Knowledge, attitude and practices [KAP] of healthcare workers in the Free State, South Africa regarding type 2 diabetes mellitus

[摘要] English: The quality of care and the implementation strategies used by health care workers (HCWs) in diabetes care is imperative. The implementation strategies used are determined by the knowledge, attitude and practice of the HCWs, which have an impact on quality of service delivery for adult diabetes patients.The design involved a descriptive, cross-sectional quantitative design with a structured questionnaire as data collection technique. The population consisted of three prominent groups of HCWs (Nurse Managers, Professional Nurses and Community Health Care Workers) providing care to T2DM patients in the public health sector in the Free State. Convenient selection of the three categories of HCWs per Community Health Care centre from the five districts in the Free State and Primary Health Care clinics, from Mangaung district only, took place.Community Health Care Workers' knowledge was tested on a set of 22 items with Nurse Managers and Professional Nurses being tested on an additional 14 items for a maximum of 36. Nurse Managers and Professional Nurses showed moderately high knowledge scores, with the lower quartile of 22 still being well above the 50% mark of 18 (out of 36). The median was 23, which does indicate however, that there is still much room for improvement. Community Health Care Workers knowledge scores ranged from 7 to 20, a higher median of 14, and an interquartile range of 11 to 16.Attitudes scoring was constructed in such a way that a score of zero would indicate an equal mix of positive and negative attitude items, and the higher the score above zero (up to +18), the more positive the attitude, and the lower the score below zero (down to -18), the more negative the attitude. The same attitude scale was used for all HCWs. The Nurse Managers and Professional Nurses displayed the most positive attitudes, with a minimum of only -4, and a maximum of 16. More importantly, the median was 12.5, and the lower quartile score was still a moderately positive 9.5. The attitude scores of the Community Health Care Workers CHWs was more positive, with a median of 7 and an interquartile range from 1 to 10 (although the lowest attitude score was still -11).Practice scores were calculated with different item sets for each of the three groups, related to their differing roles and responsibilities. Nurse Managers and Professional Nurses could obtain scores from 0 to 16, with higher scores indicating better practices, and Community Health Care Workers a score for 0 to 28. . Nurse Managers and Professional Nurses showed good practice scores, with a low of 6 and a high of 15 (out of 16), and a median of 12. For the Community Health Care Workers, the practice scores were moderately high, with a minimum of 5, but a maximum of 28 (out of 28). The median here was 16, and the interquartile range from 10 to 21.Recommendations were packaged according to knowledge, attitude and practice namely:Training was recommended to improve the knowledge of HCWsThe Provincial Department of Health should create platforms to explore value clarifications with all HCWs, andNurse Managers responsible for chronic diseases should build into the monitoring and evaluation instruments a section providing the opportunity for HCW to identify elements that influence their practice.

[发布机构] University of the Free State