Investigation of the variables that impact upon the knowledge of cardiac risk factors.
ABSTRACT Awareness of cardiac disease risk factors is required before they can be modified. The present study aimed to investigate risk factor knowledge and the variables that impact upon this knowledge.
We undertook an analytical, cross-sectional survey of 226 patients attending an ED. Patients were asked to recall as many cardiac risk factors as possible and to rate the risk of nine given risk factors. Data relating to sources of risk factor information were collected. Uni- and multivariate (multiple linear regression) analyses determined variables that impacted upon the risk factor knowledge score.
Mean patient age was 60.2 +/- 15 years, 55.3% (95% confidence interval 48.6-61.9) were male and 19.9% (95% confidence interval 15.0-25.8) had known cardiac disease. The mean risk factor knowledge score of 2.5 +/- 1.5 out of a possible 12 (median 3) was indicative of poor knowledge. Smoking, poor diet and stress/worry/tension were the most common factors reported. Variables impacting significantly on the knowledge score were English as a first language (P < 0.001), age (negative correlation, P < 0.001) and the receipt of information relating to cardiac health (P < 0.001). The patients' general practitioner and the media were the most important sources of information.
Patients' knowledge of cardiac risk factors is generally poor and education strategies are indicated. At the individual level, the general practitioner is likely to remain as an important influence on knowledge. However, complementary media education programs are indicated at the community level. Patient subgroups at 'high risk' through poor knowledge should be specifically targeted.
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ABSTRACT: BACKGROUND: Heart disease is the number one killer of both men and women in the United States, yet a comprehensive and evidence-based heart disease knowledge assessment is currently not available. PURPOSE: This paper describes the 2 phase development of a novel heart disease knowledge questionnaire. METHODS: After review and critique of the existing literature, a questionnaire addressing 5 central domains of heart disease knowledge was constructed. In Phase I, 606 undergraduates completed a 82-item questionnaire. In Phase II, 248 undergraduates completed a revised 74-item questionnaire. In both phases, item clarity and difficulty were evaluated, along with the overall factor structure of the scale. RESULTS: Exploratory and confirmatory factor analyses were used to reduce the scale to 30 items with fit statistics, CFI = .82, TLI = .88, and RMSEA = .03. Scores were correlated moderately positively with an existing scale and weakly positively with a measure of health literacy, thereby establishing both convergent and divergent validity. DISCUSSION: The finalized 30-item questionnaire is a concise, yet discriminating instrument that reliably measures participants' heart disease knowledge levels. TRANSLATION TO HEALTH EDUCATION PRACTICE: Health professionals can use this scale to assess their patients' heart disease knowledge so that they can create a tailored program to help their patients reduce their heart disease risk.American journal of health education / American Alliance for Health, Physical Education, Recreation, and Dance. 03/2011; 42(2):74-87.
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ABSTRACT: Background: Broader patient access to information, expanding clinical options and greater accommodation of patients' personal values makes clinical decision-processes increasingly complex. Given the challenges and implications of risk communication, it is important to explore what is happening when clinicians adopt different approaches to consultations.Aim: To perform an ethical analysis of personal risk communication based around a scenario of cardiovascular risk reduction by exploring how different consultation models raise different ethical implications.Method: We based our analysis on the triangle of autonomy, utility and justice. Because ethical questions arise during consultations, consultation approach is a basic context for interpretations. We chose four distinct approaches; paternalistic, shared decision-making, mandatory autonomist and narrative.Results: The ethical principles of autonomy, utility and justice proved ambiguous. Tradeoffs exist between principles to balance the rights of individual patients (autonomy and protection of personal rights and the patient's personal view on utility), with medical utility seen from the perspective of the health care system (with limited resources), equity and solidarity. Patient centredness is believed to enhance trust in the doctor – patient relationship, but the decisional authority given to patients in such approaches may hazard biomedical utility in the individual consultation and make prioritizing between tasks in the health care sector difficult.Conclusion: The consultation style of the GP has implications for the individual patient, for population health and for the cost of health care. This debate is unavoidable.Health Risk & Society 03/2007; Risk & Society(Vol. 9):19-36. · 1.13 Impact Factor
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ABSTRACT: To investigate the degree of CHD awareness as well as symptom, risk factor, and treatment knowledge in a broad sample of cardiac inpatients, and to examine its sociodemographic, clinical and psychosocial correlates. 1308 CHD inpatients (351 [27.0%] female), recruited from 11 acute care sites in Ontario, participated in this cross-sectional study. Participants were provided with a survey which included a knowledge questionnaire among other measures, and clinical data were extracted from medical charts. 855 (68.8%) respondents cited heart disease as the leading cause of death in men, versus only 458 (37.0%) in women. Participants with less than high school education (p<.001), an annual family income less than $50,000CAD (p=.022), low functional capacity (p=.042), who were currently smoking (p=.022), who had no family history of heart disease (p<.001), and who had a perception of low personal control (p=.033) had significantly lower CHD knowledge. Awareness of CHD is not optimal, especially among women, South Asians, and those of low socioeconomic status. CHD patients have a moderate level of disease knowledge overall, but greater education is needed. Tailored educational approaches may be necessary for those of low socioeconomic status, particularly with regard to the nature of CHD, tests and treatments.Patient Education and Counseling 10/2008; 75(1):99-107. · 2.60 Impact Factor