Beliefs and attitudes about chronic pain among public health professionals: cross-sectional study / Crenças e atitudes sobre dor crônica de profissionais de saúde pública: estudo transversal

ABSTRACT BACKGROUND AND OBJECTIVES: The barriers of scientific knowledge and adequate training can influence the skills of health professionals in the management of chronic pain in non-specialized environments. The aim of this study was to assess the beliefs and attitudes of the Brazilian public health care system's (Sistema Único de Saúde - SUS) professionals who work in the care of patients with chronic pain in the clinical routine. METHODS: This is a cross-sectional study carried out with non-specialized pain professionals from primary and medium-complexity care, assessed by the Inventory of Attitudes towards Pain. Participants were grouped by place of work and length of training for comparison analysis using the t-test for independent samples. Effect sizes were calculated (η² generalized), and the level of statistical significance was set at p<0.05. RESULTS: Seventy health professionals took part in this study. They presented undesirable beliefs about curing pain and caring behaviors. They also had desirable beliefs about the influence of emotions, the relationship between pain and tissue damage and the possibility of control by those who feel it. An effect of place of practice was also observed, with undesirable beliefs among primary care professionals about pain-related disability, and also an effect on length of training for the control domain, with less desirable beliefs among those with less than ten years of training. CONCLUSION: The undesirable beliefs presented by the health professionals allow for a situational diagnosis that indicates the need for continuing education in chronic pain in order to implement training with evidence-based practices in the SUS care routine.

RESUMO JUSTIFICATIVA E OBJETIVOS: As barreiras do conhecimento científico e do treinamento adequado podem influenciar as competências dos profissionais de saúde no manejo da dor crônica em ambientes não especializados. O objetivo deste estudo foi avaliar as crenças e atitudes de profissionais do Sistema Único de Saúde (SUS) que atuam no cuidado de pacientes com dor crônica na rotina clínica. MÉTODOS: Trata-se de estudo transversal realizado com profissionais não especialistas em dor da atenção primária e média complexidade, avaliados pelo Inventário de Atitudes frente à dor. Os participantes foram agrupados por local de atuação e tempo de formação para a análise de comparação através do teste t para amostras independentes. Foram calculados os tamanhos de efeito (η² generalizado) e o nível de significância estatística foi definido em p<0,05. RESULTADOS: Participaram deste estudo 70 profissionais de saúde, que apresentaram crenças indesejáveis a respeito da cura da dor e de comportamentos de solicitude. Esses profissionais também apresentaram crenças desejáveis quanto a influência das emoções, relação da dor com lesão tecidual e possibilidade de controle por quem a sente. Foi observado um efeito do local de atuação, com crenças indesejáveis dos profissionais da atenção primária sobre incapacidade relativa à dor, além de um efeito sobre o tempo de formação para o domínio controle, com crenças menos desejáveis entre aqueles com menos de 10 anos de formação. CONCLUSÃO: As crenças indesejáveis apresentadas pelos profissionais permitem um diagnóstico situacional que indica a necessidade de educação continuada em dor crônica para implementar treinamentos com práticas baseadas em evidências na rotina de cuidado do SUS.

Hepatitis B vaccine among healthcare workers: factors associated with the dimensions of the Health Belief Model / Vacina para hepatite B entre trabalhadores da saúde: fatores associados às dimensões do Modelo de Crenças em Saúde

ABSTRACT Objective: To investigate the association between the dimensions of the Health Belief Model (HBM) and complete vaccination for hepatitis B among healthcare workers (HCW). Methods: Cross-sectional epidemiological study with HCW in Primary Health and Medium Complexity Care. Univariate and bivariate analyses were performed to test the association between the outcome variable (complete vaccination for hepatitis B based on self-report) and the variables of the HBM dimensions. Prevalence ratio (PR) and its respective 95% confidence intervals (95%CI) were calculated. Results: 453 HCW participated. The prevalence of complete vaccination for hepatitis B was 56.9%. In the final analysis model, the following variables were associated with complete vaccination for hepatitis B: chances of having hepatitis B (PR=1.73) - related to the susceptibility dimension; disease severity (PR=0.74) - related to severity; reduced risk of absenteeism (PR=1.29) - related to benefits; not spending time to get vaccinated (PR=1.41) and not worrying about Events Supposedly Attributable to Vaccination or Immunization (PR=1.43) - related to barriers. Conclusions: The completeness of the hepatitis B vaccination schedule, reported by the investigated HCW, reveals the prevalence is below the target established by the Ministry of Health, which follows the national scenario of low coverage presented for other age groups. Understanding the risk perception and severity of hepatitis B can contribute to increasing the prevalence of vaccination for this infection.

RESUMO Objetivo: Investigar a associação entre as dimensões do Modelo de Crenças em Saúde (MCS) e a vacinação completa para hepatite B entre trabalhadores da saúde (TS). Métodos: Estudo epidemiológico de corte transversal com TS da Atenção Primária à Saúde e Média Complexidade. Realizaram-se análises uni e bivariada a fim de testar a associação entre a variável desfecho (vacinação completa para hepatite B a partir do autorrelato) e as variáveis das dimensões do MCS. Foram calculadas razões de prevalência (RP) e seus respectivos intervalos de confiança de 95% (IC95%). Resultados: Participaram do estudo 453 TS. A prevalência de vacinação completa para hepatite B foi de 56,9%. No modelo final de análise, estiveram associadas à vacinação completa para hepatite B as variáveis: chance de pegar hepatite B (RP=1,73) - relativa à dimensão de suscetibilidade; gravidade da doença (RP=0,74) - relativa à dimensão de gravidade; diminuição do risco de absenteísmo (RP=1,29) - relativa à dimensão de benefícios; não dispêndio de tempo para se vacinar (RP=1,41) e não preocupação acerca de eventos atribuíveis à vacinação ou imunização (RP=1,43) - relativas à dimensão de barreiras. Conclusão: A completude do esquema vacinal para hepatite B, referida pelos TS investigados, revela uma prevalência abaixo da meta estabelecida pelo Ministério da Saúde, a qual acompanha o cenário nacional de baixas coberturas apresentado para outras faixas etárias. A compreensão sobre percepção de risco e gravidade da hepatite B pode contribuir para o aumento da prevalência de vacinação para essa infecção.

Knowledge, attitudes, and beliefs regarding skin cancer among health sciences students in Turkey: A cross-sectional study

ABSTRACT BACKGROUND: Healthcare professionals' knowledge, attitudes, and beliefs regarding skin cancer are important for reducing the future impact of the disease. OBJECTIVE: This study evaluated university students' knowledge, attitudes, and beliefs about skin cancer and examined the variables influencing their attitudes and beliefs about the disease. DESIGN AND SETTING: This descriptive cross-sectional study was conducted at the Faculty of Health Sciences at Manisa Celal Bayar University, Manisa, Turkey. METHOD: A total of 960 students participated in this study. Data were collected using the Student Introduction Form, Fitzpatrick Skin Type Scale, Skin Cancer and Sun Knowledge Scale (SCSKS), and Health Belief Model Scale for Skin Cancer (HBMSSC). RESULTS: The mean SCSKS score of the participants was 14.91 ± 4.23. The mean HBSSC scores of the participants were 23.58 ± 7.79 for perceived susceptibility, 14.79 ± 4.59 for perceived severity, 20.64 ± 6.60 for perceived benefits, 15.93 ± 4.09 for perceived barriers, and 21.78 ± 7.14 for self-efficacy. The mean SCSKS total scores of the university students were significantly and positively correlated with the HBMSSC subdimensions. Gender explained 1.58 of the variance in perceived benefits and 1.65 of the variance in self-efficacy, whereas the SCSKS score explained most other variables. CONCLUSION: The students' knowledge of skin cancer and sun protection was moderate. Their attitudes and beliefs regarding skin cancer were unexpected. This study identified students' knowledge of skin cancer and sun protection as the most important variables for improving their attitudes and beliefs about skin cancer.

The effect of interventional program underpinned by health belief model on awareness, attitude, and performance of nurses in preventing nosocomial infections: A randomized controlled trial study / Efecto de un programa de intervención basado en el modelo de creencias en salud sobre el conocimiento, la actitud y el desempeño del personal de enfermería en la prevención de las infecciones intrahospitalarias. Ensayo controlado aleatorizado / Efeito de um programa de intervenção baseado no modelo de crenças em saúde no conhecimento, atitude e atuação da equipe de enfermagem na prevenção de infecções hospitalares. Teste controlado e aleatório

Objective. The present study examined the effect of an interventional program underpinned by the Health Belief Model (HBM) on nurses' awareness, attitude, and performance in preventing nosocomialinfections.Methods. This randomized controlled trial study was performed on 60 clinical nurses in lar, Iran. Nurses were selected using the simple random sampling method and assigned to two experimental (n=30) and control (n=30) groups. Data collection tool included the valid and reliable questionnaire was developed by Soleimani et al. The research intervention consisted of five 90-min sessions based on the health belief model in preventing hospital infection for experimental group. Before the intervention, immediately and two months after the intervention, the two groups completed the questionnaire. The control group received no intervention. Results. Data analysis showed that the differences between the two groups was statistically significant immediately and two months after the intervention (p<0.05). In experimental group the changes in the mean score of knowledge, attitude and performance of nurses before, immediately and two months after the intervention were significant (p<0.05), but in the control group, only the changes in the mean score of performance were significant (p<0.05). Conclusion. The results showed that the HBM-based intervention is effective in promoting nurses' knowledge, attitude, and performance in preventing nosocomialinfections. hence, periodical and in-service HBM-based training programs on preventing nosocomialinfections are recommended to be held for nurses.

Objetivo. El presente estudio examinó el efecto de un programa de intervención basado en el modelo de creencias en salud (Health Belief Model -HBM-, en inglés sobre el conocimiento, la actitud y el desempeño de las enfermeras en la prevención de las infecciones intrahospitalarias. Métodos. Este ensayo controlado aleatorizado se realizó en 60 enfermeras clínicas de lar, Irán. Las enfermeras fueron seleccionadas mediante el método de muestreo aleatorio simple y asignadas a dos grupos experimental (n=30) y de control (n=30). La herramienta para la recogida de datos incluyó el cuestionario válido y fiable desarrollado por Soleimani et al.La intervención consistió en cinco sesiones de 90 minutos basadas en el modelo de creencias de salud para prevenir la infección intrahospitalaria en el grupo experimental. Antes de la intervención, inmediatamente y dos meses después de la intervención, los dos grupos completaron el cuestionario. El grupo de control no recibió ninguna intervención. Resultados. El análisis de los datos mostró diferencias estadísticamente significativas entre los dos grupos en los momentos inmediatamente y dos meses después de la intervención (p<0.05). En el grupo experimental, los cambios en la puntuación media de conocimientos, actitudes y rendimiento de las enfermeras se observaron en los momentos de antes, inmediatamente y dos meses después de la intervención (p<0.05); mientras que en el grupo de control solamente los cambios en la puntuación media de desempeño fueron significativos (p<0.05). Conclusión. Los resultados mostraron que la intervención basada en HBM fue eficaz para promover el conocimiento, la actitud y el rendimiento de las enfermeras en la prevención de las infecciones intrahospitalaria, por lo que se recomienda impartir a las enfermeras programas de formación periódicos y en servicio basados en HBM sobre la prevención de las infecciones intrahospitalarias.

Objetivo. Examinar o efeito de um programa de intervenção baseado no Modelo de Crenças em Saúde (MBH) no conhecimento, atitude e desempenho dos enfermeiros na prevenção de infecções hospitalares. Métodos. Este ensaio clínico randomizado foi conduzido em 60 enfermeiras clínicas de lar, Irã. Os enfermeiros foram selecionados pelo método de amostragem aleatória simples e distribuídos em dois grupos experimental (n=30) e controle (n=30). O instrumento de coleta de dados incluiu o questionário válido e confiável desenvolvido por Soleimani et al. A intervenção consistiu em cinco sessões de 90 minutos baseadas no modelo de crenças em saúde para prevenir infecção hospitalar no grupo experimental. Antes, imediatamente e dois meses após a intervenção, ambos os grupos responderam ao questionário. O grupo controle não recebeu nenhuma intervenção. Resultados.A análise dos dados mostrou diferenças estatisticamente significativas entre os dois grupos imediatamente e dois meses após a intervenção (p<0.05). No grupo experimental foram observadas alterações na pontuação média de conhecimentos, atitudes e desempenho dos enfermeiros antes, imediatamente e dois meses após a intervenção (p<0.05); enquanto no grupo controle apenas as alterações na pontuação média de desempenho foram significativas (p<0.05). Conclusão.Os resultados demonstraram que a intervenção baseada no HBM foi eficaz na promoção do conhecimento, atitude e desempenho dos enfermeiros na prevenção de infecções hospitalares, pelo que se recomenda proporcionar aos enfermeiros este tipo de programas de formação em serviço baseados no HBM.

Percepção de informações sobre medidas não farmacológicas de prevenção para a covid-19 entre usuários de uma Unidade Básica de Saúde de Campina Grande, Paraíba / Perception of information about non-pharmacological prevention measures for covid-19 among users of a basic health unit in Campina Grande, Paraíba

As percepções sobre a doença pelo coronavírus 2019 (covid-19) associam-se à adoção de medidas preventivas não farmacológicas (MNF) contra o contágio. O objetivo deste estudo foi analisar a percepção de informações sobre MNF para prevenção da COVID-19 por usuários de uma Unidade Básica de Saúde (UBS). O estudo foi descritivo-transversal, quanti-qualitativo. Selecionou-se uma amostra de 70 famílias da população adstrita a uma UBS de Campina Grande (PB) para a fase quantitativa e, entre estes, 14 foram escolhidos para a fase qualitativa. A coleta de dados foi feita por questionário estruturado (dados sociodemográficos; informações sobre MNF; gravidade da covid-19; suscetibilidade à covid-19; confiança nas MNF) e entrevista não estruturada (enfrentamento, informações, impacto). Amostra predominantemente feminina (65,2%), parda (69,6%) e de instrução superior/pós-graduação (62,3%), que aplicou MNF em associação de 2 a 4, sobretudo lavagem das mãos, uso de álcool e máscara facial (51/74,2% para cada) e isolamento (36/52,4%). A maior parte se informou sobre MNF por TV e internet, e uma minoria, por amigos, parentes, governantes e profissionais da UBS; 49,2% se perceberam suscetíveis e 65,2% se sentiram confiantes nas MNF. Houve mais falas referentes a máscaras, vacinação e coletividade, nas categorias emergentes de prevenção, percepção, informação, governança e impacto. Os respondentes relataram críticas ao conteúdo e ênfase insuficiente das informações e à adesão parcial pela sua comunidade. Conclui-se que as orientações sobre as MNF alcançaram os participantes deste estudo e, para isto, deve ter contribuído o grau de escolaridade favorável da amostra.

Perceptions about coronavirus disease 2019 (covid-19) are associated with the adoption of non-pharmacological preventive measures (MNF) against contagion. The objective of this study was to analyze the perception of information about MNF for the preventionof covid-19 by users of a basic health unit (UBS). The study was descriptive-cross-sectional, quanti-qualitative. A sample of 70 families from the population assigned to a UBS in Campina Grande (PB) was selected for the quantitative phase and, among these, 14 were chosen for the qualitative phase. Data collection was performed using a structured questionnaire (sociodemographic data; information on MNF; severity of covid-19; susceptibility to covid-19; trust in MNF)and unstructured interview (coping, information, impact).Predominantly female sample (65.2%), non-white (69.6%) and with higher/graduate education (62.3%), who applied MNF in association of 2 to 4, especially hand washing, use of alcohol and face mask (51/74.2% for each) and isolation (36/52.4%).Most were informed about MNF by TV and the internet, and a minority by friends, relatives, government officials and UBS professionals; 49.2% felt susceptible and 65.2% felt confident in MNF. There were more statements referring to masks, vaccination, and collectivity, in the emerging categories of prevention, perception, information, governance and impact. Respondents reported criticism of the content and insufficient emphasis of information and partial adherence by their community. It is concluded that the guidelines on MNF reached the participants of this study and, for this, the favorable level of education of the sample must have contributed.

Percepções de mulheres com câncer de mama acerca dos tratamentos / Perceptions of women with breast cancer regarding treatments

O objetivo deste estudo foi compreender a percepção das mulheres com câncer de mama acerca dos tratamentos. Trata-se de um estudo qualitativo, descritivo, transversal, no qual participaram 40 mulheres em quimioterapia para tratamento do câncer mamário em um hospital especializado em oncologia. O instrumento utilizado para coleta de dados foi uma entrevista semiestruturada. Os dados foram analisados mediante Análise de Conteúdo de Bardin e categorizados conforme o Modelo de Crenças em Saúde. Originaram-se quatro categorias: "Suscetibilidade percebida: câncer e COVID-19", "Percepção da gravidade em face do impacto dos tratamentos", "Desafios e barreiras nos tratamentos" e "Benefícios percebidos no tratamento do câncer". Conclui-se que existem diferentes fatores que ressoam na percepção que a mulher tem sobre os tratamentos e que geram repercussões na forma de enfrentá-los. O conhecimento desses fatores pelos profissionais de saúde pode auxiliar na assistência às mulheres para melhor enfrentamento da doença.

The objective of this study was to understand the perception of women with breast cancer about treatments. This is a qualitative, descriptive, cross-sectional study, involving 40 women undergoing chemotherapy for the treatment of breast cancer in a hospital specialized in oncology. The instrument used for data collection was a semi-structured interview. Data was analyzed using Bardin's Content Analysis and categorized according to the Health Belief Model. Four categories emerged: "Perceived susceptibility: cancer and COVID-19", "Perception of severity in view of treatments impact", "Challenges and barriers in treatments" and "Perceived benefits in cancer treatment". It is concluded that there are different factors that resonate in women's perception of treatments and that generate repercussions in the way of facing them. Knowledge of these factors by healthcare professionals can help in providing better assistance to women in facing the disease.

Contexts motivating protective behaviours related to Aedes-borne infectious diseases in Curaçao.

BACKGROUND: Aedes aegypti, the vector of arboviral diseases such as dengue and Zika virus infections, is difficult to control. Effective interventions must be practicable, comprehensive, and sustained. There is evidence that community participation can enhance mosquito control. Therefore, countries are encouraged to develop and integrate community-based approaches to mosquito control to mitigate Aedes-borne infectious diseases (ABIDs). Health professionals must understand the contexts motivating individuals' behaviour to improve community participation and promote behavioural change. Therefore, this study aimed to determine how contexts shaped individuals' protective behaviours related to ABIDs in Curaçao. METHODS: From April 2019 to September 2020, a multi-method qualitative study applying seven (n = 54) focus group discussions and twenty-five in-depth interviews with locals was performed in CuraÒ«ao. The study was designed based on the Health Belief Model (HBM). Two cycles of inductive and deductive coding were employed, and Nvivo software was used to manage and analyse the data. RESULTS: In this study, low media coverage (external cue to action) and limited experience with the symptoms of ABIDs (internal cue to action) were linked with a low perceived susceptibility and severity of ABIDs (low perceived threat). The low perceived threat was linked with reduced health-seeking behaviour (HSB) to prevent and control ABIDs. We also found that the perceived barriers outweigh the perceived benefits of ABID prevention and control interventions, obstructing HSB. On the one hand, insufficient knowledge reduced self-efficacy but contrary to expected, having good knowledge did not promote HSB. Lastly, we found that our participants believe that they are responsible for preventing ABIDs (internal locus of control) but at the same time indicated that their success depends on the efforts of the community and the health system (external locus of control). CONCLUSIONS: This study used the HBM to explain individual changes in HSB concerning ABIDs prevention and control in Curaçao. We can conclude that the perceived threat (perceived susceptibility and severity) and perceived barriers played an essential role in changing HSB. Health professionals must consider these two concepts' implications when designing a bottom-up approach for ABIDs control; otherwise, community participation will remain minimal.

The effects of health belief model-based intervention on nurses' sterilizing practices when moistening surgical instruments.

OBJECTIVE: We investigated the effects of the Health Belief Model (HBM)-based intervention on nurses' behaviors in terms of keeping surgical instruments moist. MATERIALS AND METHODS: Pre- and post-training surveys about instrument moistening were conducted with the same 356 nurses from a hospital in China. Both of the surveys contained questionnaire concerning general knowledge relating to instrument moistening, perception scale-based questions concerning the same issue, and an inspection form concerning the implementation of moistening procedures. Three months' training was provided for the nurses. RESULTS: After training, the nurses' knowledge, attitudes, beliefs, and behaviors for instrument moistening were improved. CONCLUSIONS: The HBM-based intervention can bring about a significant improvement in nurses' compliance with surgical instrument moistening requirements, and corresponding improvements in instrument cleanliness and patient safety.

OBJETIVO: Investigar los efectos de la intervención basada en el modelo de creencias de salud en los comportamientos de las enfermeras en términos de mantener húmedos los instrumentos quirúrgicos. MÉTODO: Se realizaron encuestas previas y posteriores a la capacitación sobre la humectación de instrumentos con las mismas 356 enfermeras de un hospital en China. Ambas encuestas contenían un cuestionario sobre el conocimiento general relacionado con la humectación del instrumento, preguntas basadas en escalas de percepción sobre el mismo tema y un formulario de inspección sobre la implementación de los procedimientos de humectación. Se proporcionó una formación de 3 meses a las enfermeras. RESULTADOS: Después de la capacitación se mejoraron los conocimientos, las actitudes, las creencias y los comportamientos de las enfermeras para la humectación del instrumento. CONCLUSIONES: La intervención basada en el modelo de creencias en salud puede generar una mejora significativa en el cumplimiento de los requisitos de humectación del instrumental quirúrgico por parte de las enfermeras, y las correspondientes mejoras en la limpieza del instrumental y la seguridad del paciente.

Determinants for COVID-19 vaccination intention in Mexico.

This investigation aims to determine the predictors that have the most significant influence over COVID-19 vaccination intention for the population of 18 years or above in Mexico. This will be done through a comprehensive theoretical model comprising: the theory of planned behaviour, the health belief model, and the model of goal-directed behaviour. An exploratory, cross-sectional study with a quantitative approach was carried out. The structured questionnaire was applied to 1085 adults in the first trimester of 2021 through Google Forms in social media groups. The data analysis was carried out through partial least square structural equation modelling. Positive anticipated emotions, desire, subjective norms, attitude, and perceived behavioural control were the most significant predictors of intention. The model that combines the theoretical perspectives explains mostly the vaccination intention. The study can be a valuable theoretical perspective for understanding similar behavioural intentions related to health risks. The results are also valuable for public health decision-makers to design strategies that promote vaccination.

COVID-19, social identity, and socially responsible food consumption between generations.

Introduction: The objective of the research was to analyze the effect of COVID-19 with the predictors of the health belief model (perceived severity, perceived benefits, and cue to action) on the social identity of the consumer and the social identity of the socially responsible food consumption among four generation groups of adults based on the stimulus-organism-response model. Methods: The study had a quantitative approach explanatory design and a cross-sectional temporal dimension. A total of 834 questionnaires were collected from adults in the metropolitan area of Mexico City, and the data were analyzed through partial least squares structural equation modeling. Results: The results indicated that perceived severity, perceived benefits, and cue to action positively and significantly influenced social identity, and this positively and significantly influenced socially responsible consumption. In addition, identity was found to be a variable that had a total mediation effect between perceived severity and socially responsible consumption, perceived benefits and socially responsible consumption, and cue to action and socially responsible consumption. While the perceived barriers only had a direct effect on socially responsible consumption. Likewise, a difference was found between generation X and Y, generation Z and X, and generation Y and X in the relationship between cue to action, belonging to a social network group, and social identity. Discussion: In this sense, these results allow us to consider that when environmental stimuli (predictors of the health belief model) affect the organism (social identity), it will respond with socially responsible food consumption. This type of consumption is explained through social identity and is modified according to the age of the consumers due to the effects of social networks.

Parental Justifications for Not Vaccinating Children or Adolescents against Human Papillomavirus (HPV).

Vaccination coverage against Human Papillomavirus (HPV) is low compared with uptake of other vaccines in many countries, including Brazil. The aim of this study was to examine the main reasons provided by parents or guardians of a target population that did not have the first dose of HPV vaccine in a small rural Brazilian municipality, and to verify the factors associated with the reasons for non-vaccination. This is a cross-sectional study with interviews based on the Health Belief Model (HBM), conducted with parents and guardians of 177 unvaccinated children or adolescents. The outcome of interest was the main reason for not vaccinating the child/adolescent. The exposure factors of interest were knowledge about HPV and its prevention as well as sociodemographic characteristics. The main justifications for not vaccinating were lack of information (62.2%), fear or refusal (29.9%), and logistical issues (7.9%). The justifications associated with adolescents' sex, fear, or refusal were mentioned by 39.3% (95% CI: 28.8-50.6%) of parents or guardians of girls and by 21.5% (95% CI: 13.7-31.2%) of parents or guardians of boys. The main barrier to HPV vaccination is lack of information. Further training of health professionals in clarifying the benefits of vaccination and differentiating the risks between boys and girls could encourage uptake.

'It is in our hands-Why wait until you are sick?': Perceptions about diabetes prevention of Latina mothers in Mexico and the United States.

AIMS: This study aimed to understand the perceptions driving type 2 diabetes mellitus prevention and management behaviours of Mexican and Latina mothers in Mexico and the United States. METHODS: Low-income Mexican mothers in San Luis Potosí, Mexico and Latina mothers in Illinois, United States, were recruited by the Holistic Obesity Prevention Study (HOPS). Verbatim transcripts of the semistructured interviews conducted in Spanish (n = 24) and English (n = 1) were analysed using the Health Belief Model (HBM) framework. RESULTS: Of the 25 participants, 22 (88%) indicated 'knowing someone with diabetes'-specifically a father (n = 8), mother (n = 6) or grandparent (n = 7). Using the HBM, themes showed that mothers perceived: that Type 2 diabetes can happen to anyone, are attributable to genetic predisposition and may be driven by strong emotions (perceived susceptibility). Type 2 diabetes introduces severe comorbidities and emotional difficulties for people and their families (perceived severity). Adopting a healthier diet, exercising and staying in good spirits were recognized as benefits of Type 2 diabetes prevention (perceived benefits). The costs of food, challenges of exercising, dieting, modifying habits and time limitations were recognized as perceived costs. Cues to action included doctors' recommendations (external) and fear (internal). Mothers acknowledged they could live a healthy life by controlling their weight, exercising, adhering to treatments/medications and having the determination to carry-on (self-efficacy). CONCLUSIONS: Mothers sought to prevent Type 2 diabetes and live healthy lives, particularly, after receiving a diagnosis of gestational diabetes or when learning about their children's risks for Type 2 diabetes but perceived significant barriers to Type 2 diabetes prevention.

Cessation of Face Mask Use after COVID-19 Vaccination in Patients with Diabetes: Prevalence and Determinants.

Studies on the cessation of face mask use after a COVID-19 vaccine in patients with diabetes are not available, despite their greater predisposition to complications. We estimated the prevalence of cessation of face mask use after receiving the COVID-19 vaccine in patients with diabetes and identified which factor was most strongly associated with non-use. This was a cross-sectional study in patients with diabetes 18-70 years with at least one dose of vaccine against COVID-19 (n = 288). Participants were asked to respond face-to-face to a questionnaire in a primary care center. Descriptive statistics, chi-square tests, and multivariate binary logistic regression were used for analyzing the association between vulnerability, benefits, barriers, self-efficacy, vaccine expectations (independent variables), and cessation of use (dependent variable), controlling for sociodemographic, smoking, medical, vaccine, and COVID-19 history. The prevalence of cessation of face masks was 25.3% (95% CI 20.2, 30.5). Not feeling vulnerable to hospitalization increased the odds of non-use (adjusted OR = 3.3, 95% CI 1.2, 8.6), while perceiving benefits did the opposite (adjusted OR = 0.4, 95% CI 0.2, 0.9). The prevalence was low, and only two factors were associated with the cessation of face mask use after COVID-19 vaccination in patients with type 2 diabetes.

The effect of interventional program underpinned by health belief model on awareness, attitude, and performance of nurses in preventing nosocomial infections: A randomized controlled trial study.

Objective: The present study examined the effect of an interventional program underpinned by the Health Belief Model (HBM) on nurses' awareness, attitude, and performance in preventing nosocomial infections. Methods: This randomized controlled trial study was performed on 60 clinical nurses in lar, Iran. Nurses were selected using the simple random sampling method and assigned to two experimental (n=30) and control (n=30) groups. Data collection tool included the valid and reliable questionnaire was developed by Soleimani et al. The research intervention consisted of five 90-min sessions based on the health belief model in preventing hospital infection for experimental group. Before the intervention, immediately and two months after the intervention, the two groups completed the questionnaire. The control group received no intervention. Results: Data analysis showed that the differences between the two groups was statistically significant immediately and two months after the intervention (p<0.05). In experimental group the changes in the mean score of knowledge, attitude and performance of nurses before, immediately and two months after the intervention were significant (p<0.05), but in the control group, only the changes in the mean score of performance were significant (p<0.05). Conclusion: The results showed that the HBM-based intervention is effective in promoting nurses' knowledge, attitude, and performance in preventing nosocomial infections. hence, periodical and in-service HBM-based training programs on preventing nosocomial infections are recommended to be held for nurses.

Health Belief Model in studies of influenza vaccination among health care workers.

Vaccines prevent numerous infectious diseases, including influenza. Despite their significant contribution to controlling influenza, vaccine coverage against this disease varies among health care workers. The Health Belief Model could thus help to understand the reasons why these workers accept (or not) the immunobiological. The aim of this study was to describe the main results of research performed on influenza vaccination among health care workers using the Health Belief Model. This is an integrative literature review. Data search took place in October 2020 in the PubMed database, with the following descriptors: "influenza vaccine"; "health professionals"; "Health Belief Model," and their synonyms. Eleven studies were included in this review. The main dimensions of the model (susceptibility, severity, benefits, and barriers) were more explored by the studies, and self-efficacy was the least studied dimension. Moreover, we observed a relationship between the theory's dimensions (susceptibility, severity, benefits, barriers, cues to action, and self-efficacy) and influenza vaccination in health care workers. In conclusion, this review identified profiles of beliefs for each dimension of the Health Belief Model, which has traditionally been an ally for determining refusal or acceptance of the influenza vaccine among health care workers.

As vacinas previnem inúmeras doenças infecciosas, inclusive a influenza. Mesmo diante da sua significativa contribuição para o controle da enfermidade, as coberturas vacinais contra influenza entre os trabalhadores de saúde são variáveis. Dessa forma, o modelo de crenças em saúde pode auxiliar na compreensão dos motivos que levam esses trabalhadores a aceitarem ou não o imunobiológico. O objetivo deste estudo foi descrever os principais resultados de pesquisas sobre vacinação contra influenza entre trabalhadores de saúde utilizando o modelo de crenças em saúde. Tratou-se de uma revisão integrativa da literatura. A busca de dados ocorreu em outubro de 2020 na base de dados PubMed, com os descritores: "influenza vaccine"; "health professionals"; e "Health Belief Model" e seus sinônimos. Foram incluídos 11 artigos nesta revisão. Identificou-se que as principais dimensões do modelo (suscetibilidade, gravidade, benefícios e barreiras) foram mais exploradas pelos artigos, e a dimensão autoeficácia foi a menos estudada. Além disso, existe uma relação entre as dimensões da teoria (suscetibilidade, gravidade, benefícios, barreiras, estímulos para ação e autoeficácia) e a vacinação contra a influenza em trabalhadores da saúde. Conclui-se que, através da revisão proposta, pôde-se identificar perfis de crenças para cada dimensão do modelo de crenças em saúde que, tradicionalmente, vem servindo como aliado para determinar recusa ou aceitação da vacina contra influenza entre trabalhadores de saúde.

Crenças em saúde de mulheres lésbicas e bissexuais acerca da realização do teste de Papanicolaou / Lesbian and bisexual women's health beliefs about performing the Papanicolaou's test

RESUMO Objetivo identificar as crenças em saúde de mulheres lésbicas e bissexuais acerca da realização do teste de Papanicolaou. Métodos estudo transversal desenvolvido exclusivamente online, com 55 participantes. Utilizou-se o Google Forms® para coleta de dados, com questões sociodemográficas e econômicas, além de questões relacionadas às práticas, à intenção e às crenças na realização do teste de Papanicolaou. Os dados foram organizados no Google Sheets® e analisados no software SPSS®. Resultados verificou-se que mulheres bissexuais acreditam mais no benefício "quando eu faço o exame preventivo, eu fico aliviada" (p=0,047). Contudo, possuem maior pontuação de vergonha de fazer o exame preventivo (p=0,005). Identificou-se associação significativa entre ter realizado o exame e benefícios percebidos (p=0,040); gravidade percebida e nível de instrução (p=0,006); ter realizado o exame (p=0,039); e ter parceria fixa (p=0,028). Conclusão mulheres bissexuais acreditam que realizar o exame gera alívio, mas o sentimento de vergonha pode prejudicar a adesão ao exame. Mulheres lésbicas e bissexuais sem acesso à educação superior, que nunca realizaram o exame e que possuem múltiplas parcerias sexuais estão mais vulneráveis ao câncer de colo do útero. Contribuições para a prática: refletir sobre esse cenário para que estratégias educativas sejam efetivadas acerca da prevenção do câncer de colo do útero.

ABSTRACT Objective to identify the health beliefs of lesbian and bisexual women about performing the Papanicolaou's test. Methods cross-sectional study developed exclusively online, with fifty-five participants. Google Forms® were used for data collection, with sociodemographic and economic questions, as well as questions related to practices, intention, and beliefs about performing the Papanicolaou's test. Data were organized in Google Sheets® and analyzed in SPSS® software. Results it was found that bisexual women believe more in the benefit "when I do the preventive exam, I am relieved" (p=0.047). However, they have higher scores of ashamed for doing the preventive exam (p=0.005). Significant association was identified between having done the exam and perceived benefits (p=0.040); perceived severity and education level (p=0.006); having done the exam (p=0.039); and having fixed partnership (p=0.028). Conclusion bisexual women believe that performing the exam generates relief, but feelings of shame may hinder adherence to the exam. Lesbian and bisexual women without access to higher education, who never had the exam, and who have multiple sexual partnerships are more vulnerable to cervical cancer. Contributions to practice: reflect on this scenario so that educational strategies are effective for cervical cancer prevention.

Association between the risk perception of contracting COVID-19 and sociodemographic characteristics in a Peruvian population.

Background: The perception of risk regarding coronavirus disease 2019 (COVID-19) has been widely researched due to its association with the adoption of preventive measures. In addition, since the onset of vaccination, it has been reported that the population perceives a lower risk of getting infected. However, few studies have analyzed the factors associated with risk perception in low- and middle-income countries. The aim of this study was to determine the association between the risk perception of contracting COVID-19 and sociodemographic characteristics in Peruvian population. Methods: An analytical and cross-sectional study was conducted in four cities in Peru from October to December, 2021. The sample consisted of 821 individuals aged 18 years and older. A virtual questionnaire was used to collect sociodemographic data and assess the risk perception of contracting coronavirus based on the Health Belief Model. The process of back-translation, expert judgment, and reliability analysis using split-half correlation was conducted. Student's t-tests, analysis of variance with post hoc Tukey's test, and Spearman's correlation were employed. Results: Of the participants, 53.71% were women and 73.3% had a higher education level, 45.55% are self-employed, and 40.44% did not have a family member infected with COVID-19. The risk perception of COVID-19 infection was associated with participants' family antecedent of COVID-19 (p < 0.05). Regarding the factors analyzed, perceived susceptibility to COVID-19 was associated with age (p=0.002), occupation (p<0.05), and a history of COVID-19 (p<0.05), while the perceived benefits of adopting preventive measures against this disease were associated with educational level (p < 0.001). Conclusions: The risk perception of contracting COVID-19 was higher among whose had multiple infected relatives.. Furthermore, the perception of susceptibility and the perceived benefits of using preventive measures were associated with sociodemographic characteristics.

Using the health belief model to analyze nurses' perception toward their behaviors for keeping surgical instruments moist: a cross-sectional study.

BACKGROUND: Nurses' perception toward their behaviors for keeping surgical instruments moist has been rarely studied. METHODS: The survey which utilized a questionnaire regarding respondent's demographic information and a self-designed nurses' perception-behavior scale for keeping surgical instruments moist was conducted with 360 nurses from a hospital in China. RESULTS: Total score of nurses' perception-behavior scale for keeping surgical instruments moist was 139.93 ± 15.145. Score of nurses' perception-behavior scale for keeping surgical instruments moist varied with age, length of service, and job title, with a statistically significant difference (p < 0.05). Length of service was the main factor affecting nurses' perception toward their behaviors for keeping surgical instruments moist. CONCLUSIONS: Nurses should be offered intensive training on keeping surgical instruments moist due to their inadequate perception on it. The nurses' change in health beliefs and behaviors must be based on developing the right attitude.

OBJETIVO: La percepción de los enfermeros sobre sus comportamientos para mantener húmedo el instrumental quirúrgico ha sido poco estudiada. MÉTODOS: La encuesta que utilizó un cuestionario sobre la información demográfica del encuestado y una escala de percepción y comportamiento de las enfermeras de diseño propio para mantener húmedos los instrumentos quirúrgicos se realizó con 360 enfermeras de un hospital en China. RESULTADOS: La puntuación total de la escala de percepción-conducta de las enfermeras para mantener húmedo el instrumental quirúrgico fue de 139.93 ± 15.145. La puntuación de la escala de percepción-conducta de las enfermeras para mantener húmedos los instrumentos quirúrgicos varió con la edad, la duración del servicio y el cargo, con una diferencia estadísticamente significativa (p < 0,05). El tiempo de servicio fue el principal factor que influyó en la percepción de los enfermeros sobre sus comportamientos para mantener húmedo el instrumental quirúrgico. CONCLUSIÓN: Se debe ofrecer a las enfermeras un entrenamiento intensivo sobre el mantenimiento de la humedad del instrumental quirúrgico por su inadecuada percepción al respecto. El cambio de creencias y comportamientos de salud de las enfermeras debe basarse en el desarrollo de la actitud correcta.

Effectiveness of the application of an educational program based on the Health Belief Model (HBM) in Adopting Preventive Behaviors from Self-Medication among Women in Iran. A Randomized Controlled Trial / Eficacia de la aplicación de un programa educativo basado en el Modelo de Creencias sobre la Salud en la adopción de conductas preventivas de la automedicación entre las mujeres de Irán. Un ensayo controlado aleatorio / Eficácia da aplicação de um programa educativo baseado no Modelo de Crenças sobre Saúde na adoção de comportamentos preventivos de automedicação entre mulheres no Irã. Um ensaio clínico randomizado

Objective.To evaluate the effectiveness of the application of an educational program based on the Health Belief Model (HBM) in Adopting Preventive Behaviors from Self-Medication among Women in Iran. Methods. Interventional study with pre and post phases. 200 women referring to the health centers of Urmia were selected by simple random sampling, divided into two groups of treatment and control. Data collection instruments were researcher-devised questionnaire including the questionnaire of Knowledge of Self-medication, the Questionnaire of Preventive Behaviors from Self-medication, and the questionnaire of Health Belief Model. The questionnaires were assessed for expert validity and then, were checked for reliability. The educational intervention was conducted for the treatment group during four weeks four 45-minute sessions. Results.The average scores of knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, self-efficiency, and post-intervention performance in have increased in treatment group, comparing to the control group, All findings were statistically significant (p<0.05). Furthermore, social media, doctors, and disbelief in self-medication were more effective in increasing awareness and encouraging to have proper medication, also, the highest self-medication was in taking pain-relievers, cold tablets and antibiotics, which showed significant decrease in treatment group after the intervention. Conclusion.The educational program based onHealth Belief Modelwas effective in reducing the self-medication among the studied women. Furthermore, it is recommended to use social media and doctors to improve the awareness and motivation among people. Thus, applying the educational programs and plans according to the Health Belief Model can be influential in reducing the self-medication.

Objetivo. Evaluar la eficacia de la aplicación de un programa educativo basado en el Modelo de Creencias sobre la Salud (MCS) en la adopción de conductas preventivas de la automedicación entre las mujeres de Irán. Métodos. Estudio de intervención con evaluación pre y post. Se seleccionaron 200 mujeres que acudieron a los centros de salud de Urmia, a quienes se asignaron a los dos grupos de estudio (tratamiento y control) mediante un muestreo aleatorio simple. Para la recolección de la información se utilizaron los cuestionarios sobre: Conocimientos acerca de la automedicación, conductas preventivas de la automedicación y el modelo de creencias sobre la salud. Se evaluó la validez de los cuestionarios por parte de los expertos y luego se comprobó su confiabilidad. La intervención educativa se llevó a cabo para el grupo de tratamiento durante cuatro semanas con 1 sesión semanal de 45 minutos de duración.Resultados.Las puntuaciones medias de los conocimientos, la susceptibilidad percibida, la gravedad percibida, los beneficios percibidos, las barreras percibidas, las señales para la acción, la autoeficacia y el rendimiento posterior a la intervención aumentaron en el grupo de tratamiento en comparación con el grupo de control, y todos los resultados fueron estadísticamente significativos (p<0.05). Además, los medios de comunicación social fueron eficaces para aumentar la concienciación y animar a tener una medicación adecuada. La mayor automedicación fue en la toma de analgésicos, pastillas para el resfriado y antibióticos, que mostró una disminución significativa en el grupo de tratamiento después de la intervención. Conclusión. El programa educativo basado en el Modelo de Creencias de Salud fue eficaz para reducir la automedicación entre las mujeres estudiadas. Además, se recomienda utilizar los medios de comunicación social para mejorar la concienciación y la motivación de las personas.

Objetivo. Avaliar a eficácia da aplicação de um programa educativo baseado no Modelo de Crenças em Saúde (HCM) na adoção de comportamentos preventivos de automedicação entre mulheres no Irã. Métodos. Estudo de intervenção com pré e pós avaliação. Duzentas mulheres que frequentavam os centros de saúde de Urmia foram selecionadas e alocadas nos dois grupos de estudo (tratamento e controle) por meio de amostragem aleatória simples. Para a coleta de informações, foram utilizados os questionários sobre: Conhecimento sobre automedicação, comportamentos preventivos de automedicação e o modelo de crenças sobre saúde. A validade dos questionários foi avaliada pelos especialistas e, em seguida, verificada sua confiabilidade. A intervenção educativa foi realizada para o grupo de tratamento durante quatro semanas com 1 sessão semanal com duração de 45 minutos. Resultados.Os escores médios de conhecimento, suscetibilidade percebida, gravidade percebida, benefícios percebidos, barreiras percebidas, pistas para ação, autoeficácia e desempenho pós-intervenção aumentaram no grupo de tratamento em comparação com o grupo de intervenção. controle, e todos os resultados foram estatisticamente significativos (p<0.05). Além disso, as mídias sociais foram eficazes na conscientização e no incentivo à medicação adequada. A maior automedicação foi em uso de analgésicos, antissépticos e antibióticos, que apresentou diminuição significativa no grupo de tratamento após a intervenção. Conclusão.O programa educativo baseado no Modelo de Crenças em Saúde foi eficaz na redução da automedicação entre as mulheres estudadas. Além disso, recomenda-se o uso das mídias sociais para melhorar a conscientização e a motivação das pessoas.

Religiosity and Beliefs toward COVID-19 Vaccination among Adults in Puerto Rico.

Religiosity may influence COVID-19 vaccination. However, it remains unclear how religiosity is associated with beliefs toward COVID-19 and vaccination against it, particularly amongst ethnic minorities. This study examined the association between religiosity, vaccination intent, beliefs, and attitudes related to COVID-19 and vaccination among adults in Puerto Rico. Data from an online survey conducted between December 2020-February 2021 among adults (≥18 yr; n = 1895) residing in Puerto Rico were used. Rating of the importance of religiosity was used to capture the level of religiosity ('less important', 'somewhat important', 'important', and 'very important'). The health belief model (HBM) assessed beliefs and attitudes toward COVID-19 and vaccination against it. Adjusted Poisson models with robust error variance estimated prevalence ratios (PR) and 95% confidence intervals for vaccination intent and individual COVID-19 HBM constructs. Compared to individuals rating religiosity as 'less important' to them, those rating it as 'very important' were more likely to be unwilling or uncertain to get the COVID-19 vaccine (PR = 1.51, 95% CI = 1.10-2.05). Higher ratings of importance of religiosity, compared to the lowest level, were associated with significantly lower perceived COVID-19 susceptibility, more vaccine barriers, and lower vaccine benefits (all p < 0.05). Individuals who reported religiosity being very important to them were more likely to report that they will get the COVID-19 vaccine only if given adequate information about it (PR = 1.14, 95% CI = 1.02-1.27) and more likely to get the vaccine if more people decide to receive it (all p < 0.05). In conclusion, our results suggest an association between religiosity and COVID-19 vaccination intent and beliefs and attitudes toward vaccination. The study highlights important guidelines for public health campaigns to increase vaccine uptake among religious communities in Puerto Rico.