast-feeding benefits and of perceived responsibility to recommend breast-feeding. Obstetricians, family practitioners, and midwives agreed on the person identified as the opinion leader, in each case an obstetrician who was chief of obstetrics or obstetrics-gynecology. Breast-feeding rates in hospitals with the opinion leader intervention did not differ significantly from those in control-group hospitals during the study year. CONCLUSION: The opinion leader strategy in this case did not improve breast-feeding rates during the study year. Opinion leader strategies may make assumptions about clinician control that are not justified in situations such as breast-feeding.

Attitude of Health Personnel↗
PubMed2005

Unwanted control: how patients in the primary care setting decide about screening for prostate cancer.

Current guidelines recommend shared decision-making to determine whether the prostate-specific antigen (PSA) test should be performed. At a large family medicine practice in suburban Washington, DC, we administered a sequence of patient and physician surveys to examine the desired and actual level of patient control over PSA screening decisions and the circumstances in which they occur. Both before and after visits, patients expressed a preference for a shared approach to the PSA decision, but the actual decision involved a significant shift toward greater patient control. Almost 25% of patients reported greater decisional control than they desired. Fully 30% of the men who wanted a shared approach made the actual decision themselves. Patients prefer a shared approach to the PSA decision but report greater personal control when the decision is actually made. Further research is needed to understand this phenomenon and to better accommodate patients' desire for shared decision-making.

Aged↗
PubMed1997

Nursing research within bone marrow transplantation in Europe: an evaluation.

The limited contribution of nursing research and the utilisation of research findings in the field of bone marrow transplantation (BMT) in Europe have been identified as issues needing further attention. Reasons behind these issues include the lack of nursing training in research techniques, problems with funding nursing research, staff shortages and language barriers. An overall research strategy for nurses has been suggested as well as academic research support for those nurses who do not feel confident carrying out research projects. A small scale study in four European BMT centres identified that the main nursing research priorities included isolation techniques, psychosocial and quality of life issues, staff issues, central line catheter care and mouth care/management of oral mucositis. The same study also showed that only 20% of the BMT units regularly use research and research findings in their day-to-day nursing practice.

Bone Marrow Transplantation↗
PubMed2006

The promise and pitfalls of systematic reviews.

The systematic review "movement" that has transformed medical journal reports of clinical trials and reviews of clinical trials has taken hold in public health, with the most recent milestone, the publication of the first edition of The Guide to Community Health Services in 2005. In this paper we define and distinguish current terms, point out important resources for systematic reviews, describe the impact of systematic review on the quality of primary studies and summaries of the evidence, and provide perspectives on the promise of systematic reviews for shaping the agenda for public health research. Several pitfalls are discussed, including a false sense of rigor implied by the terms "systematic review" and "meta-analysis" and substantial variation in the validity of claims that a particular intervention is "evidence based," and the difficulty of translating conclusions from systematic reviews into public health advocacy and practice.

Evidence-Based Medicine↗
PubMed1996

Maternal-child immigrant health training: changing knowledge and attitudes to improve health care delivery.

This paper reports the development, implementation and evaluation of a training program for all levels of staff of Maternity Infant Care Family Planning Centers in New York City. The learner-centered training is designed to enhance cross-cultural sensitivity and communication skills. It provides epidemiological and patient management skills for serving ethnically diverse populations and focuses on skills training, such as the cross-linguistic, cross-cultural interview, and using epidemiological principles in diagnosis and treatment. In addition to the core curriculum, each module is tailored to the site-specific information needs of the participants, as determined during individualized needs assessments. There are five sessions: the cross-cultural medical interview and working with interpreters; epidemiologic issues; attitudes and practices in maternal child health; family dynamics and interactions; and a session devoted to follow-up and evaluation. This training has been very successful in enhancing health care providers' sensitivity toward immigrant health issues. Pre- and post-test measurements found statistically significant improvements in the knowledge and attitudes of participants. Patient care has been greatly improved.

Communication↗
PubMed2006

Lights, camera, education! The potentials of forum theatre in a learning disability nursing program.

Learning disability nurse education, with a current emphasis on inclusive practice and a history of listening to the person with the disability, is well placed to take advantage of more 'experimental' forms of classroom teaching. In this article we argue for the use of forum theatre as a method of addressing topics from practice within an educational setting. Based on our emergent and exploratory work with students we detail at length the theoretical background that supports such an approach and contextualise the issues with reference to a short piece of drama we have used successfully with different student groups. We feel that the success of this method is due to the involvement of students in directing their own education as well as the inclusion of individuals labelled with learning disability as an integral part of the process.

Communication↗
PubMed2001

Knowledge of newborn health care among pregnant women: basis for promotional and educational programs on breastfeeding.

CONTEXT: Promotional and educational programs relating to breast feeding are important for reversing the decline in this practice. Most programs are centered exclusively on breast feeding, although general knowledge about newborn health care may be important, especially among pregnant women. OBJECTIVE: To study pregnant women's knowledge about general health care of newborns, including breast feeding aspects. TYPE OF STUDY: Cross-sectional. SETTING: Prof. Samuel Barnsley Pessoa Health School Center, Faculty of Medicine, University of São Paulo, Brazil. PARTICIPANTS: All pregnant women who were registered in the prenatal care program during six consecutive months. MAIN MEASUREMENTS: Aspects of the current gestation, previous gestations and childbirth, knowledge of the general aspects of newborn health care and of breast feeding practices. RESULTS: The results show that only a little over half of the pregnant women had received any information on newborn health care. Misinformation was clearly present regarding proper care of the umbilical stump and the nature of jaundice, and worst regarding how to treat oral thrush and jaundice, and about vaccination. In relation to breast feeding, even though almost all the pregnant women declared their intention to breast feeding, less than half had a concrete response regarding how long to do it for. The low rates obtained in the topics dealing with the duration, nursing intervals and the attitude to be taken towards hypogalactia show unfamiliarity with the breast feeding technique. The "weak milk" belief, the misinformation about contraceptive methods during breast feeding and the cost of artificial formulas also have a negative impact on this practice. CONCLUSIONS: Pregnant women's knowledge of newborn health care is low, as much in the aspects of general care as in relation to the practice of breast feeding. These findings must be taken into consideration in educative programs promoting breast feeding.

Breast Feeding↗
PubMed2005

Conducting client supervision in community health care.

The aim of the present study was to examine registered public health nurses' views and reported actions related to client supervision in community health care. Transcript-based, qualitative and interpretative content analysis was used to analyse the findings from six focus group interviews. The main findings represented the following themes: the components of the assessment basis related to choosing supervision as an intervention strategy, the strategies related to conducting supervision and the meaning of supervision as an intentional act. In conclusion, the registered public health nurses' reported model for conducting supervision seems to correspond with principles in the new strategies for health promotion initiated by the World Health Organization. Further research is needed to explore what the nurses really do when conducting supervision in order to provide extended knowledge about their model.

Adaptation, Psychological↗
PubMed2006

Knowledge and behaviour for a sustainable improvement culture.

Wait limits have improved UK healthcare access, and Ontario's Wait Time Strategy bears a remarkable resemblance. There appears to be an implicit assumption that capacity and efficiency factors are the main causes of waits. The improvement mechanism is driven by performance measurement that reports wait time outcomes. Our experience makes us conclude that Ontario's plans contain risks. Superficially, the UK approach has been successful with dramatic wait time reductions but has incurred tremendous financial cost and patients not always benefiting. Reasons for partial success are not understanding the cause of waiting, with inappropriate"improvements"; and often encouraging unintended behaviours, with poor stakeholder management. Those sustaining their approach have significantly better performance and timely service without excess cost, but their approach has not seen a wide enough audience for acceptance and adoption. At the top, there is almost bewilderment about why others struggle with wait time targets. For an effective program it is essential to understand the system and have consistency between the measurement system and engendered behaviour, the root causes of waits and solutions, the management style and improvement culture, the reward system and good clinical practice.

Government↗
PubMedDate not supplied

Assessing the strengths and weaknesses of action research.

BACKGROUND: Proponents of action research claim that it is not just for researchers, but helps to empower research participants to make changes in practice. This literature review examines some of the evidence for and against a research methodology that might still be unfamiliar to many nurses. CONCLUSION: Action research often lends itself to small-scale studies and is time-consuming. The value of such a methodology is that it provides a powerful means of improving and enhancing practice.

Attitude of Health Personnel↗
PubMedDate not supplied

Exploring person-centred care.

This article explores the philosophy of person-centred care. Person-centred care developed in response to the need for a more patient-sensitive healthcare service and is based on a rich understanding of the patient, his or her circumstances and needs.

Adaptation, Psychological↗
PubMed2005

Parents' management of their child's postoperative pain.

In spite of its benefits, day or minor surgery is not without complications; pain is a significant issue for someatients (Kotiniemi et al 1997, Grenier et al 1998). Having witnessed considerable variation in the discharge advice given to parents about pain control we were prompted to discover what evidence there is to suggest 4 hat parents can effectively manage their child's postoperative pain at home following day or minor surgery. In this artide cle review the evidence and describe how review findings were used to inform practice.

Ambulatory Surgical Procedures↗
PubMedDate not supplied

[Do health workers practice what they preach? A study of knowledge, opinions and practices of health care professionals, with respect to their own health, in Madagascar].

In this study, a questionnaire was used to study the individual behavior of a sample of fifty health workers, doctors and nurses from Tamatave (Madagascar) with respect to a number of current health issues. We used the results to assess the impact and efficacy of previous training and to obtain information about the extent to which health staff actually follow the recommendations and standards that they are given and expected to teach, as far as their own health is concerned. It was clear that the standard management procedures and instructions concerning basic health-preserving behavior were far from being universally accepted and followed by health workers themselves. This was the case even for common diseases and health issues for which specific training had been given, such as malaria, diarrhea, AIDS and STDs, tobacco use, HBP management and the use of antibiotics. More attention should be paid to involving health workers in their training programs so that they are really convinced by the recommendations given. So long as most health workers are not themselves committed to the recommendations and have inadequate behavior regarding their own health, they are unlikely to be effective at promoting good health practice.

Health Behavior↗