Nursing students' immunisation status and knowledge about viral hepatitis in Turkey: a multi-centre cross-sectional study

Hepatitis B Vaccination, Knowledge, Attitudes, and Practices Among Sample of Greek Nursing Students: A Cross-Sectional Study

BACKGROUND

Nursing students share their study time between clinical and university environments, and due to their clinical training, are at increased risk of contracting the hepatitis B virus (HBV). This study investigated the vaccination coverage, knowledge, attitudes, and practices of nursing students regarding HBV in Greece.

METHODS

A cross-sectional study was conducted from September 2022 to July 2023, using an anonymous self-administered questionnaire, with informed consent obtained from each participant.

RESULTS

A total of 1261 nursing students from University Institutions of the Attica region participated in the convenience sampling. The response rate of the nursing students was 68.6%. A total of 27.7% of the sample was fully vaccinated against HBV. The reasons for not accepting the vaccine were not found to be related to participants' level of knowledge or attitudes (p > 0.05). The knowledge score ranged from 0% to 96.9%, with a mean of 62.2% (SD = 17.0%). Multivariate linear regression showed that longer year of nursing education was associated with better practices and attitudes towards HBV (p < 0.05).

CONCLUSIONS

The emergence of low vaccination coverage of nursing students against HBV identifies the need for departments of nursing studies to proceed in the development of educational and intervention programs on infection control. This study was not registered.

Incidence, knowledge, attitude and practice toward needle stick injury among nursing students in Saudi Arabia

Background

Needle stick injuries constitute the greatest threat to nursing students during clinical practice because of accidental exposure to body fluids and infected blood. The purpose of this study was to (1) determine the prevalence of needle stick injuries and (2) measure the level of knowledge, attitude and practice among nursing students about needle stick injuries.

Methods

Three hundred participants undergraduate nursing students at a private college in Saudi Arabia were included, of whom 281 participated, for an effective response rate of 82%.

Results

The participants showed good knowledge scores with a mean score of 6.4 (SD = 1.4), and results showed that students had positive attitudes (Mean = 27.1, SD = 4.12). Students reported a low level of needle stick practice (Mean = 14.1, SD = 2.0). The total prevalence of needle stick injuries in the sample was 14.1%. The majority, 65.1%, reported one incidence in the last year, while (24.4%) 15 students reported two incident of needle stick injuries. Recapping was the most prevalent (74.1%), followed by during injection (22.3%). Most students did not write a report (77.4%), and being worried and afraid were the main reasons for non-reports (91.2%). The results showed that female students and seniors scored higher level in all needle stick injuries domains (knowledge, attitude and practice) than male students and juniors. Students who had needle stick injuries more than three times last year reported a lower level of all needle stick injury domains than other groups (Mean = 1.5, SD =1.1; Mean = 19.5, SD =1.1; Mean = 9.5, SD =1.1, respectively).

Conclusion

Although the student's showed good knowledge and positive attitudes in NSI, the students reported a low level of needle stick practice. Raising awareness among nursing students and conducting continuing education related to sharp devices and safety and how to write an incident reporting is highly recommended.

Knowledge, Vaccination Status, and Reasons for Avoiding Vaccinations against Hepatitis B in Developing Countries: A Systematic Review

(1) Background: The coverage of hepatitis B vaccination remains low in developing countries to date. This systematic review thus analyzes the determinants of people's knowledge and vaccination status as well as the reasons why people in developing countries chose not to receive the hepatitis B vaccination. (2) Methods: We searched four databases to identify all studies from developing countries published within the past 10 years. Both low-risk and high-risk populations aged older than 15 years old were eligible for the study. The quality of studies was assessed by the Newcastle-Ottawa Scale assessment. (3) Results: This study identified 2443 articles, 89 of which were included in the analysis. Monthly income, occupational status, and profession as a health-care worker were the strongest predictive factors for both knowledge of hepatitis B and vaccination status. In addition, strong predictor variables of hepatitis B knowledge were knowing an infected person and level of education, while health insurance, management's protection at workplace, infection training, and experience of hepatitis B exposure were strong influencing factors for vaccine uptake. (4) Conclusions: Exposure to information, support from institutions, and financial support related to vaccination cost have a positive impact on the knowledge about hepatitis B infection and vaccination coverage.

Pharmacist intervention to improve patients' knowledge and attitude towards hepatitis B infection

OBJECTIVE

Lack of knowledge/awareness of people living with hepatitis B (PLH) often leads to misinformation and stigmatisation. This study aimed to assess the contribution of the clinical pharmacist (CP)-led education on knowledge of PLH about their disease.

METHODS

This prospective, cross-sectional study was carried out between 1 October 2017 and 1 April 2018, at infectious disease and gastroenterology outpatient clinics in a university hospital. All PLH were interviewed face-to-face by a CP and a questionnaire about hepatitis B virus (HBV) knowledge was applied both at the beginning of the study (first interview) and 3 months later (second interview). Correct information was provided verbally to the patients by the CP concerning their incorrect answers during the first interview. A 10% increase in the number of correct answers was targeted for the second interview.

RESULTS

A total of 147 PLH with a mean age of 43.05 ± 13.25 years were included in the study (55.8% female). In the first interview, the mean (±standard deviation) number of correct answers was 35.53 ± 9.15 out of 51 questions. In the second interview, correct answers were 48.67 ± 2.74 with an increase of 25.8% (P < .001). In the first interview, the number of correct answers was higher for the following groups: 20-39 age group, people with monthly income of >1081 $ and university graduates. The number of correct answers to all questions but one was elevated (P < .001) in the second interview. Answers to the question "there is a carrier state in chronic hepatitis B (CHB)" did not change (P = .125).

CONCLUSION

Significant improvement was observed in the correct answer rate after CP's contribution, therefore as a team member, CP has an important role in improving patients' knowledge and attitude towards HBV infection.

Knowledge, Attitude and Behavior Levels of University Students About Hepatitis A, Hepatitis B and Hepatitis C

Aim: The aim of this study is to reveal the knowledge, attitude and behaviors of the university students about Hepatitis A, Hepatitis B and Hepatitis C. Methods: This study was done among 1048 students from different faculties of five different universities in Ankara, was carried out between October 2012 and July 2013. A questionnaire was prepared by the authors by rewieving the literature and the participants were asked to fill this questionnaire. Knowledge level of participants was scored from 1 to 5 out of 100 according to the answers given about Hepatitis A, B and C. Results: When the average points of knowledge about hepatitis A, B and C is considered, it is seen that the knowledge points of males according to females and the knowledge points of the students who study in medical faculties according to the other faculties are higher. Participants were found to have a risky attitude with respect to the spread of Hepatitis A, B and C infections. While males had more risky behaviors, it was seen that there was no significant difference between the students of medical faculties according to other faculties. Conclusion: Despite advances in technology and health, Hepatitis A, B and C infections continue to be an important public health problem today. This study showed that even university students, whose education and intellectual levels are considered to be high according to society, have low level of knowledge about viral hepatitis and exhibit risky attitudes and behaviors, necessity of individual and social education. The most effective way to protect against these diseases is to increase the knowledge and awareness levels of the society and prevent the transmission of these diseases. Keywords: hepatitis, knowledge, attitude, behavior, vaccines

Nursing students: A vulnerable health-care worker for needlesticks injuries in teaching hospitals

Background:

Occupational exposure to bloodborne pathogen is a significant risk to health-care workers. In any teaching hospital apart from regular health-care workers and employees, there are significant population of students and trainee. It is important to assess the health-care worker in hospital which has maximum chances of exposure to these pathogens. The aim of this study is to determine the most susceptible job group for needlestick injury (NSI) reported in a newly established teaching medical institute in the Western part of Rajasthan, India.

Methods:

This is a retrospective analysis of data of NSI occurred during September 2014 to January 2017.

Results:

Sixty three NSIs were reported during the study. Nursing students were the most vulnerable group who reported maximum number of NSI. Among the nursing students, 72% were completely vaccinated against hepatitis B virus.

Conclusions:

Nursing students are at utmost risk for NSIs, the prevention of which requires regular training and education.

Students nurses' knowledge and prevalence of Needle Stick Injury in Jordan

BACKGROUND

Student nurses are at high risk of blood-borne pathogens transmitted via Needle Stick Injury (NSI). Understanding various aspects of NSI is essential if they are to avoid the risks associated with it.

OBJECTIVES

The study was conducted to measure student nurses' level of knowledge about NSI and to examine its prevalence and post-exposure measures in Jordan.

DESIGN

A cross-sectional and descriptive design was used.

SAMPLE AND SETTING

A sample of 279 student nurses studying at one private and four government universities distributed throughout Jordan.

METHOD

The study used an online survey composed of 22 questions developed from NSI literature. The questionnaire was divided into three parts: background, to measure students' demographics; knowledge, to measure nurses' understanding of NSI; and prevalence, to measure exposure to NSI and the follow-up measures. Student nurses were recruited through Facebook. The survey was available online for one full semester in 2016/2017.

RESULTS

The total number of completed surveys was 279 (response rate=61%). Most of the students were female (n=198; 71%), in their fourth year (n=114; 40.9%). Their mean age was 21years (SD=2.5). The mean score for the knowledge part was 7 out of 10 (SD=1.7). Almost a third of the students had at least one incident of exposure to NSI (n=73; 26.2%). Most of the students who had suffered NSI did not inform their clinical instructors (67.1%) or write an incident report (86.3%). The results showed that there was no significant difference in the knowledge total scores between males and females or between students across different universities. However, a significant difference was found between students in different years of study (F (276, 2)=6.77, p=0.001).

CONCLUSION

Student nurses in Jordan have a moderate understanding of issues regarding NSI. This knowledge improved with seniority. However, exposure to NSI and its under-reporting is a prevalent problem. This study recommends focusing on NSI in the nursing curriculum, and providing more protection and post-exposure intervention for students during their clinical practice.

Vaccinating healthcare workers: Level of implementation, barriers and proposal for evidence-based policies in Turkey

The role of healthcare workers in life-long vaccination is very important in the means of 2 sided infection, rising patient awareness and being a role model for the patients. Numerous organizations publish guidelines for vaccination of HCWs, while healthcare facilities develop vaccination policies according to the accreditation standards. Nevertheless, vaccination rates among HCWs are far below targets. The obstacles to getting vaccinated or recommending vaccination may include rather universal factors such as the vaccine paradox, however in the case of HCWs, probably a different set of factors are included. The aims of this article are to gain an overview of vaccination strategies for HCWs, to assess the coverage rates of HCWs and make in-depth analyses of the potential barriers to vaccination and potential factors to motivate HCWs for vaccination in Turkey and to compare them with the global picture to improve implementation of policies concerning vaccination of HCWs.

Nurses' Knowledge toward Hepatitis B and Hepatitis C in Guilan, Iran

Background:

Health care workers (HCWs) represent high risk population for viral hepatitis infection.

Objectives:

This study sought to assess the knowledge of HCWs regarding hepatitis B (HBV) and hepatitis C (HCV) infection.

Methods:

In a multi-center cross sectional study, all HCWs from eight teaching hospitals were invited to participate in the study and to fill in a self-administered questionnaire.

Results:

A total of 1008 eligible HCWs have responded to the study. A high proportion of the study participants (55.4% and 52.9%) had unsatisfactory knowledge about HBV and HCV. Mean knowledge score toward HBV was significantly higher among more educated staff, p <0.001 and vaccinated personnel, P=0.02. Majority of responders answered correctly to transmission questions toward HBV and HCV (90% and 80%, respectively). There was statistically significant difference in only transmission domain score between various hospitals (p<0.05). The highest scores were related to surgical hospital.

Conclusion:

Although more than ninety percent of our participants were educated about HBV and HCV, knowledge about nature of disease, prevention, treatment and vaccine availability was unsatisfactory. Continuous training program toward viral infection is a matter of necessity.

Hepatitis B Virus Vaccination Coverage in Medical, Nursing, and Paramedical Students: A Cross-Sectional, Multi-Centered Study in Greece

Students of health professions are at high risk of hepatitis B Virus (HBV) infection during their clinical training. The aim of this cross-sectional, multi-centered study was to investigate the HBV vaccination coverage in Greek medical, nursing, and paramedical students, to look into their attitudes towards the importance of vaccines and to reveal reasons associated with not being vaccinated. A self-completed, anonymous questionnaire was distributed to 2119 students of health professions in Greece, during the academic year 2013-2014. The HBV vaccination coverage of students was high (83%), being higher among medical students (88.1%, vs. 81.4% among nursing and 80.1% among paramedical students; p < 0.001). The vast majority of them (95%) have been vaccinated during childhood. In addition, 30% of the unvaccinated students declared fear over HBV safety. Our results indicate that the healthcare students achieved higher reported immunization rates compared to the currently serving healthcare workers, but also to the students of the last decade. The fact that nursing and paramedical students have lower coverage figures underlines the importance of targeted interventions for the different subgroups of healthcare students in terms of educational programs and screening for HBV markers in order to increase HBV vaccination uptake.

Predictors of hepatitis A vaccine coverage among university students in Korea

AIM

To investigate the status of hepatitis A vaccination, knowledge, and health beliefs among university students in Korea and identify factors influencing their hepatitis A vaccination rate.

METHODS

A self-reporting survey was conducted with 367 university students in Korea via descriptive survey. Data were collected on demographics, status of hepatitis A vaccination, knowledge, and health beliefs.

RESULTS

The hepatitis A vaccination rate was 23.4%. The hepatitis A vaccination rate was significantly higher in those who had a general awareness about the hepatitis A (odds ratio [OR] = 3.56, P = 0.003), those with some overseas travel experience (OR = 2.64, P = 0.025), those perceiving the benefits of hepatitis A vaccination (OR = 1.66, P = 0.023), and those perceiving barriers (inversed) to hepatitis A vaccination (OR = 1.95, P = 0.011).

CONCLUSION

To promote hepatitis A vaccination among university students, information and education should be provided to improve their health beliefs. In addition, this demographic should be a major target population for hepatitis A vaccination. This study's results suggest that the development of national promotional campaigns and hepatitis A vaccination programs based on predictors of the vaccination rate are needed.

Vaccination learning experiences of nursing students: a grounded theory study

PURPOSE

This study aimed to explore the experiences of nursing students being trained to perform vaccinations.

METHODS

The grounded theory method was applied to gather information through semi-structured interviews. The participants included 14 undergraduate nursing students in their fifth and eighth semesters of study in a nursing school in Iran. The information was analyzed according to Strauss and Corbin's method of grounded theory.

RESULTS

A core category of experiential learning was identified, and the following eight subcategories were extracted: students' enthusiasm, vaccination sensitivity, stress, proper educational environment, absence of prerequisites, students' responsibility for learning, providing services, and learning outcomes.

CONCLUSION

The vaccination training of nursing students was found to be in an acceptable state. However, some barriers to effective learning were identified. As such, the results of this study may provide empirical support for attempts to reform vaccination education by removing these barriers.

Vaccination status, knowledge and awareness towards hepatitis B among students of health professions in Vientiane, Lao PDR

Health care workers (HCW) are a population at high risk of hepatitis B virus (HBV) infection, especially in endemic countries such as Lao PDR. Effective vaccines are available since over 10 years, but many HCWs are not aware of the risk of infection and are still not immunized against hepatitis B. This study aimed to assess immunization coverage against hepatitis B among the students of the University of Health Sciences (UHS) of Lao PDR in 2013 and to look for the causes of non-vaccination. A cross-sectional survey was conducted by self-administered questionnaire on a representative stratified sample of each academic year in each faculty. In total, 961 questionnaires were collected, Basic Sciences: 143, Medicine: 167, Pharmacy: 148, Dentistry: 139, Nursing Sciences: 159, Medical Technology: 99, and Postgraduate Studies: 106. Respondents were predominantly female (59.1%), mean age 25.1±7.0 years, single (76.3%), from the provinces (68.0%), of the Lao Loum ethnic group (84.4%). Among them, 21% were fully vaccinated against hepatitis B and 9.5% partially. Immunization coverage rates were significantly higher among women (p=0.01), students aged over 25 years, married or belonging to the post-graduate faculty (p<0.001). The most common reason (38.6%) given for non-vaccination was not knowing where to get vaccinated. Knowledge about hepatitis B, scored from 0 to 5, was poor (0-1) for 86.5% of the students, but 77.5% were aware of the hepatitis B vaccine. The knowledge scores were significantly higher for students aged over 25 years, married or post-graduated (p<0.001). Vaccination coverage against hepatitis B is dramatically low among students of health professions in Laos, largely because of their lack of knowledge and awareness. Upon admission to the University, all future HCWs should receive information about the occupational risks of blood-borne viruses transmission and be encouraged to get vaccinated against hepatitis B.

Occupational exposures to body fluids and behaviors regarding their prevention and post-exposure among medical and nursing students at a Brazilian public university

A cross-sectional study was conducted to assess the frequencies and characteristics of occupational exposures among medical and nursing students at a Brazilian public university, in addition to their prevention and post-exposure behavior. During the second semester of 2010, a self-administered semi-structured questionnaire was completed by 253/320 (79.1%) medical students of the clinical course and 149/200 (74.5%) nursing students who were already performing practical activities. Among medical students, 53 (20.9%) suffered 73 injuries, which mainly occurred while performing extra-curricular activities (32.9%), with cutting and piercing objects (56.2%), in the emergency room (39.7%), and as a result of lack of technical preparation or distraction (54.8%). Among nursing students, 27 (18.1%) suffered 37 injuries, which mainly occurred with hollow needles (67.6%) in the operating room or wards (72.2%), and as a result of lack of technical preparation or distraction (62.1%). Among medical and nursing students, respectively, 96.4% and 48% were dissatisfied with the instructions on previously received exposure prevention; 48% and 18% did not always use personal protective equipment; 67.6% and 16.8% recapped used needles; 49.3% and 35.1% did not bother to find out the source patient's serological results post-exposure; and 1.4% and 18.9% officially reported injuries. In conclusion, this study found high frequencies of exposures among the assessed students, inadequate practices in prevention and post-exposure, and, consequently, the need for training in “standard precautions” to prevent such exposures.

Perceptions about preventing hepatocellular carcinoma among patients with chronic hepatitis in Taiwan

AIM: To measure patient perceptions about preventing hepatocellular carcinoma (HCC) and to predict the factors that influence patient willingness to receive therapy.

METHODS: A cross-sectional descriptive study was conducted at an outpatient clinic of a medical institution in southern Taiwan. Four hundred patients with chronic hepatitis B/C were recruited as participants. Two structured questionnaires based on the health belief model were utilized in this study, including the scales of perceptions about preventing HCC and knowledge of hepatitis B/C.

RESULTS: The statistical results demonstrated that the participants’ perceived susceptibility (r = -0.22, P < 0.001), benefits (r = -0.11, P = 0.028) and cues to action (r = -0.12, P = 0.014) about the prevention of HCC was significantly correlated with their age. The participants’ perceptions were also associated with their educational levels, household incomes and knowledge of hepatitis. Older patients and those with a lower socioeconomic status tended to have negative perceptions and less knowledge of hepatitis. Multivariate logistic regression further indicated that the participants’ age (B = -0.044, SE = 0.017, odds ratio = 0.957, P = 0.008, 95%CI: 0.926-0.989) and perceived barriers (B = -0.111, SE = 0.030, odds ratio = 0.895, P < 0.001, 95%CI: 0.845-0.949) were correlated with their willingness to receive antiviral therapy.

CONCLUSION: Healthcare professionals should provide appropriate and effective guidance to increase their patients’ awareness and to decrease the perceived barriers for continuing surveillance and antiviral therapy.

Commentary: the importance of education and vaccination in reducing the risk of hepatitis infection among nursing students

BACKGROUND

Healthcare workers are at risk of contracting blood-borne viral infection during contact with blood and body fluids. Nursing students may be at particular risk because of their inexperience. Adoption of suitable precautions, hepatitis B vaccination and appropriate post-exposure prophylaxis will significantly reduce the risk of infection.

AIM

This commentary puts into context the findings of a study by Yamazhan et al. who explored nursing students' knowledge on hepatitis together with their immunization status.

EVALUATION

Knowledge of hepatitis, its mode of transmission and the risks of infection following adverse exposure to blood and body fluids are essential to ensure safe practice. This paper identifies that nursing students' knowledge of hepatitis is moderate only and varies between universities. However, the uptake of hepatitis B vaccination among the sample was high, suggesting a high commitment to reducing the risk of this infection by the universities and clinical placements.

IMPLICATIONS

This paper highlights the need for a standardized education package to be developed and delivered by all universities in Turkey to ensure that nursing students have a sound knowledge of hepatitis and other blood-borne infections. Vaccination programmes must continue to ensure that nursing students are protected from hepatitis B.