Knowledge, attitudes and beliefs about tobacco use after an educative intervention in health sciences' students

Observación e intervención educativa para modificar la prescripción de antibióticos en un instituto social de la ciudad de Corrientes, Argentina

Objetivo: analizar y mejorar las prescripciones de antibióticos por parte de odontólogos, a través de una intervención educativa. Método: se realizó un estudio analizando las recetas de prescripción de medicamentos antes y después de la intervención educativa, en el Instituto de Servicios Sociales de la Universidad Nacional del Nordeste. El estudio comprendió tres etapas; en la etapa A se identificaron problemas de prescripción, que fueron socializados con los profesionales durante la intervención educativa como parte de la etapa B, cuya modalidad consistió en dos entrevistas presenciales, con talleres de discusión y debate. En esta se trabajó, además, con el informe de los resultados obtenidos en el análisis de situación de la etapa A. En la etapa C se analizó el impacto de la intervención educativa. Resultados: en la etapa A se observaron 417 recetas con 202 prescripciones de antibióticos, los más indicados fueron azitromicina (31%), amoxicilina con clavulánico (10%) y amoxicilina (8%). La adecuación de prescripción en relación a la indicación fue del 26%. En la etapa C, de un total de 191 recetas, se analizaron 107 recetas con prescripción de antibióticos. La amoxicilina fue el medicamento más prescripto (37%); la prescripción de azitromicina disminuyó a 14% y su adecuación fue del 46%. Ello evidenció una mejoría del 20%, la cual fue validada a través del test chi2 (p=0,00). Conclusión: por medio de la intervención educativa presencial es posible mejorar las prescripciones de antibióticos, no obstante se desconoce si el cambio de conducta prescriptiva se mantiene en el tiempo.El estudio comprendió tres etapas, la primera para identificar problemas de prescripción a fin de ser socializado con los profesionales durante la intervención educativa, que incluía procedimientos educativos presenciales. En la última etapa se analizó el impacto de la intervención educativa. Resultados: Etapa A: se observaron 417 recetas con 202 prescripciones de antibióticos, los más indicados fueron azitromicina (31%); amoxicilina con clavulánico (10%) y amoxicilina (8%).  La adecuación de prescripción en relación a la indicación fue del 26%; la etapa B correspondió a la intervención educativa, a través de discusión y análisis de la situación. En la etapa C se analizaron 107 recetas con prescripción de antibióticos, se observó que el más prescrito fue amoxicilina (37%) y la prescripción de azitromicina disminuyó a 14%. La adecuación fue del 46%, evidenciándose una mejoría del 20%, validado a través del test chi2 (p=0,00). En conclusión se observó que a través de una intervención educativa con los profesionales prescriptores, se pudo mejorar las prescripciones de antibióticos, no obstante se desconoce si el cambio de conducta prescriptiva se mantiene en el tiempo.

Design and Validation of an Instrument to Evaluate the Learning Acquired by Nursing Students from a Brief Tobacco Intervention (BTI-St©)

The aim of this study was to design and validate an instrument, based on the WHO 5As+5Rs model, to test the acquisition by nursing students of a brief tobacco intervention (BTI) learning. A validation design of an instrument following the criterion referenced tests model using videos of simulated BTIs in the primary care setting was carried out. The study included 11 experts in smoking prevention/care and 260 second-year nursing students. The study was in two stages: (1) selection and recording of clinical simulations (settings), and (2) test construction. Content was validated by applying the Delphi consensus technique and calculating the Content Validity Ratio (CVR) and Content Validity Index (CVI). A pilot test was conducted for item analysis. Reliability was evaluated as internal consistency (Kuder-Richardson [KR-20]) and test-retest temporal stability (intraclass correlation coefficient [ICC]). Three simulation settings were recorded. An instrument (BTI-St^®) was developed with 23 items for dichotomous (yes/no) response. CVR was >70% for all items, KR-20 of 0.81-0.88, and ICC between 0.68 and0.73 (p < 0.0001). The BTI-St^® is a robust and reliable instrument that is easily and rapidly applied. It follows the WHO 5As+5Rs model and offers objective criterion-referenced evaluation of BTI learning in nursing students.

Knowledge, attitude, and practice among tobacco and alcohol addicts before and after psychological intervention in a de-addiction center at Madhya Pradesh, India

CONTEXT

Tobacco and alcohol addiction has emerged as a major public health issue in most of the regions of the world. It has resulted in enormous disability, disease, and death and acquired the dimension of an epidemic. It is estimated that five million preventable deaths occur every year globally, attributable to tobacco use. The number is expected to double by 2020 if death due to tobacco continues to occur at the same rate. Alcohol, on the other hand, contributes to 25% of all deaths in the age group of 20-39 years. The interventions such as supportive pharmacotherapy, nicotine replacement therapy, counseling, behavioral intervention, psychotherapy, and detoxification therapy are being commonly employed in the management of patients with addiction to tobacco and alcohol.

AIM

The aim of this study is to compare the knowledge, attitude, and practice (KAP) among tobacco and alcohol addicts before and after psychological intervention in a de-addiction center.

SETTINGS AND DESIGN

This study was a randomized control trial, focusing on psychological interventions practiced in a de-addiction center, Indore, Madhya Pradesh, India.

MATERIALS AND METHODS

The information on KAP related to tobacco and alcohol was collected at baseline from 83 participants. This was compared with the information collected in the postintervention follow-ups from each participant.

STATISTICAL ANALYSIS USED

Statistical tests for parametric analysis were done using one-way ANOVA with Scheffe's post hoc test, RMANOVA with Mauchly's test for sphericity assumption, and Bonferroni test for comparing the main effects. Nonparametric tests included Pearson's Chi-square test, McNemar's Chi-square test, Spearman's rho, and Kruskal-Wallis test. The statistical significance was fixed at 0.05.

RESULTS

The mean KAP score for the study population was highest at the first follow-up followed by the second follow-up for both tobacco and alcohol addiction. The least KAP score was observed at the baseline.

CONCLUSIONS

Although a significant improvement in the mean KAP score was observed at the first follow-up, subsequent follow-up revealed a reduction in the overall KAP score in the present study. This could be attributed to the fact that following their discharge from the de-addiction center, most of the participants reverted back to their deleterious habits.

Preparing nurses to intervene in the tobacco epidemic: Developing a model for faculty development and curriculum redesign

As the largest group of health professionals, nurses have a tremendous potential to help curb the tobacco epidemic. However, studies conducted across a range of global settings continue to indicate that both practicing nurses and nursing student have limited knowledge, skills and confidence needed to implement evidence-based tobacco cessation interventions. A contributing factor is the limited inclusion of tobacco control content in nursing curricula. Additionally, there is limited understanding of nurse educators' knowledge and perceptions about teaching tobacco dependence content. This paper presents the Loma Linda University School of Nursing's concurrent experience with both faculty development and curriculum redesign in the area of tobacco dependence prevention and treatment. An internal survey was administered at baseline and at 2-year follow-up to assess faculty's knowledge, perceptions and practices related to teaching tobacco dependence content and skills (n = 42). Faculty and curriculum development strategies and resources utilized, evaluation findings and subsequent lessons learned are described. The findings have implications for nursing programs seeking to enhance their curricula and commitment to ensuring that their graduates are prepared to provide evidence-based tobacco cessation interventions with each patient they encounter.

[Smoking behavior, knowledge, and attitudes towards anti-smoking regulations of nursing students in Sousse, Tunisia]

BACKGROUND

Smoking prevalence has reached high rates among health professionals. Our study aimed to assess smoking behavior, knowledge and attitudes towards anti-smoking regulations of nursing students.

METHODS

In 2013, we conducted a cross-sectional study among nursing students enrolled in private and state nursing institutions of Sousse (Tunisia).

RESULTS

In our study, 440 students were selected. The mean age was 22 ± 2 years. The sex ratio was 0.65. The prevalence of smoking was 20.6%. It was significantly higher in men than women (50% vs 4.5%, P < 10(-3)). Strong dependency was noted in 9%. One-third of smokers stated they wanted to quit smoking. Prohibiting the sale of cigarettes to minors and smoking in enclosed public places were the two most mentioned anti-smoking regulations.

CONCLUSION

Our rate was lower than those reported in the literature. This result should encourage policymakers to continue actions and ensure sustainability.

Making a case for systematic integration of theory-based tobacco education into graduate psychiatric/mental health nursing curriculum

Tobacco use and dependence is a serious public health issue that disproportionately affects the mentally ill client population. Mental health professionals, including psychiatric/mental health advanced practice nurses (PMHAPNs), are disinclined to integrate tobacco cessation interventions into their practice, due in part, to a general lack of tobacco-related knowledge (C. Essenmacher, C. Karvonen-Gutierrez, J. Lynch-Sauer, & S. A., Duffy, 2008; A. J. Molina, T. Fernandez, D. Fernandez, M. Delgado, S. de Abajo, & V. Martin, 2012; L. Sarna, L. L. Danao, S. Chan, S. Shin, L. Baldago, E. Endo, & M. E. Wewers, 2006); D. Sharp, S. Blaakman, R. Cole, & J. Evinger, 2009). This paper provides an in-depth literature review of tobacco education in nursing curricula and proposes the systematic integration of theory-based tobacco content into psychiatric/mental health graduate nursing programs.