Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Effectiveness of a community-based participatory health promotion intervention to address knowledge, attitudes and practices related to intimate partner violence: a quasi-experimental study(BioMed Central, 2024) Reyal, H.P.; Perera, M.N.; Guruge, G.N.D.BACKGROUND Intimate partner violence is the most common form of violence experienced by women. It has detrimental consequences. A range of determinants cause intimate partner violence and to reduce it, effective interventions are required to address the determinants. Health promotion interventions have been recommended as effective to enable people to control over the determinants and to improve health. Hence, a community based participatory health promotion intervention was developed and tested in a selected study setting. The objective was to evaluate the effectiveness of a health promotion intervention in terms of addressing knowledge, attitudes and practices related to intimate partner violence.METHODS A quasi-experimental study was conducted by recruiting ninety women aged 15 to 49 years separately from two health administrative areas identified as the intervention area and the control area from the Kandy district of Sri Lanka. A pretested interviewer-administered questionnaire was used in both pre- and post-assessments. Selected groups of women from the intervention area were facilitated with a health promotion intervention to improve knowledge, attitudes and practices related to intimate partner violence. To evaluate the effectiveness of the intervention descriptive summaries and bivariate analysis were used.RESULTS The response rate was 90.9% (N = 90) during the pre-assessment and 87.9% (n = 87) and 82.8% (n = 82) from the intervention and control areas, respectively, during the post-assessment. Statistically significant improvement was reported in the total mean score comprising knowledge, attitudes, practices and identification of determinants from 59.6 to 80.8 in the intervention area [Pre-assessment: Mean = 59.6 (standard deviation-SD) = 17.5; Post-assessment: Mean = 80.8, SD = 19.0; p < 0.001) compared to the improvement in the control area from 62.2 to 63.0 (Pre-assessment: Mean = 62.2, SD = 17.3; Post-assessment: Mean = 63.0, SD = 18.9; p = 0.654).CONCLUSIONS The intervention was effective to improve knowledge, attitudes and practices related to intimate partner violence. Hence, the present approach can be used in similar contexts to address the knowledge, attitudes and certain practices related to intimate partner violence.Item Electroconvulsive therapy in South Asia: Past, present, and future(Elsevier, 2024) Menon, V.; Kar, S.K.; Gupta, S.; Baminiwatta, A.; Mustafa, A.B.; Sharma, P.; Abhijita, B.; Arafat, S.M.Y.The practice of electroconvulsive therapy (ECT) varies both between and within countries. We aimed to review historical and current trends in ECT practices, perceptions, and legislations in South Asia, a region with a high burden of mental illness and suicide. We searched MEDLINE (PubMed) and Google Scholar databases for relevant literature on ECT from each country. Additionally, a team of country-specific investigators performed supplemental searches and contacted key country contacts for relevant information. Relevant data were abstracted under the following headings: ECT practices, perceptions, and legislations. Knowledge gaps and research priorities were synthesized. Modified bitemporal ECT, delivered using brief pulse devices, was most commonly offered across institutions. Schizophrenia, not affective illness, was the most common indication. Electroencephalographic monitoring of seizures was rarely practiced. Thiopentone or propofol was preferred for anesthetic induction, while the favored muscle relaxant was succinylcholine. In India and Sri Lanka, perceptions about ECT were largely favorable; not so in Pakistan and Nepal. Only India and Pakistan had laws that governed any aspect of ECT practice; ECT practice guidelines were available only in India. There is a lack of research on efficacy, ECT in special populations, continuation ECT practices, and interventions to improve ECT-related perceptions. Most regional institutions offered modified brief-pulse ECT, and schizophrenia was the most common indication. Knowledge of and attitude towards ECT varied between countries. There is a need to develop a regional ECT consortium to facilitate uniform training, advocacy efforts, and the development of regional practice guidelines.Item Knowledge and attitudes toward children with specific learning disabilities among primary school teachers in the Mathugama Educational Zone; a preliminary study(University of Kelaniya, Sri Lanka, 2022) Kumari, H.R.G.M.; de Silva, M.D.K.Background: The teachers’ role in identifying Specific Learning Disabilities (SLD) in primary grades is significant, and teachers play a unique role in this process. To make the education for the students with SLD successful, teachers require knowledge of different types of SLD and an understanding of their students with SLD.Objectives: The purpose of this study is to investigate primary school teachers’ knowledge and attitudes toward children with specific learning disabilities (SLD).Methods: This descriptive cross-sectional study was conducted with 248 primary school teachers. The self-selection sampling method was used to select participants from the Mathugama Educational Zone in Sri Lanka. An online questionnaire was used to collect data, and the questionnaire consisted of 3 sections: demographical details, teachers’ knowledge, and their attitudes toward children with SLD. Results: Most primary school teachers are conversant on some aspects of children with SLD such as characteristics of SLD and handling a child with SLD in the regular class. Teachers’ knowledge of SLD significantly changed according to gender (p < .05). This indicated that males have more knowledge about SLD than female teachers. However, there was no significant association between teachers’ knowledge with other demographical details such as age, teaching experience, educational level, teaching grade, training in special education, and having a student with SLD in the class. Overall, participants have positive attitudes about training programs.Conclusion: Overall, most of the study participants had average knowledge levels in areas such as management of children with SLD, risk factors, and some symptoms about SLD. However, knowledge level in some symptoms such as IQ level and aetiology of SLD were inadequate. Attitudes regarding their responsibilities in managing children with SLD were positive. On the contrary, a majority of teachers do not have positive attitudes to raise the quality of life of children with SLD and they reported that they felt more sympathy toward the student with SLD than the student without SLD. The study further revealed that most participants had not attended the training programs on teaching children with SLD. Therefore, the relevant institutes or authorities should implement frequent workshops to improving the above aspects regarding the knowledge and attitudes of SLD.Item Teachers’ knowledge on symptoms, attitudes, and classroom teaching strategies for Specific Learning Disabilities: A study among Tamil speaking primary school teachers in the Nuwara Eliya Educational Zone, Sri Lanka(University of Kelaniya, Sri Lanka, 2022) Kanagendran, K.; Caldera, A.V.Background: A learning disability is a condition that is characterized by difficulties with listening, speaking, reading, writing or mathematics. Dyslexia, dysgraphia, and dyscalculia are the most common learning disabilities. The primary level teachers carry a significant responsibility in identifying children with Specific Learning Disabilities (SLD). Objectives: The objective of this study was to identify the teachers’ levels of knowledge and their attitudes towards children with specific learning disabilities, and their use of classroom strategies when working with children with specific learning disabilities in the Nuwara Eliya Educational Zone. Methods: A sample of 167 Tamil primary school teachers were recruited for the study. A descriptive cross-sectional quantitative study was used to collect information from the participants. The questionnaire was developed based on evidence-based research. In addition, a convenient sampling method was used. The Statistical Package for the Social Sciences (SPSS) Software was used to analyze the data. Results: The majority of the teachers were females (69.3%-n = 115). Most of the teachers were aware of SLD characteristics as 77.7% (n =129) of the participants believed that language-based learning disability is called dyslexia. Also, 23.5% (n=39) teachers reported that students with dysgraphia mix up upper/lower case/cursive writing. More than 42.2% (n = 70) teachers believe that pupils who have difficulty in measuring (weight/distance/time) have dyscalculia. Most of the teachers had a personal experience of at least one student with SLD who has difficulty taking notes in the class. Although most of the teachers understand the challenges, nearly 121 out of 165 primary teachers agree that they have insufficient time to teach students with SLD. Conclusion: Most of the primary teachers had a basic understanding of SLD identification and characteristics. Teachers are also aware of how to use classroom strategies for students with SLD. However, teachers frequently use those strategies for the entire class and are unaware of specific strategies like Individual Education Plans. In addition, the majority of the teachers had a reasonable understanding of the difficulties experienced by children with SLD.Item Knowledge and attitudes on basic life support and associated factors, among selected nursing schools/ nursing faculties in Sri Lanka(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Thoradeniya, V.; Munasinghe, S.; Thilakarathna, G.; Jayasena, A.; Wijesooriya, N.Introduction: Basic Life support (BLS) skills are an essential part of the medical curriculum which are utilized to save lives in emergency situations. Objectives: To determine the knowledge and attitudes in BLS and factors associated with those, among nursing students in selected nursing schools/faculties in Sri Lanka. Methods: A descriptive cross-sectional study was conducted among a convenient sample of 325 nursing students using a pre-tested online questionnaire. Descriptive statistics and chi-square tests were used in data analysis. Results: Out of 317 valid responses, 46.4% had good knowledge while 53.6% had good attitude on BLS. The majority were females (89.3%), Sinhalese (96.2%) and Buddhists (91.2%). Majority were from nursing schools (63.7%) and were in 3rd academic year (45.7%). Among the students 71.9% had had lectures, 34.7% had experienced and 40.7% had participated in training programmes related to BLS. Non-westem province residence (p=0.010), academic year (p=0.011), BLS lectures (p=0.001), experience (0.009), practical training (0.010) were significantly associated with good knowledge. Following were statistically significantly associated with good attitude towards BLS. Religion (p= 0.027), non-westem province residence (p= 0.000), academic year (p= 0.003), having BLS lectures (p= 0.046), training programmes (p= 0.001), experience (p= 0.033), practical training (p=0.003), time since last training (p=0.005) Conclusions: From the study-population 46.4% had good knowledge & 53.6% had good attitudes towards BLS. Religion, non-westem province residence, academic year, lectures, training programs, experience in BLS were associated with good knowledge & attitudes. Therefore, implementation of more training programs, lectures on BLS is recommended.Item Infection control and hand hygiene (ICHH) practices of Audiolog* service providers in the Western Province of Sri Lanka(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Wijethunga, R.Introduction: Clinical audiology settings are vulnerable to infection. Therefore, audiology service providers should have adequate knowledge and training for infection control and hand hygiene practices. Objectives: This study aims to investigate knowledge, practices and attitudes towards ICHH practices of Audiology service providers in the Western province of Sri Lanka. Method: A descriptive study was conducted for audiology service providers in the Western province of Sri Lanka using a self-administrative questionnaire in 2021. The main study was conducted after receiving ethical clearance from the ethical review committee of the Faculty of Medicine, University of Kelaniya. Results: All participants were aware about their clinical setting being exposed to infection. Majority of the participants (93.33%) were aware of at least one ICHH policy, guideline. Less than half of the participant (43.33%) had ICHH training. Most of the participants apply more than one method to clean and disinfect devices which are used for clinical practices. Furthermore, 53.33% of participants used to dispose general and clinical waste separately but all the clinical waste together. Majority of participants have mentioned that it is vital to include ICHH training to audiology education system and having annual infection control training. Conclusions: Knowledge and training for ICHH practices should be increased. A national infection control policy and guideline should be implemented and an annual infection control program should be held in order to assess the progress and to disseminate the knowledge.Item Awareness and attitudes among nursing officers of National Institute of Mental Health, regarding the COVID 19; Descriptive cross-sectional study(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Dharamarathna, N.D.; Samarasekara, D.; Madubhashin, D.; Rupasena, S.; Rajapaksha, N.; Sansala, T.Introduction: Individuals who seek inpatient hospital care due to COVID 19 infection are drastically increasing and nurses are crucial in caring for patients. Proper awareness and positive attitudes are the key pillars for pertinent caring of patients with COVID 19. Objectives: The study aimed to evaluate the awareness and attitudes towards COVID- 19 among nursing officers of National Institute of Mental Health (NIMH), Sri Lanka. Methods: A descriptive cross-sectional study was conducted among randomly selected 201 nurses of NIMH. A pretested self-administered questionnaire was used to collect data. Data were analysed using descriptive statistics and Pearson chi-square test. Overall awareness was categorised using modified Bloom’s cut-off point as good (80%-100%), moderate (50%-79%), and poor (< 50%). Results: The majority were female (92%) with a mean age of 31±6 years. Of participants, 40% reported a history of exposure to COVID 19 while 27% had quarantine. Nearly half of the participants (52%) had moderate awareness with a mean of 70±14 (range 20-90). Referring the COVID 19 guidelines (p=0.001) and working experience (p=0.04) was significantly associated with the awareness. The mean value of the attitudes was 61 ±6 (range 46-80) and 63% (n=127) had a neutral attitude towards COVID-19. Working in a medical ward (p=0.01) or COVID suspected ward (p=0.005) and experience of quarantine (p=0.01) were significantly associated with attitudes. Conclusions: Overall awareness and attitudes were at a moderate level among most. It is necessary to take measures to enhance the knowledge and attitudes towards COVID 19 among nurses.Item Prevalence and associated factors of risky sexual behaviors among undergraduate students in state universities of Western Province in Sri Lanka: a descriptive cross sectional study(BioMed Central, 2018) Perera, U.A.P.; Abeysena, C.BACKGROUND: Risky sexual behaviors (RSB) are becoming an important problem all over the world. RSB are defined as behaviors leading to sexually transmitted diseases and unintended pregnancies. The objective of this study was to determine the prevalence and associated factors of RSB among undergraduate students in state universities of Western Province in Sri Lanka. METHODS: A descriptive cross sectional study was conducted on1575 second and third year undergraduates using stratified cluster sampling of the selected universities. A pretested self-administered questionnaire was used to assess socio-demographic, knowledge attitudes and behavior on reproductive health. RSB was defined as reporting of one or more following behavior/s; having more than one sexual partner, use of alcohol or inability to use condom or other contraceptive methods in sexual activities. The results were expressed as prevalence and its 95% confidence interval (CI) of RSB. Multiple logistic regression was performed ascertain the association between RSB and possible associated factors. The results were expressed as adjusted odds ratios (AOR). RESULTS: Prevalence of RSB in last 1 year and 3 months periods were 12.4%, (95% CI: 11.8-13.1) and 12.1% (95% CI: 11.5-12.7) respectively. The significantly associated risk factors for RSB were, attended night clubs in last month (AOR = 3.58, 95% CI: 1.29-9.88), alcohol consumption within last 3 months (AOR = 2.67, 95% CI: 1.87-3.80) and good knowledge on condoms (AOR = 2.82, 95% CI: 1.94-4.10). Those who thought religion was very important to their lives (AOR = 0.68, 95% CI: 0.48-0.95) was a protective factor. CONCLUSIONS: Alcohol consumption and attending night clubs were associated with RSB. Necessary measures should be taken to reduce risk behaviors within university to reduce RSB.