| ObjectiveUsing cross-sectional survey methods,The research aims to investigate the knowledge and attitudes of primary health professionals about dementia in Chongqing.The influencing factors of knowledge and attitudes were analyzed.And we also analyzed the impact of knowledge and attitudes on cognitive screening behavior.The study will be important to design the training strategies.MethodThis study was mainly divided into three steps:establish a Chinese Version of Dementia Attitudes Scale(C-DAS),conduct the cross-sectional survey,propose the training strategies.1.We used the C-DAS,and test the reliability and validity among 287 primary health professionals.The data was used to content validity,structure validity,internal reliability.2.The self-designed questionnaire,the Dementia Knowledge Assessment Scale(DKAS),the Dementia Attitude Scale(DAS)were used to evaluate the knowledge and attitude level of 2566 primary health professionals in Chongqing who meet the inclusion criteria.Descriptive statistical analysis was used to analyze the general demographic data of the primary health professionals.Independent sample T test,ANOVA test was used to analyze the effects of the general information of health professionals on the knowledge and attitudes.Pearson correlation was applied to measure the correlation between knowledge and attitude.Multiple linear regression was used to determine the factors contributing to the knowledge and attitudes.Logistic regression analysis was used to study the impact of the knowledge and attitudes on cognitive screening behavior.The SPSS19.0 statistical software package was used to analyze the data.3.According to the survey results,the targeted training strategies were proposed.Results1.The C-DAS contains 20 items,three dimensions of"Dementia Knowledge","Positive Social Comfort","Negative Social Comfort".The score reveals the attitudes of people.The reliability and validity of the scale are as follows:(1)Content validity index(CVI)The I-CVI of the C-DAS was ranged from 0.80 to 1.0,and the S-CVI is 0.98.(2)Structure validityExploratory factor analysis showed that the cumulative variance contribution rate of the C-DAS is 47.724%,and each factor had a perfect factor load on the corresponding item.(3)Internal reliabilityThe Cronbach‘s coefficient of each dimension of the C-DAS was from 0.701 to 0.842.The Cronbach‘s coefficient of the C-DAS was 0.800.2.The dementia related knowledge,attitude of primary health professionals and the impact of knowledge,attitudes on cognitive screening behavior(1)The level of primary health professionals‘knowledgeThe total scale score was 33.22±5.68(score rate:66.44%),the score of―Care Considerations‖dimension was 10.30±1.95(score rate:85.83%),the score of―Risk and Health Promotion‖dimension was 8.14±2.29(score rate:67.83%),the―Causes and Characteristics‖dimension was 9.20±2.41(score rate:65.71%),the score of―Communication and Behavior‖dimension was 5.58±2.56(score rate:46.50%).(2)The status of primary health professionals‘attitudesThe total scale score was 92.35±14.97(mean score:4.62),the score of―Dementia Knowledge‖dimension was 49.84±8.52(mean score:5.54),the score of―Positive Social Comfort‖dimension was 20.14±6.51(mean score:4.03),the score of―Negative Social Comfort‖dimension was 22.36±6.22(mean score:3.73).(3)The correlation between knowledge and attitudesThe score of DKAS was significantly correlated with the score of DAS and its sub-dimensions(P<0.05),the score of―Communication and Behavior‖dimension of DKAS was significantly correlated with the score of DAS and its sub-dimensions(P<0.01);the score of―Dementia Knowledge‖dimension was significantly correlated with the score of DKAS and its sub-dimensions(P<0.01).(4)Influencing factors of primary health professionals‘knowledgeThe knowledge of primary health professionals can be influenced by different variables,such as sex,occupation,education,professional title,department,form of employment,contact history,care/diagnosis history,and willingness to train at statistically significant level(P<0.05).However,The knowledge of primary health professionals who had different training history,ages,years of work,economy,culture and units had no difference(P>0.05).It was showed that forms of employment,contact history,department,education,occupation,,willingness to train and care/diagnosis history were the main influencing factors of primary health professionals‘knowledge by multiple stepwise regression analysis,and coefficient of determination R~2 was 0.047.The knowledge of regular health professionals was better than that of ones with contract establishment.The knowledge of health professionals in public health department was better than that of ones in―other departments‖.The knowledge ofhealth professionals with associate degree was better than that of ones with technical secondary school diploma or below.The knowledge of doctors was better than that of nurses.The knowledge of the people who contacted with dementia patients,or provided service for dementia patients was better.The knowledge of the people who want to be trained was also better.(5)Influencing factors of primary health professionals‘attitudesThe attitudes of primary health professionals can be influenced by different variables such as sex,age,occupation,department,professional title,years of working,contact history,care/diagnosis history,training history and willingness to train at statistically significant level(P<0.05).However,the attitudes of people who had different education,forms of employment,districts,culture and units had no differences(P>0.05).It was showed that care/diagnosis history,willingness to train,years of work experience,sex,training history and professional title were the main influencing factors of primary health professionals‘attitudes by multiple stepwise regression analysis,and coefficient of determination R~2 was 0.062.The attitudes of people with shorter working years were better.The attitudes of male were better than that of female.The attitudes of people with intermediate title were better than that of ones with senior professional title.The attitudes of the people who provided service for dementia patients were better.The attitudes of the people who want to be trained were also better.(6)Impact of knowledge and attitude on cognitive screening behaviorThere were only 1427(55.6%)primary health professionals that choose to conduct cognitive screening for the people with subjective cognitive complaints.By logistic regression analysis,the scores of DAS sub-dimensions were associated with the behavior of screening.Conclusions1.Based on the three-dimensional theory of attitudes,DAS was constructed.The C-DAS has good reliability and validity,and provides an optional measuring tool for enriching the study of dementia related attitudes in China.2.The level of primary health professionals‘knowledge about dementia is low.They lack the knowledge about―communication and behavior‖dimension very much.Primary health professionals have positive attitudes towards dementia.It is mainly reflected in the cognitive component of attitude,while the emotional and behavioral components of attitude are neutral or negative.It is suggested that the training about dementia should be strengthened to improve the knowledge and attitudes of primary health professionals in Chongqing.3.Damographic factors have a small impact on the level of dementia related knowledge and attitudes among primary health professionals.It is suggested that we can uniformly train primary health professionals about the dementia related knowledge such as etiology.The people with different occupations and work can be trained separately.The trainers should pay attention to the negative attitudes of the people with senior professional titles,and the corresponding training strategies should be formulated.4.The previous training about dementia in primary medical institutions is not good.We suggest to optimize the training program.Firstly we should have the goal,and make plans.Then,we emphasize the importance about the prevention,and promote people-centred service.Further more,we use network in the training. |
PDF Full Text Request