Higher Total Knowledge Scores Research Articles

Pediatrician Knowledge of Early Intervention Process as Contributor to Disparities in Management of Development Delay.

Lack of knowledge of Early Intervention (EI) is a barrier to developmental delay (DD) management. We aimed to examine the feasibility of measuring pediatricians' knowledge of EI, determine the distribution of EI knowledge, and determine factors associated with increased EI knowledge. We conducted an exploratory cross-sectional study with a convenience sample from a local American Academy of Pediatrics chapter to administer a survey with 10 multiple-choice questions regarding the EI referral process, evaluation process, eligibility criteria and fee structure. Our outcome variable was a composite score of these 10 multiple-choice questions, Total Knowledge Score (TKS). Our predictor variables included physician characteristics (i.e., years of experience, percentage of patients seen with private insurance, receipt of EI training in the last 5years) and practice characteristics (i.e., medical home status). Our sample consisted of a total of 194 pediatric residents/attendings. Multivariable regression demonstrated seeing ≥ 50% patients who were privately insured, increased experience, and receiving training in the last 5years were associated with higher TKS. We were able to quantitatively evaluate physician's knowledge of EI and demonstrated that seeing a majority of privately insured patients, having more experience, and having received formal EI training in the last 5years were associated with higher EI knowledge. This disproportionate distribution of EI knowledge has the potential to contribute to disparities in the management of DD. This may indicate that medical institutions, where physicians see a small percent of privately insured patients, need to hire more experienced physicians, and provide routine EI training.

Association between dyslipidaemia knowledge & lipid testing practice among adults, a community-based study.

Various factors have been described in the literature to explain the tendency of an individual to undergo medical screenings. This study aimed to assess the association between the level of knowledge about dyslipidaemia and the frequency of lipid testing, as well as the potential impact of predisposing, enabling, and need factors on the uptake of blood lipid screening. This study was a cross-sectional survey involving 314 participants who were Malaysian residents of Taman Selatan, Klang, aged 30 and above. The study utilized a 42-item paper-based bilingual questionnaire to evaluate the predisposing, enabling, and need factors that could potentially influence the practice of lipid testing. Out of the 314 residents approached, 271 responded to the questionnaire yielding a response rate of 86.31%. The median knowledge score was 5 out of 17. Lower monthly income (OR = 3.225, 95% CI = 0.255 to 2.141), higher number of comorbidities (OR = 2.724, 95% CI = 0.037 to 2.013), higher total knowledge score (OR = 1.334, 95% CI = 0.063 to 0.512) and respondent's belief and attitude (OR = 0.813, 95% CI = -2.033 to -0.539), were found to be significantly associated with the frequency of lipid testing. In conclusion, the knowledge level regarding dyslipidaemia was below average and associated with a lower tendency to undergo frequent lipid testing. There is a need for innovative health awareness such as active educational campaigns in various settings of the community. Further qualitative studies that explore the understanding of the publics', and antecedents of their, lipid screening behaviour are required. Appropriate communication by healthcare providers should be encouraged during patient consultations for higher impact.

Access to Breast Reconstruction in Kuwait: Assessing Surgeon-related Factors as a Barrier to Referral.

This is an online questionnaire-based study to investigate the variation in the referring general surgeons' knowledge and perception towards breast reconstructive surgery. A total of 141 general surgeons responded to the questionnaire, and only 63 (44.7%) always discuss the available options for reconstruction with their breast cancer patients. When asked about referral to a plastic surgeon, only 49 (34.8%) responded with always, and the majority (N = 61; 43.3%) responded with sometimes. More than half (N = 73; 51.8%) believe that the general surgeon should determine patient suitability for referral to a plastic surgeon, while only 53 (37.6%) agree that breast cancer patients should always be referred to a plastic surgeon for consideration of reconstruction. The mean knowledge score was 6.6 of 8, while the mean perception score was 8.9 of 12. Responders with a higher total knowledge score were more likely to discuss with patients the availability of reconstruction. Despite the acceptable knowledge scores in our general surgeons, there is a low rate of referral for breast reconstruction in Kuwait. There is a pressing need to generate legislations and a streamlined protocol for referral that facilitate access to breast reconstructive services.

Parents' knowledge and attitude and behavior toward autism: a survey of Chinese families having children with autism spectrum disorder.

BackgroundIn recent years, parent-mediated intervention for children with autism spectrum disorder (ASD) has increased. Therefore, implementing effective parent training programs for parents of children with autism is of paramount importance, particularly in low- and middle-income countries. However, little is known about the status of and gaps in parents’ knowledge on ASD, which may hinder the development of valid parental training programs. Herein, we aimed at exploring the status of Chinese parents’ knowledge, attitude and behavior toward ASD, and potential factors affecting the acquisition of correct knowledge.MethodsThis study used a self-designed parental knowledge questionnaire of autism (PKQA) comprising 20 questions alongside another questionnaire comprising additional 17 questions covering the aspects of family demographics, attitudes, and behaviors of parents. In total, we included 394 parents who visited the outpatient department of the Child’s Development and Behavior Center of the Third Affiliated Hospital of Sun Yat-Sen University between December 2018 and May 2019, with their children meeting the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnostic criteria for ASD.ResultsThe median knowledge score in the PKQA was 15 [interquartile range (IQR), 13–17]. Advanced paternal age and longer time interval from diagnosis to enrolling into the parent training program were associated with a lower total knowledge score (all P<0.001). Higher maternal education attainment, higher family income, child being currently under intervention, and family members sharing a common perception of the diagnosis were associated with a higher total knowledge score (all P<0.01). Reading autism-related books (P<0.001) or attending professional lectures (P=0.019) were also associated with a higher total knowledge score.ConclusionsTaken together, this study revealed that family demographics and parents’ attitudes and behaviors toward ASD may significantly influence their knowledge about autism, suggesting the need for promoting more targeted parental skills training programs.

Medical student readiness to treat LGBTQ patients.

11030 Background: The lesbian, gay, bisexual, transgender and queer (LGBTQ) community experiences cancer health disparities. It is thus imperative that medical trainees receive training in the care of LGBTQ populations. Identifying gaps in trainees’ knowledge and comfort in providing care for this population is important in preparing future physicians. Methods: A Likert-scale survey of US medical students at three institutions assessed attitudes, comfort and knowledge in providing care for LGBTQ patients. Results were quantified with descriptive and stratified analyses. Exploratory factor analysis found four factors in which attitude summary measure (ASM) scores were calculated; lower values indicate more agreeability with given attitude items. Total knowledge scores were calculated with higher values indicating greater knowledge. Results: Of 300 medical students who completed the survey, the majority were female (55.7%), white (54.7%), and heterosexual (64.3%). The majority of students felt comfortable (strongly agree/agree) participating in the care of patients who identify as lesbian (94.3%), gay (96.0%), and bisexual (96.3%); this percentage dropped to 82.3% for non-binary and 71.3% for transgender patients. Only 27.0% of students reported confidence in their knowledge of health needs of transgender patients. LGBTQ self-identification, percent of core rotations completed, and having LGBTQ friends/family were significantly associated with various ASM subscales (Table 1). Knowledge questions had high percentages of “neutral” responses, and students who identified as LGBTQ had significantly higher total knowledge scores. Conclusions: Overall, medical students feel comfortable and willing to provide care for LGBTQ patients. However, as in our prior study in oncologists, there is limited knowledge about specific LGBTQ health and cancer needs. More education and training in the needs of transgender and non-binary patients is indicated. [Table: see text]

Knowledge and Practice Survey on Zika Virus Infection Among General Adults in Brunei Darussalam.

A cross-sectional survey was conducted to assess the knowledge and practices on Zika virus infection among general adults in Brunei Darussalam. From February to June 2017, 439 adults were interviewed from outpatient health care settings. Most participants were Malays (87.0%) and females (61.5%), with a mean age of 40.7 years. Only 25.1% had a total knowledge score of 15 to 28 points (of a possible score of 0-28). Females and those living in households of <8 people were more likely to have higher total knowledge scores (15-28 points). Media was the preferred source to get updates. Also, 67.4% had a total prevention practice score of 19 to 36 points (of a possible score of 0-36). Those who attained secondary level education or below, had no pregnant women present in their household, and scored 15 to 28 points for knowledge were more likely to have higher prevention practice scores (19-36 points). Knowledge on Zika was significantly associated with prevention practices against mosquito bites and breeding.

Hepatitis C care continuum and associated barriers among people who inject drugs in Chennai, India

BackgroundLittle is known regarding barriers to hepatitis C virus (HCV) treatment among people who inject drugs (PWID) in low-resource settings, particularly in the era of direct-acting antiviral therapies. MethodsBetween March, 2015–August, 2016, a cross-sectional survey was administered to community-based PWID in Chennai, India to examine the HCV care continuum and associated barriers. Adjusted prevalence ratios (APR) were estimated by multivariable Poisson regression with robust variance. ResultsAll participants were male (n = 541); 152 participants had HCV mono-infection and 61 participants had HIV/HCV co-infection. Only one HCV mono-infected and one HIV/HCV co-infected participant was linked to HCV care. Overall, there was moderate knowledge of HCV disease but poor knowledge of HCV treatment. Higher total knowledge scores were negatively associated with HIV/HCV co-infection (vs. HCV mono-infection), though this was not statistically significant in adjusted analysis (APR = 0.71 [95%CI = 0.47–1.06]). Participants ≥45 years (APR = 0.73 [95%CI = 0.58–0.92]) and participants with HIV/HCV co-infection (APR = 0.64 [95%CI = 0.47–0.87]) were less willing to take weekly interferon injections for 12 weeks. Willingness to undergo HCV treatment improved with decreasing duration of therapy, higher perceived efficacy, and use of pills vs. interferon, though willingness to use interferon improved with decreasing duration of therapy. Most participants preferred daily visits to a clinic for HCV treatment versus receiving a month’s supply. Participants ≥45 years (vs. <45 years; APR = 0.70 [95%CI = 0.56–0.88]) and participants with HIV/HCV co-infection (APR = 0.75 [95%CI = 0.57–0.98]) were less likely to intend on seeking HCV care. Common reasons for not having already seen a provider for HCV treatment differed by HIV status, and included low perceived need for treatment (HCV-mono-infected), competing money/health priorities and costs/fears about treatment (HIV/HCV-co-infected). ConclusionResidual gaps in HCV knowledge and continuing negative perceptions related to interferon-based therapy highlight the need to scale-up educational initiatives. Readiness for HCV treatment was particularly low among HIV/HCV co-infected and older PWID, emphasizing the importance of tailored treatment strategies.

Interactive online learning on perioperative management of elderly patients

IntroductionSurgical specialists and residents lack knowledge to adequately manage frail older patients. This study aims to evaluate the effects of an interactive online course regarding attitude, self-confidence and knowledge in perioperative management of the elderly patient. MethodsThe six-weeks course consisted of expert videos, literature readings, quizzes and forum discussions. Surgical consultants with geriatric expertise and geriatricians moderated online discussions and stimulated interaction. Knowledge, self-confidence and attitude of course participants were compared at the beginning and end of the course. Results206 medical practitioners started the course. Knowledge scores improved significantly from 49% to 65% (p < 0.005). Participants felt more secure (p < 0.005) in the treatment of the older patient at the end of the course. A better attitude correlated with a higher total knowledge score in surgeons and surgical residents (p = 0.02). ConclusionA six-week interactive online course on perioperative management of elderly patients increases relevant geriatric knowledge and improves self-confidence of residents and faculty.

Australian general practice nurse's knowledge, attitudes and practices regarding influenza vaccination: a cross-sectional survey.

The aim of this study was to examine the knowledge, attitudes and practices of Australian general practice nurses (GPNs) regarding influenza vaccination. Despite the evidence for the benefits of influenza vaccination, vaccination rates remain sub-optimal. The knowledge, attitudes and practices of nurses both affects vaccination rates and the advice given to consumers. Given their significant role in opportunistic and planned vaccinations, GPNs are in an optimal position to positively influence vaccination rates. A descriptive cross-sectional survey was used. GPNs were recruited by email to complete an online survey. The survey tool comprised the King's College Nurses' Influenza Vaccination Questionnaire and adapted demographic items. Data analysis used descriptive and inferential statistics. Open-ended questions were analysed using thematic analysis. Most of the 85 respondents had received the seasonal influenza vaccination in the last year (n=67; 78·8%); fewer received the H1N1 vaccination (n=54; 63·5%). Intention to receive vaccination was affected by previous vaccination. Those who had received the seasonal influenza vaccine in the last year had a higher total knowledge score. The seasonal and total influenza knowledge score was high, with lower scores on the H1N1 sub-scale. A positive correlation was identified between influenza knowledge and risk perception. This study highlighted the high level of knowledge amongst GPNs related to seasonal influenza, whilst identifying a knowledge deficit around the H1N1 items. It demonstrated that GPN's knowledge of seasonal influenza was related to vaccination status and risk perception. Further research is required to explore how this translates into the advice GPNs give to consumers. Influenza vaccination should be considered as a key topic for GPNs ongoing professional development. The evidence for links between education and vaccination uptake should encourage employers to facilitate opportunities for this training. Future efforts to increase vaccination uptake in nurses should promote the benefits of vaccination in protecting the individual rather than as a professional responsibility.

Impact of an Evidence-Based Practice Intervention on Knowledge and Clinical Practice Behaviors Among Registered Dietitians

Implementation of evidence-based practice in clinical practice is essential for safety, quality, cost, and reimbursement of dietetics services. This prospective randomized controlled trial aimed to measure changes in knowledge and practice behaviors of evidence-based practice after an educational intervention. The ability to interpret statistical results improved significantly in the intervention group. When motivation to change was controlled for over time, a higher total knowledge score was demonstrated in the intervention group. This finding suggests that motivation to change was an important factor for the adoption of evidence-based practice knowledge into clinical practice among registered dietitians.