Effects of Health Education with Problem-Based Learning Approaches on the Knowledge, Attitude, Practice and Coping Skills of Women with High-Risk Pregnancies in Plateau Areas

Objective: Given the unique cultural background, way of life, and physical environment of the Tibetan Plateau, this study aims to investigate the effects of health education using problem-based learning (PBL) approaches on the knowledge, attitude, practice, and coping skills of women with high-risk pregnancies in this region. Methods: 76 high-risk pregnancy cases were enrolled at Tibet’s Linzhi People’s Hospital between September 2023 and April 2024. 30 patients admitted between September 2023 and December 2023 were selected as the control group and were performed with regular patient education. 46 patients admitted between January 2024 and April 2024 were selected as the observation group and were performed regular patient education with problem-based learning approaches. Two groups’ performance on their health knowledge, attitude, practice and coping skills before and after interventions were evaluated, and patient satisfaction were measured at the end of the study. Results: There was no statistical significance (P P P Conclusions: Health education with problem-based learning approaches is worth promoting as it can help high-risk pregnant women in plateau areas develop better health knowledge, attitude and practice and healthier coping skills. Also, it can improve patient sanctification.

Knowledge,attitude,practice and factors that influence the awareness of college students with regards to breast cancer

BACKGROUND Breast cancer has the highest incidence of all global cancers.Recent data show that breast cancer is becoming more prevalent in the younger population.Therefore,preventing breast cancer in young populations is a significant priority for public health.Relevant investigations of the incidence of breast cancer in young females have already been undertaken in China;however,none of these previous studies investigated the awareness of female college students with regards to breast cancer.AIM To investigate the knowledge,attitude,and practice(KAP)of female college students in Yunnan with regards to breast cancer and a series of influential factors.METHODS A random sample of 1387 female college students from two universities in Dali city were investigated by questionnaires.RESULTS The total KAP scores for breast cancer were 9.86±2.50,3.19±2.01 and 13.31±2.49,respectively.Multiple linear regression analysis showed that educational grade was the most significant influential factor underlying the level of knowledge female college students had with regards to the treatment of breast cancer(P<0.05).Registered residence and educational grade were the most significant factors that influenced attitude(P<0.05).Age,registered residence,grade and major,were the most significant factors that influenced behavior(P<0.05).The KAP of female college students in western Yunnan with regards to breast cancer were low.CONCLUSION There is an urgent need to provide standardized publicity and educational strategies in China to improve the knowledge,attitude,and practice,of college students with regards to breast cancer.

Effect of KAP Intervention Model on Resilience and Cancer-related Fatigue in Patients with Colorectal Cancer Undergoing Chemotherapy

Objective:To explore the effect of KAP intervention mode on resilience and cancer-related fatigue in patients with colorectal cancer undergoing chemotherapy.Methods:A prospective randomized trial was conducted.55 patients with colorectal cancer who received routine nursing from February 2018 to February 2019 were included in the control group,and 55 patients who received routine nursing+KAP intervention from March 2019 to March 2020 were included in the observation group.The scores of Resilience Scale and cancer-related fatigue scale(CFS)before and 6 months after intervention were compared between the two groups.Results:After 6 months of intervention,the score of resilience of the two groups was higher than that before intervention,and that of the observation group was higher than that of the control group,the difference was statistically significant(P<0.05);The CFS score of the two groups was lower than that before intervention,and that of the observation group was lower than that of the control group,the difference was statistically significant(P<0.05).Conclusion:KAP intervention model can improve the resilience of patients with colorectal cancer chemotherapy,reduce cancerrelated fatigue.

Gap between evidence and physicians＇ knowledge and practice regarding hypertension and its drug treatment： a survey in a Chinese city

Background Evidence-based medicine has come into its second decade. How prepared clinicians are in practicing it in particular in developing countries remains unclear. Thus we conducted this survey of physicians in urban hospitals in China to determine the size of the gap between research evidence and physicians＇ knowledge and practice regarding antihypertensive drugs for primary prevention of cardiovascular diseases in China.Methods A cross sectional survey by a face-to-face interview was conducted in 20 tertiary general hospitals in China in 2005. A total of 444 physicians （mostly cardiologists） in internal medicine who had treated at least one hypertensive patient in the past 12 months were invited for the interview on their perception of the cardiovascular risk of hypertension,the magnitude of the benefit of antihypertensive drugs, knowledge on the overall risk approach, first-line drugs used, the risk above which drug treatment is recommended, and knowledge on evidence-based medicine.Results A total of 444 of the 468 eligible physicians were successfully interviewed with a response rate of 94.9%. They estimated that a hypertensive man with an actual 5-year cardiovascular risk of 8.4% would have a 5-year cardiovascular risk of 40% （95% CI： 38% to 42%） if not treated, and have an absolute risk reduction and relative risk reduction from drug treatment by 20% （95% CI. 18% to 22%） and 39% （95% CI： 37% to 42%） respectively, as compared to 3.3% and 33%respectively shown in research evidence. On average, the physicians would recommend drug treatment at a number needed to treat （NNT） of 368 or smaller, as compared to the actual NNT of 50 for drug treatment in an average hypertensive Chinese. Fifty-five percent （95% CI： 50% to 59%） of them had never intently used the national hypertension guidelines. The majority still prescribed drugs primarily based on blood pressure alone by ignoring other risk factors or the overall risk and 78% （95 % C/. 76% to 83%） used new expensive drugs such as calcium channel blockers and angiotensin converting enzyme （ACE） inhibitors as first-line treatment. Only 13% （95% CI：9% to 18%） could correctly interpret the NNT. Forty-three percent （95% CI： 39% to 48%） did not know the randomized controlled trial was scientifically the most rigorous among other study designs for evaluating the effectiveness of anti-hypertensive drugs.Ninety-two percent （95% CI： 90% to 94%） did not know they could start by searching systematic reviews when looking for evidence on the effectiveness of anti-hypertensive drugs as opposed to trials. Ninety-six percent （95% CI： 94% to 98%）did not know the Cochrane Library was an important source of systematic reviews.Conclusions The surveyed physicians significantly over-estimated the cardiovascular risk of hypertension and the benefit of drug treatment, and had insufficient knowledge on the overall risk approach. They recommended drug treatment at a cardiovascular risk which was even much lower than the cutoff suggested for western populations, which would make many more people eligible for drug treatment. They also tended to prescribe new expensive drugs although the older cheaper ones may be more appropriate in many patients. They showed inappropriate knowledge on the basics of evidence-based medicine.

Elimination of schistosomiasis requires multifactorial diagnostics: evidence from high- and low-prevalence areas in the Nile Delta, Egypt

Background:Schistosomiasis is one of the neglected tropical diseases(NTDs)selected for worldwide elimination in the near future.Egypt has made strong progress against its two endemic species of Schistosoma mansoni and S.haematobium.The former is prevalent in the Nile Delta with the latter dominating in the Nile south of Cairo.Innovative efforts are needed to reach the goal as further reduction of the prevalence has stalled due to ongoing transmission.In this study we aimed to explore the difference between low and high prevalence villages with regard to knowledge attitude and practice about schistosomiasis,utilization of health services,infection and transmission indices.Methods:A hybrid cross-sectional longitudinal study was conducted with three annual follow-ups conducted during 1994-1996.We used a representative systematic random sampling technique investigating 993 individuals from the high prevalence village and 614 from the low prevalence village.Data were analyzed using SPSS,comparing proportions with the Chi square test and means with the Student t test,and ANOVA.Results:Compliance of faecal sampling and chemotherapy was above 70%in both villages over the whole study period.Selective praziquantel treatment resulted in a significant reduction of prevalence and intensity of infection in both villages,dropping from 35.8%prevalence to 20.6%,in the low-prevalence village,and from 69.5 to 45.9%in the high-prevalence one.Intensity of infection at the base line was 30 eggs per gram(EPG)of stool in the low-prevalence village versus 105 EPG in the high-prevalence village.However,after the second round,reinfection rebounded by 22%in the high-prevalence village,while a slight improvement of the infection indices was demonstrated in the low-prevalence one.The level of knowledge was modest in both villages:people knew about self-protection and treatment,but not much about the role of human excreta for schistosomiasis transmission.While all participants maintained that using the water from the canals was inevitable,inhabitants in the high-prevalence village showed significantly lower scores reflecting higher water contact compared to the low-prevalence one.Many of them(67%)did not utilize the health centre at all compared to 26%of the people in the low-prevalence village.Interestingly,private clinics were seen as the primary source of health care by both villages,but more frequently so in the high-prevalence village(used by 87.2%of the inhabitants)compared to the low-prevalence one(59.8%).Conclusions:Even if chemotherapy works well as reflected by the observed downregulation of intensity of infection in both villages,reinfection continued due to difficulties to avoid water contact.Efforts must be made to make people understand the role of human excreta for transmission.There is also a need to make people better trust the medical services available.