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Results for “Knowledge Management”

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At least 1,279 records · Page 71Linked to original sources

PubMed2001

Patients' knowledge of health plan coverage and satisfaction with care.

OBJECTIVE: To test the hypothesis that patients' satisfaction with their healthcare is related to their knowledge of their managed care plan. STUDY DESIGN: A written survey was sent to beneficiaries of the military health system. PATIENTS AND METHODS: Respondents were active or retired military personnel and their nonmilitary, immediate family members enrolled in either TRICARE Prime, a voluntary, gatekeeper-based managed care program (enrollees), or other military managed care programs (nonenrollees). Responses to 5 questions that measured patients' understanding of their program served as independent variables; satisfaction with care was the dependent variable. Responses were stratified according to whether care was received in a military or a civilian healthcare organization. Analysis of variance (ANOVA) and regression analysis were used to determine the association between the variables. RESULTS: Enrollees differed from nonenrollees in certain sociodemographic characteristics, with nonenrollees being older (eta 2 = 0.035; P < .01), closer to retirement (eta 2 = 0.051; P < .01), and tending to receive healthcare in military healthcare organizations (HCO) (eta 2 = 0.009; P < .01). After controlling for sociodemographic characteristics, patients' understanding of their coverage served as a poor predictor (military HCO [R2 = 0.003; P < .01]; civilian HCO [R2 = 0.025; P < .01]) of satisfaction with their care. CONCLUSIONS: Patients' understanding of their coverage appears to be a statistically significant, but rather small, contributor to satisfaction with their care. The study suggests that health plan understanding is a poor predictor of patient satisfaction.

Adolescent↗

PubMed2005

Knowledge and attitude of Jordanian school health teachers with regards to emergency management of dental trauma.

The purpose of this study was to assess, by means of a self administered structured questionnaire, the level of knowledge of school health teachers in northern Jordan with regards to the immediate emergency management of dental trauma. The questionnaire surveyed teacher's background, Knowledge of management of tooth fracture, avulsion, and loss of consciousness, it also investigated teacher's attitudes, and self assessed knowledge, as well as knowledge of availability of emergency services in Jordan. The sample consisted of all school health teachers in northern Jordan (220) who attended an oral health education course held by the Jordanian dental association. Only 190 were included in the survey. Sixty-three percent were females, 44% were in their twenties, and 43% in their forties. Their school health teaching experience ranged from 1 to 7 years. Only 20% were officially trained in school health. Less than half of the teachers received first aid training only once in their teaching career, not necessarily as part of school health training. Only 10 teachers were trained in dental first aid, and more than half had a previous experience with handling dental trauma in children. Overall the teachers' knowledge with regards to the emergency management of the trauma cases presented in the report was deficient. Chi-square test showed that, the difference in their responses to the knowledge part of the questionnaire was not statistically significant with regards to age, gender, years of teaching experience, first aid training, or number of seen trauma cases. Generally, the attitude was positive, most teachers wanting further education on the topic, however those who were trained in first aid, thought they were able to give proper action when needed in cases of trauma (P = 0.026). Most teachers were unsatisfied with their level of knowledge, and only 30% knew of the availability of after hour emergency services for dental trauma. The present report indicated the gross lack of knowledge among school health teachers with regards to dental trauma emergency management. Educational programs to improve the knowledge and awareness of this group of adults, who are usually the first line of advice in case of dental trauma in schools, are mandatory. These programs should be properly designed to insure that proper information is retained with a positive effect on attitude, and self assessed competence.

Adult↗

PubMed1991

Management of the pregnant patient with a cerebral venous angioma: a report of two cases.

Though there is a large body of knowledge regarding the management of pregnant women with arterial lesions in the central nervous system, little information is available on venous malformations. We report our experience with two pregnant patients with cerebral venous angiomas. These lesions are usually asymptomatic and only rarely cause seizures or subarachnoid hemorrhage. Based on our experience and literature review, we suggest that patients with venous angiomas without a history of hemorrhage can safely undergo labor and vaginal delivery.

Adult↗

PubMed1994

An operational evaluation of the Community Oral Rehydration Units in Peru.

Since 1984, in Latin America donor agencies and national governments have extensively supported the implementation of the Community Oral Rehydration Units (CORUs) in an attempt to increase the access to oral rehydration therapy and improve the case management of diarrhoea at the community level. This study surveyed 40 CORUs in two regions of Peru to assess their operation, the number of patients with diarrhoea attended, and the knowledge of volunteers in charge. The results show that CORUs were mainly implemented close to existing health centres; the median of case load was 2.0 patients in the preceding month; and the volunteers' knowledge of case management was principally deficient in the diagnosis of hydration status, dietary management and in preventive measures. This lack of knowledge was replicated by professionals at the supervising health centres. Despite the fact that CORUs have been functioning for around four years, they exhibit numerous deficiencies which prevent them from fulfilling their objectives. A global review of the whole CORU strategy is called for.

Community Health Services↗

PubMed1997

Adherence to clinical guidelines for the therapeutic management of HIV disease.

OBJECTIVE: To determine the knowledge of HIV-disease management and the adherence to contemporary guidelines among British Columbia physicians whose practices focused on HIV/AIDS. DESIGN: Self-administered mail survey. PARTICIPANTS: All 659 physicians registered in a province-wide HIV/AIDS drug treatment program. OUTCOME MEASURES: Data on demographic and personal characteristics of respondents, level of HIV-related experience, use of preventive vaccinations and tests, and preferred approaches to the prophylaxis and treatment of common opportunistic infections. Knowledge scores in 4 areas of patient care, as well as an overall score, were computed by comparing respondents' answers with the therapeutic strategies recommended at the time of the survey. Associations between physician characteristics and knowledge scores were identified by linear regression analysis. RESULTS: Of the 659 physicians surveyed, 65% returned responses: only 38% returned completed surveys while a further 27% returned a follow-up survey that asked nonrespondents about their demographic characteristics and HIV-related experience. Scores for specific areas of patient management ranged from 29% for the treatment of opportunistic infections to 62% for preventive measures, with a mean overall score of 47%. Physician knowledge in all areas of patient care was associated with the number of HIV-positive patients in the practice (p = 0.003 to p < 0.001). Physicians who were younger were more knowledgeable regarding preventive measures (p = 0.001); those whose practice location was in Vancouver had a greater knowledge of prophylaxis (p = 0.047); and those who had medical specialty training were more knowledgeable about the treatment of opportunistic infections (p = 0.009). CONCLUSIONS: There is substantial disparity in how physicians approach the management of HIV and related conditions. Deviations from therapeutic guidelines are common and may be associated with physician characteristics, particularly lack of experience in managing HIV.

AIDS-Related Opportunistic Infections↗

PubMed2004

Junior doctors' opinions about the transition from medical school to clinical practice: a change of environment.

INTRODUCTION: Concerns have been growing about the effects of the working environment on junior doctors and the learning opportunities available to them. In order to identify problems and opportunities for improvement, we explored junior doctors' opinions about the transition from student to practitioner. METHOD: Seventeen recent graduates in four focus groups discussed the transition. DATA ANALYSIS: Related comments were combined in the report of the discussions, which was approved by the participants. RESULTS: The transition was perceived as a major change, particularly the increased responsibility and workload and contacts with other health care workers and patients. Preparation during undergraduate training was adequate as regards knowledge, communication, history taking and physical examination skills but not for pharmacological knowledge and patient management skills. Problems were connected with practical procedures and feelings of uncertainty. There was little formal education. Proposals to ease the transition were earlier patient contacts, more involvement in patient management and growing responsibility during clerkships. DISCUSSION: Although the sample was small, the uniform opinion in all groups supports the validity of the findings. Junior doctors felt confident with regard to knowledge and skills, but experienced difficulties with patient management, practical matters and their role on the team. Contrary to the idea of an educational continuum, formal learning appeared to be very limited in the hospital environment. CONCLUSIONS: Preparation for medical practice may benefit from active involvement of clerks in patient management decisions and a gradual increase in responsibilities. An effective medical education continuum would require more attention for house officers' learning.

Attitude of Health Personnel↗

PubMed1999

Nursing assessment and patient management.

OBJECTIVES: To review contemporary knowledge and recent research in the nursing assessment and management of patients receiving radiation therapy. DATA SOURCES: Published scientific papers, review articles, book chapters, and clinical practice. CONCLUSIONS: Despite the enormous advances in treatment technology, dose-limiting acute and late effects of radiation therapy have not been eliminated. Astute assessment and early interventions can have a positive impact on the quality of life of the patient receiving radiation therapy. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses need to be well-informed about treatment advances and be able to integrate research findings into clinical practice. The increased use of concurrent or sequential combined modality therapy requires nurses to broaden their skills of assessment and management.

Fatigue↗

PubMed2006

Automated recognition of malignancy mentions in biomedical literature.

BACKGROUND: The rapid proliferation of biomedical text makes it increasingly difficult for researchers to identify, synthesize, and utilize developed knowledge in their fields of interest. Automated information extraction procedures can assist in the acquisition and management of this knowledge. Previous efforts in biomedical text mining have focused primarily upon named entity recognition of well-defined molecular objects such as genes, but less work has been performed to identify disease-related objects and concepts. Furthermore, promise has been tempered by an inability to efficiently scale approaches in ways that minimize manual efforts and still perform with high accuracy. Here, we have applied a machine-learning approach previously successful for identifying molecular entities to a disease concept to determine if the underlying probabilistic model effectively generalizes to unrelated concepts with minimal manual intervention for model retraining. RESULTS: We developed a named entity recognizer (MTag), an entity tagger for recognizing clinical descriptions of malignancy presented in text. The application uses the machine-learning technique Conditional Random Fields with additional domain-specific features. MTag was tested with 1,010 training and 432 evaluation documents pertaining to cancer genomics. Overall, our experiments resulted in 0.85 precision, 0.83 recall, and 0.84 F-measure on the evaluation set. Compared with a baseline system using string matching of text with a neoplasm term list, MTag performed with a much higher recall rate (92.1% vs. 42.1% recall) and demonstrated the ability to learn new patterns. Application of MTag to all MEDLINE abstracts yielded the identification of 580,002 unique and 9,153,340 overall mentions of malignancy. Significantly, addition of an extensive lexicon of malignancy mentions as a feature set for extraction had minimal impact in performance. CONCLUSION: Together, these results suggest that the identification of disparate biomedical entity classes in free text may be achievable with high accuracy and only moderate additional effort for each new application domain.

Algorithms↗

PubMed2005

Physician attitudes regarding cardiovascular risk reduction: the gaps between clinical importance, knowledge, and effectiveness.

Reducing risk factors for patients with vascular disease can reduce the subsequent incidence of cerebro-cardiovascular disease. While physicians have had extensive training in the importance of atherosclerotic vascular disease risk factor modification, evidence suggests that they systematically miss opportunities for clinical prevention during routine practice. The aim of this study was to identify whether physicians felt confident in their knowledge and effectiveness regarding counseling patients to reduce cardiovascular risk and to determine barriers to prevention interventions in the office setting. Surveys were mailed to 509 physicians affiliated with an academic community hospital. Nonrespondents were sent reminders and a second survey. Comparisons were made using chi-square analysis. Two hundred and five surveys were returned (40.3%). Thirty-six percent of physicians felt knowledgeable about weight management techniques, compared to 3% who were confident that they succeeded in their practice (p < 0.001). Similar patterns were found for Tobacco Cessation (62% versus 14%, p = 0.001), Alcohol Reduction (46% versus 7%, p < 0.001), Stress Management (35% versus 5%, p < 0.001), Exercise (53% versus 10%, p < 0.001), Nutrition (36% versus 8%, p < 0.001), Diabetes Management (48% versus 23%, p < 0.001), Blood Pressure Management (57% versus 43%, p < 0.001) and Lipid Management (59% versus 38%, p < 0.001). We identified a significant gap between physician confidence in their knowledge about risk factors and their effectiveness at providing counseling and obtaining results in their office. Most physicians felt that the routine office follow-up visit was an ineffective method for instituting vascular risk factor reduction. Alternate settings for risk factor reduction may be needed for improving atherosclerosis prevention.

Academic Medical Centers↗

PubMed1995

Pain and quality assessment/improvement.

Pain is a common symptom of acute and chronic illness and has been targeted as an area of improvement across settings and populations. Advances in the treatment of pain have created a standard of care by which quality can be assessed. The article describes the process of quality assessment and improvement (QA/I) in pain management. QA/I tools and case examples from two institutions are provided. QA/I activities based on current knowledge of pain management can improve the care provided to patients in pain.

Humans↗

PubMed2005

Financial management and job social skills training components in a summer business institute: a controlled evaluation in high achieving predominantly ethnic minority youth.

Ninety-two adolescents, predominantly ethnic minority high school students, participated in a structured Summer Business Institute (SBI). Participating youth were randomly assigned to receive either job social skills or financial management skills training components. Students who additionally received the job social skills training component were more likely to recommend their employment agency to others than were youth who received the financial management component, rated their overall on-the-job work experience more favorably, and demonstrated higher scores in areas that were relevant to the skills that were taught in the job social skills workshops. The financial management component also appeared to be relatively effective, as youth who received this intervention improved their knowledge of financial management issues more than youth who received job social skills, and rated their workshops as more helpful in financial management, as well as insurance management. Future directions are discussed in light of these results.

Achievement↗

PubMed2006

An XML-based framework for personalized health management.

This paper proposes a framework for personalized health management. In this framework, XML technology is used for representing and managing the health information and knowledge. Major components of the framework are Health Management Prescription (HMP) Expert System and Health Information Repository. The HMP Expert System generates a HMP efficiently by using XML-based templates. Health Information Repository provides integrated health information and knowledge for personalized health management by using XML and relational database together.

Humans↗

PubMed1991

What administrators need to know about clinical engineers. Understanding the equipment manager's responsibilities and concerns.

Despite the proliferance of computer systems in hospitals, many administrators--both new and experienced--have only a passing knowledge of technology management and managers. To make both the administrators' and the clinical engineers' jobs less difficult and more effective, the authors offer a profile of the "typical" clinical engineer. In the process, they underscore how health-care-administration programs need to increase students' exposure to and training in technology management.

Biomedical Engineering↗

PubMed1995

Multiple meanings of pain and complexities of pain management.

Pain is a human experience with many different definitions and meanings. Under the influence of science these meanings multiplied and added complexity to the process of managing pain as a clinical problem. Over the last four decades nurses have made important contributions to pain knowledge and pain management through research and clinical innovation. Nurses are pivotal providers in the implementation of effective pain management programs and in fostering multidisciplinary efforts to improve the services currently available to cancer patients and their families.

Attitude to Health↗

PubMed2000

Increasing the knowledge base of asthmatics and their families through asthma clubs along the southwest border.

This study focused on behavior modification and enhancement of knowledge concerning home asthma management. The intervention focused on asthma awareness, severity assessment, medication use, and development of management plans while building a support group. The quasi-experimental design utilized various tools to evaluate knowledge, behavior modification, and self-care management. A 25% increase in knowledge and a 13% decrease in emergency department visits was identified over the 12-month period of the study.

Asthma↗

PubMed1999

A development protocol for a diagnostic DSS.

A diagnostic decision support system (DSS) in medicine is an expert system that aids the physician in the determination of the diagnosis based on findings and test results. The DSS can be divided into 2 different types of components: the knowledge component and the information system component. Methods from software engineering, knowledge engineering and management are combined into a dynamic development cycle that allows stepwise update and refinement. The development of the knowledge component is based on knowledge engineering. In the starting phases, rapid prototyping is convenient to determine and evaluate the specification. The content of the knowledge base is frequently updated during its life time. For this purpose, a knowledge modelling protocol is supplied.

Artificial Intelligence↗

PubMed2001

Nurses' knowledge of pain in the elderly.

The purpose of this study was to investigate nurses' knowledge of pain and pain management with respect to elderly persons. Registered nurses at several general hospitals and nursing homes were surveyed by questionnaire concerning their knowledge of pain management in the elderly. The findings indicated a significant knowledge deficit in this area. There were also significant differences in knowledge levels between general hospital nurses and those working in nursing homes. We conclude that more education about pain management in elderly patients is needed for nurses. This deficit needs to be addressed in both undergraduate nursing programs and hospital in-service courses. Presently, the majority of patients entering hospitals are aged 65 years and over. Hence, nurses in all areas of care, not just specifically those working in aged care facilities, need a sound knowledge of pain management of the elderly to facilitate compassionate and effective nursing care.

Aged↗

PubMedDate not supplied

Nonsurgical management of the infant with gastroesophageal reflux and respiratory problems.

Gastroesophageal reflux (GER), which is associated with respiratory problems such as choking, aspiration, apnea, and chronic respiratory disorders, is a source of significant concern to parents and health care providers. An understanding of the physiologic basis for the association between GER and these disorders enables the nurse practitioner (NP) to act as case manager for these patients. Knowledge of diagnostic procedures and components of management such as positional therapy, feeding techniques, pharmacologic therapy, home monitoring, and social support strategies enables the NP to collaborate effectively with other members of the health care team in providing nonsurgical treatment for these infants.

Continuity of Patient Care↗