HEALTH PROMOTION QUESTIONNAIRES IN PRIMARY

HEALTHCARE WORKERS IN SLOVAKIA

Department of Hygiene, Faculty of Medicine, Košice,

Slovakia. University of P.J.Šafarik, Košice, Slovakia.

PHARE Local Expert, Ministry of Health, Slovakia

Rimárová Kvetoslava

METHDOLOGY AND MATERIAL

1. KAP QUESTIONNAIRES FOR PHYSICIANS

AND NURSES

standardised international questionnaires

K ... knowledge 7 questions

A ... attitude 6 questions

P ... practice 3 questions

2. FREQUENCY OF RESPONDENTS 658 COMPLETE QUESTIONNAIRES 52.6 % of nurses, 47,4 % of physicians 83,9 % females, 16,1 % males

physicians 66,7 % females 33,3 % males nurses 99,4 % females 0,6 % males

3. DATA COLLECTION AND RESPOND RATE by personal visit 89 % ... respond rate ... 98 % by mail 11 % ... respond rate ... 67 %

4. FREQUENCY RURAL AND URBAN urban 62 % rural 48 % covering all districts of Slovakia

5. databases created and analyzed in STATA and EPI - INFO

6. results, graphs and tables MS WORD and MS EXCELL

KAP TEST RESULTS

All 658 Questionnaires

PHYSICIANS47%

NURSES53%

KAP TEST RESULTS

Physicians

FEMALES67%

MALES33%

Nurses

MALES0,6%

FEMALES99,4%

KAP TEST RESULTS

K A P T EST K NOWL EDGE QU EST I ONS „OR“ for phys ic ians

QUES TION

ANSWER

ALL

n = 658

PHYSICIANS n = 312

(208 females, 104 males)

NURSES n = 346

(344 females, 2 males)

STAT. SIGN. (chí-

square) K1

HEALTH DIMENS.

correct

95,4%

96,8%

94,2%

OR=1,14 chí=2,5 p=0,11

n.s. K2

SCREEN

.

correct

32,5% 39,7% 26,0%

OR=1,59 chí=14,1 p=0,0001

***

K3

VACCIN.

correct 87,2% 83,3% 90,8%

OR=0,85 chí=8,11 p=0,004

** K4

BMI

correct 54,1% 60,3% 48,6%

OR=1,31 chí=9,05 p=0,002

**

STAT. SIGN.: * p < 0.05 OR adusted for sex and age ** p < 0.01 *** p < 0.001

KAP TEST KNOWLEDGE QUESTIONS CORRECT ANSWERS

0102030405060708090

100

K1 - HEALTHDIMENS.

K2 - SCREEN. K3 - VACCIN. K4 - BMI

PHYSICIANS NURSES

n.s.

p < 0.001

p < 0.01

p < 0.01

KAP TEST KNOWLEDGE QUESTIONS

„OR“ for physic ians

QUES TION

ANSWER

ALL

n = 658

PHYSICIANS n = 312

(208 females, 104 males)

NURSES n = 346

(344 females, 2 males)

STAT. SIGN. (chí-

square)

K5

H.PROM. H.EDUC.

correct 54,0% 57,7% 50,9%

OR=1,13 chí=3,08 p=0,08

n.s. K6

HYPERT.

correct 93,3% 94,2% 92,5%

OR=1,02 chí=0,80 p=0,37

n.s. K7

H.P. PLAN.

correct 69,9% 71,3% 68,2%

OR=1,04 chí=0,67 p=0,41

n.s. STAT. SIGN.: * p < 0.05 ** p < 0.01 *** p < 0.001 OR adusted for sex age

KAP TEST KNOWLEDGE QUESTIONS CORRECT ANSWERS

01020

3040506070

8090

100

K5 - H.PROM.,H.EDUC. K6 - HYPERT. K7 - H.P.,PLAN.

PHYSICIANS NURSES

n.s.

n.s.

n.s.

KAP TEST ATTITUDE QUESTIONS

QUES TION

ANSWER

ALL

n=658

PHYSICIANS n = 312

(208 females, 104 males)

NURSES n = 346

(344 females, 2 males)

STAT. SIGN.

(chí square)

A8

WHO

physician specialist myself phys.+ myself

7,9 % 2,1 %

18,2 % 71,1 %

0,6 % 1,9 %

22,4 % 75,0 %

14,5 % 2,3 %

14,5 % 68,8 %

chí=46,3

p=0,000

***

A9

EFFECT OF H.C.

positive negative both

39,5 %

0 % 60,5 %

36,5 %

0 % 63,5 %

42,8 %

0 % 57,2 %

chí=2,32

p=0,13 n.s.

A10

IMPORT.

curative H.promotion equal

28,0 % 3,3 %

68,4 %

30,8 % 2,6 %

66,7 %

25,5 % 4,6 %

69,9 %

chí=0,81

p=0,37 n.s.

STAT. SIGN.: * p < 0.05 ** p < 0.01 *** p < 0.001

KAP TEST ATTITUDE QUESTIONS

QUES TION

ANSWER

ALL

n=658

PHYSICIANS n = 312

(208 females,

104 males)

NURSES n = 346

(344 females, 2 males)

STAT. SIGN. (chí

square)

A11

H.P.TASK disagree

agree 98,2 % 1,8 %

97,4 % 2,6 %

98,8 % 1,2 %

chí = 1,82

p=0,18

n.s. A12

COMUN. DEVELO

P.

political financial health poverty

38,0 % 40,1 % 67,2 % 54,7 %

39,1 % 37,8 % 66,0 % 55,8 %

37,0 % 42,2 % 68,2 % 54,0 %

chí = 1,16

p=0,76

n.s. A13

HEALTH EDUCAT.

T.V. tax.smoke expl.advis. immunis. raising

86,6 % 35,6 % 65,0 % 64,4 % 40,4 %

89,1 % 34,0 % 64,7 % 64,1 % 36,5 %

84,4 % 37,0 % 65,3 % 64,7 % 43,9 %

chí = 2,81

p=0,59

n.s. STAT. SIGN.: * p < 0.05 ** p < 0.01 *** p < 0.001

0

10

20

30

40

50

60

70

80

90

100

physician specialist myself phys.+ myself

PHYSICIANS NURSES

KAP TEST ATTITUDE QUESTIONS

A8 - WHO

KAP TEST PRACTICE QUESTIONS

QUES TION

ANSWER

ALL

n=658

PHYSICIANS n = 312

(208 females,

104 males)

NURSES n = 346

(344 females, 2 males)

STAT. SIGN.

(chí square)

P14

SELFEXAM.

T.V. group individual

25,5 % 45,3 % 29,2 %

24,4 % 39,7 % 35,9 %

26,6 % 50,3 % 23,1 %

chí = 13,5

p=0,001 **

P15

H.P. medical

word

disagree agree

93,9 % 6,1 %

92,9 % 7,1 %

95,4 % 4,6 %

chí = 1,78

p=0,18 n.s.

P16

MY WORK

pay job descr. time education don´t know

13,6 % 12,7 % 60,5 % 44,1 % 24,0 %

15,4 % 8,3 %

66,0 % 37,0 % 36,5 %

12,1 % 16,8 % 55,2 % 50,3 % 12,7 %

chí = 55,7

p=0,000

***

STAT. SIGN.: * p < 0.05 ** p < 0.01 *** p < 0.001

0

10

20

30

40

50

60

70

80

90

100

pay job descript. time education do not know

PHYSICIANS NURSES

KAP TESTPRACTICE QUESTIONS

P16 MY WORK

p < 0.001 p < 0.001

p < 0.001

p < 0.001

p < 0.001

Conclusions and practical issues:

1. K - Knowledge questions show not sufficient knowledge of prevention and health promotion among primary health care workers more expressed, of course, in the group of nurses despite sufficient curricula on both university and secondary school level2. A - Attitude questions show higher preference of curative measures in the work of PHT,preference of health aspects in the community development and responsibility both physicians and patient for own health3. P - Practice questions show problem in the system of proportion between preventive and curative measures where is stressed the shortage of time to make a preventive measure and also a lack of education and legal gaps4. In the KAP test analysis there are no age statistical difference, the primary health care workers were divided into 3 age groups (20-35, 36-49, 50 an more)

Practical issue and support of PHARE:

1. Interactive 3 weeks seminar for specialists working in health promotion with foreign lecturers

2. List to the Ministry of Health to support preventive activities

3. Recommendation for health insurance companies to support prevention also on financial level

THANK YOU!