Disease knowledge and functional disability of a cohort of rheumatoid arthritis in a tertiary government hospital in Manila, Philippines

Background@#Rheumatoid arthritis (RA) is a chronic and progressive disease resulting in disability and poor quality of life. Patients’ knowledge (PxK) of disease can contribute to better disease control, reduced disability, and improved quality of life. @*Objective@#The objective of this study was to determine the disease knowledge and functional disability of a cohort of patients with RA. @*Methods@#We conducted a cross-sectional study among patients with RA at the University of the Philippines - Philippine General Hospital Arthritis Clinic. The subjects were recruited using convenience sampling over three months in 2019. We obtained demographic and disease characteristics, clinic attendance, patient knowledge, and functional status through chart review, a questionnaire, and a disability index. Descriptive statistics, 2-sample T-test, Pearson’s correlation, analysis of variance (ANOVA), and multiple linear regression analysis were used for data analysis. Informed consent was obtained before participation in the study. @*Results@#Eighty percent (57/71) of recruited patients participated in the study. All were female, and the mean age was 51.6 years (±12.9). Most participants completed secondary education, were employed, had an average duration of RA of 8 (±6.8) years, had been consulting at the Arthritis Clinic for an average of 4.8 years (±3.8), and had moderate disease activity (49.1%). Most patients had American College of Rheumatology (ACR) class I or II functional status (50/57, 88%). The usual source of the patients' knowledge about RA was their physician. The mean knowledge score was 5.10 (±0.93) out of a perfect score of 9. Most patients were aware of their disease diagnosis and the non-communicable nature of RA. There was low awareness of the need for self-monitoring for disease flares or treatment adverse events and the extra-articular involvement in RA. The mean functional disability score was 6.65 ± 5.33, and the mean functional disability index (FDI) was 0.83 (±0.66). These correspond to mild functional disability (FD). There was no significant relationship between the total knowledge score and age, duration of disease, number of consultations in the past year, level of education, employment status, perceived level of disease knowledge, or the practice of asking their physician about illness. Perception of overall health status was associated with functional disability (p=0.001). @*Conclusion@#Most of the patients in our cohort of RA patients had a mild functional disability and low knowledge scores. The study identified the gaps in our patients’ knowledge of disease and its management. A re-evaluation of existing educational and treatment strategies will be beneficial to enhance disease knowledge and improve health outcomes.

Evaluation of Knowledge, Disease Severity and Quality of Life of Patients with Psoriasis

Background@#Psoriasis vulgaris is a chronic immune-mediated inflammatory multi-system disease characterised by keratinocyte hyperproliferation. Data regarding patients’ disease severity, knowledge and quality of life (QOL) is important to optimize treatment strategies for psoriasis. This study aims to evaluate and investigate the relationship between disease severity, knowledge and QOL of patients with psoriasis. @*Methods@#A cross-sectional multicentre study utilizing a socio-demographic data collection form, Psoriasis Knowledge Assessment Questionnaire (PKAQ), Dermatology Life Quality Index (DLQI) and Psoriasis Area and Severity Index (PASI was conducted. Correlations between PKAQ, DLQI and PASI were analysed using Spearman’s test. @*Results@#A total of 114 subjects participated in this study. Majority of them had mild psoriasis (n=73, 64%) based on PASI. The mean score of PKAQ was fourteen out of a total possible score of twenty-five, whereas the DLQI had a non-parametric distribution with a median (interquartile range) of 7 (10). Most subjects (32.5%) stated that psoriasis had a ‘moderate effect’ on their QOL, while only 3.5% said that it had an ‘extremely large effect’ on their QOL. There was a statistically significant correlation between PASI and DLQI (rs = 0.264, p = 0.004), with higher PASI scores corresponding to higher DLQI scores. No statistically significant correlation was found between DLQI and PKAQ (rs = -0.048, p= 0.612), and between PASI and PKAQ (rs = 0.058, p= 0.542).@*Conclusion@#Impairment of QOL was positively associated with severity of psoriasis. However, there was no significant relationship between knowledge and quality of life, as well as between knowledge and psoriasis severity.

Conhecimento da pessoa com transtornos mentais sobre o tratamento medicamentoso / Conocimiento de la persona con trastornos mentales sobre el tratamiento medicamentoso / Knowledge related to drug therapy among people with mental disorders

Objetivo: identificar o conhecimento da pessoa com transtorno mental sobre o tratamento medicamentoso. Método: pesquisa observacional transversal desenvolvida com 300 pessoas em tratamento em dois Centros de Atenção Psicossocial de Curitiba, Paraná. Os dados foram coletados por entrevista estruturada e consulta à prescrição de medicamentos em prontuário. Foi realizada análise descritiva e inferencial. Resultados: a maioria dos participantes apresentou conhecimento insuficiente quanto ao nome dos medicamentos (64%), dose (91,9%) e frequência de administração (82,6%). Houve associação entre conhecimento insuficiente sobre a terapêutica medicamentosa e uso de medicamentos para comorbidades, desconhecimento do diagnóstico, depressão, idade avançada, autoadministração dos medicamentos, consumo de álcool e informações fornecidas pela enfermagem ou psicólogos. Conclusões: destaca-se que, principalmente, a autoadministração de medicamentos, transtornos depressivos e uso de medicamentos para outras condições de saúde podem estar relacionadas ao nível de conhecimento insuficiente da terapêutica medicamentosa, representando possíveis obstáculos a adesão e uso seguro dos medicamentos.

Objective: to identify knowledge about drug therapy among those people with mental illness. Method: cross-sectional observational research carried out with 300 people undergoing treatment at Psychosocial Care Centers in Curitiba, Paraná. Data were collected through structured interviews and by consulting prescriptions for medications in medical records. A descriptive and inferential analysis was performed. Results: the majority of participants had insufficient knowledge regarding the name of the drugs (64%), dose (91.9%) and frequency of administration (82.6%). There was an association between insufficient knowledge regarding drug therapy and the use of drugs for comorbidities, ignorance about the diagnosis, depression, advanced age, self-administration of drugs, alcohol consumption and misunderstanding information provided by nurses or psychologists. Conclusions: it is underscored that self-administration of medications, depressive disorders and use of medications for other health conditions may be related to the level of insufficient knowledge regarding their drug therapy; thus representing obstacles to adherence of medications.

Objetivo: identificar el conocimiento de la persona con trastorno mental sobre el tratamiento medicamentoso. Método: investigación observacional transversal desarrollada con 300 personas en tratamiento en Centros de Atención Psicosocial de Curitiba, Paraná. Los datos han sido recolectados por entrevista estructurada y consulta a la prescripción de medicamentos. Ha sido realizado análisis descriptivo e inferencia. Resultados: La mayoría de los participantes ha presentado conocimiento insuficiente cuanto al nombre de los medicamentos (64%), dosis (91,9%) y frecuencia de administración (82,6%). Ha habido asociación entre conocimiento insuficiente sobre la terapéutica y uso de medicamentos para comorbilidad, desconocimiento del diagnóstico, depresión, edad avanzada, auto-administración de medicamentos, consumo de alcohol e información provista por la enfermería o psicólogos. Conclusiones: Se destaca que la auto-administración de medicamentos, trastornos depresivos y uso de medicamentos para otras condiciones de salud pueden estar relacionadas al nivel de conocimiento insuficiente de la terapéutica medicamentosa, representando obstáculos de adhesión.

Research on doctor intention and patient demand of doctor-patient knowledge transfer based on cognition theory / 中华医院管理杂志

Objective To compare the differences between doctor knowledge transfer willingness and patient knowledge transfer demand,and propose matching behavior model of Doctor-Patient knowledge transfer.Methods Useing empirical analysis through questionnaire survey,tests and verities investigate data's reliability,validity.Significant test of the differences between doctor knowledge transfer willingness and patient knowledge transfer demand is conducted with ANOVA,and the detail relationship is conducted by comparison of the average values.Results Patient knowledge transfer demand is much higher than doctor knowledge transfer willingness.What' s more,this paper divides content of Doctor Patient knowledge transfer into four kinds:high doctor intention-high patient demand,high doctor intention-low patient demand,low doctor intention-high patient demand,low doctor intention-low patient demand.Conclusions Mismatching of doctor knowledge transfer willingness and patient knowledge transfer demand is the main reason of medical information asymmetry.Doctor-Patient knowledge transfer strategies are suggested based on the performance features of the four groups.

Patient-trust-based patients classification and the management strategy / 中华医院管理杂志

Doctor-patient trust plays an important role in doctor-patient knowledge transfer.Investigating the basic features and trust performance of the patients, the authors classified by means of a cluster analysis, the patients into four groups with such criteria as the trust on hospital, trust on doctors, patient's awareness of the knowledge, and patient's compliance to the doctor's advice. The four groups are rational and suspicious, passive compliance, high self-confidence, and blind trust groups. In view of behavioral characteristics of the patients, different doctor-patient knowledge transfer strategies are suggested, in an effort to perform effective doctor-patient communication and to gain patient's trust.

The development and validation of a low back pain knowledge questionnaire - LKQ

OBJECTIVE: The objective of this study was to develop and validate a questionnaire on specific knowledge about low back pain entitled "The Low Back Pain Knowledge Questionnaire". INTRODUCTION: There is a need for instruments to assess patient knowledge regarding chronic illness. Such methods can contribute to the education of patients. METHODS: The Low Back Pain Knowledge Questionnaire was developed through five focus groups. The questionnaire was distributed to 50 patients to assess their comprehension of the terms. To assess the reproducibility, 20 patients were surveyed by two different interviewers on the same day and twice by a single interviewer with a one-to-two week interval. For the construct validation, the Low Back Pain Knowledge Questionnaire was given to 20 healthcare professionals with knowledge on low back pain and 20 patients to determine whether the questionnaire would discriminate between the two different populations. To assess the sensitivity of the questionnaire to changes in the knowledge level of the patients, it was given to 60 patients who were randomly assigned to the Intervention Group and the Control Group. The Intervention Group answered the questionnaire both before and after attending a chronic back pain educational program (back school), whereas the Control Group answered the questionnaire twice with an interval of one month and no educational intervention. RESULTS: The focus groups generated a questionnaire with 16 items. The Spearman's correlation coefficient and the intra-class correlation coefficients ranged from 0.61 to 0.95 in the assessments of the intra-observer and inter-observer reproducibility (p< 0.01). In the construct validation, the healthcare professionals and patients showed statistically different scores (p< 0.001). In the phase regarding the sensitivity to change, the Intervention Group exhibited a significant increase in their specific knowledge over the Control Group...

Research on the strategy of doctor-patient knowledge transfer based on patient preference / 中华医院管理杂志

Doctor-Patient knowledge transfer plays an important role in clinical service.In an evidence-based investigation on their basic features and preference,patients investigated fall into six categories according four influence factors.These factors comprise,set as the criteria,information preference,decision-making preference,perceived severity of disease and influence of reference group.The six groups are the contradiction group,reactive group,ego group,decision preference group,total equality group,and positive group.Doctor-Patient knowledge transfer stategiea are suggested based on the preference features of the six groups.These strategies serve as references and paramedics for doctors to perform effective doctor-patient communication.