Background Human immunodeficiency virus (HIV), the agent responsible for acquired immunodeficiency syndrome, remains a worldwide public health problem. Therefore, this study aimed to assess Portuguese healthcare students’ knowledge of HIV, identify risk behaviors for HIV transmission, and assess the frequency of HIV testing and its dissemination by general practitioners.
Methods A cross-sectional observational study was conducted using an anonymous questionnaire published online. The questionnaire was administered to Portuguese healthcare students who voluntarily agreed to participate in the study after clarifying its objectives and procedures.
Results Most students were aware of the three main HIV transmission routes; however, 66.3% were unaware of the level A recommendation for HIV screening in adolescents and adults. In addition, 59.6% of the students were never informed by their general practitioner about HIV screening tests or risk behaviors for HIV transmission. Of the sample, 78.9% had never been tested for HIV infection. Of the 74.6% of sexually active students, 82.0% had or had already had unprotected sex (without a condom). Men showed riskier sexual behaviors than women. None of the inquiries reported intravenous drug use, and most students (69.9%) never shared personal objects.
Conclusion General practitioners and awareness campaigns need to alert and disseminate HIV screening tests. Sexual health and risk behaviors should be addressed more frequently in schools to educate this population because prevention is the best strategy against HIV transmission/contraction.
Background The awareness and practice of pelvic floor muscle exercise (PFME) in the prevention and reduction of the rate of urinary incontinence among pregnant women was considerably poor, despite the increased prevalence of urinary incontinence during pregnancy across Malaysia. There healthcare providers do not give adequate attention to the potential impact of PFME on urinary incontinence and there is limited local intervention addressed urinary incontinence during pregnancy. The objective of this study was to determine the effectiveness of a newly developed PFME intervention in terms of knowledge, attitude, practice, self-efficacy, and urinary symptoms.
Methods A single-blinded, two-armed, randomized control trial was included pregnant women from 18 to 20 weeks of gestation and was conducted at the Maternity Hospital of Kuala Lumpur. The intervention group received PFME in addition to the usual perinatal care. The data were collected using validated questionnaires at 4 time points: baseline, post-intervention in the early third trimester, late third trimester, and early postnatal period. The intervention effects were analyzed using a generalized estimating equation.
Results The primary analysis included pregnant women who had at least one follow-up; 122 women (71.8%) in the intervention group had significant improvement in knowledge, attitude, practice, and self-efficacy, as well as in the severity of urinary incontinence over time. However, improvement was not observed in self-reported urinary incontinence.
Conclusion PFME can be considered an effective initial intervention to provide information about urinary incontinence prevention to pregnant women.
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Background Breastmilk is the best nourishment for an infant for the first 6 months of life. Health professionals like medical doctors and dentists can help promote and support exclusive breastfeeding. We aimed to assess knowledge, attitudes, exposure, and future intentions toward exclusive breastfeeding among final year medical and dental students at Universiti Sains Malaysia, Kelantan, Malaysia.
Methods A total of 162 students participated in this cross-sectional study that was conducted between May and September of 2015. Self-administered questionnaires were used to collect the variables of interest.
Results Most students knew exclusive breastfeeding is recommended for the first 6 months of life (98.1%). However, some students incorrectly thought formula milk can be given if the infant appears hungry after having been breastfed (61.7%). Additionally, some incorrectly thought expressed breastmilk can be warmed on direct heat (47.5%) and left-over expressed milk can be re-stored (60.5%). Most students agreed that exclusive breastfeeding is easier to practice than formula feeding and that it is the best choice for working mothers. Most students (93.2%) intend to breastfeed their children, and this intention was significantly associated with their experience being breastfed as infants and attitudes toward exclusive breastfeeding.
Conclusion Generally, final year medical and dental students have favorable attitudes and future intentions toward exclusive breastfeeding, although some of them lacked knowledge about certain important aspects of the practice. Past experience of being exclusively breastfed and a more positive attitude toward the practice were associated with their future intentions to practice exclusive breastfeeding.
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Background Pelvic floor muscle exercise is effective for pelvic floor muscle dysfunction. Despite the high prevalence of pelvic floor muscle dysfunction in women in the community, pelvic floor muscle exercise recognition is low in Malaysian society; thus, this intervention is not frequently used . This study assessed the knowledge of, attitudes towards, and use of pelvic floor muscle exercise among antenatal women before and after educational classes. The study also determined factors associated with exercise practice.
Methods An interventional study was conducted in 121 antenatal women selected through systematic random sampling between June and December 2010. Baseline knowledge of, attitude towards, and practice of pelvic floor muscle exercise were assessed using self-administered validated questionnaires at first visit and at 2 months postpartum. All participants attended two exercise education classes on their next two visits before delivery. A paired ttest and multivariate analysis were used for data evaluation.
Results The mean pre-intervention scores for knowledge, attitudes, and practice were 24.98, 24.25, and 3.51, respectively, with statistically significant mean score increments after intervention (P<0.001). The mean differences were 4.67 (95% confidence interval [CI], 3.86–5.49), 3.77 (95% CI, 3.05–4.50) and 3.45 (95% CI, 2.90–4.00) for knowledge, attitudes, and practice, respectively. Lack of baseline information on pelvic floor muscle exercise was significantly associated with practice change following an educational class.
Conclusion Education is effective in improving knowledge of, attitude towards, and practice of pelvic floor muscle exercise. There is a need for greater effort to increase exercise awareness in our community, especially during antenatal class.
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Background : The primary physician may be the first or the only professional who may come in contact with victims of spouse abuse. But little is known about family physician's knowledge of and attitude towards spouse abuse in Korea. Therefore, this study was conducted.
Methods : We selected 191 doctors from the participants of the 2003 annual meeting of the Korean Academy of Family Medicine (KAFM). We distributed a 5 paged questionnaire them to fill out and analyzed 125 cases among them. The questionnaire included social demographic characteristics, individual knowledge of and attitudes toward spouse abuse, individual practice experience, education and training experience, and others.
Results : We found a significant relationship between doctor's knowledge of spouse abuse and intervention after coming in contact with the victim. Also, this study showed that 31.8% of doctors intervened and traced the spouse abuse cases actively after physical treatment of victims, but none of the cases were reported to the police. Among the total 64.7% of the doctors explained that they did not want to intervene because they were afraid of getting involved in a legal situation. Some of the doctors who had prior educational experience concerning spouse abuse showed very significant high rate of actual intervention (P=0.0112).
Conclusion : The more educational experience on spouse violence the doctors had, the more active intervention they showed. Therefore, we need to intensify the practical educational program along with the training medical program targeting medical practitioners. Of course we need to request sacrifice from doctors based on moral principles, but we also need systemic aid and reform to legal system to minimize burden to doctors.
Background : Breastfeeding is not common in Korea despite its known benefits. The role of family physicians is important in promoting breast-feeding since they can provide prenatal and postnatal care on lifelong basis. This paper analyzed a survey of family physicians on their knowledge, attitude, experience, and training concerning breastfeeding.
Methods : The survey was carried out by e-mail enquiry to the residents and board-certified physicians registered in the Korean Academy of Family Medicine. The enquiry was developed by Gary L. Freed composed of 18 questions about knowledge, attitudes, experience, and training. The answers to the questions were analyzed to give frequency and the associations between the variables.
Results : Among the total, 64% of the residents and 76% of the physicians answered yes to whether breastfeeding was the best means of feeding an infant under 6 months of age. Also, 83% of the residents and 85% of physicians answered it was right to quit breastfeeding completely when breast abscess developed. The breastfeeding promotion was done more frequently by those who had personal experience. They had higher rate of educating patients than those who did not (28% vs. 9%, P＜0.0001). Despite its importance, 86.5% of the residents and 77.6% of the physicians answered that they did not have enough opportunity to learn about breastfeeding during their training years.
Conclusion : Although family physicians are required to play a role in promoting breastfeeding, they are insufficiently trained under the current system. Therefore, it is necessary to develop a training program to educate the residents on breastfeeding.
Background : Two representative groups of family physicians and oncologists were surveyed concerning their knowledge and attitudes toward cancer pain management (CPM).
Methods : A questionnaire, designed to assess knowledge (13 items) and attitudes (6 items) toward CPM, was sent to 2,200 members of Korean Association of Family Medicine and 800 members of Korean Cancer Association.
Results : Three hundred and eighty eight family physicians (17.6%) and one hundred and forty seven oncologists (18.4%) responded and completed the questionnaire. They had inadequate knowledge toward CPM, especially, chance of respiratory depression, tolerance to adverse effect, ceiling effect, risk of addiction, and use of adjuvants. Most of the physicians had positive attitude toward importance of CPM, best judge of pain severity, and priority of CPM but had negative attitude toward concerns about potential problem of addiction and earlier prescription of maximum dose of opioid. Family physicians displayed more lack of knowledge about CPM in 9 of 13 items and more negative attitudes toward 4 of 6 items. Adjustment for demographic characteristics and experiences in cancer patients with pain showed that while family physicians had poor knowledge of tolerance to confusion, they had more adequate knowledge on the effect of antidepressant and had positive attitude towards best judge of pain severity and priority of CPM. Poor knowledge about CPM was rated by 66.3% of physicians as the most important barrier to adequate CPM.
Conclusion : These findings that most of the physicians had poor knowledge and negative view toward CPM suggest a continuous need for comprehensive education program focused on CPM for physicians.
Background : Nowadays there is an upsurge of, social concern on domestic violence. The role of doctors in the prevention and screening of domestic violence is becoming important. Therefore, we selected medical residents to find out about the attitude and knowledge of doctors on domestic violence.
Methods : From 2000 March to October, we surveyed questionnaires to residents. The contents included the attitude on the victims, assailants and the children of domestic violence, whether they had the will to report domestic violence to the police or not, and finally the knowledge about the law on domestic violence.
Results : Among 210 residents, 95 (45.2%) answered. Almost 90% of the subjects agreed to the necessity of social intervention on the assailants. And most residents agreed that the psychosocial impact of domestic violence to the exposed children was important. 65 (68.4%) residents said they would report to the police when they recognized victims of domestic violence during their consultation. 27-68% answered correctly about the law related to domestic violence. 40% agreed to the need of education for domestic violence.
Conclusion : The residents had little knowledge on domestic violence law. Therefore, it is essential for residents to be educated accordingly. The factors of marital status and sexual difference of doctors on domestic violence should be investigated.
Background : Recent advances have been made in the treatment of acute stroke, but the effectiveness of the new therapies is highly time dependent. Patients with acute stroke often arrive at the hospital too late to receive the maximum benefit from these new stroke therapies. Efforts to reduce delay time of therapy for acute stroke may be more effective if the factors that delay hospital arrival are identified and targeted for specific intervention. So we studied about reason of delay of hospital presentation in patients with acute stroke.
Methods : The 85 acute stroke patients group who admitted to the Young-dong severance hospital from April to August 1999 were enrolled in this study. We collected clinical data from the medical record, including demographic characteristics, date and time of symptom onset, date and time of presentation to the hospital, medical history, and symptoms at stroke onset. And informants about stroke, method of transportation, the patient's interpretation of the symptoms were interviewed. We defined early arrival as within 3 hours of awareness of symptoms.
Results : The 85 patients were interviewed, early arrival were more likely to arrive by ambulance (P<0.001), admit via emergency department(p=0.001), interpret their symptoms as a stroke(P=0.005) and use readings as a informants about stroke(P=0.027) than late arrivals. Also they were younger than late arrivals(P=0.027). Main reason of delay of hospital presentation was because they expect spontaneous improvement(43%), mistake as other disease(23.3%), arrive via other medical institute(20%).
Conclusion : Late arrivals expected spontaneous improvement, misinterpreted their symptoms as those of other disease and didn't choose proper medical institute for acute management. Considerable education is needed to increase the knowledge about stroke and proper acute management.
Background : Although institution of the no-smoking areas have been required in hospitals since 1995, It has not been evaluated. This study was conducted to assess the effectiveness of the current no-smoking areas, and to collect employee's opinions about no-smoking policy in th hospital.
Methods : The self-administered anonymous survey was distributed to all employees of a university hospital in January 1999. Respondents were asked about their smoking status, awareness and compliance of the no-smoking areas, perception of tobacco smoke during work, preference for the type of no-smoking policy. Differences in outcome vairables' distribution by sex, smoking status, and occupation were analyzed using x² analysis.
Results : The overall response rate for the survey was 65.3%(670/1026). Among the total, 77.9% were females, and mean age of the respondents was 31.6 years(±80). While the overall smoking prevalence was 10.6%, men's prevalence was 46.6%. Although the awareness of the no-smoking areas was high in most areas, the rate of which all of the 10 no-smoking areas had been well kept was only 15.2%, 47.% of non-smokers reported that they could still smell some tobacco smoke while on duty. While 65.5% agreed on the opinion that penal regulations should be strengthened in order not to violate no-smoking areas, only 32.1% agreed on the current policy without penalty. 80% of smokers replied that they would follow the strict no-smoking policy.
Conclusion : The current no-smoking areas was not well observed. However, most employees wanted the no-smoking policy with penal regulation. Therefore, this survey could provide a solid foundation to implement a strict no-smoking policy.
Background : Acquired immune deficiency syndrome (AIDS) is becoming more prevalent in the world, but there is no definite treatment method and no proved vaccine available. Therefore, prevention is the best method to lessen it and blocking it's transmission route is the most effective method. We conducted a survey on the changing trend of knowledge, attitude and perception for AIDS between the year 1993 and 1999 among freshmen of a university. Method: The subjects were 2,340 freshmen of a university in Seoul and the study period was one month from Jan. 16 to Feb. 15 1999. The survey had been done with pre-designed questionnaire methods which was same to the one in 1993. Total 2,305 cases were analyzed and compared with the results in 1993 excluding 35 cases with insufficient responses.
Results : Among the questions about knowledge for AIDS the increasing trend was found in 13 items "AIDS is caused by a virus", "AIDS can be contracted by light kissing with AIDS patients", "AIDS can be contracted by hugging AIDS patient", "AIDS can be contracted by using AIDS patient's belongings", and so on. The decreasing trend was found in items "All homosexuals are apt to get AIDS", "Most of AIDS patients die of the disease", "AIDS patients are easy to contract other diseases", and "AIDS can be contracted by other sexually-transmitted viruses".
Conclusion : The freshmen entered in 1999 knew the transmission route of AIDS relatively well. They thought tat AIDS was not a serious disease but they could get ADIS. The changing trend showed that public education had a considerable effect on students' knowledge and attitude for AIDS.
Background : Hormone replacement therapy(HRT) has an established role in reducing cardiovascular risk and in preventing osteoporosis. But compliance with HRT is not good as expected. Therefore, so we assessed perimenopausal women's knowledge and attitude towards menopause and HRT too.
Methods : Questionnaires were provided to the students' mothers of a high school located in Seoul from June 10th to 15th, 1996. General characteristics and routine breast examination, routine Pap smear, the knowledge and practice of high calcuim diet for preventing osteoporosis, their menstrual pattern, the information source of HRT, in attitude for HRT, and the reasons for refusing.
Results : Among 560 women, 362 women(64.6%) responsed, and the mean age was 45.5 years. For osteoporosis prevention, they knew milk(74.7%) were, anchovy(27.4%), calcium(23.6%). HRT(7.4%) were beneficial. And almost(91.8%) all subjects answered that menopause was a natural course and 40.5% of women answered that physical change after menopause could not prevent. Among 34 postmenopause, 5(14.2%) received HRT and 48(20.3%) answered that they would receive HRT, and 57(24.1%) answered that they would not receive HRT. The reasons for refusing HRT were that menopause was a natural course, therefore devoiding the need for artificial hormone therapy(22.4%), increased incidence of breast cancer(21.8%), and that lack of information for HRT(13.9%). The association was not proven between the attitude for HRT and regular Pap smear, regular breast examination, exercise, oral intake for osteoporosis prevention.
Conclusion : Almost all of the respondents recognized that menopause was a natural course. And the effectiveness of diet and exercise in preventing osteoporosis was more well known compared to HRT.
Background : It is an important task to give adequate nutritions to infants and to wean properly for rapid growth during infancy. Adequate behavior requires precise knowledge. This study was conducted to assess the level of child-caretakes' knowledge about weaning food which is essential to infants' healthy growth.
Methods : From April to June, 1997, we acquired 156 child-caretakers who visited a family medicine clinic in Kyungju and a pediatric clinic in Taegu(from 2 months old to 6 years old) medical care. They were asked to respond to the pre-made questionnaire. The data were coded and analyzed using Excel and SPSS/PC(version 7.0). Student's t-test was used to test the score difference between two groups by general characteristics.
Results : The proportion of correct answers to the question concerning the definition of weaning, was 66.7% ; on proper feeding method when infants do not accept weaning food. 18.5% ; on the starting time of weaning food, 64.1% ; on the interval to add new ingredients, 23.1% ; on the sequence of feeding weaning food compaed to milk or breast milk, 56.4% ; on how to prepare commercial weaning food, 54.5% ; and to the question on the completing time of weaning food, the proportion of correct answers was 19.2%. The main information sources on weaning food were books and magazines related to child care and rearing(50.6%). The total average score was 4.6/10.
Conclusion : There are many child-caretakers who misunderstand the knowledge of weaning food. Therefore, primary care physician plays an important role in the education of child-caretakers on weaning food.
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