Attitude Scores Research Articles

AWARENESS AND ATTITUDES OF ICU NURSES REGARDING POST-EXTUBATION DYSPHAGIA IN TRACHEALLY INTUBATED PATIENTS

Post-extubation dysphagia is a common yet under-recognized condition in intubated patients, which can lead to severe complications. The awareness and attitudes of Intensive Care Unit (ICU) nurses towards post-extubation dysphagia play a critical role in early detection and management of the condition, improving patient outcomes. Objective: To assess the awareness and attitudes of ICU nurses regarding post-extubation dysphagia in intubated patients. Methodology: This cross-sectional study was conducted at the Intensive Care Unit of Sheikh Zayed Hospital, Rahim Yar Khan, from June 2023 to June 2024. One hundred nurses working full-time in general and specialized ICUs were included. Data were collected using a 28-item questionnaire divided into two sections. The first section collected demographic information, while the second assessed knowledge and attitudes toward post-extubation swallowing disorders using 20 specific questions. Statistical analysis, including multivariate analysis, was performed to identify factors associated with knowledge and attitude scores. Results: The average total standard score was 60.87 ± 14.31. The mean knowledge score was 7.54 ± 2.99, with a standard score of 75.40 ± 29.9. The average attitude score was 8.10 ± 2.01, with a standard score of 81.0 ± 20.1. Multivariate analysis revealed that age group 31-35, job title, and job satisfaction were significantly associated with higher knowledge scores. In contrast, attitude scores were significantly associated with sex, job title, age group, and department. Conclusion: The knowledge and attitudes of ICU nurses regarding post-extubation dysphagia in intubated patients are unsatisfactory. Professional training and educational programs are needed to improve critically ill patients' awareness and management of this condition.

Attitudes Towards Learning Communication Skills Among University Nursing Students

A major skill of nurses for achieving high-quality care is their ability to communicate effectively with patients, and this has been considered very valuable in the patient healing process. Objectives: To assess the learning attitudes of university nursing students towards communication skills and to find out the association of demographic characteristics of students with their attitude level. Methods: This cross-sectional analytical study design was conducted on 230 student nurses studying in a four-year Bachelor of Science in Nursing program. Permissions were obtained from the Ethical Review Committee and the Head of the Department for data collection. Data were collected via non-probability purposive sampling. Communication Skills Attitudes Scale was used to assess the attitude of university nursing students. Student's t-test and One-way analysis of variation were used to identify the differences in Positive Attitude Scores and Negative Attitude Scores between demographic variables. Results: Most of the study participants (77.4%) were male and 94% belonged to the age group 18-25 years. There was a significant difference in the Positive Attitude Score between gender and education of the students with p-values of 0.009 and 0.015 respectively. Furthermore, education level is the only variable that shows a significant association with a Negative Attitude Score with a p-value<0.0001. Conclusions: It was concluded that female students had more positive attitudes compared to their counterparts. Third-year students had a more positive attitude compared to other study years.

Exploring mental health through the eyes of physiotherapy students: Revealing knowledge and attitudes towards mental health roles

The social stigma associated with mental illness leads to a reluctance to seek help and can negatively impact the therapeutic connections between individuals with mental illness and healthcare practitioners. With the rising prevalence of mental health illness, physiotherapy students will encounter a growing number of these patients during their undergraduate education. A cross-sectional online survey was done on undergraduate physiotherapy students using the Mental Health Knowledge Schedule and Mental Illness Clinicians' Attitudes scores. All participants demonstrated moderate knowledge and a favorable attitude toward mental health. Final-year students had more awareness and a better attitude towards mental health than the other students. Physiotherapy undergraduates with clinical experience tend to see psychiatry and individuals with mental illness more positively.

Integrating virtual-reality into restorative dentistry training: A study on the acceptability and effectiveness of tooth preparation simulations.

Digital education using virtual-reality simulators is essential for precise learning in modern education. This study aimed to develop a virtual-reality dental system for tooth preparation training and assess pre-virtual-reality experiences and perceptions of its potential benefits. We evaluated the post-virtual-reality experience in terms of the effectiveness of the virtual-reality system. The virtual-reality platform development phase involved learning- and assessment-based frameworks for participants. The first step involved creating a storyboard for a virtual dental clinic environment using virtual-reality glasses. This simulated a dental chair-like setup with instruments and tools, allowing participants to practice dental procedures. This study utilized a mixed-methods approach to assess participants' experience with virtual reality in dental education using a tooth preparation simulation system and evaluated post-virtual reality measures, including the system usability scale, usefulness, educational effectiveness, and participant attitudes through structured survey questionnaires. This study included 150 participants (49 dental students, 52 dental interns, and 49 faculty members). Most participants were females (76%). Significant differences were observed in attitude scores between students and faculty members, with third-year dental students having more positive attitudes toward the integration of virtual-reality in dental education. No significant differences were found in system usability, usefulness, or assessment scores between the groups. The virtual-reality dental module system shows promise for improving dental education. The varied responses from different user groups should be considered to ensure successful implementation and acceptance.

Development and Reliability and Validity Analysis of the Knowledge,Attitude, and Practice Evaluation Scale for Teachers' Early Childhood Sex Education.

Objective To develop the knowledge,attitude,and practice evaluation scale for teachers' early childhood sex education and analyze the reliability and validity of the scale,providing evaluation tools for the research on teachers' early childhood sex education. Methods On the basis of relevant guidelines,publications,and the theory of knowledge,attitude,and practice,a preliminary pool of items for the scale was formed by group discussions.The scale was drafted after two rounds of Delphi expert consultation.In May 2023,stratified cluster sampling was conducted,and 535 preschool teachers from Changshou District,Chongqing were selected for a survey.Cronbach's α coefficient,split-half reliability,exploratory factor analysis,and content validity were adopted to assess the reliability and validity of the scale. Results An evaluation scale for teachers' early childhood sex education was formulated,involving 27 items in 3 dimensions of knowledge,attitude,and practice.The total Cronbach's α coefficient of the scale was 0.875,and that of the knowledge,attitude,and practice dimensions were 0.902,0.743,and 0.879,respectively.The total split-half reliability of the scale was 0.937,and that of the knowledge,attitude,and practice dimensions were 0.934,0.821,and 0.912,respectively.The content validity of the scale was good,with a factor loading range of 0.500-0.836 and a cumulative variance contribution rate of 61.57.The average score of teachers' knowledge,attitude,and practice in sex education was 72.85±7.13,with a good rate of 70.84%. Conclusions The developed scale for evaluating teacher's early childhood sex education demonstrates good reliability and validity,and it can be used to evaluate the teachers' knowledge,attitude,and practice in early childhood sex education.The evaluation results indicate that teachers have low levels of knowledge,attitude,and practice in sex education,and relevant departments need to carry out training on the sex education for young children.

Sexual Knowledge, Attitude and Behaviors of Medical Students: A Cross-sectional Study

Introduction: Exposure to sexually explicit media influences the sexual knowledge, attitudes, and behavior of youth, so studying this among medical students is of utmost importance. Aim: To study sexual knowledge, attitudes, behaviors, and sources of influence among medical students. Methodology: A descriptive, cross-sectional, analytical, web-based study was conducted to assess sexual knowledge, attitudes, behaviors, and sources influencing sexuality in medical students via Google Forms. The form consisted of three parts: the first part was an information sheet and consent form, the second part included the participant’s sociodemographic data and the third part related to two study tools, the Sexual Knowledge and Attitude Questionnaire-II (SKAQ-II) and the sexual behavior and sources of influence scale. Result: A total of 300/950 (31.5%) medical students responded to the Google questionnaire. Their mean age was 20.43 ± 1.87 years (range: 18–26 years). The mean score for sexual knowledge and attitude was 24.35 ± 4.93 and 23.79 ± 4.87, respectively, which suggested that they had good sexual knowledge and liberal attitudes toward sexuality with female preponderance. As student’s academic year progresses, their sexual knowledge improves. There was a significant strong positive correlation between sexual attitude and knowledge with a Pearson correlation of r = 0.95, P = 0.004, which means the higher the knowledge, the better the attitude. Medical student’s engagement in sexual behaviors with self- and others was at age 18.45 years. The internet was the major source for getting information related to sexual behaviors for them, but they relied on doctors and friends for guidance. Conclusion: Medical students had adequate sexual knowledge, which was the reason for their liberal attitude toward sexuality. Their major source of sexual knowledge was the internet, although they confided in doctors for sexual doubts.

Pain Perception, Knowledge, Attitude, and Diet Diversity in Patients Undergoing Fixed Orthodontic Treatment: A Pilot Study.

This study aimed to determine the correlation between pain perception and knowledge, attitude, and diet diversity in patients undergoing fixed orthodontic treatment. A total of 103 patients (15-40 yrs.; 67 females, 36 males) undergoing orthodontic treatment with a 0.022-inch slot (MBT prescription) in both arches were recruited. Information on pain perception, knowledge, attitude, and diet diversity scores was collected through validated questionnaires using visual analogue scale and close-ended questions at one time point. The correlation between variables was analyzed using the Pearson's correlation coefficient. Of the patients, 48.5% were aged 15 to 19 years old, with 65% females and 73.8% of Chinese ethnicity. Approximately 90% of the orthodontic patients perceived low levels of pain from orthodontic treatment, and 98% had a positive attitude toward orthodontic treatment. The patients had a good level of knowledge (Mean: 6±0.65). Approximately 49.5% of patients reported having moderate diet diversity. No significant correlation was found between pain perception and knowledge, or pain perception and diet diversity (r=0.062, p=0.534). However, a significant weak negative correlation (r=-0.289, p<0.05) between pain perception and attitude was observed. Patients undergoing fixed orthodontic treatment presented with overall low pain perception, a positive attitude, and good knowledge about their treatment with moderate diet diversity. Informing the patient in advance about different orthodontic procedures encourages a positive attitude and facilitates patient cooperation. An interprofessional approach involving nutritionists can provide a holistic patient approach during orthodontic treatment.

The Attitudes of 8th Grade Students Towards the Republic of Turkey Revolution History and Kemalism Course

This study is quantitative research that aims to examine the attitudes of 8th graders towards the T.R. History of Revolution and Kemalism Course. The study population consists of 6.650 students studying in the 8th grades of Samsun province central district secondary schools in the 2022-2023 academic year, while the sample consists of 1424 students. A stratified sampling method was used in sample selection, and simple random sampling was used to draw units from the sub-populations of the sample. A survey form, the first part of which includes demographic information of the participants and the second part of which provides for the T.R. History of Revolution and Kemalism Course Attitude Scale, was used as a data collection instrument. Descriptive statistics and hypothesis tests were used in data analysis. The range width of the scale was interpreted based on the formula "range width/number of groups.” Whether the scale scores showed significant differences between demographic groups was tested with hypothesis tests, an independent sample t-test was used to compare independent demographic variables with two groups, and a one-way ANOVA test was used for independent variables with more than two groups. The difference in test scores between these groups was interpreted using the post hoc test, Scheffe. As a result of the study, it was found that the attitude scores of the study sample towards the course were undecided. There were significant differences between participants' attitudes towards the course and the variables of gender, nationality, school type, parental educational status, place of residence, number of people in the household, and course achievement.

Investigation of the effect of psychological birthorder on perceived parental attitudes and early maladaptive schemas in adults

Aims: The aim of this study is to examine the effect of psychological birth order on perceived parental attitudes and early maladaptive schemas. Methods: In this study, the Psychological Birth Order Inventory, Perceived Parental Attitudes Scale-Child Form, and Young’s Schema Scale were used. The sample consisted of 189 women and 102 men. Relational and predictive analyses were conducted regarding birth order, psychological birth order, perceived parental attitudes, and schema domains. Results: There was a moderate positive relationship between the sibling rank of the women who participated in the study and the emotional deprivation schema area. For female participants, being the middle child was found to have a moderately positive relationship with emotional deprivation, dependence, pessimism, and defectiveness schemas. A weak positive relationship was found between being the middle child and emotional warmth maternal attitude, overprotective mother/father attitude, and rejecting father attitude scores. Conclusion: The study concluded that there is a significant relationship between psychological birth.order and perceived parental attitudes as well as early maladaptive schemas.

KAP ANALYSIS AND DECISION-MAKING OF NURSES REGARDING SEPSIS ASSESSMENT AND MANAGEMENT IN CRITICALLY ILL PATIENTS

Sepsis is a life-threatening condition that requires prompt identification and management, particularly in critically ill patients. Nurses play a pivotal role in sepsis management, and their knowledge, attitudes, and practices directly impact patient outcomes. However, there is limited data on the awareness and competency of nurses regarding sepsis assessment and management, especially in low-resource settings. Objective: This study aimed to evaluate the knowledge, attitudes, and practices (KAP) of nurses towards the assessment and management of sepsis in critically ill patients. Methods: A cross-sectional study was conducted in the Intensive Care Unit (ICU) and emergency department of DHQ Hospital, Narowal, from July 2023 to July 2024. A total of 100 ICU and CCU nurses were selected using convenience sampling. Data were collected through a 32-item questionnaire that assessed knowledge, attitudes, and practices related to sepsis. Additionally, the 24-item Nursing Decision-Making Instrument (NDMI) was used to evaluate decision-making skills. Descriptive statistics were calculated, and relationships between variables were analyzed using t-tests and ANOVA. Results: The mean knowledge score was 5.1 ± 1.8, with 83% of nurses demonstrating poor awareness of sepsis. The mean attitude score was 2.0 ± 0.9, with 85% of nurses displaying negative attitudes toward sepsis management. The mean practice score was 79 ± 17.8, with 72% of nurses showing poor practice skills. The mean decision-making score on the NDMI was 63.3 ± 19.6. Qualifications (p=0.010, p=0.00) and work experience (p=0.005, p=0.050) significantly influenced knowledge and practice scores. Moreover, knowledge and practice scores varied significantly with different modes of decision-making (p&lt;0.001, p=0.020). Conclusion: The study revealed that ICU and emergency department nurses had insufficient knowledge, negative attitudes, and inadequate practices concerning sepsis assessment and management. Training programs, targeted educational interventions, and policy reforms are urgently required to improve nurses' competency and decision-making skills in sepsis management, ultimately enhancing patient outcomes.

The Impact of the Clinical Pharmacist-Led Diabetes Education on the Knowledge and Attitude of Individuals with Type II Diabetes Mellitus: An Interventional Study.

Diabetes mellitus is a complex condition to manage. Patients with a greater understanding and knowledge of their condition might achieve better glycemic control than others. This study aimed to evaluate the impact of clinical pharmacist-led diabetes education on the knowledge and attitude of individuals with type II diabetes mellitus (T2DM). This study was a quasi-experimental study which was conducted at a diabetes clinic in Khartoum, Sudan. The study population was adult individuals with T2DM who attended the diabetes clinic. The estimated sample size was 182 participants. The participants were selected randomly by a simple random sampling method. The knowledge and attitudes of the participants were assessed at baseline and at the end of the study after 12 months. The intervention was carried out through educational materials about diabetes and medications for its treatment. The majority of the participants were females. The mean age was 54.5 (±10) years. Most participants had a family history of diabetes (69.2%). The mean knowledge score after the intervention was increased by 1.4 (±0.1) from baseline, p value (<0.001), while the mean attitude score was increased by 1.7 (±0.2) from baseline, p value (<0.001). At baseline, 14.8% of the participants had a high level of knowledge and 18.7% had a negative attitude, while after intervention for 12 months, 28.5% of them had a high level of knowledge and 16.8% had a negative attitude (p values < 0.001, 0.032, respectively). The knowledge of and attitudes towards diabetes differed significantly as a result of the educational program provided by the clinical pharmacist.

Attitudes and Levels of Concern and Trust Towards COVID-19 Vaccination Among Patients Hospitalized at Shahid Beheshti Hospital in Kashan, Iran

Introduction: This study aimed to explore hospitalized patients' attitudes, concerns, and trust regarding Coronavirus disease 2019 vaccination. Materials and Methods: This descriptive-cross-sectional study was conducted on 128 patients hospitalized at Shahid Beheshti Hospital in Kashan, Iran, in 2022. Participants were selected using simple random sampling. The questionnaire included questions about demographic information, attitudes towards vaccination (7 items), levels of concern (14 items), and trust (15 items). Data were analyzed using SPSS 26 software. Descriptive statistical analysis and chi-square tests applied. Results: Fifty-three (41.4%) of cases had a history of two vaccinations. Sinopharm was used in 28.12% of patients. The average attitude score was 8.21 ± 2.88, significantly associated with age (p = 0.02), nationality (p = 0.01), education (p = 0.01), and vaccination history (p = 0.02). The mean concern score was 35.41 ± 11.87, significantly linked to gender (p = 0.01) and vaccination history (p = 0.02). The average trust score was 40.50 ± 13.64, significantly associated with age (p = 0.04), gender (p = 0.01), vaccination history (p = 0.01), hospitalization history due to COVID-19 (p = 0.03), and COVID-19 infection history (p = 0.03). Conclusion: The vaccination rate among participants was acceptable. However, concerns about vaccination and its complications were the primary reasons for vaccine hesitancy. Given that vaccine acceptance across various community groups is as crucial as vaccine development, it is recommended that health organizations provide information on vaccine benefits and address concerns about potential side effects.

Knowledge, attitudes, and practices toward femtosecond laser small incision lenticule extraction surgery and postoperative care among recipients

BackgroundTo investigate the knowledge, attitudes, and practices (KAP) of individuals who underwent small incision lenticule extraction (SMILE) surgery and explore the influencing factors.MethodsThis cross-sectional study was conducted from June 21, 2023, to August 13, 2023, at Xiangyang Central Hospital. The participants were patients who had undergone SMILE surgery. The self-designed questionnaire had a Cronbach’s α = 0.849. Multivariable analyses were performed to determine the factors influencing the KAP scores.ResultsFinally, 485 valid questionnaires were analyzed. The median knowledge score was 14 (/17, 82.4%; IQR: 12–15). The median attitude score was 15 (/20, 75.0%; IQR: 14–16). The median practice score was 48 (/60, 80.0%; IQR: 42–54). The knowledge scores correlated to the attitude (r = 0.323, P < 0.001) and practice (r = 0.202, P < 0.001) scores, while the attitude scores correlated to the practice scores (r = 0.065, P < 0.001). College diploma (OR = 0.299, 95%CI: 0.110–0.812, P = 0.018), myopia for < 2 years (OR = 0.177, 95%CI: 0.060–0.526), and not receiving proper eye training (OR = 0.588, 95%CI: 0.402–0.862) were independently associated with knowledge. Being 19–30 years old (OR = 0.421, 95%CI: 0.235–0.756), being ≥ 31 years old (OR = 0.259, 95%CI: 0.111–0.601), myopia for 2–5 years (OR = 0.476, 95%CI: 0.232–0.978), myopia for 5–10 years (OR = 0.480, 95%CI: 0.263–0.875), and moderate myopia in the right eye (OR = 1.745, 95%CI: 1.024–2.974) were independently associated with attitude. Female gender (OR = 1.826, 95%CI: 1.196–2.787), being ≥ 31 years (OR = 2.587, 95%CI: 1.113–6.014), college diploma (OR = 3.436, 95%CI: 1.366–8.641), bachelor’s degree (OR = 2.826, 95%CI: 1.214–6.581), and not having proper eye training (OR = 0.458, 95%CI: 0.310–0.677) were independently associated with practice.ConclusionsPatients who underwent SMILE had high KAP regarding SMILE. This study identified KAP items that would warrant education.

Purchasing medicines and functional foods on the internet: a cross-sectional study investigating the knowledge, attitudes, and experience of Vietnamese people in 2023

ObjectiveTo investigate Vietnamese people’s knowledge, attitudes, and experience in purchasing medicines and functional foods online.MethodsVia an online survey, the data of 1,070 participants were collected, including their general characteristics, Internet use, previous experience, knowledge, and attitudes towards purchasing medicines/functional foods online. Factors associated with their knowledge and attitudes were identified via multivariate linear regression models.ResultsDuring 2022–2023, about 97.2% of participants used the Internet to seek health information (self-diagnosis: 65.0%, self-medication: 72.6%). Roughly 52.8% bought medicines and/or functional foods online. Among 565 buyers, 41.8% felt satisfied. Only 19.9% understood that selling medicines online was illegal in Vietnam. The main benefits of purchasing medicines/functional foods online that many people agreed on included convenience (87.1%), freedom from location (84.8%), and being able to order/buy products after opening hours (84.7%). Many people felt worried about the ability to buy counterfeit or substandard products (87.7%), inaccurate product information (85.0%), the lack of supervision of the authorities (83.7%), and increasing risks of drug abuse, self-medication, and treatment non-adherence (82.5%). Roughly 84.3% found distinguishing between legal and illegal online pharmacies difficult. Participants’ average knowledge and attitude scores were 6.514 ± 2.461 (range: 0–16) and 89.330 ± 13.720 (range: 23–115), respectively. The main factors associated with people’s knowledge and attitudes towards purchasing these products online included their frequency of Internet use, seeking health information online for self-medication, feeling satisfied with previous experience, and having at least one chronic disease.ConclusionsMany Vietnamese people’s knowledge about purchasing medicines/functional foods online was limited. With the increasing need for online shopping, enhancing their knowledge is paramount. In the forthcoming years, when the Ministry of Health and relevant authorities publish legal documents and enact laws involving online pharmacies and trading medicines on the Internet, ways to recognize licensed online pharmacies must be widely propagated and disseminated in the community.

Effects of three-dimensional quality assessment nursing intervention on efficacy and disease management of patients undergoing esophageal cancer surgery.

Esophageal cancer is one of the most common malignant tumors. The three-dimensional quality structure model is a quality assessment theory that includes three dimensions: Structure, process, and results. To investigate the effects of nursing interventions with three-dimensional quality assessment on the efficacy and disease management ability of patients undergoing esophageal cancer surgery. In this prospective study, the control group received routine nursing, and the intervention group additionally received a three-dimensional quality assessment intervention based on the above routine care. Self-efficacy and patient disease management abilities were evaluated using the General Self-Efficacy Scale (GSES) and Exercise of Self-Care Agency scale, respectively. IBM SPSS Statistics for Windows, version 17.0, was used for the data processing. This study recruited 112 patients who were assigned to the control and experimental groups (n = 56 per group). Before the intervention, there was no significant difference in GSES scores between the two groups (P > 0.05). After the intervention, the GSES scores of both groups increased, with the experimental group showing higher values (P < 0.05). At the time of discharge and three months after discharge, the scores for positive attitudes, self-stress reduction, and total score of health promotion in the experimental group were higher than those in the control group (P < 0.05). The implementation of a three-dimensional quality structure model for postoperative patients with esophageal cancer can effectively improve their self-management ability and self-efficacy of postoperative patients.

Impact of theory of planned behavior based intervention on breastfeeding patterns of the mothers with preterm infants: a randomized trial

BackgroundThe birth of a preterm infant is considered a crisis for the mother and the family. Given the significance of breastfeeding for these high-risk infants, failure to initiate and maintain exclusive breastfeeding in this group of infants is a prevalent and serious problem. The aim of this research was to investigate the impact of Theory of Planned Behavior based intervention on breastfeeding patterns of the mothers with preterm infants: a randomized trial.Materials and methodsThis study is a field trial conducted in Isfahan, Iran in 2021–2022. It included 72 mothers of late preterm infants, divided into the intervention (n = 36) and control (n = 36) groups. The intervention group received four training sessions focused on breastfeeding patterns based on the Theory of Planned Behavior. Before, immediately after, and two and four months after the intervention, the constructs of the Theory of Planned Behavior related to breastfeeding patterns were assessed using a researcher-made questionnaire, and the infant’s breastfeeding pattern was recorded. Statistical analysis was performed using SPSS version 19, g repeated measures ANCOVA, Bonferroni post hoc test, and chi-square test.ResultsThe results indicated that immediately after the intervention, as well as two and four months later, the mean scores for attitude (P < 0.001), subjective norms (P < 0.001), perceived behavioral control (P < 0.001), and behavioral intention (P < 0.001) were significantly higher in the intervention group than in the control group. Additionally, the results showed that, the rate of breastfeeding immediately, two months, and four months after the intervention was significantly higher in the intervention group than before the intervention (P < 0.001). However, in the control group, the rate of breastfeeding immediately, two months, and four months after the intervention was significantly lower than before the intervention (P < 0.001).ConclusionInterventions based on the Theory of Planned Behavior can improve exclusive breastfeeding in late preterm infants by changing the attitudes, subjective norms, perceived behavioral control and the behavioral intentions of the mothers of preterm infants.Trial registration“IRCTID: IRCT20210524051392N1”, 13/06/2021.

A Cross-Sectional Study of Pre-Prepared Foods Knowledge, Attitudes, and Practices of College Students in Central China.

Objectives: This study aimed to investigate knowledge, attitudes, and practices related to pre-prepared foods among college students in Central China. Methods: From the end of May 2024 to June 2024, we completed a cross-sectional study using an online questionnaire. A total of 1676 questionnaires were distributed online, and 1566 valid questionnaires were collected. Data were analyzed using Kruskal-Wallis tests or Wilcoxon rank-sum tests for univariate analysis. A multiple linear regression model was employed with knowledge, attitudes, and practices scores as dependent variables to identify factors associated with the scores on pre-prepared food knowledge, attitudes, and practices. Results: The survey results showed that 56.7% of the participants had high knowledge scores, 4% of the participants had high attitudes scores, and only 0.4% of the participants had high practices scores. Multiple linear regression analysis showed that ethnicity, the number of children in the family, academic qualifications, and monthly living expenses were associated with college students' knowledge of pre-prepared foods (p < 0.05). Gender and the satisfaction with school catering services were associated with college students' attitudes of pre-prepared foods (p < 0.05). Gender, knowledge and attitudes were associated with practices of pre-prepared foods (p < 0.05). Conclusions: College students have a relatively high level of knowledge of pre-prepared foods. However, they have more negative attitudes and practices towards pre-prepared foods, and the overall KAP levels are low.

A cooperative learning intervention for improving a simulation-based paediatric nursing course: A quasi-experimental study

AimThis study aimed to examine if a cooperative intervention improved outcomes for a simulation-based paediatric nursing course. BackgroundFostering cooperative learning can enhance student engagement and improve learning. Simulation-based courses provide nursing students an opportunity to practice and hone nursing skills when hands-on experiences are limited. Providing instruction in cooperative learning could improve course outcomes. DesignA quasi-experimental study with pre-test/post-test assessments. MethodsThird-year nursing students enrolled in an 18-week paediatric simulation-based nursing course were purposively recruited (N = 110). One class (n = 55) received a researcher-developed cooperative learning program, which encouraged student support during class activities and simulations. The second class (control) received usual class instruction and simulations. The efficacy of the intervention was assessed by comparing mean scores at class enrolment (pre-test) and completion (post-test) for self-perceived problem-solving attitude, cooperative learning experience and knowledge of paediatric nursing. Paired t-tests compared pre-test with post-test scores for the two groups. ANCOVA examined differences in mean scores between groups. Correlations between differences in mean pre-test and post-test subscale scores for problem-solving attitude and cooperative learning experience were also examined. ResultsThere was no significant difference in age or gender between groups. Mean post-test scores on the final exam were significantly higher for students who received the intervention (85.26, 95 % CI 84.19, 86.33) compared with controls (83.61, 95 % CI 82.52, 84.69; F = 4.63, p = 0.034). There were no significant differences in total scores for problem-solving attitude or cooperative learning experience or between groups. For the intervention group, two problem solving subscales were correlated with two cooperative learning subscales: problem solving confidence with learning motivation, respectively (r = 0.302, p = 0.025) and personal control with classroom learning, respectively (r = 0.389, p = 0.003). For the control group, approach-avoidance problem solving was negatively correlated with cooperative learning efficacy (r = −0.343, p = 0.01). ConclusionsCompared with the control group, nursing students who received the cooperative learning intervention had higher scores for knowledge of paediatric nursing, as well as learning motivation and attitude and problem-solving confidence, suggesting that the researcher-designed intervention facilitated simulation-based learning as well as confidence in problem-solving. Nurse educators could easily integrate the intervention into simulation-based paediatric nursing courses to enhance students' problem-solving abilities.

Medical residents' knowledge, attitudes and practices regarding antibiotics, antimicrobial stewardship and multidrug-resistant bacteria: a cross-sectional study in a major university in Iran.

Antimicrobial resistance (AMR) is one of the biggest threats to global public health systems. This study aimed to assess the knowledge, attitudes and practice about AMR, antimicrobial stewardship programs (ASPs) and multidrug-resistant (MDR) bacteria. A web-based questionnaire survey was conducted among the residents of Isfahan University of Medical Sciences from May to November 2023. Data analysis was done using SPSS version 24.0 software. Overall, 400 out of 450 medical residents responded to the questionnaire, giving a response rate of 88.9%. The participants' ages ranged from 26 to 54 years, and the majority were female (227/400 56.8%). Average scores for knowledge, attitudes, and practices were 53.70 ± 15.88, 36.97 ± 5.89 and 24.69 ± 4.24, respectively. In terms of knowledge, only 26.8% had heard the term "ASPs" and knew what it was. Most incorrect answers appeared to the treatment of infection caused by MDR bacteria including ESBL-producing Escherichia coli (27.8%) and carbapenem-resistant Klebsiella pneumoniae (30.8%), as well as the atypical bacteria (45.5%). Approximately, 50 and 71.7% said they had received no specific training in the fields of microbiological sampling methods and the appropriate time to prescribe antibiotics, respectively. Surprisingly, regarding practice, 81.8% of the respondents stated that antibiotics are used to treat flu or the common cold. Residents considered their training on important issues including ASPs, MDR bacteria and the spectrum of antibiotics insufficient. This result highlights the need for targeted training interventions about antibiotic prescription in the curriculum at the university with more emphasis on ASPs to limit the development of resistance.

Self-Perceived Competencies and Attitudes on Palliative Care in Undergraduate Nursing Students: A Multicenter Descriptive Study.

Introduction: Caring for the dying can generate anxiety and emotional distress, particularly in nursing students, and perceived competence could play a crucial role in enabling nurses to perform their duties with greater confidence. Unfortunately, few studies describe the relationship between students' nursing attitudes and perceived self-efficacy in palliative care (PC). To overcome this gap, this survey aimed to assess the attitudes towards dying patients and the perceived competence of nursing students in palliative care at different universities in the south of Italy. Methods: A cross-sectional study was conducted from September 2022 to March 2023 involving nursing students from the three major Sicilian universities (Italy). The study included a survey investigating socio-demographic characteristics, palliative care training, knowledge about pain management, and previous experience with dying. Moreover, the Professional Competence of the Core Curriculum in Palliative Care Nursing (CCPCN) questionnaire and the Frommelt Attitudes Toward Care of the Dying-B Italian version (FATCOD-B-I) assessed competencies and emotional attitudes. Results: A total of 1913 nursing students were recruited, of which 71.3% were females, and 53.9% were in the age range of 18 to 21 years. In the multivariable analysis, practical PC training was a substantial factor in enhancing competencies (Adj-OR 2.78 [95% CI = 2.12-3.65]). Male students had higher competence odds (Adj-OR 1.38 [95% CI = 1.14-1.66]), and perceived knowledge strongly correlated with self-assessed competence. Advancement in academic years also positively influenced competence self-assessment (Adj-OR 1.98 [95% CI = 1.75-2.24]). Regarding emotional attitudes, a per-quartile increase in competence score was found to improve the attitude score (Adj-OR 1.24 [95% CI = 1.13-1.35]). Conclusions: Nursing students gain valuable experience during clinical experience. PC training and perceived knowledge of PC significantly increase nurses' competencies, and the latter seem to be strongly associated with attitudes. Thus, introducing palliative care education into nurses' core curricula could be a way to reduce anxiety and emotional distress in young students.