Validity and reliability of an adapted questionnaire measuring knowledge, awareness and practice regarding familial hypercholesterolaemia among primary care physicians in Malaysia

Development, validation and reliability of a questionnaire to evaluate coaches' and players' perceptions, learning, and resources regarding the ruck in rugby union

Background

The lack of a reliable research tool for assessing the attitudes, behaviours, and learning resources of rugby coaches and players regarding the ruck event is a significant gap in rugby research.

Objectives

This study aimed to adapt an existing questionnaire focused on the tackle event and to validate and establish the reliability of the instrument. The questionnaire explores the attitudes, behaviours, and learning resources of rugby coaches and players, with a focus on the ruck event and its impact on coach and player development, as well as coaching practices.

Methods

A seven-step design process was followed to validate the questionnaire's content, construct, clarity, and relevance. A panel of 12 experts evaluated the questionnaire, followed by a test-retest procedure involving 15 coaches and 16 players, highlighting the effectiveness of this questionnaire, and emphasising its potential to generate data that can impact the field of rugby coaching and player development.

Results

The questionnaire was deemed appropriate and clear by the expert panel, with an average completion time of 22 minutes. Moderate to good agreement was observed among players (ICC Agreement = 0.71) and coaches (ICC Agreement = 0.88), with high response consistency (ICC Consistency = 0.71 for players and 0.87 for coaches). Significant agreement was also found in Kendall's W scores (players = 0.85, coaches = 0.93, p<0.01).

Conclusion

This study presents a developed questionnaire noted for its clarity, reliability, and consistency. It serves as a valuable tool for future rugby research, with the potential to impact coach and player development significantly.

Clinical Decision Support Requirements for Ventricular Tachycardia Diagnosis Within the Frameworks of Knowledge and Practice: Survey Study

BACKGROUND

Ventricular tachycardia (VT) diagnosis is challenging due to the similarity between VT and some forms of supraventricular tachycardia, complexity of clinical manifestations, heterogeneity of underlying diseases, and potential for life-threatening hemodynamic instability. Clinical decision support systems (CDSSs) have emerged as promising tools to augment the diagnostic capabilities of cardiologists. However, a requirements analysis is acknowledged to be vital for the success of a CDSS, especially for complex clinical tasks such as VT diagnosis.

OBJECTIVE

The aims of this study were to analyze the requirements for a VT diagnosis CDSS within the frameworks of knowledge and practice and to determine the clinical decision support (CDS) needs.

METHODS

Our multidisciplinary team first conducted semistructured interviews with seven cardiologists related to the clinical challenges of VT and expected decision support. A questionnaire was designed by the multidisciplinary team based on the results of interviews. The questionnaire was divided into four sections: demographic information, knowledge assessment, practice assessment, and CDS needs. The practice section consisted of two simulated cases for a total score of 10 marks. Online questionnaires were disseminated to registered cardiologists across China from December 2022 to February 2023. The scores for the practice section were summarized as continuous variables, using the mean, median, and range. The knowledge and CDS needs sections were assessed using a 4-point Likert scale without a neutral option. Kruskal-Wallis tests were performed to investigate the relationship between scores and practice years or specialty.

RESULTS

Of the 687 cardiologists who completed the questionnaire, 567 responses were eligible for further analysis. The results of the knowledge assessment showed that 383 cardiologists (68%) lacked knowledge in diagnostic evaluation. The overall average score of the practice assessment was 6.11 (SD 0.55); the etiological diagnosis section had the highest overall scores (mean 6.74, SD 1.75), whereas the diagnostic evaluation section had the lowest scores (mean 5.78, SD 1.19). A majority of cardiologists (344/567, 60.7%) reported the need for a CDSS. There was a significant difference in practice competency scores between general cardiologists and arrhythmia specialists (P=.02).

CONCLUSIONS

There was a notable deficiency in the knowledge and practice of VT among Chinese cardiologists. Specific knowledge and practice support requirements were identified, which provide a foundation for further development and optimization of a CDSS. Moreover, it is important to consider clinicians' specialization levels and years of practice for effective and personalized support.

Korean Version of the Nursing Student Attitudes and Knowledge toward Lesbian, Gay, Bisexual, and Transgender Patients Scale

AIM

This study aimed to analyze the reliability and validity of a Korean version of the Nursing Student Attitudes and Knowledge Toward Lesbian, Gay, Bisexual, and Transgender Patients (K-NAKL) Scale, which measures health and heterosexual attitudes toward LGBT individuals.

BACKGROUND

Lesbian, gay, bisexual, and transgender (LGBT) individuals often face discrimination and a lack of care experience on the part of healthcare professionals.

INTRODUCTION

In South Korea, the current knowledge and attitude measurement tools for medical staff regarding LGBT individuals are limited, as they only focus on homosexuality and do not account for different sexual orientations.

METHODS

The participants were 217 nursing college students aged 18-25. The item-total correlations method and Cronbach's alpha coefficient were used to analyze internal consistency reliability. Face validity, content validity, construct validity, and criterion validity testing were conducted to establish scale validity. We made sure to follow STROBE guidelines when carrying out this research.

RESULTS

The K-NAKL is a culturally appropriate instrument used to measure the attitudes and knowledge of Korean nursing students when it comes to LGBT health.

DISCUSSION

As LGBT health is increasingly gaining social interest, the nursing education curriculum needs to produce culturally competent graduates to meet the health needs of this vulnerable and marginalized population. The current study contributes to that goal.

CONCLUSION

The K-NAKL is a valid and reliable tool with which to measure attitudes and knowledge regarding LGBT health among Korean nursing students.

IMPLICATIONS FOR NURSING

The K-NAKL can enable Korean nursing students to increase their knowledge and improve their attitudes when caring for the LGBT population.

IMPLICATIONS FOR NURSING POLICY AND HEALTH POLICY

The study highlights the importance of incorporating LGBT-related health education into nursing curricula and developing inclusive policies to improve the quality of care and health outcomes for LGBT individuals.

A mixed methods study of the awareness and management of familial hypercholesterolaemia in Irish general practice

Introduction

Familial Hypercholesterolemia (FH) is one of the most common genetic disorders, with an estimated global prevalence of 1:200-500, which leads to premature cardiovascular disease. Nevertheless, public and professional awareness of FH is often lacking, with an estimated 20,000 largely undiagnosed cases in Ireland.

Purpose

The overall aim of the project was to test the feasibility of a model of care that would include electronic record screening, clinical assessment, and coding of possible FH patients across a network of general practices in Ireland. In addition, a secondary aim was to gauge the awareness and knowledge of FH across the network.

Methods

This study took part in multiple phases, employing a mixed methods design. The study included a validated questionnaire, tailored online educational resources, a retrospective chart review of patients with a history of elevated LDL cholesterol (LDLc) and an active review with a selection of those patients. Results were analyzed using SPSS V27, where descriptive statistics and relevant correlation tests were employed.

Results

Eighteen general practices agreed to take part in the study. In the initial survey, respondents rated their personal and practice familiarity with FH as slightly below average. Around one-third of respondents were not aware of FH guidelines. Of over 55,000 adult patient records searched, only 0.2% had a recorded FH diagnosis and 3.9% had ever had an LDLc above 4.9 mmol/l. Eight practices completed 198 chart reviews. Among these, 29.8% of patients had a family history recorded, and 22.2% had a family history of CVD recorded. Female patients had higher averages for highest and recent LDLc. Seventy patients underwent a clinical review-with 27% of these patients identified as "probable" or "definite FH." There was a statistically significant (p = 0.002) relationship between FH status and whether the patient had other CVD risk factors.

Conclusion

General practitioners in Ireland had similar levels of awareness of FH compared to findings from elsewhere. The activities discussed encouraged clinicians to consider FH when talking to their patients, especially those with elevated LDLc at an early age. Broader awareness of the condition could increase conversations about FH and benefit patient outcomes.

Factors Associated with Screening Mammogram Uptake among Women Attending an Urban University Primary Care Clinic in Malaysia

Screening mammograms have resulted in a reduction in breast cancer mortality, yet the uptake in Malaysia was low. This study aimed to determine the prevalence and factors associated with screening mammogram uptake among women attending a Malaysian primary care clinic. A cross-sectional study was conducted among 200 women aged 40 to 74 attending the clinic. The data was collected using questionnaires assessing sociodemographic, clinical characteristics, knowledge and health beliefs. Multiple logistic regression was used to identify factors associated with mammogram uptake. The prevalence of screening mammograms was 46.0%. About 45.5% of women with high breast cancer risk had never undergone a mammogram. Older participants, aged 50 to 74 (OR = 2.57, 95% CI: 1.05, 6.29, p-value = 0.039) and those who received a physician’s recommendation (OR = 7.61, 95% CI: 3.81, 15.20, p-value < 0.001) were more likely to undergo screening mammography. Significant health beliefs associated with mammogram uptake were perceived barriers (OR = 0.81, 95% CI: 0.67, 0.97, p-value = 0.019) and cues to action (OR = 1.30, 95% CI: 1.06, 1.59, p-value = 0.012). Approximately half of the participants and those in the high-risk group had never undergone a mammogram. Older age, physician recommendation, perceived barriers and cues to action were significantly associated with mammogram uptake. Physicians need to play an active role in promoting breast cancer screening and addressing the barriers.