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PubMed2002

Knowledge and beliefs about influenza, pneumococcal disease, and immunizations among older people.

OBJECTIVES: Despite the burden of disease caused by influenza and pneumococcus, immunization rates are moderate and have not reached national goals set for 2010. This study's objective was to identify patient knowledge, attitudes, and beliefs that serve as facilitators of and barriers to influenza and pneumococcal vaccination. DESIGN: A survey conducted in 2000 by computer-assisted telephone interviewing. SETTING: To encounter a broad spectrum of patients and healthcare systems, we sampled patients at inner-city health centers, Department of Veterans Affairs outpatient clinics, and rural and suburban practices. PARTICIPANTS: Inclusion criteria were patients aged 66 and older and an office visit after September 30, 1998. MEASUREMENTS: Responses to questionnaire. RESULTS: Overall, 1,007 (82%) interviews were completed among 1,234 people contacted by phone. Vaccination against pneumococcal disease was significantly related to being able to accurately describe one or more classic symptoms of pneumonia (P =.05). Vaccination against influenza and pneumococcal disease was significantly related to belief that vaccination was the best way to prevent these diseases (P <.001). The unvaccinated reported that they felt they were not likely to contract influenza and that they did not know they needed the pneumococcal vaccine. Access was not related to vaccination status. CONCLUSIONS: Educational campaigns to increase vaccination rates among older adults should focus on symptoms of, risk for, and severity of influenza and pneumococcal diseases and encouraging physicians to recommend the vaccines to their patients.

Aged↗
PubMed2006

Integrative medicine: implementation and evaluation of a professional development program using experiential learning and conceptual change teaching approaches.

OBJECTIVE: To meet the increasing patient interest in complementary and alternative medicine (CAM), conventional physicians need to understand CAM, be willing to talk with their patients about CAM, and be open to recommending selected patients to appropriate CAM modalities. We aimed to raise physicians' awareness of, and initiate attitudinal changes towards CAM in the context of integrative medical practice. We developed and implemented a professional development program involving experiential learning and conceptual change teaching approaches. METHODS: A randomized controlled study with a pre-post design in a large academic medical center. The 8-hour intervention used experiential and conceptual change educational approaches. Forty-eight cardiologists were randomized to participant and control groups. A questionnaire measured physicians' conceptions of, and attitudes to CAM, the likelihood of changing practice patterns, and the factors most important in influencing such changes. The questionnaire included an embedded control question on a topic that was not the focus of this program. We administered the questionnaire before (pretest) and after (posttest) the intervention. We compared differences in pre- and post-intervention scores between the participant (N = 20) and control (N = 16) groups. We used both groups to identify factors that influenced their practice patterns. The study was NIH-funded and IRB-exempt. RESULTS: Both groups initially had little knowledge about, and negative attitudes to CAM. The participant group had significant positive changes in their conceptions about, and attitudes to CAM after the program, and significant improvements when compared with the control group. Participant physicians significantly increased in their willingness to integrate CAM in their practices. Physicians (combined groups) rated research evidence as the most important factor influencing their willingness to integrate CAM. They requested more research evidence for CAM efficacy, and more information on non-conventional pharmacology. Participants reflected enthusiasm for the experiential program. CONCLUSIONS: The participants were able to experience the positive effects of selected CAM modalities. It is possible to increase physician knowledge and change attitudes towards integrative medicine with an eight-hour intervention using experiential and conceptual change teaching approaches. PRACTICE IMPLICATIONS: Professional development on integrative medicine can be offered to medical practitioners using experiential learning and conceptual change teaching approaches, with the help of local CAM practitioners.

Attitude of Health Personnel↗
PubMed2003

New approach for teaching health promotion in the community: integration of three nursing courses.

The complexity of the health care system and its interdisciplinary nature require that each component of the system redefine its professional framework, relative advantage, and unique contribution as an independent discipline. In choosing the most efficient and cost-effective work-force, each profession in the health care system must clarify its importance and contribution, otherwise functions will overlap and financial resources will be wasted. As rapid and wide-ranging changes occur in the health care system, the nursing profession must display a new and comprehensive vision that projects its values, beliefs, and relationships with and commitment to both patients and coworkers. The plans to fulfill this vision must be described clearly. This article presents part of a new professional paradigm developed by the nursing department of the University of Haifa, Israel. Three main topics are addressed: The building blocks of the new vision (i.e., community and health promotion, managerial skills, academic research). Integration of the building blocks into the 4-year baccalaureate degree program (i.e., how to practice health promotion with students in the community setting; managerial nursing skills at the baccalaureate level, including which to choose and to what depth and how to teach them; and academic nursing research, including the best way to teach basic research skills and implement them via a community project). Two senior student projects, demonstrating practical linking of the building blocks.

Attitude of Health Personnel↗
PubMed2004

Improving adolescent sexual and reproductive health. A view from Australia: learning from world's best practice.

There is increasing awareness worldwide of the importance of sexual and reproductive health in adolescents. Australia's high rates of teenage pregnancy and increasing rates of sexually transmitted infections in young people reflect a failure to prioritise adolescent sexual and reproductive health on the public health agenda. This paper reviews adolescent sexual and reproductive health in Australia in comparison with international data, and examines the systemic, social and cultural factors that influence it. Based on comparisons with international best practice, recommendations are included for improvement in adolescent sexual and reproductive health within the Australian context.

Abortion, Induced↗
PubMed1994

The lived experience of care within the context of cultural diversity.

This study explored the health promotion experiences of 10 Euro-American advanced practice nurses who provided care in rural settings to predominantly African American families. Relational themes that emerged from the discussions of the participants were authentic connecting, unconditional help giving, and openness to knowing. The constitutive pattern that emerged across all the texts was care as uncovering healing. The nurses' knowledge or lack of knowledge about differences in cultural health beliefs and practices was in the background, whereas the relationship was the contextual core of the experience that transcended the knowledge of differences.

Adolescent↗
PubMedDate not supplied

Staying the course: the Captain's Log continues.

This paper introduces the reader to the context for the papers in this journal supplement by describing the background and task assigned to the authors, a short history of the development of the field of literacy and health in Canada, some recent developments and opportunities, some information on the nature and magnitude of the issue, and an overview of the supplement. The publication results from the Second Canadian Conference on Literacy and Health. Authors were asked to summarize what was learned at the conference, what we need to know, and what we need to do to move the field forward in relation to the themes of the conference. The four themes were: Building Best Practices in Literacy and Health; Focusing on Language and Culture; Building Knowledge in Literacy and Health; and Building Healthy Public Policy.

Canada↗
PubMed2007

A comparative evaluation of self-reported oral hygiene practices among medical and engineering university students with access to health-promotive dental care.

AIM: This study was conducted to test the null hypothesis that no difference exists in the oral hygiene knowledge and practices of university students in different courses when they have equal opportunity to access health-promotive dental care. METHODS AND MATERIALS: The study was conducted using 120 students each from the medical and engineering colleges at the University of Manipal Academy of Higher Education who had easy access to the dental college within the campus which provides health-promotive dental care to all its patients. A self-administered structured questionnaire consisting of questions on demographic data, oral hygiene knowledge and practices, and dental service utilization patterns was distributed among the students. The data collected was analyzed using SPSS 10 version. RESULTS: Statistically significant differences were found between the two groups with respect to the knowledge of fluoridated toothpastes, frequency of toothbrush renewal, use of dental floss, and a tongue cleaner (p < 0.001). The groups were similar in all other practices including the utilization of dental services. There were no significant differences between the self-reported oral hygiene knowledge and practices among medical and engineering university students, but the knowledge levels of the students were considerably lower than expected.

Dental Care↗
PubMed1993

Assessment of respiratory rate and chest indrawing in children with ARI by primary care physicians in Egypt.

In a baseline study for training purposes, two indicators of acute respiratory infections (the respiratory rate (RR) and chest indrawing) were assessed by Ministry of Health physicians in Egypt using a WHO test videotape. Chest indrawing, as defined by the WHO Acute Respiratory Infections (ARI) programme, was not widely recognized by current health personnel. Viewing a WHO training videotape led to significantly more correct assessments of chest indrawing compared with a group that had not viewed this videotape. The accuracy of using a timer versus a watch, and a 30-second versus 60-second counting interval was also evaluated. Rates counted over 60 seconds were more accurate than 30-second counts although the difference between them was not clinically significant. Counting of rates using timers with audible cues was comparable to using watches with second hands. Careful training of primary health workers in the assessment of RR and chest indrawing is essential if these clinical findings are to be used as reliable indicators in pneumonia treatment algorithms.

Acute Disease↗
PubMed1997

Factors influencing Hispanic participation in prostate cancer screening.

PURPOSE/OBJECTIVES: To identify factors that influence Hispanic males decisions to participate in prostate cancer screening. DESIGN: Survey. SETTING: One hospital and three community clinics serving as sites for a community-sponsored prostate screening project in Texas. SAMPLE: 51 Hispanic males. METHOD: Face-to-face interviews. MAIN RESEARCH VARIABLES: Health, procedural, and scheduling variables affecting participation in screening. FINDINGS: The majority of participants reported that their health, the availability of Saturday and evening hours, the convenience of screening site locations, and offering exams at little or no cost were very important factors that influenced their decision to be screened for prostate cancer. Participants most frequently suggested promoting awareness among themselves as the most effective strategy for increasing prostate screening participation among Hispanics. CONCLUSION: Future research is recommended to ascertain if the study participants insights and strategies can lead to increased prostate screening participation among Hispanics. IMPLICATIONS FOR NURSING PRACTICE: Health professionals need to provide Hispanic males with cancer information and positive screening experiences to promote cancer awareness and screening in this population.

Adult↗
PubMed1976

Family planning in Pakistan: an analysis of some factors constraining use.

Family planning efforts by the Pakistan government were greatly expanded during its third Five-Year Plan (1965-70). Cross-sectional data obtained from the 1968-1969 IMPACT Survey are analyzed to determine the relative importance of demand and availability factors in explaining the response of Pakistani couples to the program's efforts. The findings indicate that the proportion of couples who express interest in controlling their fertility in the future is larger than the proportion who report current use of a family planning method. The analysis, however, shows that the program delivery system did not reach most of those who indicated they were potential users. When adequate availability was reported, family planning was adopted despite existing traditional social constraints; nonetheless, the analysis also points out that the potential of the program was severely limited by these constraints.

Delivery of Health Care↗
PubMed2003

Oral health profile of education and health professionals attending handicapped children.

The purpose of this study was to evaluate the knowledge and attitudes toward oral health of education and health professionals working in a children care program for handicapped children from 0 to 6 years of age, run by a public municipal institution in Rio de Janeiro. Using a printed questionnaire, 67 professionals (teachers, attendants and health professionals) were interviewed. The results were compared to the children's oral hygiene habits, by directly observing their daily nursery routine. Although 97.0% said that oral health could play a part in general health, only 37.3% of the professionals answered correctly on this matter. As for methods for preventing caries, although 92.5% said that they were aware of them, only 17.9% went to the dentist for preventive treatment. Although the majority (81.3%) indicated oral hygiene as a way of preventing caries, observation showed that this practice is not always put into effect in the program's day nursery. Regarding when to start toothbrushing in children, 75.0% of the teachers and 94.4% of the health professionals said that they were aware of the need to begin brushing before one year of age, although this reply was given by only 52.5% of the attendants (chi-square, p = 0.006). In view of these results, it was concluded that attitudes toward oral health were not always coherent with the knowledge that these professionals express.

Child↗
PubMed2005

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↗
PubMed2000

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↗
PubMed2006

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↗
PubMed2006

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↗
PubMed1998

What do the public and profession know about dental caries prevention in Korea?

The availability of known preventive dental measures has no value, unless they are used appropriately by the public and by dental health care providers. Nevertheless, there is a wide gap between what is known about preventive procedures and dental public health measures in the preventive and public health dental world and what is known and used by the public and dental health care providers in Korea. The gap should be minimised to enable dental caries to be conquered. Firstly, an emphasis on the appropriate use of preventive procedures is needed in colleges of dentistry, dental hygienist training technical colleges and continuing educational courses. Simultaneously, there should be reform of the state run qualifying examinations for dentists and for dental hygienists in order to upgrade preventive and public health dentistry. Meanwhile, to promote personal dental health, introduce community preventive dental measures and maintain their use through self-help personal efforts and organised combined efforts, all dental health care providers have to educate the public. In addition, dental health care providers and the public should be regularly questioned on their knowledge, opinions and practices about community water fluoridation programmes, school-based fluoride mouthrinsing programmes and preventive procedures at an interval of several years, as a test to measure the achievements of dental educational and dental health education aims.

Attitude of Health Personnel↗