Meta-Analysis: Effects of Knowledge and Training on the Readiness of Electronic Medical Record Use in Health Workers

BackgroundDespite the availability of TB infection control guidelines, and good levels of healthcare worker knowledge about infection control, often these measures are not well implemented. This study sought to determine the factors associated with healthcare workers’ good TB infection control practices in primary health care facilities in the Free State Province, South Africa.MethodsA cross-sectional self-administered survey among nurses (n = 202) and facility-based community healthcare workers (n = 34) as well as facility observations were undertaken at all 41 primary health care facilities in a selected district of the Free State Province.ResultsThe majority of respondents were female (n = 200; 87.7 %) and the average age was 44.19 years (standard deviation ±10.82). Good levels of knowledge were recorded, with 42.8 % (n = 101) having an average score (i.e. 65–79 %) and 31.8 % (n = 75) a good score (i.e. ≥ 80 %). Most respondents (n = 189; 80.4 %) had positive attitudes towards TB infection control practices (i.e. ≥ 80 %). While good TB infection control practices were reported by 72.9 % (n = 161) of the respondents (i.e. ≥75 %), observations revealed this to not necessarily be the case. For every unit increase in attitudes, good practices increased 1.090 times (CI:1.016–1.169). Respondents with high levels of knowledge (≥80 %) were 4.029 (CI: 1.550–10.469) times more likely to have good practices when compared to respondents with poor levels of knowledge (<65 %). The study did not find TB/HIV-related training to be a predictor of good practices.ConclusionsPositive attitudes and good levels of knowledge regarding TB infection control were the main factors associated with good infection control practices. Although many respondents reported good infection control practices - which was somewhat countered by the observations - there are areas that require attention, particularly those related to administrative controls and the use of personal protective equipment.

Towards a National Electronic Health Record in Qatar: Building on International Experiences

BackgroundIt is estimated by the year 2050, 80% of the global elderly population will be from the low-and middle income countries. Elderly care requires health workers with skills associated with an understanding of the biological, psychological, social and cultural theories related to aging. Nurses with better knowledge, skills and positive attitudes towards elderly care are highly needed and critically important for better healthcare and wellbeing of the elderly population. Therefore the objective of this study was to assess the level of knowledge and attitude of nursing students towards elderly care in Zanzibar Island.MethodsA cross-sectional study was conducted in Zanzibar involving three out of five nursing training institutions. Participants were selected by systematic random sampling. Facts on Aging Quiz 2 and Kogan’s Attitudes Toward Old People scale were used to assess the level of knowledge and attitude towards elderly care among the students respectively. Simple and multivariable logistic regressions were applied to determine the predictors of knowledge and attitude among the participants.ResultsA total of 393 students participated in this study. Only 17% (69) of the participants had good level of knowledge and about 67.9% (267) had positive attitude towards elderly care. Living in an extended family and with an elderly person at home were both associated with good level of knowledge and positive attitude towards elderly care. Furthermore, living in a rural area (adjusted odds ratio = 2.23; 95% confidence interval: 1.22, 4.10) and studying at public institution (adjusted odds ratio = 2.59; 95% confidence interval: 1.41, 4.63) were associated with positive attitude towards elderly care.ConclusionThis study has shown that the majority of nursing students in Zanzibar have positive attitude but poor level of knowledge towards elderly care. The current findings have demonstrated that past experience with an elderly person can help in influencing good knowledge and shaping positive attitudes towards elderly care. Low level of knowledge shown in the study suggests for further research on adequacy of nursing curriculum and/or its implementation.

Hypertension is a major risk factor for cardiovascular disease, which is a common cause of death in Zambia. Data on hypertension prevalence in Zambia are scarce and limited to specific geographic areas and/or populations. We measured hypertension prevalence among persons living with HIV (PLHIV) in Zambia using a national electronic health record (EHR) system. We did a cross-sectional study of hypertension prevalence among PLHIV aged ≥18 years during 2021. Data were extracted from the SmartCare EHR, which covers ~90% of PLHIV on treatment in Zambia. PLHIV with ≥2 clinical visits in 2021 were included. Hypertension was defined as ≥2 elevated blood pressure readings (systolic ≥140 mmHg/diastolic ≥90 mmHg) during 2021 and/or on anti-hypertensive medication recorded in their EHR ≤5 years. Logistic regression was used to assess for associations between hypertension and demographic characteristics. Among 750,098 PLHIV aged ≥18 years with ≥2 visits during 2021, 101,363 (13.5%) had ≥2 recorded blood pressure readings. Among these PLHIV, 14.7% (95% confidence interval [CI]: 14.5-14.9) had hypertension. Only 8.9% of PLHIV with hypertension had an anti-hypertensive medication recorded in their EHR. The odds of hypertension were greater in older age groups compared to PLHIV aged 18-29 years (adjusted odds ratio [aOR] for 30-44 years: 2.6 [95% CI: 2.4-2.9]; aOR for 45-49 years: 6.4 [95% CI: 5.8-7.0]; aOR for ≥60 years: 14.5 [95% CI: 13.1-16.1]), urban areas (aOR: 1.9 [95% CI: 1.8-2.1]), and on ART for ≥6-month at a time (aOR: 1.1 [95% CI: 1.0-1.2]). Hypertension was common among PLHIV in Zambia, with few having documentation of treatment. Most PLHIV were excluded from the analysis because of missing BP measurements. Strengthening integrated management of non-communicable diseases in HIV clinics might help to diagnose and treat hypertension in Zambia. Addressing missing data of routine clinical data (like blood pressure) could improve non-communicable diseases surveillance in Zambia.

The objective of this study was to evaluate the population behavioural influence towards generic medicines use in a Klang Valley. A self-administered questionnaire in the Klang Valley, Malaysia, was distributed conveniently. A total of 222 respondents have participated in the study (response rate 57.8%). The majority of the respondents (87.7%) have reported considerable amount of knowledge on the generic medicine availability in the market. In comparison of sociodemographic influence, only household size was found to influence the respondent’s knowledge and curiosity. For the perception, there was a statistically significant difference in attitude scores for respondents who had good level of knowledge (M = 3.322, SD = 0.516) and poor level of knowledge (M = 3.011, SD = 0.591) towards generic medicines; t(220) = –4.180, p &lt; 0.05. In terms of subjective norms, data findings indicate a statistically significant difference in scores for respondents who had good level of knowledge (M = 3.456, SD = 0.704) and poor level of knowledge (M = 3.057, SD = 0.616) towards generic medicines; t(220) = –4.393, p &lt; 0.05. Similarly, this study found a statistically significant difference in perceived behavioural control scores for respondents who had good level of knowledge (M = 3.605, SD = 0.548) and poor level of knowledge (M = 3.121, SD = 0.577) towards generic medicines; t(220) = –6.350, p &lt; 0.05. Therefore, these results reveal that good level of knowledge really influence the level of perceptions among consumers of generic medicines. It is imperative that more initiatives to be introduced by the government to promote the practice to prescribe generic drugs to the population. The need to educate both health professionals and patients on the availability of the cheaper and bioequivalence medicine should be put into formality, thus increasing the awareness of the patient of the generic medicine and next reduce the dependency of the costlier innovator brand medicine in the prescription at both public and private healthcare settings.

Public trust in national electronic health record systems is essential for the successful implementation within a healthcare system. Research investigating public trust in electronic health records is limited, leading to a lack of conceptual clarity. In response, the objective of this study is to gain a clearer understanding on the conceptualizations of public trust in electronic health records, which can support the implementation of national electronic health record systems. Guided by the PRISMA-ScR checklist, a scoping review of 27 qualitative studies on public trust in electronic health records found between January 2022 and June 2022 was conducted using an inclusive search method. In an iterative process, conceptual themes were derived describing the promoters and outcomes of public trust in electronic health records. Five major conceptual themes with 15 sub-themes were present across the literature. Comprehension, autonomy, and data protection promote public trust in electronic health record; while personal and system benefits are the outcomes once public trust in electronic health records exists. Additional findings highlight the pivotal role of healthcare actors for the public trust building process. The results underscore comprehension, autonomy, and data protection as important themes that help ascertain and solidify public trust in electronic health records. As well, health system actors have the capacity to promote or hinder national electronic health record implementation, depending on their actions and how the public perceives those actions. The findings can assist researchers, policymakers, and other health system actors in attaining a better understanding of the intricacies of public trust in electronic health records.

There are increasing cases of diabetic foot ulcer in world and in India and the staff nurses have less knowledge about the topical insulin in healing of diabetic foot ulcer. Present study is aimed to assess the effectiveness of planned teaching programme regarding topical insulin in healing of diabetic foot ulcer among staff nurses in selected hospitals at kota, Rajasthan. 60 samples were selected using simple random sampling technique. The findings revealed that In Control group none of the participants had good level of knowledge in pre and post test. Average level of knowledge 43.33% was found in pre test whereas 53.33% was found in post test. Poor level of knowledge 43.33% was found in pre test whereas 30.00% was found in post test in control group. In experimental group none of the participants had good level of knowledge in pre test whereas 100.00% had good level of knowledge in post test. Average level of knowledge 60.00% was found in pre test whereas none of the participants had average level of knowledge in post test. Poor level of knowledge 40.00% was found in pre test whereas none of the participants had poor level of knowledge in post test in experimental group. This study concluded that there was significant improvement in the level of knowledge of nurses regarding topical insulin in healing of diabetic foot ulcer which indicated that the planned teaching programme was effective. The socio-demographic variables like age, gender, education qualification, area of work, years of experience, previously attended workshop seminar programme had significant association with the pre test knowledge score. Hence this kind of education programmes should be conducted from time to time for health personnel so that their knowledge can be improved.

Stunting is a type of chronic malnutrition caused by a lack of nutrient intake for a long time, causing growth problems. One of the causes of stunting is early marriage, which has an impact on a mother's knowledge. Mothers, as primary caregivers for toddlers, must get sufficient information about how to optimize child growth and development in the first 1000 days of life so that they can help prevent stunting in children. The purpose of this study was to determine whether there was an effect of education on increasing the knowledge of early childhood mothers about preventing stunting in toddlers in the village of North Bonde. The research method used is pre-experimental design research with the type of one-group pretest posttest design. The sampling technique used is non-probability sampling by means of purposive sampling, so the samples used in this study amounted to 30. The results showed that before being given education, the number of mothers who had a good level of knowledge was 1 person (3.3%), mothers with a fair level of knowledge were 6 people (20%), and those with a poor level of knowledge were 23 people (76.7%). After being given education, there were 9 mothers with a good level of knowledge (30%), 12 mothers with a fair level of knowledge (40%), and 9 mothers with a poor level of knowledge (30%). the average knowledge before being given education was 46.00, after being given education there was an increase in the average knowledge to 64.50. In the results of the analysis of the marginal homogeneity test, it was found that education has an effect on increasing the knowledge of early childhood mothers about stunting prevention among toddlers in North Bonde Village. It is recommended for respondents to be more active in seeking information and increasing their knowledge from both the media and health workers regarding stunting prevention.

Tobacco use has become a major contributor to morbidity and mortality in Nigeria as it has globally. Health workers, particularly nurses could play an important role in the provision of tobacco cessation services in health care settings. This study sought to assess the baseline knowledge, attitude and practice of nurses in Lagos University Teaching Hospital (LUTH), Lagos, Nigeria, as part of a tobacco cessation training programme for health workers in the institution. A cross-sectional study was conducted among 108 nurses, who attended a one-day training workshop on the role of health workers in tobacco cessation in LUTH in August 2008, using a pre-tested self-administered questionnaire. Descriptive analysis was done using SPSS 16.0. Only 18.5% had good level of knowledge regarding tobacco use and cessation. The attitude of the nurses was relatively positive and 85.8% agreed that it was their responsibility to help their patients quit smoking and that patients who were smokers were likely to yield to counselling when offered by health workers. Only about half (51%) of the study participants routinely asked patients about their smoking status at first visit while 49% routinely offered some cessation advice. Majority (81%) were willing to spend at least five minutes of their time to assist their patients in quitting. Those who had received prior training on tobacco cessation had higher levels of knowledge but not necessarily better attitudes or practices compared with those who did not have prior training. The nurses surveyed have a poor level of knowledge and lack training on tobacco cessation. A significant proportion however had positive attitudes and were willing to assist their patients in quitting tobacco use. Regular training for nurses to equip them with the knowledge and skills to support and assist patients in quitting tobacco use are recommended. Key words: tobacco cessation, nurses

Background and Purpose: Electronic medical record (EMR) systems are increasingly incorporated into the healthcare systems of developing countries to improve the effectiveness and efficiency of the healthcare institutions. Inaccuracy, non-timeliness, incompleteness and inconsistency of paper-based data are basic triggering points to adopt EMRs in developing countries. The purpose of this study was to assess the attitude, use, and hindering factors of health professionals’ use of EMR in one referral hospital in Ethiopia that has used the EMR for the last two years. Methods: An institutional based cross-sectional quantitative study was conducted in March 2014 among 501 health professionals. Self-administered questionnaire was used to collect data. Data were entered and analysed using Epi-Info version 7 and SPSS version 20 respectively. Descriptive statistics were computed to describe study variables. Bivariate and multivariate logistic regression analyses were used to show the presence of association between the study and outcome variables. Odds ratio at 95% confidence level was used to describe the strength of association. Results: A total of 428 health professionals participated in the study with a response rate of 86%. The majority, 318 (74.3%) were computer literate and more than half, 246 (57.5%) of them had computer access. A large number (71.0%) of respondents used EMR and more than half (56.1%) had a good attitude towards it. Health professionals’ age, computer literacy, computer assess, working experience, regular meeting and training on the EMR system were significant factors (p-value <0.05) to the attitude and use of EMR system. Educational level, knowledge on EMR and using EMR were also variables affecting users’ attitude towards EMR. Conclusions: Majority of the respondents used the EMR system in their daily works and more than half of them had a good attitude towards EMR. Technical (computer literacy, knowledge), organizational (computer access, infrastructure, training access, regular meeting, management support), and personal (age, working experience) variables are significant factors to develop a good attitude towards and high use of the system. Improving skills, awareness, infrastructure, management and resource allocation are important interventions to improve the EMR system performance and positive attitude towards health professionals in the study area. Keywords: Electronic Medical Record, Ethiopia, Attitude.

Most upper respiratory infections (URTIs) are caused by viruses and are self-limiting. It is one of the most frequent diseases to be treated with self-medication. Approriate self-medication practices will increase the safety of drug use. These practices need to be supported by a good level of knowledge. Therefore, this study was aimed to assess the association between level of knowledge and self-medication practices for URTIs in DKI Jakarta population. This cross-sectional study used an online questionnaire distributed around DKI Jakarta. The answers given by the subjects in the questionnaire will be used as our primary data, and the sample population was comprised of adult residents of DKI Jakarta. The questionnaire was developed by the study team and had been tested for validity and reliability before being used for data collection9. The questionnaire was divided into 3 parts, for collecting demographic data, self-medication patterns and level of knowledge regarding self-medication in URTIs. A Chi Square test was performed to analyze the association between level of knowledge and appropriateness of self-medication practices, with p value = 0.05. A total of 102 participants were analyzed at the end of this study. Information from peers tends to be the source of information for most participants, with 73.5% from friends and neighbors and 84.3% from family members. Only 21.6% of participants sought information from medical professionals. As many as 91.2% of participants took antibiotics to relieve their symptoms of URTI without prescription. Most subjects had an adequate level of knowledge (51%) and only a few subjects had a poor level of knowledge (4.9%). There was no significant association between the level of knowledge and the appropriateness of selecting drugs to treat fever, cough and rhinorrhea in this study. Most of the participants have an adequate level of knowledge on self-medication for URTI symptoms. However, there was no association between level of knowledge and the appropriateness of drug selection and the consumption of antibiotics without doctor prescription is still a common practice

Introduction: Glaucoma is the leading cause of irreversible blindness worldwide. The prevalence of glaucoma is estimated at 111.8 million people will suffer from glaucoma in 2040, so that through good knowledge, attitudes, and behavior of health workers, it can support the control of the severity of glaucoma. Purpose: To assess awareness and knowledge about glaucoma, attitude and behavior to glaucoma screening in Health center, Makassar city, South Sulawesi, Indonesia. Methods: Quantitative with cross sectional descriptive research design. Through filling iut questionnaires on 107 Health workers at Makkassar health city center on September 11 -12. In this research there are theree variables that are assessed, namely knowledge, attitude, and behavior. Result: Health workers As many as 52 respondents had a good level of knowledge, 55 respondents had a sufficient level of knowledge, and no respondents had a poor level of knowledge. Attitudes towards glaucoma were obtained 86 respondents (80.4%) conducted visual acuity tests on patients who complained of impaired vision, 76 respondents (71%) conducted visual field tests on patients suspected of glaucoma, 71 respondents (66.4%) conducted eyeball palpation examinations on patients suspected of glaucoma, and as many as 98 respondents (91.6%) behaved positively as indicated by referring patients with glaucoma to hospitals that have eye specialists. Conclusion: Awareness and level of knowledge about glaucoma among health workers in health centers are good. This condition can help in suppressing the occurrence of permanent blindness due to glaucoma. Efforts to prevent blindness due to glaucoma can be done by increasing the knowledge, attitudes, and behavior of health workers so that glaucoma can be detected early. Keywords: glaucoma, awareness, knowledge, attitude, behavior, glaucoma screening

BackgroundEpilepsy is a chronic neurological disease that could indirectly affect oral health, and it is necessary for dentists to be familiar with the specific needs of patients with epilepsy. Therefore, aim of the present study was to assess the factors associated with the level of knowledge about management of epileptic patients in Peruvian dental students.MethodsThis analytical, observational, cross-sectional and prospective study assessed 312 dental students from a Peruvian university during February to April 2022. A validated questionnaire of 20 closed multiple-choice questions was used to measure the level of knowledge about dental management in epileptic patients. A logit model was used to assess the influence of variables: gender, age, year of study, marital status, place of origin and area of residence, with the level of knowledge in dental students considering a significance level of p < 0.05.ResultsOf the total, 28.8%, 36.2% and 34.9% had a poor, fair and good level of knowledge, respectively, about the dental treatment of epileptic patients. On the other hand, it was observed that being a woman (OR = 0.44, CI 0.26–0.75) and being a third year student (OR = 0.39, CI 0.21–0.74) and fourth year student (OR = 0.43, CI 0.23–0.89) constituted a protective factor against poor knowledge about the dental management of epileptic patients, while being from the capital city constituted a risk factor. Finally, age, marital status and the students' area of residence were not considered influential factors (p > 0.05).ConclusionMost of the students showed a poor and fair level of knowledge about the dental management of epileptic patients, with gender, academic year and place of origin being influential factors. It is advisable that authorities and teachers in the dental profession organize recurrent training programs on the care of patients with chronic diseases requiring special attention, since knowing general concepts, pharmacological management and dental care of epileptic patients will allow future dentists to develop competencies to improve and implement good quality care protocols for this group of patients.

Reproductive health is a fundamental competency that must be mastered by midwifery students because it is closely related to professional practice in maternal and child health services. This study aims to analyze determine the level of knowledge of students of the Faculty of Midwifery at the Medistra Health Institute, Lubuk Pakam, regarding reproductive health. The study design used a quantitative descriptive approach with a cross-sectional method. The study sample consisted of 100 students selected using a purposive sampling technique. Data were collected using a structured questionnaire and analyzed using SPSS software with descriptive statistical tests and Pearson correlation. The results showed that 72% of students had a good level of knowledge, 20% had a sufficient level of knowledge, and 8% had a poor level of knowledge. The correlation analysis showed a positive relationship between knowledge level and semester (r = 0.416; p &lt; 0.05), meaning that the higher the semester, the better the level of knowledge. The conclusion of this study indicates that the level of student knowledge about reproductive health is quite good, but it is necessary to improve continuous education through contextual learning and field-based training.

Background: Oral health is an essential part of general health. Many studies have mentioned the usage of oral health services to be often symptoms-oriented, despite the availability of oral health specializations to serve different oral health problems. A common person usually cannot differentiate between other dental specialties. Therefore, this study aimed to assess the level of knowledge and awareness about different dental specialties among the population of Madinah, Saudi Arabia. Methodology: In this cross-sectional study, 344 participants were randomly enrolled, among them 63.4% were female, and 36.6% were male. A pre-tested questionnaire was used in the data collection. Statistical Package for the Social Sciences was used to analyze the collected data. Results: The findings of this study indicated that 63.1% of the participants do not go to the dental clinic periodically for checkups, while the majority of visits reported were every 6 months (10.2%). The mean score for the knowledge and awareness regarding different dental specialties was 4.4 ± 2.0. Overall, the percentage of the participants who had a good level of knowledge was 3.5%; 44.5% had an average level of knowledge; and 52% had a poor level of knowledge. We found that there was an association between age group and level of knowledge (p = 0.048). We did not find any association between the level of knowledge and the following factors: gender (p = 0.054) and level of education (p = 0.113). Conclusion: This study revealed a knowledge gap that exists about dentistry specialties. An eye-catching outcome reported in this study was poor adherence to periodic dental visits observed even among health workers.