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Aksay H, Kus C, Gumustakim RS. Circumcision Knowledge and Opinions of Primary Healthcare Workers: The Case of Turkey. JOURNAL OF RELIGION AND HEALTH 2022; 61:4887-4902. [PMID: 36109468 DOI: 10.1007/s10943-022-01661-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/27/2022] [Indexed: 06/15/2023]
Abstract
This study evaluates the knowledge levels and opinions of Islamic primary healthcare workers regarding the medical indications of circumcision, its mode of application, contraindications, and possible complications together with the current literature. Our study was conducted with the participation of 400 healthcare personnel having Islamic faith and working in primary healthcare centers in Kahramanmaras. Data were collected through in-person interviews with healthcare workers who completed our questionnaire consisting of 52 questions and designed based on a literature review. SPSS 21 was used to evaluate the collected data statistically. Findings were considered statistically significant if the p-value was lower than 0.05. We evaluated these participants in terms of their levels of knowledge on circumcision. None of the participants had a very high knowledge level. In correlation analysis, it was detected that age (r = 0.194, p < 0.001) and duration of employment in the profession (experience) (r = 0.164, p = 0.001) were positively correlated with knowledge level. Those who found circumcision necessary mostly justified its necessity due to medical benefits (n = 321, 80.3%) and/or religious obligations (n = 242, 60.5%). Our study demonstrates the importance of providing information about circumcision, including the information from the current literature, to primary healthcare workers together with theoretical training and practice both during their formal training and after graduation in Turkey.
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Affiliation(s)
- Halit Aksay
- Department of Family Medicine, Adıyaman Sincik Public Hospital, Kahramanmaraş, Turkey
| | - Celal Kus
- Department of Family Medicine, Kahramanmaraş Sütçü İmam University School of Medicine, Batı Çevreyolu Blv. No: 251/A, 46040, Onikişubat/Kahramanmaraş, Turkey.
| | - Raziye Sule Gumustakim
- Department of Family Medicine, Kahramanmaraş Sütçü İmam University School of Medicine, Batı Çevreyolu Blv. No: 251/A, 46040, Onikişubat/Kahramanmaraş, Turkey
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Morgan AM, Hu YY, Benin A, Lockwood GM. Decision-Making Regarding Newborn Circumcision: A Qualitative Analysis. Matern Child Health J 2021; 25:1972-1980. [PMID: 34709527 DOI: 10.1007/s10995-021-03228-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Circumcision of newborn males is left to parental preference, as medical necessity has not been demonstrated. For medical providers seeking to help parents make decisions and provide informed consent, there is little information regarding how parents gather and process information about circumcision. This study aimed to characterize the comprehensive range of parental attitudes, gaps in knowledge, and decision-making regarding circumcision. METHODS Qualitative data was obtained from semi-structured open-ended interviews conducted during the postpartum hospitalization. Interviews were recorded, transcribed, and coded by multiple independent reviewers. A grounded theory approach was used to identify emergent themes regarding attitudes towards, sources of information about, and decision-making surrounding circumcision. RESULTS Ten mothers were interviewed, of whom six planned to circumcise and four did not. Major themes emerged: the importance of cultural norms, limited yet influential discussions, and the lack of, but desire for, more knowledge. Discussions with medical providers were often limited, though when physician conversation was more extensive, provider input was highly influential. Parents lacked evidence-based knowledge of the risks and benefits of the procedure. They uniformly desire more information and counseling from their medical providers. CONCLUSIONS FOR PRACTICE This study affirms the importance of sociocultural factors and identified a discrepancy between parents' desire for empiric information and the counsel offered by providers, identifying a need for improved parent counseling. The qualitative themes that emerged from this work enabled the development of a comprehensive conceptual model that can be further tested to develop a decision aid for circumcision of the newborn.
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Affiliation(s)
- Allison M Morgan
- Surgical Outcomes and Quality Improvement Center, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Yue-Yung Hu
- Surgical Outcomes and Quality Improvement Center, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Pediatric Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Connecticut Children's Medical Center, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Andrea Benin
- Connecticut Children's Medical Center, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Gina M Lockwood
- Connecticut Children's Medical Center, University of Connecticut School of Medicine, Farmington, CT, USA.
- Department of Urology, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA.
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FalcÃo BP, Stegani MM, TenÓrio SÉB, Matias JEF. Postoperative aesthetic and healing features of postectomy using three different surgical techniques: a randomized, prospective, and interdisciplinary analysis. ACTA ACUST UNITED AC 2020; 47:e20202626. [PMID: 33237182 DOI: 10.1590/0100-6991e-20202626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 07/02/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE to compare the postoperative esthetic and healing aspects of postectomy performed by different surgical techniques, based on the evaluation of different specialty expert professionals. METHODS prospective and randomized clinical trial enrolling 149 preschool children with a medical indication for circumcision, divided into three groups: postectomy with the hemostatic device Plastibell® (PB group), conventional technique (CV group) and conventional with subcuticular stitches (SC group). Pictures were taken from patients at pre-defined angles on the 30th and 60th postoperative days. Photos were evaluated by three specialists (dermatologist, pediatrician and plastic surgeon), who assigned scores from 1 to 5 regarding the esthetic and healing features at each moment. Grades 4 or 5 from all specialists characterized "best result". Data were analysed to compare the used surgical techniques, the judgments from specialties and postoperative complications. RESULTS most of the patients obtained the "best result" regarding healing (70%) and esthetics (56%). The final overall result showed the PB group as the best for healing (p=0.028) and the SC group as the best for esthetics (p=0.002). For the dermatologist, on the 60th postoperative day, the CV group presented the worst aesthetic result, whereas for the pediatrician and the plastic surgeon, the PB group presented the best healing result and the SC group had the best esthetic result. There was no difference between the groups regarding the presence of complications. CONCLUSION the most common surgical techniques used to perform postectomy in children were differently assessed regarding healing and esthetic features by distinct medical professionals. The analysis of these two parameters among experts from related areas diverged among them and over time.
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Affiliation(s)
- Bruno Pinheiro FalcÃo
- - Universidade Federal do Paraná, Departamento de Cirurgia Pediátrica - Curitiba - PR - Brasil
| | - Marcelo Marcondes Stegani
- - Universidade Federal do Paraná, Departamento de Cirurgia Pediátrica - Curitiba - PR - Brasil.,- Universidade Federal do Paraná, Departamento de Cirurgia - Curitiba - PR - Brasil
| | - SÉrgio Bernardo TenÓrio
- - Universidade Federal do Paraná, Departamento de Cirurgia - Curitiba - PR - Brasil.,- Universidade Federal do Paraná, Programa de Pós-graduação em Clínica Cirúrgica - Curitiba - PR - Brasil
| | - Jorge Eduardo Fouto Matias
- - Universidade Federal do Paraná, Departamento de Cirurgia - Curitiba - PR - Brasil.,- Universidade Federal do Paraná, Programa de Pós-graduação em Clínica Cirúrgica - Curitiba - PR - Brasil
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Kankaka EN, Kigozi G, Kayiwa D, Kighoma N, Makumbi F, Murungi T, Nabukalu D, Nampijja R, Watya S, Namuguzi D, Nalugoda F, Nakigozi G, Serwadda D, Wawer M, Gray RH. Efficacy of knowledge and competence-based training of non-physicians in the provision of early infant male circumcision using the Mogen clamp in Rakai, Uganda. BJU Int 2016; 119:631-637. [PMID: 27753243 DOI: 10.1111/bju.13685] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess acquisition of knowledge and competence in performing Early Infant Male Circumcision (EIMC) by non-physicians trained using a structured curriculum. SUBJECTS AND METHODS Training in provision of EIMC using the Mogen clamp was conducted for 10 Clinical Officers (COs) and 10 Registered Nurse Midwives (RNMWs), in Rakai, Uganda. Healthy infants whose mothers consented to study participation were assigned to the trainees, each of whom performed at least 10 EIMCs. Ongoing assessment and feedback for competency were done, and safety assessed by adverse events. RESULTS Despite similar baseline knowledge, COs acquired more didactic knowledge than RNMWs (P = 0.043). In all, 100 EIMCs were assessed for gain in competency. The greatest improvement in competency was between the first and third procedures, and all trainees achieved 80% competency and retention of skills by the seventh procedure. The median (interquartile range) time to complete a procedure was 14.5 (10-47) min for the COs, and 15 (10-50) min for the RNMWs (P = 0.180). The procedure times declined by 2.2 min for each subsequent EIMC (P = 0.005), and rates of improvement were similar for COs and RNMWs. Adverse events were comparable between providers (3.5%), of which 1% were of moderate severity. CONCLUSION Competence-based training of non-physicians improved knowledge and competency in EIMC performed by COs and RNMWs in Uganda.
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Affiliation(s)
| | | | | | | | - Frederick Makumbi
- Rakai Health Sciences Program, Kalisizo, Uganda.,School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | | | | | | | | | - Daniel Namuguzi
- Rakai Health Sciences Program, Kalisizo, Uganda.,Department of Surgery, Makerere University College of Health Sciences, Kampala, Uganda
| | | | | | - David Serwadda
- Rakai Health Sciences Program, Kalisizo, Uganda.,School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Maria Wawer
- Rakai Health Sciences Program, Kalisizo, Uganda.,Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ronald H Gray
- Rakai Health Sciences Program, Kalisizo, Uganda.,Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA
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Knowledge, Attitudes, Practices and Beliefs about Medical Male Circumcision (MMC) among a Sample of Health Care Providers in Haiti. PLoS One 2015; 10:e0134667. [PMID: 26237217 PMCID: PMC4523202 DOI: 10.1371/journal.pone.0134667] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Accepted: 07/13/2015] [Indexed: 12/21/2022] Open
Abstract
Background Haiti has the highest number of people living with HIV infection in the Caribbean/Latin America region. Medical male circumcision (MMC) has been recommended to help prevent the spread of HIV. We sought to assess knowledge, attitudes, practices and beliefs about MMC among a sample of health care providers in Haiti. Methods A convenience sample of 153 health care providers at the GHESKIO Centers in Haiti responded to an exploratory survey that collected information on several topics relevant to health providers about MMC. Descriptive statistics were calculated for the responses and multivariable logistic regression was conducted to determine opinions of health care providers about the best age to perform MMC on males. Bayesian network analysis and sensitivity analysis were done to identify the minimum level of change required to increase the acceptability of performing MMC at age less than 1 year. Results The sample consisted of medical doctors (31.0%), nurses (49.0%), and other health care professionals (20.0%). Approximately 76% showed willingness to offer MMC services if they received training. Seventy-six percent believed that their male patients would accept circumcision, and 59% believed infancy was the best age for MMC. More than 90% of participants said that MMC would reduce STIs. Physicians and nurses who were willing to offer MMC if provided with adequate training were 2.5 (1.15–5.71) times as likely to choose the best age to perform MMC as less than one year. Finally, if the joint probability of choosing “the best age to perform MMC” as one year or older and having the mistaken belief that "MMC prevents HIV entirely" is reduced by 63% then the probability of finding that performing MMC at less than one year acceptable to health care providers is increased by 35%. Conclusion Participants demonstrated high levels of knowledge and positive attitudes towards MMC. Although this study suggests that circumcision is acceptable among certain health providers in Haiti, studies with larger and more representative samples are needed to confirm this finding.
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