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Dynamics of knowledge and attitudes about AIDS among the educated in southern India.

AIDS awareness and attitudes among an educated segment of the Indian population were assessed. The study population was a total of 433 students and faculty in colleges and universities, and research & technical staff of the Public Health Service. While most knew that sexual intercourse (96%) & injection drug use (85%) could transmit HIV, and that shaking hands (95%) & mosquitoes (86%) could not, 63% did not know that breastfeeding was a mode of transmission and 71% falsely believed that they could acquire HIV by donating blood. The only variable to correlate positively with knowledge was education. Knowledge about true and false modes of transmission constituted three distinct dimensions as determined by factor analysis. An overwhelming majority (90%) harboured at least one hostile view towards persons with AIDS. Knowledge and education independently correlated with decreased hostility. There was great concern about the impact of the disease: 85% believed that AIDS is a very serious problem in India and 93% favoured increased government spending on AIDS education. These results display high levels of knowledge (with some gaps), and widespread support for increased action.

Adolescent↗

Prenatal knowledge and informational priorities of pregnant adolescents.

One hundred and forty-six indigent pregnant adolescents (12 to 18 years of age) were asked to complete a questionnaire concerning their prenatal care priorities (Scale I) and their knowledge of correct perinatal behaviors (Scale II). On Scale I, over 75% of teens considered parenting skills, infant care, and diet extremely important. On Scale II correctly answered items focused on the need to avoid substance abuse and smoking during pregnancy, visit the doctor, and eat balanced meals. The mean number of correct answers, however, was only 11.8 out of a total possible scale of 18 items. Less than 50% correctly answered statements about the effects of weight gain and other health behaviors on risk for high blood pressure and toxemia, safety of laxatives during pregnancy, possibility of becoming pregnant again before resuming menstruation, and the safety of various physical activities. Performance on both knowledge and health priority scales showed correct health information was limited to basic concrete facts. Abstract and technical aspects of health care did not appear to be easily assimilated.

Adolescent↗

Pesticide use on agricultural fields and health problems in various activities.

OBJECTIVES: To assess the health status, attitude and level of awareness of safe pesticide handling practices of farm workers engaged in the application of pesticides on agricultural farms. DESIGN: Cross sectional study. SETTING: Two farms in northwest Ethiopia, 2004. SUBJECTS: Farm workers of job categories; sprayers, pest assessors, supervisors, spraymachine mechanics and tractor operators. RESULTS: The farm workers had respiratory symptoms of cough, phlegm and wheezing. Systolic and diastolic blood pressures did not show abnormalities. Liver function tests showed elevated values. Respiratory symptoms in the farm workers revealed that cough phlegm and wheezing at Ayehu farm were significantly (p < 0.05) higher than the controls. Alkaline phosphatase (ALP) at Birr Farm in the sprayers and mechanics were significantly higher than the controls (p < 0.05). The ALP value in the sprayers, glutamate pyruvate transaminase (GPT) in the assessors and glutamate oxaloacetate transaminase (GOT) in the sprayers and mechanics at Ayehu were significantly higher than the controls (p < 0.05). From a total of 82 farm workers 35.7% at Birr and 75% at Ayehu Farm described that they were not formally instructed about safe pesticide handling methods. CONCLUSION: The farm workers health is affected by the unwise use of pesticides. The level of awareness and attitude on safe pesticide handling practices is low. It is recommended that appropriate type of personal protective device (PPD), in service training about the proper use of chemical pesticides and periodic medical check-up should be fulfilled to minimise the adverse health effects of chemical pesticides.

Adult↗

Development of a healthy bladder education program for older adults.

The Healthy Bladder Program was developed as part of an academic and health care partnership and was designed specifically for older adults residing in independent and assisted living. Program content was based on best practices that can be used by nursing staff to provide information about promoting and maintaining bladder health. One hundred eighty older adults, recruited from long-term care retirement communities, attended the 1-hour program. Findings showed that the program was successful in providing bladder health information that older adults could use immediately; suggestions are given for best practice applications.

Adult↗

Post-exposure prophylaxis for HIV infection in gay and bisexual men. Implications for the future of HIV prevention.

OBJECTIVE: To assess the psychological and behavioral characteristics of gay and bisexual men who intend to use antiretroviral post-exposure prophylaxis (PEP) to prevent HIV infection. METHODS: Gay and bisexual men who had not tested HIV seropositive and were not in long-term exclusive sexual relationships (n = 327) completed anonymous surveys consisting of demographic characteristics, gay community acculturation, experience with and attitudes toward PEP, substance use, and sexual behavior in the past 6 months. SETTING: A large annual Gay Pride festival in Atlanta, Georgia. RESULTS: There were 8 (3%) men who had already used PEP and 85 (26%) who planned to use PEP to prevent themselves from becoming HIV infected. Compared to the 242 (74%) men who did not indicate plans to use PEP, those planning to use PEP were younger, less well educated, more likely to have used illicit substances in the past 6 months, and were more likely to have a history of injection drug use. Men intending to use PEP were also more likely to have practiced unprotected anal and oral intercourse as the receptive partner and were more likely to have multiple anal intercourse partners with whom they were receptive. CONCLUSIONS: Gay and bisexual men are generally supportive of the immediate use of PEP and a significant number of men are planning to use PEP, particularly less educated men who use multiple substances and practice the highest-risk sexual behaviors. Concurrent behavioral interventions must, therefore, be considered critical in the advancement of PEP.

Adult↗

Physicians and exercise promotion.

Regular exercise has been associated with numerous health benefits. In response, the promotion of regular exercise for patients has become a recommended component of preventive health care. The extent to which primary care physicians encourage their patients to exercise and the factors associated with exercise promotion are not well elucidated. We surveyed the attitudes and practices of 63 family physicians and 63 internists regarding exercise promotion to patients. We evaluated the associations between demography, cognition, belief, and behavior with exercise promotion. Several factors were associated with physicians' recommending exercise to their patients. A logistic regression model suggests that physicians who have a follow-up plan, who have been in practice over 10 years, who exercise themselves, and who estimate that more than 10% of their patients exercise encourage exercise in greater than or equal to 50% of their patients.

Adult↗

Spiritual care: practical guidelines for rehabilitation nurses.

Spiritual care has long been recognized as an essential component in providing holistic care to patients. However, many nurses have acknowledged that their education lacked practical guidelines on how to provide culturally competent spiritual care. Although all nurses are required to provide spiritual care, rehabilitation nurses are particularly challenged to be competent in this area, due to the lengthy recovery time and special needs often presented by rehabilitation patients. This article provides practical guidelines for rehabilitation nurses, to assist patients in meeting their spiritual needs.

Attitude to Health↗

Lay concepts of the relative importance of different influences on health; are there major socio-demographic variations?

There is an extensive literature within anthropology, sociology and psychology about lay concepts of determinants of health and illness. Many of these studies have used single sex or social class samples, often in narrow age bands, and many are qualitative in approach. We asked respondents in a health survey to say how important (on a five-point scale) they thought seven potential influences on health (habits, self-care, the environment, family relationships, one's constitution, money and luck) were. The first three were regarded as very important, the second three as less important and luck as least important. Responses were consistent with current public health and epidemiological knowledge; these respondents endorsed prevailing views about personal responsibility for health and about the role of the physical and social environment in influencing health. In mutually adjusted models, there were no significant gender differences, social class differences and neighbourhood differences in three out of seven influences, and age differences in four out of seven influences. Thus, socio-demographic differences were less marked than might be inferred from studies of specific social groups, indicating a need for caution in health education and health promotion practice against always assuming socio-demographic differences.

Adolescent↗

"They were talking about me"--elderly women's experiences of taking part in a discharge planning conference.

INTRODUCTION: Discharge planning procedures needs improving to make transition to care settings in the community smooth, safe and secure. Research about discharge planning that involves a patient perspective is limited. The intention of this study was to focus on the patients' (elderly women) experiences of taking part in discharge planning conferences (DPCs) to deepen our understanding of the meaning of facing "the world of the institution" from a life-world perspective. AIM: This study aims at describing elderly women's experience of taking part in a DPC as they are about to be discharged from hospital. METHODOLOGICAL DESIGN: To illuminate the phenomenon from a life-world perspective, an interview study was chosen. Eight follow-up interviews with seven elderly women were carried out. The interviews were analysed using a qualitative content analysis methodology. FINDINGS: The interpretation of data was that the women's future was as in suspense as they got ill or were hit by accidents. The analysis revealed four themes that reflected the women's experiences of taking part in the DPCs: Being affiliated; Being in focus, Standing outside; and finally Being unprepared. STUDY LIMITATIONS AND CONCLUSION: The limitations of the study are related to: selection of participants; participation in the interview was connected to a video recording study; gap in time between participation in the DPC and the interview. The findings are still seen as trustworthy as the experiences expressed by the participating women in data are to be seen as a contribution to an emerging understanding of the meaning of the phenomenon from a life world perspective. The findings make clear that the institutional world easily and without much resistance from the patients transgresses the border of their life worlds. This awakes a need to reconsider how a caring perspective can be established in practice.

Adaptation, Psychological↗

A low-cost, community-based measles outbreak investigation with follow-up action.

An outbreak of measles in Kampala, Uganda, in 1990 raised concern about the effectiveness of the measles vaccine that was used. The Uganda EPI programme and the medical office of the Kampala City Council therefore conducted a community-based investigation, with door-to-door interviews in two selected communities. They revealed 68 measles cases ranging in age from 5 months to 12 years; the highest age-specific attack rate (32%) was found in children aged 12 to 23 months. BCG immunization coverage was high (85%), but measles immunization coverage was moderate (48%). One community, served by a mobile clinic, presented a vaccine efficacy of only 55%. Responses by mothers revealed that many had failed to have their children completely immunized because of a lack of information, and not because of difficulties in access to the service. In a follow-up, community leaders initiated monthly checking of immunization cards of both children and mothers. The low vaccine efficacy found in one of the communities resulted in a thorough assessment of the city's cold chain. This community-based approach proved to be cost-effective and practical for identifying the obstacles to effective immunization delivery.

Child↗

Using action research in nursing practice with older people: democratizing knowledge.

AIM: This paper reports on an action research study which raised some questions about the processes of developing a sense of shared ownership in action research in a research environment which does not always have the appropriate mechanisms to support and sustain action research. BACKGROUND: Action research has gained popularity in nursing and healthcare research, offering a way of developing practice-based knowledge, which can assist in changing practice and democratizing inquiry. METHODS: There are other organizational constraints on action research which arise at different levels, and which also require discussion. These can be issues about communication and ownership at a practice level and issues of funding and project management procedures. This paper reports on a study in which these issues came to the fore, and offers some thoughts on how they can affect the processes of action research. CONCLUSION: While the principles of action research appear to offer much towards the development of a practice-rooted body of knowledge for nursing, unless some of the issues of ownership are resolved, it is unlikely to move beyond academic rhetoric. RELEVANCE TO CLINICAL PRACTICE: If nursing is to engage in action research, this must be done critically and reflectively and careful attention paid to developing an inclusive and collaborative approach to knowledge and practice development. Furthermore, to develop in nursing and health care research, it must find ways to meet the requirements of funding bodies.

Activities of Daily Living↗

Acute-care nurses' attitudes towards older patients: a literature review.

With increases in life expectancy and increasing numbers of older patients utilising the acute setting, attitudes of registered nurses caring for older people may affect the quality of care provided. This paper reviews recent research on positive and negative attitudes of acute-care nurses towards older people. Many negative attitudes reflect ageist streotypes and knowledge deficits that significantly influence registered nurses' practice and older patients' quality of care. In the acute setting, older patients experience reduced independence, limited decision-making opportunities, increased probability of developing complications, little consideration of their ageing-related needs, limited health education and social isolation. Available instruments to measure attitudes towards and knowledge about older people, although reliable and valid, are outdated, country-specific and do not include either a patient-focus or a caring perspective. This paper argues for the development and utilisation of a research instrument that includes both a patient focus and a caring dimension.

Aged↗

Knowledge and attitudes towards attention deficit hyperactivity disorder among elementary school teachers.

OBJECTIVE: Attention deficit/hyperactivity disorder (ADHD) is one of the most common psychiatric disorders in child and adolescent psychiatry. ADHD children are at risk for academic and psychological difficulties. Lack of cooperation between schools, parents and therapeutic institutions inhibits a multimodal treatment program. This study surveys teachers' knowledge and attitudes towards attention deficit hyperactivity disorder. METHOD: One hundred and ninety six elementary school teachers in Shiraz, Iran, anonymously completed a self-report questionnaire on ADHD. RESULTS: Knowledge about ADHD was relatively low. 46.9% of respondents agreed that ADHD is due to biological and genetic vulnerabilities and causation. 53.1%of all the teachers considered ADHD to be the result of parental spoiling. The attitude score towards ADHD children was also low. 64.8% agree that the same disciplinary rules used for all students should also be applied to ADHD children. 77.6% believe that ADHD students experience difficulties in their relations with their classmates. There was a significant correlation between teachers' knowledge of ADHD and their attitude. The main sources of knowledge about ADHD were: Television and radio; friends and relatives; periodical, newspapers and magazines. CONCLUSION: Knowledge about ADHD was sound to be very low. PRACTICE IMPLICATIONS: Health and/or Educational Ministry should promote a special course on ADHD for teachers and education should be part of the curriculum in faculty training. Providing these educational programs on television and radio may be highly effective as they were the most common source of information.

Adult↗

Health workers' support for breastfeeding in Ibadan, Nigeria.

Breastfeeding in Nigeria is universal, and exclusive breastfeeding was introduced in 1992, yet no study has assessed health workers' support for breastfeeding at the grassroots level. This study assessed health workers' tangible support for breastfeeding at primary care facilities in Ibadan and factors affecting it, including knowledge of and attitudes toward breastfeeding. Among the 386 workers, there was moderate support for breastfeeding (median score = 15.0, maximum = 20). Following multivariate analysis, young age of worker (20-29 years; odds ratio [OR] = 2.9, 95% confidence interval [CI]: 1.2-6.8), more than 5 years of post-training experience (OR = 2.3, 95% CI: 1.2-4.4), senior profession (OR = 2.1, 95% CI: 1.0-4.4), high breastfeeding knowledge scores (OR = 2.5, 95% CI: 1.4-4.5), and sufficient opportunities to practice tangible breastfeeding support (OR = 4.3, 95% CI: 2.4-7.7) were found to predict tangible breastfeeding support. Deliberate efforts should be made to incorporate continuing education workshops to better prepare health professionals for their role in providing tangible breastfeeding support at the primary care level.

Adult↗