Knowledge and perception of oral health promotion in schools among dental nurses in Sarawak, Malaysia

In recent years, the concept of a Health-Promoting School has received much interest. In Malaysia, dental nurses are ideally placed to play a lead role in promoting Oral Health within the school setting. This study aims to provide information on the knowledge, perception and perceived role of Oral Health Promotion in schools, among dental nurses. A postal questionnaire was used to measure dental nurses' knowledge, perception and perceived role of Oral Health Promotion. The majority (60%) of dental nurses had good knowledge of Oral Health Promotion. Generally, they perceived that they play an important role in promoting Oral Health in schools. However, a sizeable proportion (25%) did not think they had a role to play in working together with school authorities to provide children with healthy food choices in school canteens. The majority (60%) of dental nurses did not perceive Oral Health Promotion to be important as a whole. They had a good perception of the concepts: it supports behaviour change, it has appropriate goals, it integrates oral health and general health and relieves anxiety. However, they had a poorer perception of the concepts; diverse educational approaches, participation, focus on prevention, early intervention, "spread of effect" of dental health education and "make healthier choices the easier choices". Years of service was not significantly associated with knowledge and perception of Oral Health Promotion. Dental nurses should be reoriented towards a more holistic practice of Oral Health Promotion. Workshops that invite active participation from dental nurses should be conducted to equip them with the necessary knowledge and skills.     

Management nurses's attitudes in the family health program: view of the family health group

This article was a part of a research called Management Competences required from the nurse in the Family Health Program (FHP) and has as aim to identify the management attitudes required from the nurse to the manager of the nurse assistance in the Family Health Units (FHU) of a city of the "catarinense" seashore under a perception from these professionals. It was a descrptive-exploratory study based on a semi-structured questionary for data colection. The population was constituted by 72 participants that scored from 01 and 05 to each item of the questionary. The study pointed to the emphasis in the development of new competences by the nurses that lead the reach of the performances and consequently the quality of the assistance and to the community satisfaction.     

Evaluation of oral health actions in the Family Health Program in the Mosqueiro district, Pará State, Brazil

The extension of Brazil's Family Health Program Teams through the introduction of Oral Health Teams (OHT) as required by Decree N degrees 1,444 dated December 28, 2000, was an important step in the restructuring of the Oral Healthcare System, ensuring easier access to good quality dental care and treatment for less privileged segments of the population. In the Mosqueiro district of Pará State, an Oral Health Team was added to the Family Health Program in 2002, working closely with the local community through home calls and school visits, as well as at the Family Health Unit. In order to assess these Oral Health activities, 103 users of the Family Health Program Unit responded to a questionnaire with closed and semi-open questions in July 2004. The resulting data were tabulated, showing that most of these users were young adult women with high school diplomas but lacking access to higher education. This public felt that Oral Health quality had improved considerably, being satisfied with the performance of the current team.     

Smoking behaviour,knowledge and attitudes among Family Medicine physicians and nurses in Bosnia and Herzegovina

Background

Smoking rates among the general population in Bosnia and Herzegovina are extremely high, and national campaigns to lower smoking rates have not yet begun. As part of future activities of the Queen's University Family Medicine Development Program in the Balkans Region, technical assistance may be provided to Bosnia and Herzegovina to develop of national tobacco control strategies. This assistance may focus on training doctors and nurses on smoking cessation strategies with a view to helping their patients to stop smoking. Given this important role that health professionals have, data is needed on smoking rates as well as on smoking behaviour among doctors and nurses in Bosnia and Herzegovina. This study therefore seeks to determine the smoking rates and behaviour of family medicine physicians and nurses in Bosnia and Herzegovina and to determine how well prepared they feel with respect to counselling their patients on smoking cessation strategies.

Methods

The WHO Global Health Professional Survey, a self-administered questionnaire, was distributed to physicians and nurses in 19 Family Medicine Teaching Centres in Bosnia and Herzegovina in June 2002. Smoking rates and behaviour, as well as information on knowledge and attitudes regarding smoking were determined for both physicians and nurses.

Results

Of the 273 physicians and nurses currently working in Family Medicine Teaching Centres, 209 (77%) completed the questionnaire. Approximately 45% of those surveyed currently smoke, where 51% of nurses smoked, compared to 40% of physicians. With respect to knowledge and attitudes, all respondents agreed that smoking is harmful to one's health. However, "ever" smokers, compared to "never" smokers, were less likely to agree that health professionals who smoke were less likely to advise patients to quit smoking than non-smoking health professionals. Less than half of physicians and nurses had received formal training in smoking cessations strategies, but about two thirds of health professionals felt very or somewhat prepared to counsel their patients on how to quit smoking.

Conclusions

Our study indicates that almost half of Family Medicine health professionals in Bosnia and Herzegovina are smokers. This indicates a severe public health problem throughout the country. Steps need to be taken at a national level to address the fight against tobacco.

     

Variations in practice nursing: implications for family health services authorities

Differences between Family Health Services Authorities (FHSAs) in practice nurse activities are described and interpreted, using the results of postal questionnaires to all practice nurses in England and Wales in late 1992. There were an estimated 15000 practice nurses of whom 12589 (85%) returned a completed questionnaire, which asked about 30 tasks, including domiciliary visits, carried out by practice nurses; employment conditions, professional qualifications, experience, and clinical grading; and practice characteristics. The proportion of nurses undertaking four out of five tasks varied by a factor of two or more across FHSAs. Just over a third (39%) of the variation in nurses' activities could be explained by professional and practice characteristics. The analysis distinguished between FHSAs where nurses were more likely to engage in tasks requiring diagnostic and clinical skills, including assisting with minor surgery, and FHSAs where nurses were more likely to conduct domiciliary visits, help with chronic disease management, and provide advice on welfare benefits, incontinence and health promotion. The former FHSAs were characterized by larger practices with four or more partners employing several nurses, training practices, and practices with a manager. The latter group was characterized by smaller inner city or urban practices, including single-handed partnerships, and practices often employing one nurse. The 1990 general practitioner (GP) contract boosted nurses' involvement in those activities attracting new payments but its impact on their roles and responsibilities was mediated by their professional skills and experience and the type of practice where they worked. The contribution of practice nursing to the delivery of primary and community health care varies considerably. Further research is required to find out whether role diversity reflects uncertainty about the appropriate use of their skills. FHSAs need to develop a variety of strategies to support and promote practice nursing.     

Professional trajectory in the Family Health Strategy: focus on the contribution of specialization programs

This case study with a qualitative approach analyzes the professional trajectory of graduates from specialization programs in Family Health offered by the Family Health Center (FH-Center) in the metropolitan region of S?o Paulo, Brazil, between 2002 and 2004 identifies the contributions of this program to the performance of these professionals in the Family Health Strategy (FHS). The sample included 11 former students and data were collected through a questionnaire with semi-open questions from December 2007 to March 2008. The results revealed that six graduates no longer worked in the FHS and most of those still working in the FHS reported a low level of identification with the FHS. The program enabled changes in these professionals' daily practices, although some difficulties implementing the FHS principles into practice still remain. The conclusion is that the program positively impacted these professionals' trajectory, even though it represents a modality of training designed to complement knowledge and skills required by the FHS work.     

Professional competence and contraceptive care

OBJECTIVE: To evaluate the technical competence of professionals carrying out activities related to contraceptive care. METHODS: Evaluative research in the field of health was conducted in eight districts of the State of Ceara from July to September 2003. Data was collected by means of interviews with 29 nurses working in the Family Health Care Program within these districts and 50 people being attended by this program. Observations of the Family Health Care Units were a complementary source of data within this study. RESULTS: The majority of nurses had received some form of training regarding contraception and the technical norms regulating their use. However, professional barriers were reported by the nurses and others were identified by lay persons being attended by the program, that indicate the need to provide better training for professionals engaged in this area of care. The nurses recognized they had deficits in information and communication skills as well as technical deficits in dealing with contraception. CONCLUSIONS: There are gaps in professional competence with regard to contraceptive care that, when associated to the lack of systematization of team work, generates distortions in the quality of care. Team work was characterized by the lack of definition of team members' specific attributions and tasks.     

Educating health educators: a survey of hospital staff completing a certificate in health education course.

Health care professionals (nurses, a midwife, a physiotherapist and an occupational therapist) working in a large NHS Trust hospital who had completed the Certificate in Health Education with the support of their employer, were interviewed. The study objectives were to seek their views on the quality of the course, to determine the extent to which participants were able to apply their new found knowledge and skills in the care they provided to patients and the level of support received to allow them to do this. Barriers that prevented staff from routinely applying health education in their work were identified. The findings indicated that the majority found the course content to be good and relevant to their clinical work but they identified lack of time due to the pressure of routine clinical work as the main barrier to the promotion of health education in their clinical area.     

Implementing Family Health Nursing in Tajikistan: from policy to practice in primary health care reform

The health systems of former Soviet Union countries are undergoing reform away from the highly centralised, resource-intensive, specialised and hierarchical Soviet system, towards a more generalist, efficient health service with greater focus on primary health care. Family Health Nursing is a new model designed by WHO Europe in which skilled generalist community nurses deliver primary health care to local communities. This paper presents a qualitative evaluation of the implementation of Family Health Nursing in Tajikistan. Using Stufflebeam's 'Context, Input, Process, and Product' model, the paper aims to evaluate the progress of this reform, and to understand the factors that help or hinder its implementation. A four-phase research design investigates the development of the Family Health Nurse role over time. In 5 rural areas, 6 focus groups and 18 interviews with Family Health Nurses, 4 observations of their practice, 7 interviews with families and 9 interviews with physicians were carried out. Data were analysed according to the components of Stufflebeam's model. Although the legacy of the Soviet health system did not set a precedent for a nurse who is capable of decision-making and who works in partnership with the physician, Family Health Nurses were successfully implementing new practices. Crucial to their ability to do so were the co-operation of physicians and families. Physicians were impressed by the nurses' development of knowledge, and families were impressed that the nurses could offer real solutions to their problems. However, failure to pay the nurses regular salaries had led to serious attrition of the workforce. We conclude that the success of the Family Health Nurse role in other countries will depend upon its position in relation to the historical health care system.     

脑卒中家庭病床照顾者护理技能培训效果评价

目的评价照顾患者人员（以下称照顾者）护理技能培训在社区脑卒中家庭病床患者中应用的效果。方法对2010年10月1日—2012年9月30日期间在上海市花木社区卫生服务中心新建脑卒中家庭病床患者进行日常生活活动（ADL）评估,选择评估值≥10分的患者主要照顾者,由社区护士入户实施护理知识与操作技能培训。采用自行设计的护理知识问卷及家庭护理质量评估表,对41名照顾者在家庭病床建床初及培训3个月后分别进行测评与评估。结果培训后,照顾者护理知识掌握度得到提升（t=8．246,P〈0．01）,患者护理质量也比培训前提升（t=10．760,P〈0．01）。结论脑卒中家庭病床照顾者实施护理能力培训,有助于照顾者了解脑卒中疾病相关知识,掌握患者基础生活护理、安全护理、功能锻炼、自我尊重等护理要点与操作技能,提升患者生活质量,促进患者回归社会。照顾者培训后可作为社区护理资源的良好补充。     

外科护士对术前禁食禁饮知识、态度、行为的调查分析

目的：了解外科护士对术前禁食禁饮问题的循证知识、态度、行为及培训状况,探索影响因素,为提高护士的临床问题解决能力提供参考。方法：方便整群抽取太原市某三级甲等综合医院外科护士150名,采用术前禁食禁饮知信行问卷进行调查。结果：外科护士术前禁食禁饮知识评分为（52.95±11.59）分,态度评分为（88.34±12.74）分,行为评分为（78.66±10.86）分;外科护士对术前禁食禁饮相关循证知识掌握情况较差,知识得分为良者仅占3.27%;学历、技术职称、工龄等因素影响术前禁食知识、态度、行为（P〈0.05）。结论：临床外科护士术前禁食禁饮循证知识和技能仍有欠缺,对开展循证护理培训需求迫切,应改变观念,加强对外科护士术前禁食禁饮循证知识技能的培训,提升护士对临床常见问题的循证护理能力。     

Aspects related to vaccine management and preservation in healthcare centers in the Northeastern Brazil

This study characterizes the expertise and updated knowledge on immunization of nursing team responsible for vaccine rooms; it describes the work conditions in that sector from the team's view, and identifies the procedures and daily activities performed by such professionals. This cross-sectional study conducted in 2007 in vaccine rooms of 11 Family Healthcare Centers (CSF) in Fortaleza (CE, Brazil), involved 22 nursing team professionals and used a checklist and self-applicable questionnaire as the survey instrument. Among the participants, 44.4% were nurses and 30.8% technicians/assistants have an experience of more than five years; 55.6% of the nurses had attended no training on vaccines; and 76.9% of all other professionals keep themselves updated by referring to books, manuals and the Internet. Gaps in physical structure, examination and record of temperature maps, and guidance on post-vaccine effects were detected in most rooms under study. The study indicates that managing any vaccination work requires knowledge of the area and specific training to allow the professionals to provide a quality service to the population in a way to ensure the eradication and control of immunopreventable diseases.     

The purpose of the communication process of group activities in the Family Health Strategy

This study identified the purposes of the communication process in the group activities of the Family Health strategy from the perspective of nurses. Semi-structured interviews were conducted and recorded with 60 nurses and non-participant observation with 19 group activities, analyzed according to qualitative content analysis. Five categories emerged: Health education, Clinical follow-up, co-responsibilization of patients, Team-Community Interaction, and Work Organization. These categories revealed that the establishment of reciprocal interactions among professionals, patients and families favor health promotion because it encourages the exchange of knowledge among the participants concerning their health experiences.     

Research related to the status of "collaboration" among municipal public health nurses in Japan

PURPOSE: The two main goals of this research were: (1) To clarify the current state of collaboration among municipal public health nurses throughout Japan (referred to collectively as "Public Health Nurses"); and (2) To identify personal factors that separate Public Health Nurses who collaborate frequently from those who do not, and to clarify the characteristics of relevant interventions. The author believes that the results of this study should be valuable in demonstrating specific methodologies related to the ability of Public Health Nurses the ability to execute collaborative activities. OBJECTIVE: Before conducting the main survey, a preliminary survey was performed to determine the affiliate divisions for Public Health Nurses employed by all of the 3,190 municipalities in Japan. Based on this survey, we gained an understanding of factors such as the number of Public Health Nurses and their places of employment. Next, during December 2003 to August 2004, we carried out a questionnaire survey by post to the 21,631 Public Health Nurses in Japan who had been identified through the preliminary survey. METHODS: Survey items included: the Public Health Nurse's gender, age, position, most recent academic history, total years of work, number of years working with the current employer, affiliated division, types of tasks undertaken, status of execution of those tasks, and collaborative activities, as well as specialists institutions and organizations involved in such collaboration. RESULTS: Data were gathered from 13,024 Public Health Nurses, which represents roughly 80% of the Public Health Nurses in Japan. First, regarding collaboration, links with health and medical institutions, health centers, and other government institutions appeared active, but this was not the case for social welfare facilities for the physically or mentally disabled. Furthermore, although the subjects collaborated with Public Health Nurses from other institutions, as well as with government administrators and doctors, there was little collaboration with pharmacists or with mental health and welfare workers. When we analyzed data for individual specialists and specialized institutions, we found that the "collaborating" group had significantly higher scores for collaborative activities than the "not collaborating" group. These scores are believed to reflect actual conditions. When we analyzed the relationships between personal factors for Public Health Nurses and collaborative activity scores, we found that scores tended to be higher for older nurses and for those with more years of experience. Looking at the relationship between details of tasks undertaken and collaborative activity scores we found that the group developing new business or securing budgets to develop new business had significantly higher scores, and that in terms of the execution of day-to-day operations, the Public Health Nurses with higher scores were those undertaking tasks that required new knowledge, or tasks that demanded high-level skills. CONCLUSIONS: Municipal Public Health Nurses often collaborate with specialists or health-related divisions, but they do not collaborate closely with divisions related to welfare services for the physically or mentally disabled. The Public Health Nurses with the highest collaborative activity scores were those scores clearly indicated active collaboration, and whose personal factors included extensive experience in the field. These Public Health Nurses were also involved in tasks that demanded a high level of skill.     

Knowledge and practices in breastfeeding promotion by Family Health teams in Montes Claros, Brazil

The Family Health Strategy has been implemented in Brazil with the aim of reorganizing the health care system with an emphasis on promotion and prevention. Thus, encouragement for breastfeeding is one of the most important activities by family health care teams. The objective of this study was to assess knowledge and practices by family health care teams in relation to breastfeeding. In addition to a questionnaire on health professionals' characteristics, a specific knowledge test on breastfeeding was conducted with 41 physicians and nurses and another test on the same subject was given to 152 community health workers. Scores were above 80% on the advantages of breastfeeding in all the teams, but knowledge on practical issues concerning technique and management of the main problems encountered in breastfeeding was not uniform among the health professions. Nurses scored better than physicians, and community health workers had the lowest scores. Practical activities to promote breastfeeding were not developed uniformly among health care professionals. There is a need for systematic and ongoing training in breastfeeding management in the family health teams.     

Important curriculum content for baccalaureate allied health programs: a survey of deans.

The purpose of this study was to assist deans of baccalaureate-level schools of allied health professions to come to consensus on knowledge and skills that graduates should have over and above what is required for professional accreditation and credentialing, and prerequisite or cognate courses that may be utilized to develop them. An adaptation of the Delphi method was used in 1990-1991 to survey the deans of 74 institutional members of the Association of Schools of Allied Health Professions (ASAHP) offering programs at the bachelor's degree level. Three rounds of questionnaires were completed. The study concluded that there was consensus among the 54 deans who responded to the third questionnaire that 19 items of knowledge and skill are important for allied health students, and that 14 courses are important for the development of this knowledge and these skills.     

Assessing Competencies of the Public Health Workforce in a Frontier State

The purpose of this study was to determine the level of perceived proficiency of a public health workforce based on the Public Health Practice Core Competencies. The Public Health Profile and Training Needs Assessment questionnaire was mailed out to public health employees representing mostly public health nursing, environmental health, mental health, and public health management/administration (n = 696). Nearly three-quarters (74%) of participants were female and 96% reported being white. Eighty one percent of participants were currently employed full-time. The majority of participants were trained at the bachelors level (54%). The response rate was 63.9%. Findings from this study show that all disciplines reported higher perceived proficiency in the Communication skills domain compared to the other seven skills domains. Perceived low skills domains included financial planning and management skills and policy development/program planning skills among public health nurses, mental health professionals, and environmental health specialists. Management/administration level staff reported their lowest perceived proficiency in Basic Public Health Science skills. Each group had different strengths and weaknesses and the necessary level of skill needed differs among discipline groups, thus future trainings on the Public Health Core Competencies should be discipline specific.