Guidelines to reduce sexually transmitted infections at primary health care centres--part 2

Sexually transmitted diseases are the second highest cause of death among women aged 15-44 years. The incidence and prevalence of sexually transmitted diseases is on the increase at many health care centres despite their dreadfulness and many preventative measures. According to the Scope of Practice of registered professional nurses working in a community health clinic, the registered professional nurse has a responsibility to prevent disease and promote health as well as do research. This paper aims to describe guidelines to reduce sexually transmitted infections at primary health care centres based on research done to investigate the community specific knowledge, attitudes and perceptions regarding sexually transmitted infections. Structured interviews were used to collect data from 1694 participants (males and females) who were consulted at a primary health care clinic in Mamelodi, Gauteng province. Existing patients' records were also utilised to calculate the incidence rate of sexually transmitted infections. Data were computerised and analysed quantitatively to reflect the results in frequencies and percentages as reported in Part 1 of this research. Guidelines to direct the practice of registered professional nurse were developed based on the findings of the results. These guidelines must underpin community specific interventions to reduce the incidence of sexually.     

The knowledge and attitudes of student nurses towards patients with sexually transmitted infections: Exploring changes to the curriculum

Evidence suggests that nurses can struggle to care for patients with sexually transmitted infections in a non-judgemental way. It is unknown how targeted education can influence the knowledge and attitudes of student nurses towards caring for patients with sexually transmitted infections. This study aimed to investigate how a change in curriculum influenced the reported sexual health knowledge and attitudes of pre-registration adult student nurses in a University in the UK.A two phase mixed methods study, using a sequential explanatory strategy, collected quantitative questionnaire data (n = 117) followed by qualitative group data (n = 12). Data were collected from one cohort of students before a curriculum change and then from a subsequent cohort of students. Those students who had increased educational input in relation to sexual health reported higher degrees of knowledge and demonstrated a more positive attitude towards patients with a sexually transmitted infection. Both cohorts of students identified that education in this subject area was essential to challenge negative attitudes and positively influence patient care. Active learning approaches in the curriculum such as small group debates and service user involvement have the ability to allow students to express and challenge their beliefs in a safe and supportive environment.     

Improving care for patients with sexually transmitted infections in South Africa

AIM: To assess the quality of integrated sexually transmitted infection (STI) services in primary health care. METHOD: A two-page questionnaire, in collaboration with district health service supervisors, was developed to assess the quality of care and health services for STIs in individual clinics. RESULTS: The data suggest that the quality-assessment instrument used has the potential to promote the improvement of STI care delivery at district and clinic levels. CONCLUSION: The quality-assessment instrument proved easy to use, can be adapted to local requirements and is appropriate for use in developing countries. The authors maintain that using this instrument in various district clinics could help supervisors identify the main impediments to the delivery of high quality services, and give them a platform from which to set priorities in training, infrastructure, equipment and supplies.     

性传播疾病就诊患者艾滋病相关知识行为态度调查

目的调查和分析性传播疾病（STD）门诊患者艾滋病（AIDS）相关知识、行为和态度,为介入STD人群开展AIDS相关的防治干预提供依据。方法采用自制STD就诊患者情况调查表对280例STD就诊患者进行人口学特征、AIDS相关知识、行为和态度等的问卷调查,用SPSS13．0进行统计描述分析。结果STD就诊患者对AIDS相关知识认识不足;STD就诊患者存在感染人体免疫缺陷病毒（HIV）的高危行为。结论STD患者是HIV感染的高危人群,做好STD患者的健康教育和行为干预对预防STD／AIDS具有特殊重要的意义。     

Nurses’ knowledge, attitudes, and practices regarding provision of sexual health care in patients with cancer: critical review of the evidence

Background  The experience of living with cancer is associated with a variety of consequences in several central aspects of a patient’s quality of life, including intimacy, body image, human relationships, sexuality, and fertility. Despite their importance, incidence, and impact on psychosocial well-being, sexual health care (SHC) is a matter not frequently dealt with by nurses in daily practice. Goals of work  The purpose of this study was to gather evidence regarding knowledge, attitudes, and behaviors of oncology nurses toward sexual health issues and to identify salient and latent key factors which influence provision of SHC in the context of cancer. Materials and methods  A critical review of the literature was conducted over a period of three decades and 18 original research articles were retrieved and analyzed. Results  A comprehensive data analysis revealed that, although oncology nurses hold relatively liberal attitudes and recognize provision of sexual health care as an important nursing role, they possess limited sexual knowledge and communication skills, while often avoid or fail to effectively respond to patients’ sexual concerns. Nine possible influential key factors have been studied: incorrect assumptions toward sexual issues, comfort, sexual knowledge, professional nursing role, patient- and nurse-related issues, work environment-related issues, continuing education activities, and society-related factors. Conflicting findings are reported. Conclusions  The findings of the present study propose that there is an evident need of dispelling the myths about sexual health in cancer care. Besides, continuing education activities and availability of education materials could assist nurses to adequately address sexual concerns while caring for patients with cancer. This paper was presented as an oral presentation at the 7th Congress of the Balkan Union of Oncology (BUON) in Kusadasi, Turkey, 15-19 October 2008, and it was awarded as the best nursing oral presentation.     

Raising health care provider awareness of sexually transmitted disease in patients over age 50

An increase in sexual activity among persons over age 50 has resulted in a dramatically increased prevalence of sexually transmitted diseases (STDs), including higher rates of HIV/AIDS, syphilis, gonorrhea, and chlamydia. Raising awareness of health care providers regarding STDs in this age group is essential for appropriate prevention and treatment.     

Point of care diagnostics for sexually transmitted infections: perspectives and advances

Accurate and inexpensive point-of-care (POC) tests are urgently needed to control sexually transmitted infection epidemics, so that patients can receive immediate diagnoses and treatment. Current POC assays for Chlamydia trachomatis and Neisseria gonorrhoeae perform inadequately and require better assays. Diagnostics for Trichomonas vaginalis rely on wet preparation, with some notable advances. Serological POC assays for syphilis can impact resource-poor settings, with many assays available, but only one available in the U.S. HIV POC diagnostics demonstrate the best performance, with excellent assays available. There is a rapid assay for HSV lesion detection; but no POC serological assays are available. Despite the inadequacy of POC assays for treatable bacterial infections, application of technological advances offers the promise of advancing POC diagnostics for all sexually transmitted infections.     

Prevalence and correlates of migraine among women attending a prenatal care clinic in Lima, Peru

Migraine headaches are among the leading causes of disability in the world. The burden of migraines is highest in women of reproductive age. This cross-sectional study characterized the prevalence, symptoms and correlates of migrainous headaches in 154 pregnant women attending a prenatal care clinic in Lima, Peru. Lifetime prevalence of migraine defined by modified IHS criteria was 9.1% (95% CI 4.6-13.6). When probable migraines were included, the lifetime prevalence of migraine in this population was 29.2% (95% CI 22.0-36.4). Migraine headaches were associated with a maternal history of headache, childhood carsickness, a diagnosis of allergies, and a high frequency of fatigue. Although headache-related disability was low in terms of missed work and recreation, high rates of headache pain and medicinal use reflect the true impact on this population.     

健康教育对性病患者知识及行为的影响研究

目的探讨健康教育对性病患者疾病相关知识掌握及安全性行为的影响。方法对7名专职宣教护士进行专业知识及技能培训,培训后护士在悄悄话诊室对362例患者进行一对一的性病相关知识教育、健康性行为指导、加强心理干预及随访等。结果干预后患者对疾病复发相关知识、危险因素、预防常识和严重后果的知识掌握率显著提高(P<0.01);性行为时每次使用安全套意愿从干预前的8.01%提高到干预后的51.66%,选择配偶的比例从15.19%提高到40.88%,选择固定性伴的比例从23.48%提高到33.98%,与交易性伴发生性关系的比例从31.49%降低至11.05%,干预前后比较,差异有统计学意义(P<0.01)。结论对性病患者实施健康教育,可有效提高性病患者对性病相关知识的认知,促进其高危行为的改变和安全套的使用。     

Knowledge,attitudes and practices regarding COVID-19 among dental health care professionals: a cross-sectional study in Saudi Arabia

ObjectivesWith the increasing severity of the coronavirus disease (COVID-19) pandemic, it is essential that dental health care professionals (DHCPs) are prepared. The study aim was to assess the knowledge, attitudes and practices (KAP) regarding COVID-19 among DHCPs in Saudi Arabia.MethodsA cross-sectional study using a web-based survey was conducted. A validated and reliable questionnaire was developed that comprised 44 questions. Using Qualtrics survey software, DHCPs working in different settings were approached across five geographical regions of Saudi Arabia.ResultsA total of 318 respondents voluntarily participated in the survey. Most DHCPs showed a moderate level of knowledge (51.6%), a positive attitude (92.1%) and adequate practice standards (86.5%). We found that 94.7% of DHCPs had an adequate overall level of KAP. DHCPs with a doctorate significantly outscored DHCPs with other educational levels with respect to knowledge and practice. Older (51–60 years) DHCPs reported significantly more knowledge than younger DHCPs.ConclusionDHCPs displayed an average level of knowledge that needs to be enhanced through continuing education programmes. However, they showed a positive attitude and an acceptable level of practice, as they were abiding by guidelines issued from various international and national health agencies.     

A qualitative study of nurses' attitudes and practices regarding brief alcohol intervention in primary health care

BACKGROUND: Excessive alcohol consumption causes significant mortality, morbidity, economic and social problems in the United Kingdom (UK). Despite strong evidence for the effectiveness of brief intervention to reduce excessive drinking in primary health care, there is little indication that such intervention routinely occurs. AIMS: This study aimed to explore primary health care nurses' attitudes and practices regarding brief alcohol intervention in order to understand why it is underexploited. METHODS: The study design was qualitative, using a grounded theory approach to data collection and analysis. Semi-structured in-depth interviews were conducted with 24 nurses from practices that had previously been involved in a General Practitioner (GP) led brief alcohol intervention trial in the North-east of England. A combination of convenience and purposive sampling was used to recruit subjects and gain a broad range of perspectives on issues emerging from ongoing data-analysis until data saturation occurred. RESULTS: It was clear that although primary health care nurses have many opportunities to engage in alcohol intervention, most have received little or no preparation for this work. This has left nurses at a disadvantage as alcohol consumption is a confusing and emotive area for both health professionals and patients. An analysis of factors influencing nurse involvement in alcohol intervention outlined a requirement for clear health messages about alcohol, training in intervention skills, facilitation to enhance confidence regarding intervention and support to help deal with negative patient reactions. CONCLUSIONS: As current health policy is to encourage, sustain and extend the health promotion and public health role of primary care nurses, more attention should be given to providing them with better preparation and support to carry out such work.     

Knowledge and attitudes of patients with diabetes mellitus in a primary health care system

The objective of this study was to characterize patients with type 2 diabetes mellitus, according to sociodemographic and clinical variables, and to analyze scores of knowledge and attitudes regarding the disease. Participants were 79 users who received care in a primary health care service, in 2008. The Diabetes Mellitus Knowledge (DKN-A) and Attitude (ATT-19) questionnaires were used for data collection. The population was formed by adults and elderly adults, who were between 30 and 80 years old. Most were literate (96.3%); married (63.3%); female (63.3%) and classified as class-2 obesity. As to the knowledge about the disease, subjects obtained scores lower than 8, indicating unsatisfactory results on self-care. Scores obtained regarding attitudes show difficulties to cope with the disease. Results evidence the need to adopt a Diabetes Education Program at the studied unit.     

Lymphoedema care of breast cancer patients in a breast care clinic: a survey of knowledge and health practice

Lymphoedema, an accumulation of protein-rich fluid in interstitial tissue, is a well-recognised life-altering result of breast cancer treatment. With the goal of studying the prevalence and management of lymphoedema after breast cancer therapy, 171 patients were invited to complete a self-administered questionnaire following completion of treatment for breast cancer. The survey revealed that 82.5% of patients knew they were at-risk of developing lymphoedema. However, the level of knowledge about preventive care in lymphoedema was inadequate, with a mean score of 4.07 out of a full mark of 10 (SD=2.35, mode=2). A substantial proportion (45.6%; n=78) of respondents reported that they had experienced lymphoedema and subsequently developed multiple sites of lymphoedema, but only 34.7% (n=26) had been referred for physiotherapy. The study also revealed that patients who had received the combined regimen of mastectomy, lymph node dissection, radiotherapy and chemotherapy were at a higher risk of developing lymphoedema (chi2=6.305, P=0.043). Interestingly, it was found that nurses were the most frequently cited resource for information, but the least consulted professionals for discussion on treatment. It is apparent from our patient survey that there is a lack of knowledge on lymphoedema care amongst breast cancer patients. In order to improve patients' level of knowledge and their awareness of lymphoedema care, the provision for systematic and comprehensive patient education, including management protocols for lymphoedema, needs to be addressed. Education and training, will be essential components of efforts to ensure appropriate care for lymphoedema patients.     

Experience,knowledge and attitudes of mental health staff regarding clients with a borderline personality disorder

A survey of mental health staff experience, knowledge and attitudes regarding the management of clients with a diagnosis of borderline personality disorder (BPD) aimed to obtain baseline data to provide direction for developing planned education and determining staff willingness to participate in such training. A 23-item questionnaire was developed and posted to mental health staff in a public Area Mental Health Service in New South Wales ( n = 516). A total of 229 staff completed the questionnaire. Most staff (85%) reported having contact with clients who have a diagnosis of BPD at least once a month or more frequently, with 32% of respondents reporting daily contact. Eighty per cent of respondents found dealing with clients who have a BPD to be moderate to very difficult; 84% of staff felt that dealing with this client group was more difficult than dealing with other client groups. Most staff (82%) believed that, as mental health professionals, they had a role in the assessment, management and referral of clients with BPD, as well as in educating and providing information. Staff readily identified resources which would be helpful to them when working with such clients. It was encouraging to see that the majority of staff (95%) indicated their willingness to gain further education and training in the management of these clients. Although many staff believed they were knowledgeable about and confident in managing these clients, most staff also indicated difficulties posed by these clients and perceived a need for further education and training in this area .     

An examination of critical care nurses' knowledge and attitudes regarding pain management in hospitalized patients.

The purpose of this study was to determine the effectiveness of an educational intervention focused on pain management. The sample consisted of 30 medical/surgical intensive care nurses (age range, 23 to 62 years) employed in a large metropolitan hospital in the southeastern United States. McCaffery and Ferrell's Nurses' Knowledge and Attitude Survey Regarding Pain was administered at 2 points in time: before and after the educational program. The survey simultaneously measures knowledge and attitude levels regarding pain control. The paired t test was used to test for differences between pre- and posttest scores. The Point-biserial and Spearman's correlation coefficients were computed to examine relationships between selected sociodemographic variables and scores (baseline and change) on the survey. Results revealed a significant increase in scores after the educational intervention (t = 9.60. p = .0005). Additionally, a statistically significant correlation was found between change scores (posttest minus pretest scores) and years of nursing experience (rs = .37, p = .047). However, no significant relationships were found between type of nursing degree and baseline or change scores (rpb = .11, p = .575; rpb = .01, p = .955). These results support previous research findings related to the problem of inadequate pain management in the hospital setting. Further, the findings indicate that education regarding pain control is crucial for current nursing students as well as practicing nurses. The challenge for nurses is to be responsive to and integrate current pain management techniques in an effort to decrease the discomfort of hospitalized patients.