Designing and Conducting Knowledge, Attitude, and Practice Surveys in Psychiatry: Practical Guidance

Hip and Knee Arthroplasty Patient Perceptions of Nutrition in the Perioperative Episode of Care

Background

While malnutrition in patients undergoing hip and knee arthroplasty occurs with moderate frequency and can be associated with postoperative complications, enhanced nutrition has been shown to have postoperative benefits. To date, patient knowledge and perceptions of the role of nutrition in recovering from surgery have not been studied.

Methods

A Knowledge, Attitudes, and Practice survey was administered to arthroplasty candidates presenting to a hip and knee orthopaedic clinic. The survey collected information on demographics, surgical history, patient concerns around the time of surgery, and patients' attitudes toward and perceptions of nutrition.

Results

A total of 500 patients (62.4% women) completed the survey. More than half of patients reported having a physician discuss nutrition with them, but only a third had been asked to modify their nutritional habits. The greatest patient concerns surrounding surgery were pain (59.2% of patients) and accomplishing activities of daily life (53.2%). The fewest patients were concerned with nutrition (7.6%), but most patients (94%) would modify their habits if they knew nutrition would positively impact their recovery. Most patients felt nutrition could help maintain muscle mass and function after surgery.

Conclusions

Candidates for hip and knee replacements generally recognize nutrition's importance, but few are concerned with their preoperative nutritional status. Current joint replacement literature shows a range of impacts nutrition can have on recovery from surgery. The study findings highlight gaps in patient knowledge regarding nutrition and suggest it would be beneficial for arthroplasty surgeons to actively educate patients on focused perioperative nutrition.

Antimicrobial stewardship and education in optometry

CLINICAL RELEVANCE

Antimicrobial stewardship aims to improve how antibiotics are prescribed by clinicians and used by patients, to ensure safe appropriate use, and to prevent and contain antimicrobial resistance.

BACKGROUND

Australian optometrists can prescribe a range of antimicrobial agents, but to what extent they consider antimicrobial stewardship is not known. This study evaluated what final-year optometry students and optometrists understood about antimicrobial stewardship in eye care and considered relevance to oral prescribing and education.

METHODS

A knowledge, attitude, and practice (KAP) questionnaire was developed comprising four sections: i) demographic questions, ii) 10 multiple choice questions regarding Knowledge about antimicrobial agents and likely pathogens, diagnosis, treatment, and preventing resistance, iii) 10 Likert rating scale questions about thoughts and Attitudes, iv) mix of question types (5× MCQ: course of action, 16 Likert scale: confidence) related to Practice (diagnosis, management, and prescribing). Descriptive analyses were conducted (medians, mean±SD, and distributions).

RESULTS

Thirteen students and 36 optometrists completed the survey. Both groups had a good understanding of microbial resistance and antibiotic prescribing for ocular conditions; average knowledge scores were 9.2 ± 0.7 and 8.7 ± 1.1 for students and practitioners, respectively. Scores were neutral to agree for questions related to the need for more educational programs. The answers of practice-related MCQs had a dichotomy of answers indicating a diversity of opinion, as can be the case in practice. Average total practice confidence scores were approximately 57/80 for students and 68/80 for optometrists. Optometrists and students were very confident in their ability to conduct an appropriate case history and use their knowledge and clinical skills, including slit lamp anterior eye assessment. The lowest confidence scores were for conducting microbial testing, i.e. taking swabs for pathology.

CONCLUSION

Student and optometrist knowledge, attitudes, and practice around antimicrobial stewardship were high and in line with other health professions globally. There is scope for increased stewardship training.

Nurses' knowledge, attitudes and practices regarding the application of the injury severity score in emergency departments: A cross-sectional multicentre study

AIMS AND OBJECTIVES

To investigate knowledge, attitudes, and practices regarding the application of the Injury Severity Score (ISS) among emergency department nurses in China and the factors influencing these variables.

BACKGROUND

ISS is the first trauma scoring method to be developed and the most widely used in clinical practice. The correct application of the ISS by emergency department nurses plays an important role in assisting in the diagnosis and treatment of trauma patients, and it is crucial to understand nurses' knowledge, attitudes and practices.

DESIGN

A cross-sectional multicentre study.

METHODS

Nurses from the emergency departments of 25 grade II and grade III hospitals in Gansu Province, China participated in this study. Data was collected online using a self-administered questionnaire. Student's t-test or analysis of variance was performed to compare the differences between the groups. Multiple logistic regression analysis identified factors influencing nurses' knowledge, attitudes and practices regarding applying ISS. A STROBE checklist was used to report findings.

RESULTS

Among 459 nurses, a good level of attitude and passing levels of knowledge and practice regarding applying the ISS were revealed. Nurses in higher hospital grades, who had been exposed to ISS and received training had higher levels of knowledge and practices. Previous exposure to the ISS and training related to it were factors that influenced nurses' attitudes.

CONCLUSIONS

Chinese emergency department nurses' knowledge, attitudes and practices of applying the ISS still need to be improved. Hospitals and nursing managers should provide training opportunities for nurses about ISS knowledge and practices, while grade II hospitals should pay more attention to training and continuing education in this area.

RELEVANCE TO CLINICAL PRACTICE

In hospitals, nursing managers may benefit from enhancing related education and training to promote the emergency department nurses' knowledge and practice of the ISS, by developing specific curricula and providing continuing education and training opportunities, while grade II hospitals should pay more attention to training and continuing education in this area.

NO PATIENT OR PUBLIC CONTRIBUTIONS

This study focused on emergency department nurses' knowledge, attitudes, and practices regarding the application of the ISS. The research questions and design were derived from clinical nursing practice, literature review, and expert panel review, and patients or the public are temporarily not involved.

Development and validation of a Knowledge, Attitudes and Practices (KAP) questionnaire for healthcare professionals on environmental sustainability in healthcare in Southern Africa

Background

The triple planetary crisis of climate change, environmental pollution, and biodiversity loss is increasingly driving poor health outcomes worldwide. Healthcare systems and services are often not environmentally sustainable and compound the problem, while healthcare professionals are also recognised as key leaders in advancing sustainable healthcare. To adopt this leadership position, healthcare professionals' knowledge, attitudes, and practices regarding environmental sustainability in healthcare must be established. This article reports the development and validation of a new instrument for this purpose that corresponds to the specificities of the Southern African context.

Methods

Questionnaire development followed a seven-stage process. Information was obtained from a 2021 study titled 'South African Healthcare Professionals' Knowledge, Attitudes, and Practices Regarding Environmental Sustainability in Healthcare: A Mixed-Methods Study' to develop the instrument. Information was also sourced from the literature regarding environmental sustainability and healthcare to generate the first questionnaire with 29 items. The following stages included two rounds of expert input, separated by a pilot study with the target population to receive feedback regarding the instrument's structure, relevance, and length. Content validity was determined through statistical analysis.

Results

Feedback was received from nine experts in stage two and 13 pilot-study participants in stage four and incorporated to improve the questionnaire. In stage six, the questionnaire was rated by seven experts. The content validity index of the questionnaire was calculated at two different stages, after which the indices were compared. Following a final edit, the questionnaire has 24 questionnaire items. The closing analysis calculated the scale content validity index average (S-CVI/Ave) of 0,922; this indicates that the final questionnaire has excellent content validity.

Conclusion

A questionnaire that assesses the knowledge, attitudes and practices of healthcare professionals regarding environmental sustainability in Southern Africa has been developed and validated. This questionnaire can now be used for further studies in Southern Africa.

Knowledge, attitudes, and practices toward training of vascular access in chronic hemodialysis patients among nephrology fellows in Southwest China

This cross-sectional study examined the knowledge, attitudes, and practice (KAP) of training of vascular access in chronic hemodialysis patients among nephrology fellows in Southwest China. Nephrology fellows in Southwest China were recruited from June 1st to 10th, 2024. The demographic characteristics and KAP scores were determined using a self-designed questionnaire. Finally, 210 valid questionnaires were included. Among the participants, 37.6% were 36-40 years old, and 54.3% were females. The median knowledge, attitude, and practice scores were 19 (IQR: 17-20) (possible maximum of 20), 36 (IQR: 35-37) (possible maximum of 50), and 46 (IQR: 38-60) (possible maximum of 80), respectively. Knowledge and attitudes were correlated (Pearson's r = 0.439, P < 0.001), as well as knowledge and practice (r = 0.645, P < 0.001) and attitudes and practice (r = 0.560, P < 0.001). Mediation analysis showed that the knowledge scores (β = 0.266, P < 0.001), attitude scores (β = 0.268, P < 0.001), gender (β=-0.149, P = 0.001), nephrology experience (β = 0.135, P = 0.005), and experience of leading a vascular access-related surgery or procedure (β=-0.374, P < 0.001) had direct influences on practice, while the knowledge scores (β = 0.130, P < 0.001), professional background (β=-0.186, P < 0.001), and experience of leading a vascular access-related surgery or procedure (β=-0.070, P = 0.006) had indirect influences on practice. The study indicated that nephrology fellows in Southwest China had good vascular access knowledge but moderate attitudes and practices. Specific areas would require training to improve the practice of vascular access for patients requiring maintenance hemodialysis.

Pregnant women's knowledge, attitude, and practice toward food preservatives: a cross-sectional study

BACKGROUND

Sodium benzoate, a common food preservative, may harm fetuses, which could increase the safety concern for pregnant women, but the knowledge, attitude, and practice (KAP) of food preservatives' impact on health among pregnant women is limited. This study explored the KAP of pregnant women regarding food preservatives.

METHODS

This cross-sectional study was conducted in Henan Province between March and April 2023 among pregnant women. An investigated-designed questionnaire was administered to collect the demographic characteristics and KAP scores. Scores of < 60%, 60-79%, and ≥ 80% were considered poor, moderate, and good, respectively.

RESULTS

The study collected 515 valid questionnaires [303 (58.83%) < 30-years-old participants] for analysis. The knowledge, attitude, and practice scores were 10.21 ± 2.90 (/17; 60.06%), 29.59 ± 2.73 (/40; 73.98%), and 22.86 ± 3.56 (/30; 76.20%), respectively. The structural equation model (SEM) showed that the knowledge of food preservatives directly affected attitudes (β = 0.168, P = 0.005) and practice (β = 0.250, P = 0.021) and indirectly affected practice (β = 0.047, P = 0.004). The attitudes toward food preservatives directly affected practice (β = 0.280, P = 0.021).

CONCLUSION

Pregnant women in Henan Province have moderate knowledge, attitudes, and practices toward food preservatives. Education interventions are needed to improve the knowledge gaps identified in this study, which could also be encountered in other regions.

TRIAL REGISTRATION

Not applicable.

A qualitative analysis of perceived risks and benefits of mosquito abatement and bite prevention strategies in Northeastern U.S. communities

Mosquito-borne disease (MBD) incidence is increasing in the United States (U.S.), presenting an evolving health threat. Assessments of public perceptions have revealed limited awareness of MBDs among the U.S. population. Our team used focus groups to gain an in-depth understanding of risk perceptions regarding mosquito exposure and pesticide use, and benefit perceptions and motivators for bite prevention strategies. A total of 37 individuals participated in focus groups across 3 states: New Jersey (n = 14), New York (n = 15), and Massachusetts (n = 8). Most participants were unfamiliar with public mosquito control services and felt they were not at high exposure risk to any MBDs. Overall, participants were supportive of investing public funds for mosquito surveillance. However, participants across all focus groups expressed concerns over ecosystem health and long-term consequences of pesticide use for mosquito control. Participants in every focus group referenced a risk assessment that weighed the risk of MBD exposure against the use of chemical control: once participants perceived MBDs as negatively impacting human and/or animal health in their area, sentiment swung largely to supporting the use of pesticides. In the absence of an obvious MBD threat, participants preferred nonchemical control interventions. Participants felt communication from mosquito control agencies should be accessible, disseminated across multiple venues, and should include instructions for the public during spray events, resources for individual bite prevention, and information on control products used. Our research results can inform the development of improved, evidence-based MBD outreach and educational resources that are acceptable, actionable, and relevant to Northeast communities.

The Perception and Practices of Black African Subjects Toward Hemorrhoidal Disease: The Relevant Effects of Beliefs and Misconceptions in Côte d'Ivoire, West Africa

Background

The perception of black African subjects toward hemorrhoidal disease is surrounded by myths and misconceptions in sub-Saharan Africa. This study aimed to determine the magnitude of knowledge, attitudes, and practices (KAPs) of black African subjects toward hemorrhoidal disease and the impact of knowledge on their attitudes and practices.

Methods

A cross-sectional KAP survey was conducted through convenience sampling of 735 participants (mean age, 38.8 years; men, 59.2%) from urban and rural areas in Côte d'Ivoire. They received an auto questionnaire of 25 items on Likert scales depicting their KAP toward hemorrhoidal disease. A mean score of KAP < 50 points was considered low. Logistic and linear regression models were used to determine the factors associated with self-reported hemorrhoidal disease and the impact of knowledge on attitudes and practices.

Results

The overall Cronbach score was 0.75, and the sample proportions of self-reported or symptom-based hemorrhoidal disease were 44.4% (9% CI: 41-48) and 21.2% [95% CI: 18.4-24.4], respectively. The overall mean (SD) scores of KAP were low: 49 (34.4), 43.4 (18.7), and 33.6 (21.7), respectively. The attitudes and practices of the participants remained unchanged regardless of their knowledge. Hemorrhoidal disease was negatively associated with attitudes (beta = -3.1, p = 0.02) or practices (beta = -3.4, p < 0.05). Overall, the participants agreed that hemorrhoidal disease led to sexual dysfunction (85.2%) and infertility (67.1%). They preferred indigenous (52.4%) over modern treatments (30.2%) and perceived surgery for hemorrhoidal disease to be dangerous (24.4%) and not recommended (56.6%).

Conclusion

Knowledge did not change the attitudes and practices of black African subjects toward hemorrhoidal disease.

Knowledge, attitudes and practices on antimicrobial use and antimicrobial resistance among shrimp aquaculturists in Peninsular Malaysia

In aquaculture, production intensification and the increasing occurrence of diseases are equally driving antimicrobial use (AMU) and the development of antimicrobial resistance (AMR). There is inadequate awareness and knowledge regarding AMU and AMR among the public in Malaysia. Thereby, AMR reduction action plans critically require the involvement of farmers as end users of the antimicrobials. The knowledge, attitudes and practices (KAP) survey can evaluate the farmers' awareness level about the issue. To date, no KAP survey has been conducted among shrimp aquaculture farmers in Malaysia regarding AMU and AMR. In addition, no suitable questionnaire is available to conduct the study. Therefore, this study has developed a questionnaire to evaluate the KAP of Penaeus vannamei and Penaeus monodon aquaculture farmers towards AMU and AMR in selected states in Peninsular Malaysia. In total, 113 farmers participated in this survey. The majority (88.1 %, n = 89) of 101 respondents who completed answering the knowledge- and attitude-related KAP items had inadequate knowledge of AMU and AMR. Regarding attitude, the percentages of farmers with good attitudes (49.5 %, n = 50) and poor attitudes (50.5 %, n = 51) are comparable. Nevertheless, a high percentage (95.0 %, n = 96) of them have never used antibiotics on farmed shrimp, indicating good practices in terms of AMU. The Pearson correlation revealed a large positive association between knowledge and attitudes. To the best of our knowledge, this study is the first to develop a questionnaire and assess the KAP regarding AMU and AMR among shrimp aquaculture farmers in Malaysia.

Knowledge, Attitude, and Practice Towards Rehabilitation in Patients with Breast Cancer: A Cross-Sectional Study

Background

Research on rehabilitation in breast cancer (BC) patients is scarce. This study explored the knowledge, attitude, and practice (KAP) toward rehabilitation in BC patients who underwent surgery.

Methods

This cross-sectional survey study was conducted between August 2022 and February 2023 in eight hospitals in Yixing City, Jiangsu Province. An investigator-designed survey was used to evaluate the participants' KAP toward BC rehabilitation.

Results

The analysis included 578 valid surveys. The participants displayed good knowledge, positive attitudes, and proactive practice toward rehabilitation after surgery for BC. The multivariable logistic regression analysis showed that the knowledge scores and attitude scores were independently and positively associated with proactive practice, while age 45-55, age 56-60, ≥ 6 years BC duration, modified radical surgery, and radical surgery were independently and negatively associated with proactive practice (all P < 0.05). The structural equation model revealed a positive direct effect of knowledge on both attitude and practice. In addition, attitudes had a positive direct influence on practice.

Conclusion

Patients with BC exhibited favorable KAP rehabilitation after surgery for BC, but targeted education could be needed to enhance specific points of understanding and reinforce proactive engagement in clinical practice.

Knowledge, attitudes, and practices regarding the postoperative management and TSH suppression therapy among patients with thyroid cancer

Background

Patient adherence to thyroid-stimulating hormone (TSH) suppression therapy is crucial for optimizing prognosis.

Methods

This study aimed to examine the knowledge, attitude, and practice (KAP) toward TSH suppression therapy among patients. This cross-sectional study was conducted at our Hospital between March 2023 and October 2023 and included patients receiving TSH suppression therapy. A self-designed questionnaire was employed to collect their demographic characteristics and KAP. The analysis included 528 valid questionnaires.

Results

The mean knowledge, attitude, and practice scores were 11.66 ± 5.82 (possible range: 0-22), 33.31 ± 4.97 (possible range: 0-40), and 24.46 ± 3.46 (possible range: 0-34), respectively, indicating poor knowledge, favorable attitudes, and moderate practice. The knowledge scores were correlated to the attitude (r=0.399, P<0.001) and practice (r=0.401, P<0.001) scores, while the attitude scores were correlated to the practice scores (r=0.512, P<0.001). The structural equation modeling revealed that knowledge directly influenced attitude (β=0.34, P<0.001) and practice (β=0.13, P<0.001) and indirectly influenced practice through attitude (β=0.10, P<0.001).

Conclusions

Patients receiving TSH suppression therapy in Zhanjiang demonstrated poor knowledge, favorable attitudes, and moderate practices toward TSH suppression therapy.

Knowledge, attitudes, and practices of gastric cancer patients toward nutritional therapy

Background

To investigate the knowledge, attitude, and practice (KAP) of patients with gastric cancer (GC) toward nutritional therapy.

Methods

This cross-sectional study was conducted from January to March 2024 at the Affiliated Hospital of Jiangnan University (Wuxi, China) and enrolled patients with GC. Questionnaires (Cronbach's α = 0.923) were used to collect data on demographics and KAP dimensions. Scores >75% were considered good. Multivariable analyses were performed to examine the factors associated with KAP. A structural equation modeling (SEM) analysis was performed to examine the relationships among KAP dimensions.

Results

The analysis included 486 valid questionnaires. The median knowledge, attitude, and practice scores were 6.0 (0-16; 37.5%), 26.0 (7-35; 74.3%), and 28.7 (8-40; 71.7%) indicating poor KAP. Only agricultural, forestry, animal husbandry, fishery, and water conservancy production personnel (OR = 0.09, 95%CI: 0.02-0.49, p = 0.006) were independently associated with knowledge. Knowledge (OR = 1.11, 95%CI: 1.05-1.18, p < 0.001) and a monthly income of 10,000-20,000 (OR = 3.85, 95%CI: 1.23-12.06, p = 0.021) were independently associated with attitude. Knowledge (OR = 1.22, 95%CI: 1.15-1.30, p < 0.001), attitude (OR = 1.21, 95%CI: 1.11-1.32, p < 0.001), personnel other than leading cadres of state organs and enterprises (all OR < 1 and all p < 0.05), and a monthly income of 10,000-20,000 yuan (OR = 3.02, 95%CI: 1.15-7.96, p = 0.025) were independently associated with practice. Knowledge had a direct positive influence on attitude (β = 0.350, p < 0.001) and practice (β = 0.460, p < 0.001) and an indirect positive influence on practice (β = 0.146, p < 0.001). Attitude had a direct positive influence on practice (β = 0.417, p < 0.001).

Conclusion

Patients with GC in Wuxi partly had poor KAP toward nutritional support.

Knowledge and attitudes toward [18F] fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography among non-radiologist medical staff

BACKGROUND

To investigate the current knowledge and attitudes towards [18F]fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) among non-radiologist medical staff in China.

METHODS

This cross-sectional study was conducted between November 18, 2022, and December 6, 2022, at the First Affiliated Hospital (Southwest Hospital) of the Army Medical University (Third Military Medical University) among non-radiologist staff (medical, nursing, and others). The questionnaire survey (Cronbach's α = 0.887) included 28 items: 10 on demographics, 11 on knowledge (maximum score of 22), and seven on attitudes (maximum score of 35). The factors influencing knowledge and attitudes were identified using multivariable logistic regression analysis.

RESULTS

This study analyzed 631 valid questionnaires. The mean knowledge score was 7.16 ± 6.48 (32.55%), indicating poor knowledge. The mean attitude score was 22.859 ± 2.36 (65.29%), indicating positive attitudes. Nursing (OR = 0.301, 95%CI: 0.159-0.571), other occupations (OR = 0.426, 95%CI: 0.200-0.905), departments with high volumes of PET/CT prescriptions (OR = 0.419, 95%CI: 0.269-0.652), radioprotection training (OR = 2.520, 95%CI: 1.576-4.030), underwent (or a relative) a PET/CT (OR = 1.713, 95%CI: 1.063-2.761), and contact with 1-10 (OR = 2.429, 95%CI: 1.627-3.627) or > 10 (OR = 3.575, 95%CI: 1.762-7.252) patients per month were independently associated with higher knowledge scores. Only the knowledge scores (OR = 1.063, 95%CI: 1.032-1.094) were independently associated with higher attitude scores.

CONCLUSION

Non-radiologist medical staff members in China have poor knowledge but positive attitudes toward PET/CT. This study identified knowledge areas worth improving in future training interventions. Radioprotection training appears particularly useful in improving the knowledge of PET/CT, which should translate into more favorable attitudes.

TRIAL REGISTRATION

Not applicable.

Knowledge, Attitude, and Practice of Anesthetists in Managing Severe Craniocerebral Trauma in China: A Cross-Sectional Study

Objective

The study explored the knowledge, attitude, and practice (KAP) toward severe craniocerebral trauma perioperative management among anesthetists in China.

Methods

This cross-sectional study recruited anesthetists from 15 provinces in China between October 17, 2022, and November 09, 2022. Pearson's correlation was used to assess the relationships between KAP dimension scores, and multivariable linear regression was performed to identify factors associated with higher KAP scores.

Results

The study included 200 anesthetists (122 females). The mean knowledge, attitude, and practice scores were 50.41±7.36 (possible range, 0-84), 20.23±2.72 (possible range, 0-24), and 11.85±4.54 (possible range, 2-28), respectively. The knowledge scores were positively correlated with the attitude scores (r=0.522, P<0.001), but the practice scores were not significantly correlated with the knowledge or attitude scores. Anesthetists with experience in 100-300 craniocerebral trauma surgeries (B = 3.728, 95% confidence interval [CI]: 0.271-7.186, P = 0.035) or more than 300 surgeries (B = 7.680, 95% CI: 2.684-12.675, P = 0.003) were significantly more likely to achieve higher overall KAP scores compared to those with experience in fewer than 100 surgeries.

Conclusion

Anesthetists in China exhibit moderate knowledge, a positive attitude, and inadequate practice regarding perioperative management of severe craniocerebral trauma. Greater clinical experience in managing craniocerebral trauma perioperatively is associated with higher KAP scores. The results highlight the need for targeted training and experience-based education to improve perioperative outcomes, which could translate into better clinical outcomes for the patients. Policymakers should be aware of those gaps and include additional training as necessary.

Knowledge, attitude, and practice in communication assessment of speech-language pathologists working with adolescents with mental health concerns

PURPOSE

The recovery model underlying mental health services emphasises the importance of the voice of the adolescent client in identifying needs, goals, and negotiating intervention. This study aimed to characterise speech-language pathologists' (SLPs) knowledge, attitude, and practice in relation to communication assessment of adolescents, focusing on adolescents with mental health concerns and the use of discourse sampling and analysis.

METHOD

An online survey using a Knowledge, Attitude, Practice framework gathered data from 43 English-speaking SLPs. SLPs responded, using a five-point Likert scale, to closed statements regarding perceived knowledge, attitude, and practice in approaches to communication assessment. Survey items relating to discourse sampling and analysis were aggregated into subscales and six statements related to assessment of adolescents with mental health concerns. A final, open-ended question invited comments on changing clinical practice.

RESULT

A strong positive correlation was found between knowledge and practice; with a weak, positive correlation between knowledge and attitude.

CONCLUSION

SLPs are aware of the benefits of a comprehensive communication assessment. However, greater knowledge and experience is needed to incorporate more formalised approaches into clinical practice, especially as it relates to social and emotional outcomes. Participants' comments suggest that professional learning communities may be helpful in delivering this outcome.

Knowledge, Attitudes, and Practices of Patients from the Anesthesia Clinic in Jinshan District, Shanghai, Regarding Visiting the Anesthesia Clinic

Background

Anesthesia assessment outpatient clinics (AAOCs) can help personalize the anesthesia experience, alleviate anesthesia-related anxiety, and offer health management advice. This study investigated the knowledge, attitude, and practice (KAP) of patients from the anesthesia clinic in Jinshan District, Shanghai, China, regarding AAOCs.

Methods

This cross-sectional study was conducted from July 10, 2023, to October 15, 2023, at Jinshan Hospital affiliated to Fudan University. The final version of the questionnaire included four dimensions: demographic information, knowledge dimension (seven items, scores 0-7), attitude dimension (six items, scores 6-30), and practice dimension (six items, scores 6-30). The Cronbach's α was 0.935. The risk factors for the practice dimension were examined through univariable and multivariable logistic regression. The relationships among the KAP dimensions were explored using a structural equation model (SEM).

Results

A total of 531 questionnaires were included for analysis. The mean knowledge score was 5.5±1.9 (/7 points, 79.0%). The mean attitude score was 26.3±3.7 (/30, 87.8%). The mean practice score was 25.5±3.4 (/30, 85.0%). However, still over 10% of participants did not recognize AAOCs' ability to alleviate anesthesia-related fears and did not believe AAOCs affect future health management. The knowledge scores correlated to the attitude (r=0.401, P<0.001) and practice (r=0.379, P<0.001) scores, while the attitude scores correlated to the practice scores (r=0.742, P<0.001). The SEM showed that knowledge influenced attitude (β=2.409, P<0.001), while attitude influenced practice (β=0.721, P<0.001). The attitude scores (OR=2.055, 95% CI: 1.756-2.404, P<0.001) and personal/relative/friend experience with AAOCs (OR=2.771, 95% CI: 1.002-7.664, P=0.050) were independently associated with the practice scores.

Conclusion

Patients in Jinshan District had a good KAP toward AAOCs. Improving knowledge of AAOCs should improve attitudes and the use of AAOCs to improve the patient experience and outcomes of anesthesia.

Assessing the knowledge, attitudes, and practices (KAP) of dengue in Thailand: a systematic review and meta-analysis

AIM

Dengue cases are on the rise in Thailand, coinciding with increases in flooding events. Studies pertaining to public knowledge, attitudes, and practices (KAP) of dengue prevention have frequently been used to better understand the public's needs towards dengue. While these studies were conducted in different settings, it is necessary to initiate a systematic review and meta-analysis of relevant studies.

SUBJECTS AND METHOD

We conducted a systematic review and meta-analysis of prior studies in Thailand that assessed the KAP towards dengue. Eligibility criteria were established and independently used by reviewers to select nine studies for the systematic review and three for the meta-analysis. Collectively, the nine studies included 3,058 individuals and 2,519 households.

RESULTS

The overall estimate of the proportion of participants with good knowledge of dengue prevention is 35% (95% CI: 14-59%), suggesting the majority of the population in Thailand had low levels of knowledge towards dengue. The poor levels of practice in Thailand were also observed and confirmed for the majority of the population by meta-analysis, with the pooled estimate of the proportion of participants with good practice of dengue prevention being 25% (95% CI: 22-27%). In contrast, most of the studies included in the systematic review reported positive attitudes towards dengue prevention, and this finding was also affirmed by the meta-analysis, as the pooled estimate of the proportion of positive attitudes towards dengue prevention is 61% (95% CI: 43-77%).

CONCLUSION

Despite good attitudes towards dengue prevention, poor knowledge and poor practices predominate, highlighting the need for enhanced public health campaigns to educate the public on dengue risks and prevention methods.

Exploring Pesticide Knowledge, Practices, and Health Perceptions Among Farmers in Akkar, Lebanon

BACKGROUND

The unregulated and widespread use of agricultural pesticides in Lebanon has led to critical health and environmental challenges. Small-scale farmers in Akkar, a key agricultural region, are particularly vulnerable due to limited knowledge, unsafe practices, and insufficient access to safety resources.

OBJECTIVES

This study evaluates the knowledge, practices, and perceived health impacts of pesticide use among small-scale farmers in Akkar. It aims to identify gaps and provide targeted recommendations for interventions that enhance safety, sustainability, and environmental conservation.

METHODS

A cross-sectional survey involving 151 farmers was conducted from November 2022 to January 2023 using a validated questionnaire. Descriptive statistics, regression analysis, and Tukey's HSD post hoc tests were used to assess knowledge and practice scores and identify predictors.

RESULTS

Farmers demonstrated moderate knowledge (mean score: 0.545) and practices (mean score: 0.607). However, environmental awareness was low, with only 9.3% recognizing water contamination risks. Alarmingly, 37.7% of farmers reported using no protective gear, while 67.5% experienced acute symptoms such as respiratory irritation and skin issues. Education was a significant predictor of knowledge (p < 0.01).

CONCLUSIONS

This study underscores the pressing need for tailored educational programs, accessible protective equipment, stricter regulatory frameworks, and environmental conservation strategies to reduce health risks and promote sustainable pesticide use.

Evaluation of Knowledge, Attitudes, and Practices Toward Thyroid Nodules in 456 Patients with Thyroid Nodules

BACKGROUND Thyroid nodules, common in adults, especially females and older individuals, are mostly asymptomatic. While the nodules are largely benign, distinguishing malignant lesions is crucial. Overdiagnosis and overtreatment pose risks. Knowledge, attitude, and practice (KAP) surveys can identify knowledge gaps and inform targeted education; however, no studies have explored this in Chinese patients with thyroid nodules. This study aimed to investigate the KAP toward thyroid nodules among patients with thyroid nodules. MATERIAL AND METHODS This web-based cross-sectional study was conducted among patients with thyroid nodules, using a self-administered questionnaire. RESULTS A total of 456 valid questionnaires were included. The mean knowledge, attitude, and practice scores were 7.07±3.19, 26.39±3.98, and 29.16±4.65, respectively. Knowledge (OR=1.111, P=0.002), junior college (OR=1.933, P=0.035), and bachelor's degree or above (OR=2.193, P=0.015) were associated with proactive practice. Structural equation modeling showed knowledge directly influenced attitude (ß=0.244, P<0.001) and practice (ß=0.404, P<0.001). Attitude directly influenced practice (ß=-0.129, P=0.020). Occupation (ß=-0.279, P=0.038), marital status (ß=-0.752, P=0.002), thyroid nodule TIRADS classification (ß=-0.699, P=0.004), and education (ß=0.501, P<0.001) directly influenced knowledge. Average per capita income (ß=0.942, P<0.001) and education (ß=0.380, P=0.309) directly influenced attitude. Education (ß=0.457, P=0.028) directly influenced practice. CONCLUSIONS Patients with thyroid nodules have poor knowledge and unfavorable attitudes but proactive practice toward thyroid nodules. Anxiety-reducing techniques should be incorporated during education sessions, and workplace wellness programs should be explored, to promote healthy practices and early detection.

Knowledge, attitude, and practice of coronary heart disease patients towards antithrombotic therapy

BACKGROUND

The role of antithrombotic therapy in prognosticating patients with coronary heart disease (CHD) is crucial. This study evaluated the Knowledge, Attitude, and Practice (KAP) of CHD patients regarding antithrombotic therapy.

METHODS

This cross-sectional study distributed questionnaires to collect data. Participants' demographic information was recorded, and their KAP scores were assessed. The Self-Efficacy for Appropriate Medication Use Scale (SEAMS) measured self-efficacy.

RESULTS

The study comprised 639 individuals. The median scores were as follows: knowledge score 8 (IQR 6-10), attitude score 25 (IQR 23-27), and practice score 22 (IQR 20-24). Notably, up to 70% of patients incorrectly responded to questions about dosage and administration of antithrombotic agents, and approximately 40% lacked awareness of the treatment's importance and side effects. Low practice scores were independently linked to rural residence, low attitude scores, and poor self-efficacy. Furthermore, Predictive factors for low self-efficacy included being underweight, having a high family income, a short medical history, and low attitude scores.

CONCLUSIONS

The surveyed patients with CHD exhibited good attitudes, practices, and self-efficacy but demonstrated only median knowledge levels toward antithrombotic therapy, especially about the importance and precautions associated with antithrombotic treatment. Therefore, initiatives aimed at improving adherence to antithrombotic therapy among CHD patients should focus on the knowledge gaps, especially for patients in rural areas. Improving the patient KAP could help improve the physician-patient interaction.

Knowledge, attitudes, and practices regarding whole-course management among patients with gastrointestinal cancers: a cross-sectional study

BACKGROUND

This study aimed to investigate the knowledge, attitudes, and practices (KAP) regarding whole-course management among patients with gastrointestinal (GI) cancers.

METHODS

This cross-sectional study enrolled patients with GI cancers at the Inner Mongolia Hospital of Peking University Cancer Hospital between November 2023 and April 2024. Data were collected through a self-administered questionnaire, which captured demographic information and scores on KAP.

RESULTS

A total of 408 participants were included in this study. The mean KAP scores were 10.62 ± 3.14 (out of a maximum of 15), 39.11 ± 4.94 (out of a maximum of 50), and 31.35 ± 5.60 (out of a maximum of 40), respectively. Knowledge was positively correlated with attitudes (r = 0.307, P < 0.001) and practices (r = 0.417, P < 0.001), while attitudes were positively correlated with practices (r = 0.383, P < 0.001). The structural equation model indicated that knowledge influenced attitudes (β = 0.573, P < 0.001) and practices (β = 0.466, P < 0.001), while attitudes influenced practices (β = 0.525, P < 0.001).

CONCLUSIONS

Patients with GI cancers demonstrated insufficient knowledge, moderate attitudes, and suboptimal practices regarding whole-course management. Improvements in practice could be achieved by enhancing knowledge and attitudes through specialized health education.

Knowledge, attitude, and practice toward vitiligo among vitiligo patients: a mediation analysis

Knowing provoking factors of vitiligo progression and how to avoid them is essential to the successful self-management of vitiligo. Cultivating a positive attitude is also essential to avoid focusing on the negative aspects of the disease and to fuel proactive practice. This study aims to evaluate the knowledge, attitudes, and practices (KAP) of vitiligo patients and identify related factors. The study recruited 517 (54.55% male) adult vitiligo patients in Beijing and Nanjing. The mean knowledge, attitude, and practice scores were 5.45 ± 2.74 (possible range: 0-10), 23.15 ± 6.78 (possible range: 8-40), and 37.13 ± 6.78 (possible range: 10-50), respectively. Mediation analysis indicated that knowledge (β = 0.24, P = 0.023), attitude (β=-0.28, P < 0.001), disease duration (β=-1.49, P < 0.001), and negative emotions (β=-1.54, P = 0.008) had direct effects on practice. Income (β=-0.29, P = 0.003), disease duration (β = 0.16, P = 0.033), lesion duration (β = 0.25, P = 0.003), education (β = 0.11, P = 0.024), and age (β=-0.14, P = 0.036) had indirect effects on practice. Vitiligo patients exhibited significant gaps in knowledge and attitudes toward their condition despite active management practices. Given the chronic nature of vitiligo and its slow treatment response, tailored health education strategies focusing on improving knowledge and attitudes are essential for standardizing treatment and enhancing patient adherence.

Development, validity, and reliability testing of a research readiness self-evaluation scale with nurses: A cross-sectional study

Nurse research readiness determines research outcomes. Understanding of nurse knowledge, attitude, and behaviors on research preparation can better prepare them for medical search. To develop a nurse research readiness self-evaluation scale and test its validity and reliability. This cross-sectional study was performed between January and October, 2023. Based on the knowledge-attitude-practice model, we first created a draft version of a nurse research readiness scale via a literature review and semi-structured interviews with registered nurses. After a Delphi expert consultation and pilot survey, a second version of the nurse research readiness scale was developed. We then tested the validity and reliability of the scale to develop its final version. A total of 20 experts and 400 nurses were invited to participate in the study, and valid responses were subsequently obtained from 16 experts and 390 nurses. The draft version of the scale had 3 dimensions and 35 items, which was finalized to 3 dimensions and 28 items after expert consultation and validity and reliability tests. The 3 dimensions were extracted using the principal component analysis method, which includes knowledge, belief, and behavior, and this could explain 70.672% of the total variation. The content validity test showed moderate satisfaction, with content validity indexes for each item and an overall scale of 0.833 to 1.000 and 0.878, respectively. The construct validity test was performed using exploratory factor analysis, which showed satisfactory concept measurement, with a loading value > 0.4 in all 28 final items. The criterion-related validity showed a correlation coefficient of 0.893 between the research readiness scale and a previously published research capability scale for nurses, suggesting the consistency of the present scale. The Cronbach α coefficient, Spearman-Brown coefficient, split-half reliability, and test-retest reliability were 0.964, 0.886, 0.940, and 0.824, respectively, thus demonstrating satisfactory reliability of the scale. A nurse research readiness self-evaluation scale was created with satisfactory validity and reliability, which could help nurses to determine their preparations for medical search and identify areas for improvements, with the ultimate goal to improve nursing research and evidence-based nursing practice.

The effect of educational intervention based on the mobile application on women's knowledge, attitude, and practice on microplastics and health: study protocol for a randomized controlled trial

BACKGROUND

The pervasive issue of microplastic (MP) contamination is undeniable. The primary solution to this global problem lies in significantly reducing the amount of plastic entering the environment. Addressing such a large-scale issue is no easy feat. However, a necessary strategy involves public education. In parallel, a randomized controlled trial (RCT) aims to evaluate the effect of interventional education via a mobile phone application on improving women's knowledge, attitude, and practice regarding the health effects of MPs.

METHODS

This randomized controlled trial includes three phases. In the first phase, a questionnaire assessing women's knowledge, attitudes, and practices (KAP) regarding microplastics will be developed and validated. In phase two, educational content for the mobile application "PlastiWise" will be created based on behavior change constructs. In phase three, a two-arm, parallel-design RCT will be conducted with 136 women aged 18 years and older who own smartphones, have basic literacy skills, and provide informed consent. Participants will be recruited through an online call disseminated via social media platforms and health system networks in Iran. They will be randomly assigned to an intervention group (n = 68) receiving the educational program through the app or a control group (n = 68). The sample size was calculated using G*Power software to ensure sufficient power (80%) with an alpha level of 0.05, factoring in a 15% dropout rate. Primary outcome data (KAP scores) will be collected at baseline, immediately post-intervention, and 8 weeks post-intervention using self-reported questionnaires. Data analysis will include descriptive statistics and inferential tests, such as independent t-tests and paired t-tests, to assess group differences and within-group changes over time.

DISCUSSION

Implementing an educational intervention on knowledge, attitude, and practice (KAP) about MPs using a mobile application will be a first in Iran. This research is expected to benefit Iranian women by contributing evidence on factors that might influence the effectiveness of educational training related to MP consumption. TRIAL STATUS : Protocol version 1, 2024-07-12. The enrolment of participants began on 2024-09-22. The recruitment is estimated to be completed by 2024-11-21. TRIAL REGISTRATION : Iranian Clinical Trial Register IRCT20240529061941N1. https://irct.behdasht.gov.ir/user/trial/77069/view . Date is July 12, 2024.

Impact of health education on knowledge retention among caregivers of hypertensive patients: A prospective cross-sectional study in rural Malawi

Hypertension is a widespread and life-threatening condition affecting one-third of adults globally. In low- and middle-income countries, like Malawi, the burden of hypertension is escalating due to inadequate healthcare resources and lifestyle changes. Family members often become primary caregivers, playing a crucial role in managing hypertension through support and adherence to treatment. This study examined caregivers' knowledge retention by evaluating their pre- and post-health education knowledge levels. This was a prospective cross-sectional study in Neno, Malawi, a rural setting. 422 caregivers were enrolled from the Integrated Chronic Care Clinic (IC3). A structured questionnaire was used to collect baseline, post-health education, and week six data. Using SPSS V 22.0, comparison of knowledge, attitude, and practices (KAP) scores, correlation between KAP and between KAP and social demographic characteristics were done using Wilcoxon signed-rank test, Pearson correlation, and independent t-test respectively. Among the 422 caregivers who participated in the study, 267 (63.2%) were females and mean age was 44.94 years. The baseline mean knowledge level score was 9.5 (38.0%) and rose to 21.08 (84.3%) p = 0.000 immediate post-health education and a 2.1% decrease 20.54 (82.2%) p<0.001 at week six from the immediate post health education score. Attitude improved from 16.76 (93.1%) at baseline to 17.74 (98.6%) at the six-week mark. Similarly, the mean practice score rose from 25.24 (78.9%) at baseline to 27.42 (85.7%) at week six. There was a positive correlation between KAP while age had a negative correlation with knowledge (r = -0.146; p = 0.003). There was a significant difference between different education levels on knowledge retention p = 0.009. There was a positive and good knowledge retention among caregivers of hypertensive patients after health education at the week six mark. With improved knowledge and the ability to retain it resulting in improved attitude and practices, caregivers are a cornerstone for continued and improved hypertension care for the patients.

Knowledge, Attitudes and Willingness of Caregivers of Preterm Infants Toward Autism: A Cross-Sectional Study

BACKGROUND

To examine the knowledge, attitudes and willingness of caregivers of preterm infants toward autism spectrum disorder (ASD).

METHODS

This cross-sectional study was conducted from September to December 2022 at the Hospital and enrolled the caregivers of preterm infants. The final questionnaire, developed by the authors, included four dimensions: demographic data, knowledge (16 items), attitudes (10 items) and willingness (seven items).

RESULTS

This study included 702 participants (77.21% females). The average knowledge, attitude and willingness scores were 7.75 ± 3.47 (total: 16), 38.54 ± 4.38 (total: 50) and 31.38 ± 3.95 (total: 35), respectively. Female (OR = 1.945, 95% CI: 1.182-2.797, p = 0.003), college or bachelor's (OR = 4.429, 95% CI: 1.525-9.788, p = 0.006), master or above (OR = 3.864, 95% CI: 1.194-12.500, p = 0.024) and stable work (OR = 2.098, 95% CI: 1.421-3.098, p < 0.001) were independently associated with sufficient knowledge. Age 30-34 (OR = 0.639, 95% CI: 0.423-0.695, p = 0.033), age ≥ 35 (OR = 0.517, 95% CI: 0.334-0.802, p = 0.003) and urban residency (OR = 1.697, 95% CI: 1.118-2.576, p = 0.013) were independently associated with favourable attitudes. The knowledge scores (OR = 1.100, 95% CI: 1.041-1.162, p = 0.001), attitude scores (OR = 1.212, 95% CI: 1.158-1.690, p < 0.001) and a monthly income of 10,000-20,000 RMB (OR = 2.125, 95% CI: 1.208-3.736, p = 0.009) were independently associated with the positive willingness.

CONCLUSIONS

This study observed poor knowledge but favourable attitudes and willingness toward ASD among caregivers of preterm infants. More attention should be paid to the education of caregivers to improve the knowledge of autism in the families of premature infants.

Assessing the role of education level on climate change belief, concern and action: a multinational survey of healthcare professionals in nephrology

BACKGROUND

Climate change poses a significant risk to kidney health, and countries with lower national wealth are more vulnerable. Yet, citizens from lower-income countries demonstrate less concern for climate change than those from higher-income countries. Education is a key covariate. To examine its role in explaining this perception gap, we obtained the perspectives of a highly educated cohort of healthcare professionals.

METHODS

This was a cross-sectional survey of healthcare professionals involved in kidney care. Responses were compared by the income level of the participant's country (per World Bank).

RESULTS

Of the 849 healthcare professionals from 107 countries (63.4% from lower and middle-income countries) that participated, most believed climate change was happening (97.9%), displayed a high level of concern (73.3%), and took personal action to combat climate change (62.0%). While the proportion who believed in climate change did not vary by income level (high:98.1%, upper-middle:97.2%, lower-middle:97.8%, low:100%, p = 0.73), the proportion with a higher level of concern (high:80.7%, upper-middle:74.9%, lower-middle:67.5%, low:53.8%, p < 0.001), and who took climate action (high:76.2%, upper-middle:63.1%, lower-middle:51.2%, low:30.8%, p < 0.001) decreased by national wealth. Barriers to involvement in sustainable kidney care were lack of time (54.4%), knowledge (39.7%), and peer support (30.3%). Only 34.0% were aware of national mitigation plans and barriers related to finances, technologies, tools, methods, research, and evidence were perceived as greater obstacles in lower-income countries.

CONCLUSIONS

Our results highlight that predictors and correlates of climate change risk perception vary across countries. Education alone is unlikely to increase individual and group engagement in climate change. A better understanding of these factors can inform strategies towards climate action in different settings.

Knowledge, attitudes and practices of intensive care unit physicians towards the management of acute respiratory distress syndrome in China: a cross-sectional survey

OBJECTIVES

This study aimed to assess the knowledge, attitudes and practices (KAP) of intensive care unit (ICU) physicians in China towards acute respiratory distress syndrome (ARDS).

DESIGN

A cross-sectional study was conducted between September and November 2022.

PARTICIPANTS

A total of 497 ICU physicians participated, with 258 (51.91%) being male and the majority aged 30-40 years (56.74%).

INTERVENTIONS

Participants were surveyed to evaluate their KAP regarding ARDS, with mediation analysis employed to elucidate the association between demographic characteristics and KAP scores.

PRIMARY AND SECONDARY OUTCOME MEASURES

The mean scores for KAP were 11.89±2.64 (range: 0-17), 44.73±4.85 (range: 12-60) and 18.26±3.43 (range: 1-48), respectively. Pearson correlation analysis showed positive correlations between knowledge and attitude (0.367), knowledge and practice (0.582) and attitude and practice (0.314) (all p<0.001).

RESULTS

Mediation analysis indicated that attitude (β=0.07, p<0.001) and hospital type (β=-0.84, p=0.005) had direct effects on practice, while knowledge had significant direct (β=0.68, p<0.001) and indirect (β=0.03, p=0.019) effects. Additionally, education (β=0.47, p<0.001), work experience (β=0.25, p<0.001), hospital classification (β=-0.91, p<0.001), ICU type (β=-0.61, p=0.001) and ARDS experience (β=-1.57, p<0.001) showed various indirect effects on practice.

CONCLUSIONS

ICU physicians in China exhibited inadequate knowledge, moderate attitudes and suboptimal practices regarding ARDS management. Enhancing education and work experience is crucial, along with practical, scenario-based training, to improve KAP in ARDS management.

Determinants of hypertension-related knowledge, attitude, and practices (KAP) among caregivers in Neno, rural Malawi: A cross-sectional study

Background

Hypertension, a significant health concern, increases the risk of cardiovascular disease and premature mortality. Caregivers play a crucial role in ensuring optimal care for hypertensive patients and reducing associated complications. Caregivers' basic knowledge, good attitude, and relevant practices are necessary to ensure high-quality care for patients with hypertension. However, there is no research conducted in Malawi that investigated the knowledge, attitude, and practices of caregivers towards hypertension prevention and management.

Objective

The study aimed to assess knowledge, attitude, and practices towards hypertension and their determinants among caregivers of hypertensive patients in Neno, Malawi.

Methods

Our study, conducted in Neno, Malawi, involved 422 caregivers of hypertensive patients. We used a cross-sectional study design. Data was collected through a structured questionnaire and analyzed using SPSS Version 22.0.

Results

The participants had a mean age of 44.94 years (SD = 9.889), with 63.3 % being female. The mean KAP scores were 38 %, 93.3 %, and 78.7 %, respectively. Positive correlations were found between knowledge and practice (r = +0.252; p < 0.001) and knowledge and attitude (r = +0.255; p < 0.001). However, no significant relationship was observed between attitude and practice (r = +0.064; p = 0.190). Age showed a strong correlation with attitude (r = +0.233; p < 0.001) but not with knowledge or practice. On the other hand, occupation, education level, and caregiver-patient relationship significantly influenced knowledge and attitude but not practice. Gender also demonstrated a notable association with KAP regarding hypertension.

Conclusion

Caregivers demonstrated poor knowledge but engaged in good practices. Despite their limited understanding, they maintained an excellent attitude towards hypertension. This highlights the necessity for increased prevention, and control strategies within communities, emphasizing health education on lifestyle modifications and to address the gaps identified in caregivers' understanding in the prevention and management of hypertension.

Knowledge, attitude, and practice toward vocal fatigue among occupational voice users: a cross-sectional study

BACKGROUND

Occupational voice users frequently face the challenge of vocal fatigue, impacting their overall well-being and job performance. This study aimed to investigate the knowledge, attitude, and practice (KAP) toward vocal fatigue among occupational voice users.

METHODS

This web-based cross-sectional study was conducted among occupational voice users between July and October 2023 in Shenzhen People's Hospital, utilizing a self-administered questionnaire to examine the KAP of vocal fatigue. A total of 920 valid questionnaires were collected with 248 males and 672 females, with 34.35% aged between 21 and 30 years.

RESULTS

The mean (standard deviation) scores were 15.1 (5.3) for knowledge (range: 0-24), 31.6 (3.6) for attitude (range: 8-40), and 45.0 (7.5) for practice (range: 13-65). A graduate degree or higher was positively associated with knowledge (odds ratio [OR] = 1.596, P = 0.007). Negative associations with knowledge included being a salesperson (OR = 0.342, P < 0.001) or a lawyer (OR = 0.150, P = 0.001). Knowledge was positively linked to attitude (OR = 1.211, P < 0.001), while being a medical professional was negatively linked (OR = 0.390, P = 0.018). Positive associations with practice included knowledge (OR = 1.076, P < 0.001), attitude (OR = 1.106, P < 0.001), age 21-30 years (OR = 1.955, P = 0.011), age 31-40 years (OR = 2.123, P = 0.034), having one child (OR = 2.501, P = 0.016), and having two or more children (OR = 2.324, P = 0.030). Negative associations included being a medical professional (OR = 0.458, P = 0.046), being married (OR = 0.465, P = 0.031), former smoking (OR = 0.317, P < 0.001), and speaking 6-10 h daily (OR = 0.736, P = 0.048).

CONCLUSION

Occupational voice users had moderate knowledge, neutral attitude and moderate practice towards vocal fatigue. To alleviate fatigue and prevent the aggravation of vocal problems, recommendations include implementing tailored educational programs, conducting awareness campaigns, and fostering collaboration with medical professionals.

Provision of Radiology Reports Simplified With Large Language Models to Patients With Cancer: Impact on Patient Satisfaction

PURPOSE

To explore the perceived utility and effect of simplified radiology reports on oncology patients' knowledge and feasibility of large language models (LLMs) to generate such reports.

MATERIALS AND METHODS

This study was approved by the Institute Ethics Committee. In phase I, five state-of-the-art LLMs (Generative Pre-Trained Transformer-4o [GPT-4o], Google Gemini, Claude Opus, Llama-3.1-8B, and Phi-3.5-mini) were tested to simplify 50 oncology computed tomography (CT) report impressions using five distinct prompts with each LLM. The outputs were evaluated quantitatively using readability indices. Five LLM-prompt combinations with best average readability scores were also assessed qualitatively, and the best LLM-prompt combination was selected. In phase II, 100 consecutive oncology patients were randomly assigned into two groups: original report (received original report impression) and simplified report (received LLM-generated simplified versions of their CT report impressions under the supervision of a radiologist). A questionnaire assessed the impact of these reports on patients' knowledge and perceived utility.

RESULTS

In phase I, Claude Opus-Prompt 3 (explain to a 15-year-old) performed slightly better than other LLMs, although scores for GPT-4o, Gemini, Claude Opus, and Llama-3.1 were not significantly different (P > .0033 on Wilcoxon signed-rank test with Bonferroni correction). In phase II, simplified report group patients demonstrated significantly better knowledge of primary site and extent of their disease as well as showed significantly higher confidence and understanding of the report (P < .05 for all). Only three (of 50) simplified reports required corrections by the radiologist.

CONCLUSION

Simplified radiology reports significantly enhanced patients' understanding and confidence in comprehending their medical condition. LLMs performed very well at this simplification task; therefore, they can be potentially used for this purpose, although there remains a need for human oversight.

Family Poultry Farming in Sri Lanka: An Integral Component of Protein Security, Poverty Alleviation and Public Health

Family poultry farming plays a crucial role in ensuring protein availability and household income, particularly in low-income families. This study investigates the knowledge, attitudes and practices of family poultry farmers regarding poultry diseases, biosecurity and vaccinations. The research involved surveying 150 farmers in a selected area in Sri Lanka's western province, revealing significant knowledge gaps, particularly in understanding poultry diseases, their causes, transmission pathways and potential impacts on humans. Most respondents demonstrated a lack of familiarity with biosecurity practices, with only a small fraction accurately identified recommended measures. Among the total respondents, only 16.7% were familiar with the term 'biosecurity'. Additionally, only 29.3% recognized that family poultry could pose a threat to public health. A significant majority (84.67%) admitted to not knowing which diseases could be effectively prevented through vaccination, and 80% of respondents had never vaccinated their birds. These findings highlight the challenges faced by family poultry farmers due to their limited understanding of crucial aspects of poultry management. The study underscores the need for government intervention and policy development to address these issues. Education and training programmes are essential to enhance farmers' awareness regarding disease control, biosecurity measures and the benefits of vaccination.

Parents' knowledge, attitudes and practices towards the prevention and treatment of dust mite allergy: a cross-sectional study in Shenyang (China)

OBJECTIVE

This cross-sectional study aimed to evaluate parents' knowledge, attitudes and practices (KAP) concerning the prevention and treatment of dust mite allergy in children.

DESIGN

This cross-sectional study survey was conducted from September to December 2022 at Shengjing Hospital, Affiliated with China Medical University.

PARTICIPANTS

A total of 503 parents of children with dust mite allergies participated, with 253 parents having children undergoing desensitisation treatment and 250 parents whose children did not. Selection criteria were carefully defined to include parents directly responsible for caring children with dust mite allergies.

PRIMARY AND SECONDARY OUTCOME MEASURES

Two distinct questionnaires were administered to parents, tailored for those with and without children undergoing desensitisation treatment. These questionnaires covered demographic information, allergy diagnosis, treatment details and KAP related to dust mite allergy. Primary outcomes included parents' scores on KAP regarding dust mite allergy prevention and treatment. Secondary outcomes involved analysing the interaction between these factors using pathway analysis.

RESULTS

Parents of children undergoing desensitisation treatment exhibited higher scores for all items of knowledge, attitude and overall practice than those without desensitisation therapy (all p values<0.05). The pathway analyses revealed that in the non-desensitisation group, knowledge directly affected attitude (β=0.22, p<0.001) and attitude directly affected practice (β=0.16, p<0.001), but the knowledge did not affect practice (β=-0.01, 0.06, p<0.001). In the desensitisation group, knowledge directly affected attitude (β=0.13, p=0.028), but the practice was not affected by attitude (β=0.08, p<0.001) or knowledge (β=0.03, 0.12, p<0.001).

CONCLUSIONS

The study highlighted differing levels of KAP among parents of children with dust mite allergies. The KAP was influenced by desensitisation therapy status. While attitudes tended to be favourable, practices were suboptimal, particularly among parents whose children did not receive desensitisation treatment. These findings emphasise the importance of targeted educational interventions to enhance parental awareness and practices regarding dust mite allergy management, especially in cases where desensitisation treatment is not pursued. Further research is warranted to explore effective strategies for improving parental engagement and adherence to preventive measures.

Cultural & region-specific adaptation of KAP (Knowledge, attitude, and practice) tool to capture healthy lifestyle within primary care settings

BACKGROUND

Non-communicable diseases contribute to a significant global burden of disease and are associated with modifiable risk factors such as physical inactivity, unhealthy diet, tobacco use and excessive alcohol consumption. These risk factors are closely related with lifestyles and eating patterns which are often culturally embedded and managed differently in various health care settings.

AIM OF THE STUDY

To assesses the applicability and feasibility of the KAPS (Knowledge, attitude, and practice) survey in generating data about knowledge, attitudes, and practices about healthy lifestyles within eastern Mediterranean settings and providing foundations for testing other models or development of a newer model in this area which captures and influence behavior changes towards healthy lifestyles.

METHODS

The KAP survey was tailored to capture the construct of healthy lifestyles (within the context of Qatar primary care settings) by reviewing existing surveys, adaptation to local context, expert consultation and feedback, pilot testing, feedback analysis, cognitive interviews and translation and validation.

RESULTS

The study reports that most participants found the content comprehensive, relevant, easy to understand but considered it lengthy. Analysis of grading of the 73 questionnaire items (complete questionnaire included as supplementary document) included by the panel of experts (n = 13) demonstrated that more than half of questions (52.1%) have a CVR value of 1. Thematic analysis of overall perceptions of the service users (n = 11) pertaining to the feasibility of the KAP survey identified three important themes which included i) clarity & readability of the questions ii) relevance of the instrument and iii) factors influencing service users' participation in survey.

CONCLUSION

A culturally sensitive and region specific KAP tool specifically designed for healthy lifestyles can aid in health advocacy, monitoring modifiable risk factors, capturing rich epidemiological data to design preventive interventions, surveillance of high risks patients and strengthening the existing health information systems. Further research is needed to explore evidence-based methodologies to formulate an age-specific and shorter version of KAPs survey without compromising the validity of the tool within specific regional primary healthcare settings.

Diagnosis and treatment of occupational burnout in the Swiss outpatient sector: A national survey of healthcare professionals' attributes and attitudes

We aimed to describe the attributes and attitudes of Swiss health professionals who treat persons with occupational burnout (POB) in the outpatient sector and explore associated determinants. The study design was descriptive cross-sectional survey, distributed to the 16,883 general practitioners (GP), psychiatrist-psychotherapists (PP), occupational physicians (OP) and psychologists registered in the Swiss Medical Association, the Swiss Federation of Psychologists, and other specialized associations. Using an online questionnaire, we identified professionals who consult and treat POB, their attributes, volume of POB consultations, diagnostics and treatment modalities and outcomes (OB severity, average proportion of POB who returned to work and who relapsed). Multinomial regression analysis was conducted to identify attributes associated with these outcomes. Among 3216 respondents, 2951 reported to consult POB, and 1130 (713 physicians and 410 psychologists) to treat them. POB consultations constitute 5 to 25% of professionals' consultations, which varies across professionals' specialties and specializations and geographic regions. The profile of POB consulted also differs across professionals. Work psychologists reported more often consulting POB at early OB stage, GPs mostly reported having patients with moderate OB, while PPs reported having the largest proportion of patients with severe OB. The treatment practices depend on OB severity but neither latter nor former was associated with the proportion of relapsed POB or POB who return to work. Physicians with waiting time >3 months reported more often having a higher proportion of relapsed patients. Since the study had an exploratory nature using a cross-sectional survey design and aggregated outcomes, these findings should be considered as first descriptive data, motivating further research.

Knowledge, Attitudes, and Practices Towards Exercise Therapy Among Patients with Stage 5 Chronic Kidney Disease on Regular Hemodialysis

Background

Exercise therapy could improve physical and psychological health in patients with chronic kidney disease (CKD). This study aimed to investigate knowledge, attitudes and practices (KAP) towards exercise therapy among patients with CKD stage 5 on regular hemodialysis.

Methods

The cross-sectional study was conducted between August 1st and 30th, 2023; KAP and demographic characteristics of CKD-5 patients were assessed with self-distributed questionnaire and analyzed using logistic regression and structural equation modeling (SEM). A higher score represented better knowledge, more positive attitude, and more proactive practice.

Results

In 513 collected questionnaires, mean scores for knowledge, attitudes, and practices were 9.5 ± 4.1 (possible range: 0-13), 31.9 ± 5.0 (possible range: 9-45), and 21.7 ± 9.3 (possible range: 9-45). Multivariate logistic regression analysis showed that education (OR = 1.8, 95% CI: 1.1-3.0, P = 0.02), income (OR = 1.7, 95% CI: 1.1-2.6, P = 0.02), and family support (OR = 3.8, 95% CI: 2.0-7.1, P < 0.001) were independently associated with higher knowledge scores. Knowledge score (OR = 5.1, 95% CI: 1.7-15.1, P < 0.001) and attitude score (OR = 7.3, 95% CI: 3.7-14.2, P < 0.001) were independently associated with higher practice scores. According to SEM, knowledge directly influenced attitude (β=1.3, P < 0.001), while attitude influenced practice (β=0.8, P < 0.001).

Conclusion

Patients with CKD-5 who underwent regular hemodialysis demonstrated insufficient knowledge, passive attitude and inactive practices towards exercise therapy. Improving knowledge and attitude through educational interventions might result in better practice.

Knowledge, attitude and practice towards postoperative management among patients with type A aortic dissection or their relatives: a cross-sectional study in China

OBJECTIVES

To assess the knowledge, attitude and practice (KAP) of patients with type A aortic dissection (AD) or their relatives regarding postoperative management.

DESIGN

Cross-sectional study.

SETTING

The participants were recruited from three hospitals between October 2022 and February 2023.

PARTICIPANTS

Patients diagnosed with type A AD or their relatives.

INTERVENTIONS

No interventions were administered. A structured questionnaire was used to gather the demographic and KAP data from the participants.

PRIMARY AND SECONDARY OUTCOME MEASURES

The outcome measures included the levels of KAP regarding postoperative management.

RESULTS

A total of 483 participants were included. They exhibited poor knowledge (15.52±7.67, possible score: 0-32), positive attitude (31.10±5.86, possible score: 9-45) and poor practice (21.96±4.83, possible score: 8-40) towards postoperative management. The multivariable logistic analysis showed that knowledge scores (OR=1.09, 95% CI 1.05 to 1.12, p<0.001), attitude scores (OR=1.22, 95% CI 1.16 to 1.29, p<0.001) and diagnosis for ≤5 years (OR=1.97, 95% CI 1.23 to 3.15, p=0.005) were independently associated with good practice. The structured equation modelling analysis showed that knowledge directly influenced attitudes (β=0.22, p<0.001) and practice (β=0.15, p<0.001), while attitude directly impacted practice (β=0.52, p<0.001) and mediated the relationship between knowledge and practice (β=0.11, p<0.001).

CONCLUSIONS

Patients with type A AD and their relatives have poor knowledge, positive attitudes and poor practice towards postoperative management. Knowledge might be the prerequisite for practice, and attitudes have a mediating effect.

Knowledge, attitudes and practice questionnaires in dengue, Zika, chikungunya and yellow fever settings: a scoping review protocol

INTRODUCTION

Arboviruses are a broad classification of viral pathogens that require vectors such as mosquitoes for infection transmission. The burden of arboviral diseases worldwide is substantial, affecting millions of people annually, with the Aedes aegypti mosquito responsible for spreading several common arboviruses, including dengue, chikungunya, Zika and yellow fever. One public health strategy to control and prevent these viruses is to influence community members' behaviours related to reducing the breeding sites of Aedes mosquitoes, and knowledge, attitudes and practice (KAP) questionnaires are often used as part of these education campaigns.

OBJECTIVES

To explore the content of KAP questionnaires and methodologies used to evaluate arboviral infections, focusing on dengue, Zika, chikungunya and yellow fever.

METHODS AND ANALYSIS

To identify and describe KAP questionnaires for the selected arboviral infections, a scoping review will be performed and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review Extension guidelines. Scientific databases such as MEDLINE, Cochrane, EMBASE, Web of Science, Scielo and LILACS will be searched systematically. Two independent reviewers will screen the title and abstract, followed by a full-text review of the selected articles using the COVIDENCE platform. The extracted information will include citation details, the type of arbovirus, the type of questions in each domain, the scoring system, the theoretical framework and the statistical analysis. The results will be presented comprehensively in tables and figures.

ETHICS AND DISSEMINATION

Ethics approval is not required. Knowledge transfer will be conducted through conference presentations and publications.

Physicians and hospital pharmacists' knowledge, attitudes, and practices towards polypharmacy in older patients with chronic diseases

This web-based cross-sectional study aimed to evaluate the knowledge, attitudes, and practices of physicians and hospital pharmacists towards polypharmacy in older adult patients with chronic diseases in China. This study enrolled 374 physicians and pharmacists (270 females, 92 physicians) in 20 Chinese provinces between December 2022 and March 2023. The knowledge, attitude, and practice scores were 12.65 ± 2.05 (possible range, 0-18), 29.07 ± 2.68 (possible range, 7-35), and 26.16 ± 5.56 (possible range, 7-35), respectively. Working as a hospital pharmacist (vs. physician) was independently associated with adequate knowledge (OR = 2.190; 95% CI = 1.291-2.713; P = 0.004). Working in a tertiary hospital (OR = 4.296; 95% CI = 1.390-13.272; P = 0.011) was independently associated with a positive attitude. Knowledge score (OR = 1.176; 95%CI = 1.038-1.333; P = 0.011), hospital pharmacist (OR = 0.276; 95% CI = 0.137-0.557; P < 0.001), master's degree or higher (OR = 1.754; 95% CI  = 1.011-3.045; P = 0.046) and senior professional title (OR = 2.020; 95% CI = 1.032-3.952; P = 0.040) were independently associated with proactive practice toward polypharmacy in older adults. Physicians and hospital pharmacists had favorable knowledge, positive attitudes, and proactive practice toward polypharmacy. In conclusion, enhancing knowledge through continuous education, promoting interprofessional collaboration, educating patients, and conducting regular evaluations for quality improvement are necessary to improve the KAP of healthcare professionals toward polypharmacy in older adults.

Knowledge, attitudes and practices toward cervical cancer screening among ethnic minorities in inner Mongolia, China

AIMS

This study aimed to assess the knowledge, attitudes and practices (KAP) towards cervical cancer screening among ethnic minorities in Inner Mongolia, China.

METHODS

A cross-sectional study was conducted in Inner Mongolia between May and September, 2023, and recruiting participants undergoing dual-cancer screening. Demographic characteristics and KAP status were assessed using a self-administered questionnaire.

RESULTS

A total of 533 valid questionnaires were collected, with 53.66% aged 40 years or younger. Mean scores for knowledge, attitude, and practice were 13.58 ± 5.41, 41.06 ± 4.53, and 13.35 ± 1.53, respectively. Positive associations were found between knowledge and attitude (r = 0.348, p < 0.001), knowledge and practice (r = 0.288, p < 0.001), and attitude and practice (r = 0.817, p < 0.001). Structural equation modelling confirmed direct positive associations between knowledge and attitude (path coefficient = 0.307, p < 0.001) and attitude and practice (path coefficient = 0.270, p < 0.001). Additionally, knowledge demonstrated an indirectly positive association with practice (path coefficient = 0.083, p = 0.007).

CONCLUSION

Ethnic minorities in Inner Mongolia exhibit insufficient knowledge, positive attitudes, and proactive practices toward cervical cancer screening. Implementing targeted educational initiatives is crucial to enhance their KAP.

Knowledge, attitude and practices of ayurvedic medicine practitioners in Kerala towards millets and millet-based diet: a prospective cross-sectional online survey study

Introduction

Diet and lifestyle play pivotal roles in Ayurveda's preventive and therapeutic principles. The rich culinary heritage of Kerala harmoniously aligns with Ayurvedic dietetic principles. With the recent designation of 2023 as the International Year of Millets, there has been a surge of interest in integrating millets into dietary practices worldwide. Ayurveda physicians are poised to offer nutritional guidance to endorse health.

Methods

A cross-sectional online survey was conducted from 26 July to 9 August 2023 among Ayurveda practitioners in Kerala. The survey used a semi-structured questionnaire finalised through the face and content validity, comprising eight items each for knowledge, attitudes and practices (KAP) domains. A target sample size of 422 participants was determined through convenience sampling methodology. Spearman's rank correlation test was used to examine the correlations between KAP while binary logistic regression analyses were employed to identify determinants associated with favourable levels of KAP among participants.

Results

A total of 386 complete responses were used for analysis. The average scores for KAP items were 5.21, 6.36 and 5.34, respectively, (range 0-8). It was found that better Knowledge scores were associated with more favourable Attitudes towards the prescription of millet-based diet (MBD) (adjusted Odd's Ratio (AOR): 3.04) and even more positive responses towards Practice (AOR: 8.59).

Conclusion

The knowledge of Ayurveda practitioners in Kerala regarding the use of MBD is satisfactory. There is a significant relationship between Knowledge and Attitude as well as Practice. This study has underscored the importance of education and awareness in shaping favourable attitudes and practices related to MBD, aligning with Ayurvedic principles. Despite practitioners demonstrating good KAP behaviour towards MBD, gaps persist in certain aspects of contemporary knowledge and limitations in translating knowledge into practice. Addressing these gaps and barriers is essential to promote the widespread adoption and prescription of MBD.

Unlocking insights: Mahout's perceptions and practices in managing Elephant Endotheliotropic Herpesvirus (EEHV) infection among captive Asian elephants in Surin province, Thailand

Surin, situated in the northeastern region of Thailand, has earned the reputation of being an "elephant village" due to its high captive elephant population and unique tradition of elephant rearing. However, the continuous occurrence of elephant endotheliotropic herpesvirus (EEHV) infection poses a significant threat to elephants, particularly the young ones. This study investigated various aspects of EEHV-related elephant care among ninety-two mahouts at the Surin Elephant Kingdom Project. This study used semi-structured interviews and observations to assess the mahouts' knowledge, attitude, and practice (KAP scores) toward EEHV transmission, prevention, and management. The result revealed knowledge and practice scores below expectations, indicating an insufficient understanding the nature of disease and preventive measures. However, the mahouts exhibited awareness of the severity of the disease and factors contributing to transmission risk. Regarding the relationship among KAP scores, a positive correlation was observed at a low level (p < 0.05) between the knowledge and practice scores. Interestingly, approximately 55% of the survey respondents were confident that their elephants would not receive EEHV, leading to inadequate prevention measures. From the result, it is crucial to provide comprehensive knowledge about the nature of the disease and preventive measures to all mahouts. This education should emphasize the importance of early monitoring signs, appropriate weaning age, and preventing viral transmission practices. The KAP survey offers valuable insights that can identify areas requiring improvement and guide the development of effective and targeted disease prevention programs within the specific population. Therefore, it is recommended that the KAP survey should be employed in other parts of the country where the elephant management system differs.

Knowledge, attitude and practice towards arthroscopic shoulder surgery in patients with rotator cuff tear: cross-sectional study

OBJECTIVES

This cross-sectional study aimed to explore the knowledge, attitude and practice (KAP) of patients with rotator cuff tears towards arthroscopic shoulder surgery (ASS), based on the hypothesis that the knowledge of the procedure among patients would be sufficient, which in turn might influence their practice and attitude.

DESIGN

Cross-sectional study.

SETTING

Patients were recruited from Tong Ren Hospital between September and October 2022.

PARTICIPANTS

A total of 588 patients were included in the study.

INTERVENTIONS

No interventions were administered.

PRIMARY AND SECONDARY OUTCOME MEASURES

Knowledge, attitude and practice scores were measured using a self-administered questionnaire.

RESULTS

Out of 588 patients included, 50.51% had undergone ASS. Lower education level and monthly income, shorter weekly exercise time and shorter disease duration were identified as independent risk factors for the KAP total score. Structural equation modelling revealed a direct positive effect of knowledge on attitude, but neither knowledge nor attitude influenced practice scores.

CONCLUSIONS

Patients with rotator cuff tears demonstrated relatively poor knowledge, a neutral attitude and moderate practice towards ASS, highlighting the need for patient education and counselling to enhance understanding and decision-making regarding ASS.

Describing Community-Based Nurses' Knowledge, Attitudes, and Practices in the Nutritional Care of Older Adults: Results of a UK Survey

PURPOSE

To ascertain current nutritional knowledge and training needs of community-based nurses caring for older adults in the United Kingdom.

METHOD

A descriptive cross-sectional, anonymized, online survey of nurses' knowledge, attitudes, and practices related to older adults' nutrition was developed. Community-based nurses working with older adults in the United Kingdom were recruited via social media and convenience sampling.

RESULTS

Responses were received from 194 community-based nurses. Nutritional care was seen as a multidisciplinary responsibility by 62% of participants. Most undertook nutrition screening (93%), were confident in providing nutritional advice (83%), and ease of identifying those in need (88%) was high. However, some aspects of nutritional knowledge were less complete, including recommended daily intakes of protein (60% unsure) and fiber (52% unsure).

CONCLUSION

High confidence in delivering nutritional advice contrasted with uncertainty around some aspects of nutritional knowledge, suggesting opportunities to improve training on the nutritional needs of older adults. [Journal of Gerontological Nursing, 50(11), 13-19.].

Amend the Mental Health Care Act 2017: A Survey of Indian psychiatrists (Part 2)

Background

Information about the experience of practicing psychiatrists with the use of the Mental Health Care Act (MHCA), 2017, India, after 5 years of its promulgation has not been available.

Aim

The present study was carried out to understand the experience of the practicing psychiatrists in using and complying with the MHCA 2017 and to bring out the problems and suggested reforms, if any, in various provisions of the MHCA 2017.

Methods

An online survey by practicing psychiatrists of Indian Psychiatric Society on the various sections and provisions of the MHCA 17 was carried out through structured and open-ended responses. This paper presents the qualitative analysis of the open-ended responses.

Results

There were 600 respondents, who gave a total of 1239 (range 116-154) responses to eight open-ended questions about various provisions of the MHCA. Qualitative analysis revealed that most respondents opined for keeping the General Hospital Psychiatry units exempted from inclusion as the mental health establishment, thus treating physical illness at par with the mental illness; a separate stand-alone law for mental illness perpetuates stigma, asked for a larger representation of psychiatrists in the State Mental Health Authority and Mental Health Review Boards. Most respondents opined that the provisions of capacity assessment, nominated representative, and advance directive are a hinderance in treatment and should be amended; treating psychiatrists and family/caregiver's consent should suffice for supported admission, just like in other disciplines of medicine; and MHCA 2017 needs major amendments/repeal to make it convenient for patient care. Any unauthorized places/centers where persons with mental illness are kept should come under regulatory control of the state mental health authorities.

Conclusion

The survey has highlighted several deficiencies and operational difficulties in the current Act that hinder the delivery of mental health care to patients with mental illness in the country and need amendments.

Evaluation of Knowledge, Attitudes, and Practices towards Colorectal Cancer in a Community in Mexico City: A Cross-Sectional Study Based on Surveys

Colorectal cancer (CRC) is one of the most common and deadly neoplasms worldwide, with a growing burden in low- and middle-income countries, such as Mexico. This study seeks to evaluate the knowledge, attitudes, and practices related to CRC in a community in Mexico City. A cross-sectional survey was conducted between March and April 2023 among adults aged 45 to 74 residing in six neighborhoods of the Tlalpan borough in Mexico City. The questionnaire included sections on sociodemographic characteristics, medical family history, lifestyle habits, knowledge about CRC, attitudes towards prevention, and willingness to undergo screening. Data were analyzed using logistic regression models to identify factors associated with greater knowledge, attitudes, and practices. A total of 349 people were surveyed. A total of 35.2% reported knowing what CRC is, with greater knowledge of CRC being associated with higher education levels and having a family history of cancer. A total of 23.8% showed positive attitudes towards CRC screening, influenced by having a tertiary level of education. A total of 80.8% of participants expressed willingness to undergo CRC screening if offered, with lower intention observed among men. Levels of knowledge about CRC within the studied community are low, especially among those with lower education levels and without a family history of cancer. Intervention strategies should improve CRC education and foster positive attitudes towards early detection, particularly in high-risk groups.

Knowledge, attitude, and practice toward advanced precision radiotherapy among patients with head and neck cancer

Background

Advancements in radiotherapy (RT) technology have led to the prominence of precision RT in head and neck cancer (HNC) treatment. The new progress in precision RT offers more efficient therapy, potentially improving outcomes for HNC patients.

Objective

The present cross-sectional study aimed to assess the knowledge, attitude, and practice (KAP) of patients in advanced precision RT for HNC treatment.

Methods

This study enrolled HNC patients at the Affiliated Hospital of Hebei University of Engineering between October 2023 and May 2024. Then, the demographic data and KAP scores were collected using an investigator-designed questionnaire. Afterwards, descriptive statistics were provided for all study variables, and the relationship among KAP was analyzed using appropriate statistical tests, including Spearman correlation, logistic regression, and path analysis.

Results

A total of 436 participants with a mean age of 52.03 ± 12.19 years old were included. The mean knowledge score, attitude score, and practice score were 18.33 ± 4.21, 36.14 ± 1.71, and 26.26 ± 1.83, respectively. Although most of the participants were unfamiliar with advanced precision RT, they expressed a high willingness to follow their doctor's recommendation for this treatment. The multivariable analysis revealed a positive association between attitude score and proactive practice. The path analysis revealed that knowledge directly influenced attitude and practice, while attitude directly impacted practice.

Conclusion

HNC participants had poor knowledge of advanced precision RT techniques, but had a positive attitude and the willingness to undergo treatment when recommended by their physicians. These results suggest that improving patients' awareness for advanced precision RT can help to promote better attitude and advanced precision RT practice.

A qualitative approach to understanding the drivers of unequal receipt of definitive therapy for Black men with prostate cancer in Massachusetts

BACKGROUND

Despite mandated insurance coverage since 2006 and robust health infrastructure in urban settings with high concentrations of minority patients, race-based disparities in prostate cancer (PCa) treatment persist in Massachusetts. In this qualitative study, the authors sought to identify factors driving inequities in PCa treatment in Massachusetts.

METHODS

Four hospitals offering PCa treatment in Massachusetts were selected using a case-mix approach. Purposive sampling was used to conduct semistructured interviews with hospital stakeholders. Additional interviews were conducted with representatives from grassroots organizations providing PCa education. Two study staff coded the interviews to identify major themes and recurrent patterns.

RESULTS

Of the 35 informants invited, 25 participated in the study. Although national disparities in PCa outcomes were readily discussed, one half of the informants were unaware that PCa disparities existed in Massachusetts. Informants and grassroots organization representatives acknowledged that patients with PCa are willing to face transportation barriers to receive treatment from trusted and accommodating institutions. Except for chief equity officers, most health care providers lacked knowledge on accessing or using metrics regarding racial disparities in cancer outcomes. Although community outreach was recognized as a potential strategy to reduce treatment disparities and engender trust, informants were often unable to provide a clear implementation plan.

CONCLUSIONS

This statewide qualitative study builds on existing quantitative data on the nature and extent of disparities. It highlights knowledge gaps in recognizing and addressing racial disparities in PCa treatment in Massachusetts. Improved provider awareness, the use of disparity metrics, and strategic community engagement may ensure equitable access to PCa treatment.

PLAIN LANGUAGE SUMMARY

Despite mandated insurance and urban health care access, racial disparities in prostate cancer treatment persist in Massachusetts. This qualitative study revealed that, although national disparities were acknowledged, awareness about local disparities are lacking. Stakeholders highlighted the importance of ancillary services, including translators, rideshares, and navigators, in the delivery of care. In addition, whereas hospital stakeholders were aware of collected equity outcomes, they were unsure whether and who is monitoring equity metrics. Furthermore, stakeholders agreed that community outreach showed promise in ensuring equitable access to prostate cancer treatment. Nevertheless, most interviewed stakeholders lacked clear implementation plans.

Knowledge, attitude, and practice of chronic insomnia management among general practitioners in China: a cross-sectional survey

BACKGROUND

Chronic insomnia is a common yet often overlooked issue in primary health care. This study investigated the knowledge, attitude, and practices of chronic insomnia management among general practitioners (GPs).

METHODS

A cross-sectional online survey was conducted among GPs providing routine care to adults with insomnia in health facilities at all levels in Sichuan Province, China. Additionally, we designed an online questionnaire that included basic information and knowledge, attitudes, and practices regarding chronic insomnia management.

RESULTS

We included 420 GPs, 66.2% of whom were female and 58.1% were from community health service centers. Total 198 (47.1%) GPs had received specific training and only 2 GPs (0.5%) correctly answered the knowledge-related questions. Furthermore, only 44 GPs (10.5%) demonstrated excellent practice behaviors, while most GPs (70.2%) expressed high demand for training in insomnia management. Insomnia training experience was associated with higher practice scores (β = 3.318, p < 0.001).

CONCLUSION

This study established an association and correlation between knowledge, attitude, and practice scores in treating insomnia and the sociodemographic characteristics of GPs in China. Although knowledge and practice performance in this field need to be improved, they mostly displayed a positive attitude towards insomnia management. Thus, offering continuing education opportunities to GPs would be highly beneficial.