Actitudes ante la muerte en profesionales de enfermería latinoamericanos: una revisión integrativa

Introducción: La muerte es parte de los tabúes sociales existentes y puede fomentar actitudes que distan de su abordaje explícito en relación con los cuidados. Objetivo: Analizar las actitudes ante la muerte en profesionales de enfermería de acuerdo con las publicaciones científicas en el contexto latinoamericano en el período 2018 a 2022. Metodología: Se realizó una revisión de literatura integrativa de las publicaciones científicas latinoamericanas respecto de las actitudes ante la muerte en el contexto de la enfermería, empleando los siguientes términos estandarizados: actitud, muerte, enfermería y cuidados de enfermería. Se incluyeron 8 artículos publicados en el período definido, en idioma español y portugués, en los que se abordó explícitamente la temática de la revisión. La información de los artículos fue analizada tomando como referencia los conceptos de la teoría de las transiciones. Resultados: Se encontraron diseños tanto cuantitativos (50 %) como cualitativos (50 %), elaborados en su totalidad en el ámbito hospitalario. Los principales resultados dan cuenta del predominio de la indiferencia ante la muerte en el contexto de los cuidados. En relación con la teoría de las transiciones, la mayoría de los artículos abordan las condiciones en que estas se dan, además de los conceptos de terapéutica de enfermería y patrones de respuesta. Conclusiones: La producción de investigaciones sobre la actitud ante la muerte en profesionales de enfermería es escasa en Latinoamérica. Las experiencias de pérdidas cercanas, la capacitación y el soporte institucional son la base para contribuir a una mejor actitud hacia la muerte

Introdução: A morte faz parte dos tabus sociais existentes e pode fomentar atitudes que se distanciam de sua abordagem explícita em relação aos cuidados. Objetivo: analisar as atitudes diante da morte em profissionais de enfermagem de acordo com as publicações científicas no contexto latino-americano no período de 2018 a 2022. Metodologia: Foi realizada uma revisão de literatura integrativa de publicações científicas latino-americanas sobre atitudes diante da morte no contexto da enfermagem, utilizando os seguintes termos padronizados: atitude, morte, enfermagem e cuidados de enfermagem. Foram incluídos 8 artigos publicados no período definido, em espanhol e português, nos quais o tema da revisão foi abordado explicitamente. As informações dos artigos foram analisadas tendo como referência os conceitos da teoria das transições. Resultados: Foram identificados desenhos quantitativos (50 %) e qualitativos (50 %), elaborados totalmente no âmbito hospitalar. Os principais resultados mostram a predominância da indiferença diante da morte no contexto do cuidado. Em relação à teoria das transições, a maioria dos artigos aborda as condições em que as transições ocorrem, além dos conceitos de terapêutica de enfermagem e padrões de resposta. Conclusões: A produção de pesquisas sobre atitudes diante da morte em profissionais de enfermagem é escassa na América Latina. As experiências de perdas próximas, a capacitação e o apoio institucional são a base para contribuir para uma melhor atitude em relação à morte

Introduction: Death is part of the existing social taboos and can foster attitudes that are far from its explicit approach in relation to care. Objective: To analyze attitudes towards death in nursing professionals according to scientific publications in the Latin American context in the period 2018 to 2022. Methodology: An integrative literature review was conducted of Latin American scientific publications regarding attitudes towards death in the context of Nursing, using the following standardized terms: attitude, death, nursing and nursing care. Eight articles published in the defined period were included, in Spanish and Portuguese, in which the subject of the review was explicitly addressed. The information in the articles was analyzed using the concepts of the theory of transitions as a reference. Results: Both quantitative (50 %) and qualitative (50 %) designs were found, all of them elaborated in the hospital setting. The main results show the predominance of indifference to death in the context of care. In relation to the theory of transitions, most of the articles address the conditions under which these occur, in addition to the concepts of nursing therapeutics and response patterns. Conclusions: The production of research on the attitude towards death in nursing professionals is scarce in Latin America. Experiences of close losses, training and institutional support are the basis for contributing to a better attitude towards death

Effectiveness of virtual teaching programme regarding palliative care on knowledge, self-efficacy and attitude of Nursing Personnel in North India / Efectividad de un programa de enseñanza virtual sobre cuidados paliativos en los conocimientos, la autoeficacia y la actitud del personal de enfermería en el norte de la India / Eficácia de um programa virtual de ensino de cuidados paliativos sobre conhecimento, autoeficácia e atitude da equipe de enfermagem no norte da Índia

Objective.To evaluate the effectiveness of Virtual Teaching (VT) Programme regarding palliative care on knowledge, self-efficacy and attitude among Nursing Personnel working in selected hospitals of North India. Methods. A quasi-experimental study with non-equivalent control group pre-test-post-test design was conducted on 121 Nursing Personnel, selected by convenient sampling technique. Knowledge, self-efficacy and attitude were assessed using structured knowledge questionnaire, Palliative Care Self-efficacy Scale, and Frommelt Attitudes toward care of dying scale respectively. Nursing personnel in experimental group received Virtual Teaching Programme regarding palliative care whereas those in comparison group received conventional teaching (CT). The study included a pre-test followed by the teaching (virtual/ conventional) on day one. The post-test was conducted on 15th day after the intervention. Results. The results showed that there was a significant difference in mean post-test knowledge (VT group: 17.11 to CT group: 25.05; t=9.25, p<0.001), self-efficacy (VT group: 39.27 to CT group: 43.38; t=6.39, p<0.001) and attitude (VT group: 108.86 to CT group: 133.23; t=9.27, p<0.001) scores between virtual teaching group and conventional teaching group. ANCOVA test revealed statistically significant differences in the mean scores of knowledge [F (1.11) = 86.61, p<0.001], self-efficacy [F (1.11) = 841.75, p<0.001] and attitude [F (1.11) = 82.92, p<0.001] between the groups, with higher means obtained in the CT group. Conclusion. Virtual Teaching programme and Conventional teaching both were effective in enhancing the knowledge, self-efficacy and attitude among Nursing Personnel regarding palliative care with conventional teaching being more effective.

Objetivo. Evaluar la efectividad de un programa de Enseñanza Virtual (EV) sobre cuidados paliativos en cuanto a conocimientos, autoeficacia y actitud entre el personal de enfermería que trabaja en hospitales seleccionados del norte de la India. Métodos. Se llevó a cabo un estudio cuasiexperimental con un diseño de grupo de control no equivalente. Se realizaron pre y post-prueba a 121 miembros del personal de enfermería, seleccionados mediante una técnica de muestreo por conveniencia. Se evaluaron los conocimientos, la autoeficacia y las actitudes mediante un cuestionario estructurado de conocimientos, una escala de autoeficacia en cuidados paliativos y una escala de actitudes de Frommelt hacia el cuidado de personas al final de su vida. El personal de enfermería del grupo experimental recibió un programa de EV sobre cuidados paliativos, mientras que el del grupo de comparación recibió enseñanza convencional (EC). El estudio incluyó una preprueba seguida de la enseñanza virtual o convencional el primer día y una prueba posterior al decimoquinto día después de la intervención. Resultados. Los resultados mostraron que había una diferencia significativa en las puntuaciones medias post-test entre los grupos en: conocimientos (EV: 17.11 y EC: 25.05; t=9.25, p<0.001), autoeficacia (grupo VT: 39.27 y grupo CT: 43.38; t=6.39, p<0.001) y actitud (grupo EV: 108.86 y grupo EC: 133.23; t=9.27, p=<0.001) La prueba ANCOVA también reveló diferencias estadísticamente significativas en las puntuaciones medias de conocimientos [F (1.11) = 86.61, p=<0.001], autoeficacia [F (1.12) =841.75, p=<0.001] y actitud [F (1.11) = 82.91, p<0.001] entre los grupos, obteniéndose medias más altas en el grupo CT. Conclusión. Tanto el programa de enseñanza virtual como la enseñanza convencional fueron efectivos para mejorar los conocimientos, la autoeficacia y la actitud del personal de enfermería en relación con los cuidados paliativos, siendo el beneficio mucho mayor la enseñanza convencional.

Objetivo. Avaliar a eficácia de um programa de Aprendizagem Virtual (VE) sobre cuidados paliativos em termos de conhecimento, autoeficácia e atitude entre a equipe de enfermagem que trabalha em hospitais selecionados no norte da Índia. Métodos. Um estudo quase experimental foi conduzido com um desenho de grupo controle não equivalente. Foram realizados pré e pós-testes em 121 membros da equipe de enfermagem, selecionados por meio de técnica de amostragem por conveniência. Foram utilizados os instrumentos: questionário de conhecimento estruturado, escala de autoeficácia em cuidados paliativos e escala de atitudes de Frommelt em relação ao cuidado de pessoas em fim de vida. A equipe de enfermagem do grupo experimental recebeu um programa de VE sobre cuidados paliativos, enquanto o grupo controle recebeu ensino convencional (CE). O estudo incluiu um pré-teste seguido de ensino virtual ou convencional no primeiro dia e um pós-teste no 15º dia após a intervenção. Resultados. Os resultados mostraram que houve diferença significativa nas médias dos escores pós-teste entre os grupos em: conhecimento (EV: 17.11 e EC: 25.05; t=9.25, p<0.001), autoeficácia (grupo VT: 39.27 e grupo CT: 43.38; t=6.39, p<0.001) e atitude (grupo EV: 108.86 e grupo EC: 133.23; t=9.27, p=<0.001). O teste ANCOVA também revelou diferenças estatisticamente significativas nas pontuações médias de conhecimento [F (1.11) = 86.61, p=<0.001], autoeficácia [F (1.12) =841.75, p=<0.001] e atitude [F (1.11) = 82.91, p<0.001] entre os grupos, obtendo maiores médias em o grupo CT. Conclusão. Tanto o programa de ensino virtual quanto o ensino convencional foram eficazes na melhoria do conhecimento, da autoeficácia e da atitude da equipe de enfermagem em relação aos cuidados paliativos, sendo o benefício muito maior com o ensino convencional.

Construcción y validación de un cuestionario sobre actitudes hacia la higiene de manos / Construction and validation of a questionnaire on attitudes towards hand hygiene

INTRODUCCIÓN: La higiene de manos es la medida más eficaz para prevenir las infecciones asociadas al cuidado de la salud. Las actitudes hacia esta práctica tan sencilla, influyen en el grado de adherencia. OBJETIVO: Desarrollar y validar un instrumento para evaluar las actitudes hacia la higiene de manos en estudiantes de Licenciatura en Enfermería. MÉTODO: Se realizó un estudio observacional y de corte transversal. Una vez construido el instrumento se realizó la validez de contenido mediante el juicio de expertos. Para la validez de constructo se realizó análisis factorial exploratorio. Posteriormente se calculó la confiabilidad, que incluyó la consistencia interna y la estabilidad del cuestionario. RESULTADOS: Participaron 313 estudiantes de Licenciatura en Enfermería de ocho universidades de Argentina. Se calculó el Kaiser-Meyer-Olkin (KMO = 0,720) y se obtuvo una prueba de esfericidad de Bartlett significativa (x2 = 831,2; = 0,000). El análisis factorial exploratorio determinó la existencia de un único factor. El modelo explicó el 54% de la varianza. Se utilizó la implementación mejorada de la estimación Bayesiana EAP integrada en el programa FACTOR, que fue de 0,85 y se realizó test-retest utilizando análisis de correlación que arrojó un r = 0,64 (p ≤ 0,001). CONCLUSIONES: El cuestionario sobre actitudes hacia la higiene de manos (CAHM) presenta una adecuada validez y confiablidad, por lo que puede ser utilizado para indagar sobre este factor predisponente de adherencia hacia la higiene de manos.

BACKGROUND: Hand hygiene is the most effective measure to prevent health care-associated infections. Attitudes towards this simple practice influence the level of adherence. AIM: To develop and validate an instrument for the evaluation of attitudes towards hand hygiene in nursing students. METHOD: An observational and cross-sectional study was carried out. Once the instrument was constructed, content validity was carried out through expert judgment. For construct validity, exploratory factor analysis was performed. Subsequently, the analysis of construct validity and reliability was calculated, which included the internal consistency and stability of the questionnaire. RESULTS: 313 Nursing undergraduate students from 8 universities in Argentina participated. The Kaiser-Meyer-Olkin (KMO = 0.720) was calculated, and a significant Bartlett sphericity test was obtained (x2 = 831.2; = 0.000). The exploratory factor analysis determined the existence of a single factor. The model explained 54% of the variance. The improved implementation of the Bayesian EAP estimation integrated in the FACTOR program was used, which was 0.85; and test-retest was also performed using correlation analysis that yielded r = 0.64 (p ≤ 0.001). CONCLUSIONS: The Questionnaire on attitudes towards hand hygiene (CAHM) has adequate validity and reliability, so it can be used to investigate this predisposing factor of adherence to hand hygiene.

Investigation of environmental ethics, spiritual health, and its relationship with environmental protection behaviors in nursing students / Investigación sobre ética ambiental, salud espiritual y su relación con comportamientos de protección ambiental en estudiantes de enfermería / Pesquisa sobre ética ambiental, saúde espiritual e sua relação com comportamentos de proteção ambiental em estudantes de enfermagem

Objective.To investigate the relationship between environmental ethics, spiritual health, and environmental behavior among nursing students . Methods. In this cross-sectional study, 200 iranian students from the Chabahar Nursing School were selected using a simple random sampling method. The data collection tool included a questionnaire on demographic information, knowledge, attitudes and behaviors towards the environment, environmental ethics, and spiritual health. Partial least squares structural equation modeling (PLS-SEM) was utilized to evaluate the conceptual framework in this study. Results. The mean score for environmental ethics among nursing students was 65.73±10.61 out of 100. Most of the students (47%) had desirable environmental ethics. The knowledge structure (ß=0.46) predicted attitude. The attitude structure also predicted environmental behavior (ß=0.28) and spiritual health (ß=0.31). Ultimately, the results showed that spiritual health and environmental ethics predict environmental behavior directly and indirectly (p<0.001). Conclusion. Spiritual health and environmental ethics were strong predictors of environmental behavior. Therefore, it is necessary to take into account not only students' spiritual health but also their ethical behaviors to promote environmental protection behaviors in the future.

Objetivo. Investigar la relación entre la ética ambiental, la salud espiritual y el comportamiento ambiental entre los estudiantes de enfermería. Métodos. En este estudio transversal se seleccionaron 200 estudiantes iraníes de la Escuela de Enfermería de Chabahar mediante un método de muestreo aleatorio simple. La herramienta de recogida de datos incluía un cuestionario sobre información demográfica, conocimientos, actitudes y comportamientos hacia el medio ambiente, ética medioambiental y salud espiritual. Se utilizó el modelo de ecuaciones estructurales por mínimos cuadrados parciales (PLS-SEM) para evaluar el marco conceptual de este estudio. Resultados. La puntuación media en ética medioambiental entre los estudiantes de enfermería fue de 65.73±10.61 sobre 100. El 47% de los estudiantes tenían una ética medioambiental deseable. La estructura de conocimientos (0.46) predijo la actitud. La estructura de la actitud también predijo el comportamiento medioambiental (0.28) y la salud espiritual (0.31). En última instancia, los resultados mostraron que la salud espiritual y la ética medioambiental predicen el comportamiento medioambiental directa e indirectamente (p<0.001). Conclusión. La salud espiritual y la ética medioambiental fueron fuertes predictores del comportamiento medioambiental. Por lo tanto, es necesario tener en cuenta no sólo la salud espiritual de los estudiantes, sino también sus comportamientos éticos para promover conductas de protección del medio ambiente en el futuro.

Objetivo. Investigar a relação entre ética ambiental, saúde espiritual e comportamento ambiental entre estudantes de enfermagem. Métodos. Neste estudo transversal, 200 estudantes da Escola de Enfermagem de Chabahar (Irã) foram selecionados usando um método de amostragem aleatória simples. A ferramenta de coleta de dados incluiu um questionário sobre informações demográficas, conhecimento, atitudes e comportamentos em relação ao meio ambiente, ética ambiental e saúde espiritual. A modelagem de equações estruturais por mínimos quadrados parciais (PLS-SEM) foi usada para avaliar a estrutura conceitual deste estudo. Resultados. A pontuação média sobre ética ambiental entre os estudantes de enfermagem foi de 65.73±10.61 de um total de 100. 47% dos estudantes tinham uma ética ambiental desejável. A estrutura de conhecimento (0.46) previu a atitude. A estrutura da atitude também previu o comportamento ambiental (0.28) e a saúde espiritual (0.31). Por fim, os resultados mostraram que a saúde espiritual e a ética ambiental previram o comportamento ambiental direta e indiretamente (p<0.001). Conclusão. A saúde espiritual e a ética ambiental foram fortes preditores do comportamento ambiental. Portanto, é necessário considerar não apenas a saúde espiritual dos alunos, mas também seus comportamentos éticos, a fim de promover comportamentos de proteção ambiental no futuro.

Actitudes hacia la investigación en médicos residentes de un hospital pediátrico público

Introducción: La investigación es un proceso intencional de construcción de nuevos conocimientos e ideas, que impulsan la trasformación de la sociedad. Los profesionales de la salud deben desarrollar actitudes positivas hacia la investigación, toda vez que esto mejora su desempeño profesional y, por ende, la calidad de atención al paciente. Objetivo: Identificar las actitudes hacia la investigación en médicos residentes de un hospital pediátrico público. Métodos: Estudio descriptivo transversal; se incluyeron 200 médicos residentes. Se aplicó el instrumento "Escala de actitudes hacia la investigación (EACIN)", de 39 ítems. Se empleó la prueba t de Student para muestras independientes para determinar la diferencia de los puntajes de las actitudes de investigación y las variables sexo, tipo de especialidad y experiencia laboral; mientras que para la variable horas de trabajo semanal, se empleó la prueba U de Mann-Whitney. Resultados: El 58,5 % fue de sexo femenino; el 25 % (48) mostró una actitud afectiva positiva; el 98 % (196) una actitud cognitiva positiva; el 94 % (188) una actitud conductual positiva. En general, el 96 % (192) tuvo una actitud positiva y el 4 % (8) neutral. El puntaje obtenido por los médicos residentes que realizaban especialidades quirúrgicas fue mayor que el quienes realizaban especialidades clínicas (115,69 ± 6,02 vs. 113,29 ± 5,93; p= 0,012). Conclusiones: La mayor parte de los médicos residentes presentan actitudes positivas hacia la investigación, lo cual podría ser beneficioso para implementar programas de capacitación y actividades relacionadas con la investigación en el hospital.

Introduction: Research is an intentional process of constructing new knowledge and ideas, promoting the transformation of society. Health professionals must develop positive attitudes towards research since this will improve their professional performance and therefore improve the quality of patient care. Objective: Identify the attitudes towards research in resident doctors of a public pediatric hospital. Methods: The study was descriptive cross-sectional; 200 resident doctors were included. The "Research Attitudes Scale (EACIN)" of 39 items was applied. The T-Student test for independent samples was used to determine the difference in the scores of research attitudes, and the variables sex, type of specialty and work experience, while the Mann Whitney U test was used for the weekly work hours variable. Results: 58.5% were female, 25% (48) showed a positive affective attitude, 98% (196) a positive cognitive attitude, 94% (188) a positive behavioral attitude. In general, 96% (192) had a positive attitude and 4% (8) had a neutral attitude. The score obtained by resident physicians who performed surgical specialties was higher than that of those who performed clinical specialties (115.69 ± 6.02 versus 113.29 ± 5.93; p= 0.012). Conclusions: Most resident doctors have positive attitudes towards research, which could be beneficial to implement training programs and/or activities related to research in the hospital.

Development,reliability and validity of nurses'knowledge,attitude and practice questionnaire on medication management for patients with dysphagia / 重庆医学

Objective To develop nurses'knowledge,attitude and practice questionnaire on medication management for patients with dysphagia,and test its reliability and validity.Methods Based on the evidence-based summary of the best evidence of medication management for patients with dysphagia,guided by the the-ory of knowledge,attitude and practice,the basic dimensions and item pool of the questionnaire were deter-mined through group discussion,Delphi expert consultation and pre-investigation.In order to revise the ques-tionnaire,437 nurses from 10 tertiary hospitals in Jiangsu Province were conveniently selected for investigation,and the reliability and validity of the questionnaire were tested according to the survey results.Results The nurses'knowl-edge,attitude and practice questionnaire on medication management for patients with dysphagia included 43 items in three dimensions.The three dimensions were analyzed by exploratory factors,and six common factors with characteristic roots>1 were extracted.Two factors were extracted from the knowledge dimension,and the cumulative variance contribution rate was 74.958%,One factor was extracted from the attitude dimen-sion,and the cumulative variance contribution rate was 77.655%.Three factors were extracted from the prac-tice dimension,and the cumulative variance contribution rate was 72.274%.The factor load of each item was 0.618-0.902,Cronbach's α coefficient of the total questionnaire was 0.949,and the test-retest reliability was 0.909.The overall content validity coefficient of the questionnaire was 0.922,and the content validity coeffi-cient for each item was 0.800-1.000.Conclusion The nurses'knowledge,attitude and practice questionnaire on medication management for patients with dysphagia developed in this study has good reliability and validi-ty,and could be used as an effective tool to evaluate the status quo of nurses'medication management for pa-tients with dysphagia.

Application of nursing intervention based on information-knowledge-attitude-practice model in preventing radiodermatitis in tumor radiotherapy patients / 中国实用护理杂志

Objective:To explore the effect of nursing intervention based on information-knowledge-attitude-practice model (IKAP) in preventing radiodermatitis in tumor radiotherapy patients.Methods:This was a quasi-experimental study. A total of 72 patients who received radiotherapy in the Department of Oncology, the Second Hospital of Shanxi Medical University from August to October 2022 were selected and divided into the experimental group and the control group with 36 patients in each group by randomized digits table method. The control group received routine nursing, while the experimental group received nursing based on the IKAP. The self-management efficacy, radiodermatitis, self-perceived burden and quality of life of patients in the two groups were evaluated one day before and at the end of radiotherapy.Results:Thirty-five patients from each group completed the study. There were 11 males and 24 females in the control group, aged (58.09 ± 7.33) years old. There were 13 males and 22 females in the experimental group, aged (58.06 ± 7.28) years old.There was no statistically significant difference in self-management efficacy, self-perceived burden, and quality of life scores between the two groups of patients before intervention (all P>0.05). After intervention, the self-management efficacy,self-perceived burden, and quality of life scores of the experimental group were (106.89 ± 3.78), (18.69 ± 2.21), and (8.09 ± 1.27) points, respectively, the control group was (80.69 ± 5.76), (29.97 ± 2.48), and (15.91 ± 2.37) points, respectively. The differences between the two groups were statistically significant ( t=2.50, 1.12, 7.24, all P<0.01). The incidence of radiodermatitis above grade 2 in the experimental group was 31.4%(12/35), which was lower than 60.0%(21/35) in the control group, the difference was statistically significant ( χ2=4.64, P<0.01). Conclusions:Nursing intervention based on IKAP can improve the self-management efficacy, reduce the self-perceived burden and the incidence of radiodermatitis, and further improve the quality of life of tumor radiotherapy patients.

Reliability and validity of the Chinese version of disability attitude scale / 现代临床护理

Objective Reliability and validity of the Chinese version of disability attitude scales(DAS-CN)toward disabled persons were created and tested to provide an assessment instrument for measuring the attitude of medical staff toward disabled persons in China.Methods Authorised by the author of DAS in August 2020,based on BRISLIN translation model,the English version of DAS was translated into Chinese followed by back translation,cultural debugging and then put it into pre-experiment in September 2020.The reliability and validity of the finalised DAS-CN were further tested in a survey with 400 randomly selected medical staff in rehabilitation from 8 general hospitals in Jinzhou,Panjin,Yingkou and Fushun in Liaoning Province,China by using the convenience sampling method in March 2021.Results A total of 357 surveyees completed the survey.The localised DSA-CN was composed of 4 dimensions with a total of 20 items,including 4 items in clinical knowledge and skills,4 in clinical responsibility,8 in clinical behaviour and 4 in emotional response.The Cronbach α coefficient of the scales was 0.943,with the split-half reliability and test-retest reliability at 0.824 and 0.899,respectively.The Cronbach α coefficient of each dimension was 0.843～0.944,and the split half reliability was 0.854～0.904.The test-retest reliability ranged from 0.701 to 0.913.The KMO value of exploratory factor analysis was 0.921.The Bartrett spherical test value was 5534.981(P<0.01).The total explanatory rate of variation was 73.050%.Conclusion The Chinese version of Disability Attitude Scales(DSA-CN)has good reliability and validity.Therefore,DSA-CN can be used as an instrument in investigation of the current status about the attitudes towards the disabled persons among the medical staff in China.

Correlation of dietary intake during home stay of postoperative patients with digestive malignant tumors and the nutritional knowledge of their primary family caregivers / 现代医院

Objective To investigate the dietary intakes of postoperative patients with digestive malignant tumor during their recovery at home and explores the correlation of the intakes with the food nutritional knowledge of their primary family care-givers.Methods A total of 108 primary caregivers of prospective patients with digestive malignant tumors were selected for a sur-vey conducted at home from October 2022 to March 2023 in Guangzhou,from two tertiary hospitals.In this cross-sectional study,this paper investigated these caregivers using its general information questionnaire,a nutritional knowledge-attitude-behavior ques-tionnaire,and a simple dietary self-assessment tool(SDSAT).Results The SDSAT score of the patients was collected(4.16±1.22).Significant differences were observed among patients with various tumor types in terms of the recovery time at home after surgery.The total score of family primary caregivers'nutritional knowledge,attitude,and behavior was(47.64±6.97).Pearson's correlation analysis revealed a positive correlation between the knowledge of dietary guidelines and the patient's dietary intakes during home stay(r=0.285,P＜0.05).Multiple linear regression analysis revealed that caregivers'knowledge of dieta-ry guidelines significantly influenced the dietary intake of the prospective patients.Conclusion It is essential to regularly monitor the dietary intake of prospective patients at home.Medical personnel can concentrate on intervening with the patient's caregivers and encouraging them to participate in nutrition management together.This approach can improve the quality of family care and the nutritional status of the patients.

Correlation of health self-focused attention with knowledge, attitude and practice in health management of patients with essential hypertension / 中华全科医师杂志

Objective:To explore the impact of health self-focused attention on knowledge, attitude and practice of health management in patients with essential hypertension.Methods:This was a cross-sectional study. A total of 190 patients with essential hypertension were randomly selected from Shanghai Dapuqiao Community Health Service Center to participate in a questionnaire survey from October to December, 2021. The contents of the questionnaire included the general information of the patients, the degree of influence of hypertension on individuals, and the patients′ knowledge and personal cognition of hypertension, self-management behaviors, health self-focused attention, and blood pressure control. SPSS 25.0 and AMOS 24.0 were used to develop a structural equation model for analysis.Results:The recovery rate of questionnaires was 100.0% (190/190). Of the 190 patients, there were 82 males and 108 females with a mean age of (71.2±8.5) years. According to blood pressure, 190 hypertensive patients were divided into blood pressure controlled group ( n=119) and blood pressure non-controlled group ( n=71). There were significant differences in the total scores of hypertension self-management behavior and health self-focused attention between the two groups ( P<0.05). Correlation analysis showed that the degree of influence of hypertension on individuals was negatively correlated with the disease knowledge and personal cognition, and the performance of hypertension self-management behavior ( r=-0.39 and -0.28, P<0.01), while the disease knowledge and personal cognition were positively correlated with the performance of hypertension self-management behavior and health self-focused attention ( r=0.29 and 0.27, P<0.01). Hypertension self-management behavior was positively correlated with health self-focused attention and blood pressure control ( r=0.28 and 0.48, P<0.01), and health self-focused attention was positively correlated with blood pressure control ( r=0.21, P<0.01). The equation model analysis showed that health self-focused attention had a driving effect on patients′ disease knowledge and cognition and self-management behavior. Health self-focused attention significantly affected patients′ mastery of disease knowledge and formation of correct cognition (path coefficient=0.28). In addition, hypertension patients′ disease knowledge storage and internal recognition of prevention and treatment strategies determined their self-management behavior (path coefficient=0.20). On the other hand, the impact of hypertension on patients life, work and economic burden played a negative role in their acceptance of disease management knowledge, formation of correct concepts, and adoption of self-management behaviors with adjustment coefficients of -0.48 and -0.22, respectively. Conclusion:Health self-focused attention may play an initial role in the process of changing the knowledge, attitude and behavior of hypertension patients.

Relation between dysfunctional attitude and depressive symptoms in adolescents： the acting path of negative automatic thoughts and positive coping style / 四川精神卫生

BackgroundThe prevalence of depressive disorder in adolescents is on the rise. There have been studies on the pairwise relations between dysfunctional attitude， negative automatic thoughts， positive coping style and depressive symptoms in the past. However， the impact of the intrinsic relations among dysfunctional attitude， negative automatic thoughts and positive coping style on depressive symptoms is still unclear. ObjectiveTo explore the influence of dysfunctional attitude on adolescent depressive symptoms and examine the action path of negative automatic thoughts and positive coping style on it， in order to provide references for intervention for adolescent patients with depressisve disorder. MethodsThis study involved 162 adolescent patients with depressive disorder， who met the diagnostic criteria for depressive episodes in the International Classification of Diseases， 10th edition （ICD-10） and received treatment in Taiyuan Psychiatric Hospital from October 1， 2022 to October 31， 2023. These patients were evaluated using Self-rating Depression Scale （SDS）， Dysfunction Attitude Scale （DAS）， Positive Coping Style Subscale in Simplified Coping Style Questionnaire（SCSQ） and Automatic Thoughts Questionnaire （ATQ）. Pearson correlation analysis was adopted to examine the correlation among scores of scales above. Model 6 in Process 3.4.1 was adopted to test the acting path of negative automatic thoughts and positive coping style between dysfunctional attitude and adolescent depression symptoms. ResultsA total of 148 adolescent patients with depressive disorder completed an effective questionnaire survey， with a response rate of 91.36%. The direct effect value of dysfunctional attitude on depressive symptoms was 0.423 and the effect size was 63.32%. Negative automatic thoughts and positive coping style affected as acting path between dysfunctional attitude and depressive symptoms， with effect values of 0.156 （accounting for 23.35% of the total effect） and 0.045 （accounting for 6.74% of the total effect） respectively. Meanwhile， negative automatic thoughts and positive coping style affected as a chain reaction pathway between dysfunctional attitude and depressive symptoms， with an effect value of 0.044， accounting for 6.59% of the total effect. ConclusionDysfunctional attitude can not only directly affect the depressive symptoms of adolescent patients with depressive disorder， but also affect the depressive symptoms of adolescent patients with depressive disorder through the independent path or chain path of negative automatic thoughts and positive coping style.

Construction and reliability and validity of a scale for assessing psychiatric nurses' knowledge， attitude and practice towards the use of protective restraint / 四川精神卫生

BackgroundThe existing tools in China for assessing psychiatric nurses' knowledge， attitude and practice towards the use of protective restraint do not sufficiently consider the specialty in psychiatric practice， and the scale items are somewhat cumbersome to use， which together restrict their further promotion and application. Accordingly， there is an urgent need for developing a more scientific assessment tool. ObjectiveTo construct a scale for assessing psychiatric nurses' knowledge， attitude and practice towards the use of protective restraint and to verify its reliability and validity， so as to provide a generic tool for the assessment. MethodsBased on the theoretical framework of the knowledge-attitude-practice model， the preliminary scale was formed through systematic literature review， qualitative interview and Delphi method. From July to December 2021， a stratified sampling was utilized to select 729 psychiatric nurses from tertiary， secondary and primary （including unclassified medical institutions and grassroots hospitals） psychiatric hospitals in Guangdong Province. The formal scale was developed through item analysis， exploratory factor analysis and confirmatory factor analysis. The validity of the scale was evaluated by content validity and structure validity， and the reliability was verified by procedures including Cronbach's α coefficient， test-retest reliability， and split-half reliability. ResultsA total of 12 items of three dimensions （knowledge， attitude， practice） were included in the scale for assessing psychiatric nurses' knowledge， attitude and practice towards the use of protective restraint. The scale-level content validity index （S-CVI） was 0.941， and the item-level content validity index （I-CVI） ranged from 0.812 to 1.000. Exploratory factor analysis extracted three common factors， and the cumulative variance contribution rate was 62.948%. The confirmatory factor yielded adequate fit. Cronbach's α coefficient was found to be 0.887 for the scale， 0.819 for knowledge dimension， 0.842 for attitude dimension， and 0.831 for practice dimension. The split-half reliability and test-retest reliability for the scale were 0.712 and 0.922， respectively. ConclusionThe scale shows satisfactory reliability and validity， which can be used to assess psychiatric nurses' knowledge， attitude and practice towards the use of protective restraint. ［Funded by Guangdong Clinical Teaching Base Teaching Reform Research Project （number， 2021JD119）］

Study on the Knowledge-Attitude-Practice questionnaire for patients receiving oral anticoagulant therapy based on the Delphi method / 中国药房

OBJECTIVE To develop a questionnaire of the Knowledge-Attitude-Practice （KAP） for patients receiving oral anticoagulant therapy. METHODS Under the guidance of the theory of KAP， literature analysis and interview method were used to design the initial KAP questionnaire for patients treated with oral anticoagulants. Delphi method was adopted to consult the initial questionnaire and modify the questionnaire based on expert suggestions to form the final questionnaire. RESULTS Two rounds of consultation were conducted with 18 experts， and 18 questionnaires were sent out and recovered in each round， so the positive coefficient of experts was 100%. The expert authority coefficient was 0.94. The average importance scores for all dimensions， factors， and items of the questionnaire in both rounds were ≥4 points. The coefficient of variation was ≤0.25. The Kendall’s concordance coefficient for the overall questionnaire and the three dimensions of knowledge， attitude， and practice ranged from 0.09 to 0.34 （all P＜0.05）. Following the first round of expert consultation， four items were modified， two items were deleted， and five items were added； after the second round of expert consultation， ten items were modified. The final version of the questionnaire included three dimensions （knowledge， attitudes， and practice）， 17 questionnaire factors， and 40 items. CONCLUSIONS The questionnaire has high reliability and scientific validity with relatively concentrated expert opinions. It is suitable for assessing the knowledge， attitudes， and practice status of patients receiving oral anticoagulant therapy.

Serum vitamin D level of children aged 0 to 3 years and its correlation with nutritional knowledge, attitude and behavior of caregivers in Yibin / 中国儿童保健杂志

【Objective】 To explore the correlation of serum vitamin D level of children aged 0 to 3 years with their caregivers′ nutritional knowledge, attitude and practice (KAP) in Yibin, in order to provide reference for the prevention of vitamin D deficiency in children. 【Methods】 A total of 783 children aged 0 to 3 years who underwent child health care at the First People′s Hospital of Yibin from January to December 2020 were selected into this study. Children′s general conditions (feeding, growth and development, lifestyle, etc.) were collected, and venous blood samples were taken to detect serum 25-(OH)D concentration using the chemiluminescence method. The caregivers′ nutritional KAP was investigated using a self-designed knowledge-attitude-practice questionnaire. The relationship between the children′s vitamin D nutritional status and their caregivers′ nutritional KAP was analyzed using pearson correlation analysis. 【Results】 1) The exclusive breastfeeding rate of children aged 0 to 3 years was about 62.2%. Significant differences were found in outdoor activity time and average vitamin D supplementation among different age groups (t=9.030, 10.260, P<0.05). 2) The average concentration of serum 25-(OH)D was (36.8±8.7)ng/mL, and the incidence of vitamin D deficiency was 21.84%. Significant differences were found in serum 25-(OH)D level and the incidence of vitamin D deficiency among children of different ages, body shapes, outdoor activities, and vitamin D supplementation (t/F: 2.220 - 6.302, χ2: 5.346 - 33.134, P<0.05). 3) The caregivers′ nutritional KAP scores were 78.9±9.9, 88.1±8.3, and 78.3±11.8, respectively, with parents scoring higher than other caregivers (P<0.05). 4) Serum 25-(OH)D level was positively correlated with the nutritional knowledge, attitude, and behavior scores of caregivers (r=0.805, 0.650, 0.831, P<0.05). The caregivers′ nutritional KAP grade was correlated with vitamin D deficiency (P<0.05). 5) Overweight/obesity was a possible risk factor for vitamin D deficiency in children (OR=2.126, 95%CI: 1.162 - 3.887). Outdoor activity duration ≥2h/d (OR=0.592, 95%CI: 0.392 - 0.895), regular vitamin D supplementation (OR=0.618, 95%CI: 0.456 - 0.838), and good nutritional behavior of caregivers(OR=0.725, 95%CI: 0.563 - 0.933) were protective factors for vitamin D deficiency in children (P<0.05). 【Conclusions】 The prevalence of vitamin D deficiency is high among children aged 0 to 3 years in Yibin, and it is related to the nutritional KAP of their caregivers. Improving the nutritional KAP of caregivers can help prevent and manage vitamin D deficiency in children.

Suicide attitude, ideation and their relationship with family environment in adolescents with depression / 中国儿童保健杂志

【Objective】 To investigate the suicidal attitude, ideation of adolescent patients with depression, and to analyze their relationships with family environment, in order to provide evidence for the clinical treatment of adolesent depression and to reduce the suicide rate. 【Methods】 Totally 376 adolescents diagnosed with depression in Lu′an area from March 2019 to October 2021 were selected as the case group, and 376 normal adolescents were selected as the control group.The suicide attitude questionnaire (QSA), Beck scale for suicide ideation (BSS) and family environment scale (FES-CV) were used to investigate the suicide attitude, suicidal ideation and family environment of adolescents in two groups. Logistic regression analysis was used to analyze the influencing factors of suicide attitude and ideation of adolescent depression patients.Pearson correlation test was used to analyze the correlations between suicidal attitude, ideation and family environment of adolescent patients with depression. 【Results】 The scores of QSA and BSS in the case group were significantly higher than those in the control group (t=43.352, 96.527, P<0.001).The scores of intimacy, emotional expression, knowledge and entertainment in FES-CV of the case group were lower than those of the control group (t=25.487, 14.573, 22.160, 18.906), the score of contradiction was higher than that of the control group (t=30.311), and the differences were statistically significant (P<0.001).Logistic regression analysis showed that age of 20 - 25 years old (OR=2.016,2.261), severe illness (OR=2.115, 2.192), dwelling in city (OR=2.442, 2.557) were all risk factors for suicidal attitude and ideation in adolescent depression patients (P<0.05).The scores of QSA and BSS in the case group were negatively correlated with the scores of intimacy, emotional expression, knowledge and entertainment in FES-CV (QSA: r=-0.891,-0.933,-0.788,-0.698, BSS: r=-0.901,-0.832,-0.725,-0.637, P<0.05), but they were positively correlated with the score of contradiction (r=0.848, 0.883, P<0.05). 【Conclusions】 The suicidal attitude, ideation of adolescents with depression are higher than those of normal adolescents. Age, illness and growth environment are all influencing factors for suicidal attitudes and ideation in adolescent depression patients, of which the suicide attitude, ideation of patients are closely related to family environment.

Readiness and Challenges in Cardiopulmonary Resuscitation Teaching: A Preliminary Perspective Amongst Malaysian Secondary School Principles

@#Introduction: Malaysia has not legalized CPR teaching in the national curriculum, leaving it to school principals to implement the teaching of CPR who may have limited knowledge. This study aims to investigate Malaysian secondary school principals’ level of readiness, defined as knowledge, attitude, willingness to teach CPR, and barriers to implementation. Methods: Malaysian secondary school principals were invited to complete a survey that consisted of five parts: (1) demographics, (2) CPR knowledge, (3) attitude towards CPR, (4) willingness to teach CPR, and (5) barriers to implementing CPR teaching. Results: A total of 54 secondary school principals responded to the survey. Three (5.6%) principals passed the CPR test. More than 80% agreed CPR course is important for students, mandatory to be taken before graduation and best taught by certified teachers. Principals are willing to qualify themselves and teachers with CPR certification and to provide funding to support and hire an outsider to teach CPR courses. Funding, teachers’ readiness for skills and knowledge proficiency, and curriculum burden are perceived as potential barriers to successful CPR teaching. One-way MANOVA analysis showed that gender (p = .257), age (p = .108), qualifications (p = .321), teaching experience (p = .194), and administrative experience (p = .193) did not have a significant effect on the combined dependent variables. Conclusion: Malaysian secondary school principals are aware of the importance of CPR and were willing to acquire the knowledge, skills, funds, equipment, and support in ensuring its implementation in the national curriculum.

Unraveling the Sugar Rush: A Cross-sectional Study of Knowledge, Attitudes, and Practices Related to Sugar- Sweetened Beverages Consumption among Malaysian Young Adults

@#Introduction: The consumption of sugar-sweetened beverages (SSBs) among young adults in Malaysia has witnessed a notable increase in recent years, giving rise to concerns regarding the potential adverse health effects, including obesity and diabetes. Despite the urgent need for targeted interventions, there is a dearth of research examining the knowledge, attitudes, and practices (KAP) related to SSBs among Malaysian young adults. To address this research gap, the present study aims to assess the level of KAP concerning SSB intake and its associated factors in this specific population. Methods: A cross-sectional study was conducted involving 408 Malaysian young adults aged between 15 and 29 years. Respondents completed an online questionnaire survey, which encompassed the assessment of socio-demographic characteristics and KAP regarding SSB consumption. The collected data were analyzed using IBM’s Statistical Package for the Social Sciences (SPSS) version 22.0. Spearman correlation tests were performed at a significance level of 0.05. Results: The majority of respondents demonstrated moderate knowledge (60%) and practices (60%), while exhibiting a high positive attitude (100%) towards reducing SSB consumption. Significant correlations were observed between knowledge and attitude (p = 0.003, rs = 0.148) and between knowledge and practice (p = 0.005, rs = 0.138). Moreover, the attitude scores were found to be significantly associated with gender (χ2 (1, N = 408) = 10.421, p = 0.001) and locality (χ2 (1, N = 408) = 4.106, p = 0.043), while the practice scores exhibited a significant association with ethnicity (p = 0.006). Conclusion: This study provides valuable insights into the relationship between KAP related to SSB consumption and socio-demographic factors among Malaysian young adults. The findings underscore the importance of utilizing these insights to develop strategic interventions that aim to curtail SSB consumption and promote a healthy lifestyle, ultimately contributing to the reduction of non-communicable diseases. Health authorities are encouraged to capitalize on these findings to design targeted interventions tailored to the unique needs and circumstances of this population.

Leptospirosis Knowledge, Attitude, and Practice of Town Service Workers in Kuching, Malaysia

@#Introduction: This study aimed to evaluate town service personnel’s knowledge, attitudes, and practices (KAP) regarding leptospirosis prevention and the influencing factors to its practice. Methods: A cross-sectional study was conducted in Kuching, Malaysia, involving town service workers using a self-administered validated questionnaire comprising sociodemographic and KAP information. The eligibility criteria included 18 years old and above and having worked for more than six months. The KAP was determined using descriptive analysis, and associations were identified using logistic regression analysis. Results: About 189 town service workers responded, giving a response rate of 87.5%, and a majority of them were Bumiputera Sarawak, with a mean age of 38.6 (±11.00) years old. The mean duration of employment was 9.3 (±6.99) years. About 88.9% had good knowledge of leptospirosis. Meanwhile, 85.2% and 79.9% had satisfactory attitudes and good practices. The knowledge on the aetiology of leptospirosis ranged from 25% to 94%. No significant association was found between the knowledge score and income with the practice score. The attitude score (AOR 1.161; 95% CI = 1.090, 1.238; p = 0.000) and working experience (AOR 1.174; 95% CI = 1.023, 1.346; p = 0.022) were found to be significantly associated with their practice score. Conclusion: Most town service workers have good knowledge and practice regarding leptospirosis prevention. Workers with good attitudes demonstrate good practising habits toward leptospirosis prevention. Awareness and activities related to disease prevention should be encouraged to ensure the continuity of a positive attitude.

Cognition and Attitude of Chinese Medical Researchers towards Scientific Research Ethics: Based on the Results of a National Sample Survey / 中国医学伦理学

Based on the sampling survey data of 11 164 medical researchers in China, this paper analyzed the understanding, attitude and compliance of medical researchers on scientific research ethics in China. The survey found that although most medical researchers claim to have more understanding of scientific research ethics, the level of understanding of scientific research ethics is not optimistic; the channels to scientific research ethics knowledge are diversified, but the standardized training channels are insufficient; most researchers held the positive attitude toward following the ethical norms, but those male, youth under 35, with senior professional titles, or from northeast China held negative attitude relatively; more than half of the researchers claimed that the supervision of research ethics in China was basically in place, but some people said that the violation of scientific research ethics was common, and some researchers reported that there was a phenomenon of "direct seal consent and reply" in ethical review. Compared with medical institutions, enterprises and universities are the weak links of scientific research ethics training, education and review. Based on the above actuality, it puts forward policy suggestions to strengthen the scientific research ethics training and ethics review requirements.

Study on the Cognitive Attitude of Doctors and Patients towards the Rank of Rights and Interests and Its Related Factors / 中国医学伦理学

In order to further understand the cognitive attitude of different groups towards the rank of rights and interests in medical decision-making and its influencing factors, and provide theoretical reference for the practice of medical decision-making, this study conducted convenience sampling through the questionnaire star enterprise edition. The collected data were descriptive statistical analysis with SPSS 21.0 software and joint hypothesis testing. The results showed that there were differences in the cognition of religious beliefs on the same individual’s rights and interests rank among the sample population (P<0.05). There were differences in the cognition of professional title, working years and institution level on the attitude of rights and interests rank in the group of medical institutions (P<0.05). In the ranking of the importance of individual rights usually involved in medical activities, the rights to life, health and equality were the most important. Most people can rationally view the rights and interests of doctors, patients and stakeholders. In medical decision-making, we should adhere to the principle of right rank, give priority to safeguarding the right to life and give consideration to fairness and justice. In the face of conflicts of interest, we should do a good job in value evaluation, safeguard the reasonable interests of patients and give consideration to the demands of family members.