Knowledge-practice Gap Research Articles

Co-development of a programme to improve physical activity support for women after breast cancer treatment: a pre-protocol for PURE-EX

Background Breast cancer and its treatment can have long-term adverse effects on physical and mental health. Evidence-based guidelines recommend that healthcare professionals (HCPs) advise women with breast cancer to engage in physical activity to improve health outcomes. However, support to be active is not standard care. The PURE-EX (EXpanding into communities to imProve physical activity sUpport foR womEn after breast cancer) programme aims to address this knowledge-practice gap. Aim To co-develop a programme that integrates physical activity referrals into standard care for women after treatment for early-stage and locally-advanced breast cancer. Programme components will include: 1. A referral pathway enabling HCPs to refer women to community-based physical activity programmes after they have completed primary treatment for breast cancer; 2. An online training course to support community providers in adapting their existing physical activity programmes for women who have undergone breast cancer treatment. Work Packages We will co-develop, refine, and evaluate PURE-EX programme components through four work packages (WPs): WP1. Conduct a systematic scoping review to describe the characteristics of community-based physical activity programmes for women with breast cancer reported in the literature. WP2. Undertake qualitative research with: (i) women with breast cancer, (ii) HCPs responsible for their care, and (ii) exercise professionals, to explore barriers and facilitators to incorporating physical activity into breast cancer care from different perspectives. WP3. Hold co-development events to develop and refine components of the PURE-EX programme and gain insights as to how it could be operationalised in practice. WP4. Conduct a feasibility trial in 45 women who have finished primary treatment for breast cancer to assess the feasibility and acceptability of the PURE-EX programme. Discussion The PURE-EX programme will be an evidence-based, theory-informed, and person-centred intervention, with the potential to make physical activity support routinely available for women after breast cancer treatment.

The knowledge-practice gap among critical care nurses regarding intra-abdominal pressure measurement

The knowledge-practice gap among critical care nurses regarding intra-abdominal pressure measurement

A Survey Assessing Nonalcoholic Fatty Liver Disease Knowledge Among Hepatologists and Non-Hepatologists in China.

A global increase in nonalcoholic fatty liver disease (NAFLD) prevalence has been observed in the last decade. This study assesses knowledge, awareness, and clinical practice gaps of hepatologists and non-hepatologists in NAFLD management across hospitals in China. A web-based quantitative survey was conducted, and participants included hepatologists (gastroenterologists and infectious disease specialists) and non-hepatologists (internal medicine specialists, cardiologists, and pharmacists) from various hospitals across China. In total, 1627 healthcare practitioners (HCPs) responded to the survey. This included 658 hepatologists and 969 non-hepatologists. In comparison to 92.6% hepatologists, only 58.0% of non-hepatologists were aware of NAFLD. A higher proportion of hepatologists (82.8%) performed screening for NAFLD compared to non-hepatologists (56.9%). Majority of the hepatologists (70%) and non-hepatologists (67%) were aware of the four primary recommendations for managing NAFLD. Only 11% of hepatologists did not manage NAFLD patients, mainly because they felt they did not have enough time (66.7%). Of the 36% non-hepatologists who did not manage NAFLD, 78.4% stated that NAFLD is not their specialty, and 38.6% were not familiar with the treatment options. Most hepatologists were aware of and agreed to performing screening for NAFLD compared to non-hepatologists. Both hepatologists and non-hepatologists exhibited similar level of understanding on NAFLD management. However, a small percentage of both hepatologists and non-hepatologists admitted that they did not manage NAFLD patients because they were not familiar with available treatment options. This underscores the importance of further educating HCPs involved in managing NAFLD.

Integrated measure for training transfer in nursing practice: Development and validation study

BackgroundThe persistent knowledge-practice gap in nursing, where competencies gained through continuing professional development fail to integrate into practice, remains a significant challenge. Effective transfer of acquired knowledge and skills to the workplace is essential for bridging this gap. However, there is a lack of comprehensive, validated instruments to assess factors influencing training transfer in nursing practice. ObjectiveThis study aims to develop a questionnaire capable of assessing training transfer as an integrated construct, encompassing all factors influencing this process in nursing practice. DesignThe study followed a developmental, iterative approach guided by the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). Setting(s)Eight tertiary teaching hospitals in the Netherlands. ParticipantsEducational experts (n = 8) and nurses (n = 1588). MethodsThe questionnaire development consisted of three phases: Phase 1) content development, in which instruments were identified based on a literature study and translation of included instruments into Dutch, Phase 2) pilot phase: content validation and usability testing using Delphi studies with experts and nurses, Phase 3) psychometric validation: construct validation using exploratory and confirmatory factor analysis, composite reliability and discriminant validity. The phases were completed from January 2023 till June 2024. ResultsThe literature review led to the inclusion of two key instruments: the Learning Transfer System Inventory (LTSI) and the Learning Climate Questionnaire (LCQ). Following item reduction based on Delphi rounds, nurses completed the adapted instruments. Psychometric validation demonstrated a good fit for these instruments in nursing practice. The adapted LTSI showed loadings ranging from 0.37 to 0.99, with a Normed Χ2 of 1.996, TLI of 0.908, CFI of 0.920, and RMSEA of 0.050 [CI = 0.047–0.054]. The adapted LCQ exhibited loadings from 0.64 to 0.94, with a Normed Χ2 of 3.385, TLI of 0.963, CFI of 0.974, and RMSEA of 0.069 [CI = 0.061–0.078]. The combined model demonstrated a Normed Χ2 of 2.014, TLI of 0.900, CFI of 0.907, and RMSEA of 0.051 [CI = 0.048–0.054]. ConclusionsThe adapted LTSI and LCQ, both separately and combined, are reliable and valid instruments for use in the Dutch nursing hospital context. Together, they provide a comprehensive assessment of factors influencing training transfer. They can also be used independently to examine specific components such as trainers (LCQ), context (LTSI), personal aspects (LTSI), or training (LTSI/LCQ). Furthermore, these instruments can facilitate discussions between nurses, managers, and educational experts to address barriers to training transfer in nursing practice.

Bridging the Knowledge–Practice Gap: Assessing Climate Change Literacy Among Science Teachers

This research aimed to investigate the knowledge levels and teaching practices of Saudi science teachers regarding climate change, focusing on exploring the correlation between these aspects. The cross-sectional descriptive survey included teachers at middle and high school levels in public schools. The questionnaire study comprised three sections: collecting demographic data, assessing teachers’ understanding of climate change through factual inquiries, and evaluating teaching practices related to climate change. The findings reveal a promising degree of awareness among teachers, with a majority correctly identifying crucial elements of climate change while also exposing misconceptions and knowledge gaps. While a notable portion of teachers reported teaching climate change-related aspects, some indicated minimal involvement in extracurricular activities linked to climate change. The correlation analysis between science teachers’ climate change knowledge and practices indicates a weak connection between the two variables, suggesting that teachers’ knowledge might not substantially impact their actual teaching practices regarding climate change concepts. Limitations included reliance on self-reported data and a sample size that could impact result generalizability. Future research recommendations include combining quantitative data with qualitative methods, comparing knowledge and practices across regions or demographics, and conducting longitudinal studies. This study’s implications stress the importance of targeted professional development, advocating for climate change education integration into formal curricula, and policy adjustments mandating climate change education.

Assessment of ICU nurses' competency towards delirium among critically ill patients.

ICU nurses play a critical role in managing delirium in critically ill patients, yet their competency in this area remains under-explored. To assess ICU nurses' competency including their knowledge, practice, and attitudes toward delirium among critically ill patients. A correlational descriptive study was conducted with 67 nurses in the medical intensive care unit at Suez Canal University Hospitals. Data was collected using an online survey and analyzed using descriptive statistics, ANOVA, and Pearson's correlation. Nurses showed a moderate knowledge level (M = 8.55), a low practice level (M = 6.62), and positive attitudes (M = 21.65) toward ICU delirium. ANOVA results indicated significant differences in practice scores based on educational level, F (2, 64) = 3.361, p = .041, and in knowledge scores based on ICU experience, F(3, 63) = 6.455, p < .001. Nurses with Master of Science in Nursing (MSN) degrees had higher practice scores than those with diplomas or Bachelor of Science in Nursing (BSN) degrees. There were no significant differences in knowledge and attitude scores based on educational level or age. Gender differences were minimal, with male nurses slightly outperforming female nurses. Correlation analysis showed positive relationships between age, education, ICU experience, and ICU nurses' levels of knowledge and practice. ICU nurses demonstrate a knowledge-practice gap in delirium management. Targeted educational interventions, mentorship programs, and a focus on practical skills are essential to enhance delirium care. These findings highlight the urgent need for comprehensive delirium education and training programs for ICU nurses. By improving nurses' knowledge and practice, healthcare organizations can significantly enhance the early detection, prevention, and management of delirium, ultimately leading to improved patient outcomes and reduced length of stay in the ICU.

Time to close the knowledge–practice gap in field teaching

Time to close the knowledge–practice gap in field teaching

Global mapping survey research on physiotherapeutic interventions for osteoarthritis: a scoping review protocol

IntroductionPhysiotherapists provide non-pharmacological conservative treatment for osteoarthritis (OA) using a wide spectrum of interventions. Previous surveys have identified global physiotherapy OA management practices. However, no review to date summarises the...

Knowledge, Attitudes, and Practices Among Guardians of Boys Toward Concealed Penis.

Concealed penis (CP) is a condition involving a congenital abnormality of the external genitalia, wherein the penile shaft is partially or completely obscured by surrounding skin tissues, negatively affecting the psychological and physical health of children. The guardians, who are primarily responsible for the daily care of children, play a crucial role in the early detection of this condition. Therefore, this study aims to explore knowledge, attitude, and practices (KAP) toward CP among guardians of young boys; results would provide a theoretical basis for the development of health education programs. This web-based cross-sectional study was conducted among guardians of boys in the Department of Pediatric Surgery, local hospital between June 2023 and September 2023. A self-designed questionnaire was developed to collect demographic information of the guardians and to assess their knowledge, attitudes and practices toward CP. A total of 394 questionnaires were collected. Among the guardians, 143 (36.29%) of them were male, 375 (95.18%) were the parents of the children, 279 (70.81%) had a junior college or bachelor's degree, and 46 (11.68%) reported their children had CP. The knowledge, attitudes and practices scores were 4.00±2.00 (possible range: 0-7), 35.63±3.40 (possible range: 9-45), and 23.03±6.97 (possible range: 9-45), respectively. The structural equation model demonstrated that knowledge had direct effects on attitudes (β=0.63, p<0.001), and practices (β=0.81, p<0.001). Moreover, attitudes had direct effects on practices (β=0.43, p<0.001). This study found insufficient knowledge, positive attitudes, but poor practices toward the CP in guardians of boys, especially among participants from rural areas of families with lower income. It is recommended to tailor educational initiatives and implement strategies to bridge the knowledge-practice gap toward concealed penis in boys.

Fostering Healthier Choices: Empowering Pharmacy Students to Bridge the Food Label Gap in Lebanon

Background: Non-communicable diseases are a significant public health issue in Lebanon, making it crucial to promote preventive measures such as informed dietary choices. Food labels play a key role in this, but there is a disconnect between knowledge and utilization, even among healthcare professionals. This study aimed to investigate this gap among Lebanese pharmacy students by assessing their nutrition knowledge, usage of food labels, and the factors influencing their label use. Materials and Methods: This cross-sectional study examined the knowledge gap among 81 pharmacy students in Beirut. A validated questionnaire assessed demographics, nutrition knowledge, label features influencing purchase decisions, and barriers to label use. Results: Despite having high overall nutrition knowledge (mean score of 82%), students reported inconsistent use of food labels. Gender did not significantly influence the prioritization of label features. However, students in higher academic years were more likely to pay attention to production dates (p &lt; 0.001). Additionally, there was a positive correlation between the frequency of label use and knowledge scores. Conclusion: This study highlights a persistent knowledge-practice gap in food label utilization among pharmacy students. Educational interventions tailored to address specific knowledge gaps and perceived barriers are necessary.

Perceived Effects of Climate Change on Farm Income: Insights from Smallholder Arable Crops Farmers in South-west Nigeria

Climate change presents significant challenges for smallholder arable crop farmers whose major livelihood revolves around agriculture. This is further worsened by farmers’ poor awareness and limited knowledge of mitigating the associated risks with debilitating consequences on Farm Income. Therefore, this study investigated the perceived effects of climate change on farm income in South-west Nigeria, using cross-sectional data elicited from randomly selected 389 arable crop farmers. The data were analyzed using descriptive statistics, principal component analysis (PCA), and ordinary least square regression (OLS) technique. The results indicated that the farming population skewed towards older individuals, with an average age of approximately 55 years. Farmers were predominantly male, comprising 78.1% of the sample, who primarily derived their livelihood from agriculture, with 77.4% engaging in farming as their main occupation. Additionally, a significant portion of the farmers, accounting for 67.6%, possess secondary or higher education qualifications. Widely adopted coping practices include varying planting dates, multiple cropping, zero bush burning, crop rotation, irrigation, manure mulching, and cultivating drought/flood-tolerant varieties. Also, the estimates from the fitted OLS regression model revealed that farmers’ knowledge and perception of climate change had significant relationships with farm income. Factors such as education, years of farming experience, farm size, access to extension services, social networks, access to climate change information, challenges on climate change mitigation, and coping strategies employed by the farmers were indicated to significantly influence farm income among the smallholder farmers in the study area. Therefore, the promotion of sustainable agricultural practices and bridging the knowledge-practice gap can strengthen farmers’ adaptive capacity against climate change effects.

Enhancing privacy protections in national identification systems: an examination of stakeholders’ knowledge, attitudes, and practices of privacy by design

Privacy by Design (PbD) is a well-known concept that aims to provide a high level of protection for privacy throughout the entire life cycle of systems development. Despite the considerable attention from stakeholders such as researchers, government agencies, and system suppliers, the widespread adoption of PbD faces obstacles due to a lack of knowledge, insufficient awareness of PbD benefits, and the absence of specific implementation guidelines. In this study, stakeholders are identified primarily as diverse participants from government agencies and system suppliers engaged in National Identification Systems (NIDS). Specifically, government agencies representing regulatory bodies and administrators of NIDS, setting the legal framework that governs the NIDS’s privacy aspects. The NIDS system suppliers includes private companies playing a crucial role in the development and implementation of NIDS with a focus on privacy considerations. Through the perspectives of NIDS stakeholders, this study aimed to examine the Knowledge, Attitudes and Practices (KAP) of PbD principles and its integration in NIDS. A survey involving 203 participants from government agencies and NIDS system suppliers engaged in NIDS development was conducted. Subsequently, a focus group discussion was held with 11 members to provide qualitative insights into the KAP of PbD. The survey results revealed a significant correlation between attitudes and practices but a weak correlation between knowledge and attitudes or practices. The focus group discussion assured these findings, emphasizing the role of positive attitudes in facilitating PbD practices and highlighting knowledge-practice gaps. In conclusion, this study offers tailored recommendations for improving the integration of PbD in NIDS development. The recommendations includes strategies such as developing training programs, establishing clear guidelines and standards and creating awareness campaigns.

Optimising the indications for biliary stent placement during endoscopic retrograde cholangiopancreatography: a quality improvement initiative to enhance patient care and reduce healthcare resource utilisation

BackgroundA retrospective chart audit was performed to review biliary stent utilisation from January 2020 to January 2021. Non-guideline-based stent insertion was identified in 16% of patients with common bile duct...

Sheep producers report docking tails shorter than recommended, knowledge–practice gap, and inconsistent length descriptions: an Australian survey

Sheep producers report docking tails shorter than recommended, knowledge–practice gap, and inconsistent length descriptions: an Australian survey

Bridging the knowledge–Practice gap: Insights from a survey of Belgian dental professionals on diagnosis and supportive oral cancer treatment in comparison with international guidelines

ObjectiveEarly detection significantly improves the prognosis of oral cancer patients, contingent upon the knowledge of dental professionals. This study aimed to assess and compare the knowledge, practices and perceptions regarding oral cancer among dental professionals in Belgium. Materials and methodsA cross-sectional survey was distributed via Qualtrics to general dentists, dental specialists, dental hygienists, and oral and maxillofacial surgeons. The self-administered questionnaire comprised three sections: demographics (4 questions), knowledge (9 questions) and clinical practices (19 questions) related to oral cancer detection and treatment. Descriptive statistics were employed for data analysis, with Chi-square tests assessing responses by specialization, gender, years of experience and number of oral cancer patients treated. ResultsA total of 262 questionnaires were completed, with the majority of respondents being general dentists (61%) followed by dental specialists (25%), oral hygienists (8%) and oral and maxillofacial surgeons (6%). 70% of the respondents reported treating fewer than four oral cancer patients throughout their careers. 5 out of the 9 knowledge questions achieved over 50% correct responses, with an average correct answer rate of 54%. Oral and maxillofacial surgeons and dental professionals who have treated more than four oral cancer patients, demonstrated significantly higher scores on multiple knowledge questions. Responses to clinically oriented questions showed less diversity across professions, and generally aligning with guidelines from professional oncological societies. ConclusionThis survey highlights the need for enhanced education on oral cancer among Belgian dental professionals. Knowledge levels were notably higher among more experienced respondents. The development and implementation of comprehensive guidelines tailored to dentists and oral hygienists for oral cancer prevention and patient care are warranted to optimize clinical practice standards.

Diabetes knowledge among Malaysian adults: A scoping review and meta-analysis.

Optimal self-care promotes glycaemic control and prevents diabetes complications. Its performance is facilitated by an adequate level of diabetes knowledge. This review aimed to evaluate diabetes knowledge among Malaysians by assessing diabetes knowledge scores and their associated factors. A comprehensive bibliographic search for Malaysian studies on diabetes knowledge was conducted in PubMed, Scopus and Google Scholar. Relevant literature was systematically selected and described; pertinent data were extracted; and data on diabetes knowledge levels and their associated factors were synthesised. The quality of the identified studies was assessed using a Joanna Briggs Institute critical appraisal tool. Thirty Malaysian cross-sectional studies that measured diabetes knowledge levels were retrieved. Nineteen of them used a named diabetes knowledge measurement tool, with 14 using the 14-item Michigan Diabetes Knowledge Test. A low knowledge level was prevalent among patients with diabetes mellitus (pooled mean knowledge score=6.92, proportion of patients with a low knowledge level=47.97%). The knowledge score was associated with some sociodemographic variables, health literacy, self-care and glycaemic control. The association of diabetes knowledge with diabetes outcomes (e.g. self-care and glycaemic control) reflects the potential of the former as a target of intervention. Periodic measurement of diabetes knowledge in healthcare settings and among populations can help in assessing the effectiveness of diabetes educational interventions. Concerted efforts to improve diabetes knowledge among Malaysians have the potential to fill knowledge-practice gaps.

Knowledge–Practice Gaps of Good Clinical Practice amongst MBBS Student Researchers

Knowledge–Practice Gaps of Good Clinical Practice amongst MBBS Student Researchers

Nursing experiences and knowledge of paediatric delirium: Analysing knowledge-practice gaps.

Delirium commonly occurs in paediatric patients with acute critical illness and negatively affects clinical outcomes. Variations in delirium knowledge levels and its management have been noted among nurses. This study investigated nurses' experiences and knowledge levels regarding paediatric delirium. Additionally, we aimed to assess the gap between knowledge levels and practical experiences with paediatric delirium. This cross-sectional descriptive study conveniently sampled paediatric nurses from a university hospital in South Korea between September 2022 and March 2023. Nursing experiences with paediatric delirium and delirium knowledge levels were measured using structured survey questionnaires. Delirium knowledge was scored 0 to 47, and higher scores indicated higher levels of delirium-related knowledge. Data were analysed using descriptive statistics and presented as mean, standard deviation, frequency and percentage. A total of 127 paediatric nurses participated in this study; 40.2% had experience with 1-5 delirium cases in the previous year, and 86.6% (n = 110) had never used assessment tools for paediatric delirium assessment. The mean total delirium knowledge score was 34.45 ± 5.4; the mean scores of knowledge regarding aetiology, signs and symptoms and nursing management of delirium were 8.93 ± 1.31, 13.24 ± 2.81 and 12.3 ± 2.7, respectively. Interventions associated with a lower level of delirium-related knowledge and a lower performance rate included avoiding restraint use and maintaining hydration and electrolyte levels. Interventions associated with a higher level of delirium-related knowledge but a lower rate of performance comprised providing orientation, offering emotional support, allowing participants to stay with family members and administering medications to manage delirium. Although nurses working in paediatric units exhibited high rate of delirium nursing care, there was the gap between their delirium-related knowledge and practice. Nurses need to be aware of the insufficient part of delirium care, and paediatric delirium education should be reinforced. Preventing, assessing and systematically managing paediatric delirium is crucial, and considering the study results, delirium education among nurses is needed.

A Healthcare-Academic Practice Partnership Program to Promote Student Nurse Readiness for Work.

Highly skilled new graduate nurses must be better prepared to face the clinical and professional challenges in today's healthcare environment. Compounding these challenges are the growing resignations of clinical faculty and experienced clinical nurses. Innovative programs are needed to bridge the knowledge-practice gap with opportunities to create pipelines to aid the future nursing workforce. A multihospital health system partnered with a local college of nursing to develop a Nursing Student Pipeline Program, which allows nursing students to perform select nursing tasks as employees of the health system. Fifty-six students have been hired to participate in the pilot program. Of the students eligible for hire and who completed the program, 24 are current employees with the healthcare system. Students, preceptors, and managers report the benefits of this program, including that participating in the program supports increasing readiness for practice upon graduation.

The potential role of occupational therapy in the treatment of avoidant/restrictive food intake disorder.

Most individuals with avoidant/restrictive food intake disorder (ARFID) never receive treatment, and treatment needs far exceed the current capacity of mental health services. Occupational therapy (OT) focuses on enhancing function in daily activities, including eating and feeding. Given OT's rich history in mental health and pediatric feeding disorder treatment, we spotlight the potential role of OT in ARFID treatment, current knowledge, and opportunities for future research. Through a preliminary exploratory inquiry involving a review of current literature and clinical practice, we investigated OT's current involvement, knowledge, and interprofessional collaborative practice gaps in ARFID treatment. While many occupational therapy practitioners (OTPs) engage in ARFID treatment, interventions lack rigorous evaluation, and there is limited evidence defining OT's distinct role in interprofessional ARFID treatment. OTPs are uniquely positioned to provide interventions for individuals with ARFID across the lifespan, though research is needed to evaluate the efficacy of OT interventions. Future research suggestions include standardizing OT approaches to ARFID treatment and conducting single-case experiments and randomized controlled trials to compare OT approaches with alternative methods. Recommendations to address practice gaps include enhancing ARFID education for OT students and practitioners and fostering a greater understanding of OT's role on the interprofessional team. PUBLIC SIGNIFICANCE: Individuals with ARFID face barriers to eating that impact their health and function. On a multidisciplinary team, OTPs can treat diverse client populations by identifying and addressing barriers to daily participation, such as physical impairments, trauma history, and environmental barriers. More research is needed to evaluate the efficacy of OT practices in ARFID treatment.