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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Evaluating the efectiveness of a community based health promotion intervention on knowledge improvement regarding low birth weight and its determinants among antenatal couples in Sri Lanka(Springer Nature, 2024) Guruge, G.N.D.; Young, S.M.; Perera, K.M.N.; Dharmaratne, S.D.; Gunathunga, M.W.BACKGROUND Improvement of the knowledge of pregnant mothers and their partners related to low birth weight (LBW) is a vital factor in preventing LBW and reducing its prevalence. OBJECTIVES Implement and evaluate the effectiveness of a community based health promotion intervention on preg nant mothers and their partners to increase knowledge on birth weight and its determinants. The second objective is to determine the difference of the birth weight after implementing the intervention. METHODS A quasi experimental study design was used, and the setting was 806 pregnant mothers, 403 each in two dis tricts. In 26 ANCs, twenty six initial training sessions were conducted as a group, with an average of three hours for each session. Three follow up sessions were conducted in each ANC over 04 months (in total 104 sessions). All sessions were conducted in groups of 10 to 20 antenatal couples. The pregnant mothers and their partners completed interviewer administered questionnaires. Pre and post data were analysed based on four major knowledge categories using statistical methods. The McNemar’s Chi Square test; Chi Square test, Fisher’s Exact test, Paired t test, Student’s independent sample t test, Wilcoxon Signed Ranks test and Mann Whitney U test methods were applied as appropriate. RESULTS Both mothers and their partners in the intervention group (IG) reached significantly higher gains in knowledge than in the comparison group (CG). The participants who got the lowest scores for knowledge, at the pre assessment, in IG, also improved more than the CG {mothers (p = 0.002) and partners (p = 0.007)}. The mean birth weight shows that the IG has significantly improved for both mothers (p < 0.001) and partners (p = 0.013) with low knowledge scores (< 50% of total). CONCLUSIONS Knowledge about birth weight and its determinants among pregnant mothers and their partners improved significantly.Item Do doctors really know about “hs-cTnI”? A comprehensive evaluation of knowledge regarding high-sensitivity cardiac troponin I (hs-cTnI) assay among medical officers in Gampaha district(College of Chemical Pathologists of Sri Lanka, 2024) Fernando, N.; Fernando, K.; Gallage, T.; Dayanath, B.K.T.P.; De Silva, S.INTRODUCTION AND OBJECTIVES The high-sensitivity cardiac troponin I (hs-cTnI) assay is a crucial diagnostic marker in the triage of patients presenting with chest pain. Notably, errors in interpreting the testing method have been identified among medical officers, leading to an increased likelihood of inaccuracies in testing and interpretation. This study aims to evaluate the level of understanding among medical officers regarding the hs-cTnI assay in relation to the most recent European Society of Cardiology (ESC) guideline released in 2020. METHODS A cross sectional questionnaire-based study was conducted at two government hospitals in Gampaha District during June 2022. A self-administered e-questionnaire was used to assess knowledge regarding hs-cTnI. Knowledge was measured through cumulative scoring of questionnaire responses, subsequently categorized as either good or poor knowledge. Scores below 60% were designated as poor, and vice versa. Descriptive statistics were employed for data summarization. RESULTS Out of 300 participants, 76% (227) responded. Only 14.5% (33/227) exhibited proficient knowledge of the analytical component, while 41.9% (95/227) demonstrated good knowledge of the clinical component. A score ≥60% on the analytical component knowledge correlated significantly with factors such as designation being a senior registrar or consultant (p<0.001), postgraduate enrolment (p<0.001), participation in continuous professional development programmes (p<0.001), and employment in a teaching hospital (p=0.025). Conversely, no significant associations were observed with age (p=0.066) or private practice (p=0.118). Clinical component knowledge scores ≥60% were significantly associated with age between 25 and 35 years (p=0.006), postgraduate enrolment (p<0.001), participation in continuous professional development programs (p<0.001), and employment in a teaching hospital (p=0.001) but not with doing private practice (p=0.170). CONCLUSIONS In Sri Lanka, medical officers’ analytical knowledge on the hs-cTnI assay seems lacking. Ongoing training programmes are essential to enhance their knowledge and proficiency in hs-cTnI testing.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 Assessment of knowledge, attitudes and practices on chemotherapy among oncology patients(Sri Lanka Medical Association, 2023) Chandrasena, W.M.H.N.M.INTRODUCTION: Oncology patients are highly susceptible to untoward effects of chemotherapy. Their knowledge, attitude and practice (KAP) on chemotherapy are effective determinant of their treatment. OBJECTIVES: The objective of this study was to assess the KAP regarding chemotherapy medications among oncology patients. S171 METHODS: A total of 311 oncology patients undergoing chemotherapy were randomly recruited from a medical oncology ward in a tertiary care hospital in Sri Lanka. The admission register was used as the sampling frame. Data were collected using a translated version of a standard questionnaire developed by Yan Wang et al. It included questions related to patients’ KAP on chemotherapy medications. The collected data were descriptively analysed. RESULTS: Among participants 68.8% had an average knowledge of their chemotherapy medications, 62.1% had a positive attitude, and 31.2% had reported an average score for good practices. Age, education level and type of cancer significantly influenced the KAP of oncology patients on chemotherapy. CONCLUSIONS: Among participants 68.8% had an average knowledge of their chemotherapy medications, 62.1% had a positive attitude, and 31.2% had reported an average score for good practices. Age, education level and type of cancer significantly influenced the KAP of oncology patients on chemotherapy.Item Knowledge, attitudes, and beliefs about liver transplantation among caregivers of children with liver diseases; a single centre experience from Sri Lanka(Sri Lanka Medical Association, 2023) Gunaratne, A.L.S.N.; Gunarathna, P.G.P.D.; Gunawardana, A.D.J.N.; Hansamali, U.V.S.; Heenkenda, H.M.A.N.; Ekanayaka, J.; Fernando, C.M.P.INTRODUCTION: Paediatric Liver transplantation (PLT) is evolving in Sri Lanka. There is no data documented related to caregivers' knowledge of PLT. OBJECTIVES: To determine the knowledge, attitudes, and beliefs about liver transplantation (LT) among caregivers of children with liver diseases. METHODS: A descriptive cross-sectional study was conducted among the caregivers attending the paediatric liver clinic at Ragama. The calculated sample size was 186. Data were collected using an interviewer-administered questionnaire. Descriptive statistics with SPSS 27.0 were used for analysis. Ethical approval was obtained from the Faculty of Medicine, Ragama. Since there were no previous similar studies, as the tool, we used a newly designed, pre-tested questionnaire which included the basic facts about the knowledge of LT. RESULTS: Of 186 caregivers, the majority were mothers (n=107, 57%). A mixed religious background was noted with Buddhists, Catholics, Islam and Hindus being 80%, 11%, 7% and 2% respectively. Most were educated up to or above the GCE ordinary level (n=180, 97%). The majority (n=124, 68%) were from low-income families with a monthly income of less than 50,000 LKR. Almost half of the participants, 89 (47.8%) knew someone who had undergone an LT. Knowledge of having PLT within the country, living donation, diseased donation, blood group matching and life-long medications were accurate in 171 (91.9%), 170 (91%, 75 (40%), 172 (92%), 116 (62%) respectively. Regarding the beliefs and attitudes towards LT, 170 (91%) were willing to donate and 144 (77%) indicated to support LT. There were 32 (17%) who believed that liver diseases can be cured with alternative medicine and 103 (55%) believed being religious would result in better outcomes. CONCLUSION: Knowledge of LT among caregivers is promising with a positive attitude. Some of their beliefs seem to be non-scientific.Item Assessment of knowledge and attitude towards the palliative care among nurses in Sri Lanka: A hospital- based study.(Sage Publishing, 2023) Wijesinghe, T.; Gunathilaka, N.; Mendis, S.; Udayanga, L.OBJECTIVE: Palliative care is an intervention that improves the quality of life of patients. Nurses have a primary role in providing palliative care. Their knowledge and attitudes toward palliative care is important in care delivery. There is minimal information in Sri Lanka to document the knowledge and attitude of palliative care among nurses. Therefore, the present study was conducted to assess the knowledge and attitude of palliative care among nurses in Sri Lanka. METHOD: A cross-sectional, descriptive study was conducted on 200 selected nurses at Colombo North Teaching Hospital, Sri Lanka fulfilling the inclusion criteria. Socio-demographic information of the study participants was obtained through a self-administered questionnaire. The awareness and attitude levels toward the PC were assessed using the Palliative Care Knowledge Test (PCKT) and Frommelt Attitude Toward Care of the Dying, respectively. RESULTS: More than half of the participants (55%) had an inadequate knowledge level regarding the palliative care (<50% for the PCKT score). Regarding the attitude on the palliative care, the majority stated nursing care to a dying person is a worthwhile experience (92%; n = 184). Many of them disagreed with avoiding the care of dying patients (strongly disagree: 37%; n = 74, disagree: 52.5%; n = 105). Overall, 85.5% of study participants had a positive attitude towards the palliative care. According to binary logistic regression, gender (P = .04; OR = 3.57; CI = 1.03-12.41) and working setup (P < .001) were significantly associated with having a positive attitude. The knowledge level was higher among nurses working in surgical wards (OR = 7.84). Those with >10 years of experience were statistically significant to have a positive attitude (P = .02; OR = 1.35; CI = 1.13-5.50). CONCLUSION: The nurses had inadequate knowledge of the PC even though they had a positive attitude toward it. Therefore, it is essential to uplift the awareness level among health workers. This warrants the need for palliative care education in the nursing curriculum and continuous professional development.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 Evidence-based practice among speech therapists in Sri Lanka(University of Kelaniya, Sri Lanka, 2022) Wanigasooriya, I.G.; Colonne, U.T.Background: Evidence-based practice (EBP) is essential to providing quality health care. Evidence-based practice (EBP) is the process of providing high-quality health care through research findings, practical knowledge, and client preferences and values. Evidence-based health care is the careful application of current best evidence in making choices regarding individual patient care or health service delivery. Speech and Language Therapists (SLTs) treat communication difficulties and swallowing difficulties. Currently, their range of services provided is wide, and high-quality results can be obtained through EBP. Evidence-based practice provides superior service to people with speech, language, and swallowing difficulties. Objectives: Our study aimed 1- To identify the use of evidence-based practice among speech and language therapists in Sri Lanka, 2- To determine the speech and language therapists’ knowledge on evidence-based practice, 3- To determine the speech and language therapists’ skills on use of the evidence-based practice and 4- To determine the association between current knowledge skills and usage of EBP among SLTs, and their socio-demographic variables. Methods: A descriptive cross-sectional study was used to identify the level of knowledge, skills, and use of EBP among SLTs. Altogether 169 participants completed a self-administrative online survey questionnaire with 32 rank order questions (strongly agree to strongly disagree). Demographic characteristics of the participants were analyzed descriptively and presented as means, standard deviations (SD), frequencies, and percentages. The Chi-square test and Fisher’s exact test were used appropriately to determine the association of current knowledge, skills, and usage of EBP among SLTs with their socio-demographic variables (gender, age range, educational qualifications, client group, work setting). Results: The majority of SLTs had heard about EBP (71.9%) and had an idea about EBP (95.9%). However, 70% of responses (agreed or strongly agreed) were obtained for all other questions asked related to the knowledge of EBP. Forty percent to 55% of participants confirmed that they have average skills on EBP. 50% of participants confirmed that they use EBP, have access to EBP, or read research publications, sometimes. 30% of participants were using EBP, frequently. In general, a significant association was not revealed (P<0.05) between knowledge, skills, and usage of EBP among SLTs, and the five demographic variables. Conclusion: The present study showed that Sri Lankan SLTs have good to fair knowledge and skills toward EBP. The majority of participants confirmed that they are sometimes using EBP. All these current practices of EBP are not influenced by their gender, age, work setting, practicing client group, or highest educational qualification. However, there was a significant association between gender and current usage of EBP.Item A Survey on current knowledge and practices of teleaudiology among audiology professionals in Sri Lanka(University of Kelaniya, Sri Lanka, 2022) Prabodani, G.V.; Jayasena, B.N.Background: With the advancement of technology and resources, telehealth is becoming a prominent method of filling the gaps in conventional audiology services across the world. Teleaudiology services in Sri Lanka are evolving and still is an under addressed area of local literature compared to other telehealth applications in the medical sector. Objectives: To describe the current knowledge and practices of teleaudiology and factors affecting planning and implementation of teleaudiology services in Sri Lanka. Methods: This is a descriptive cross-sectional study conducted among 104 (n=104) audiology professionals employed in public and private audiology work setups across the country. Objectives of the study were evaluated through an online self-administered questionnaire, which was configured as a Google form. Results: The study yielded a response rate of 83.87% and a majority (75.0%) of the participants were female and the age distribution of participants was between 25 and 45 years. A majority (79.8%) of the practitioners reported awareness on teleaudiology while 32.7% of them were utilizing teleaudiology in practice. Initiation of teleaudiology was influenced by the COVID-19 pandemic for the majority. Audiology practitioners reported the use of telepractice predominantly in counselling, education, training, hearing aid related rehabilitation, and prevention of hearing and balance related conditions as individual or group sessions, utilizing a hybrid telehealth model. More than 75.0% of the services were centralized within the Western province in private centres and the teen to adult age range was served through telepractice predominantly. Despite practices, several factors and challenges were reported to influence teleaudiology practices, including the lack of facilities and resources as the major challenge while reporting several benefits of practice also. Conclusions: The findings of the study indicate that teleaudiology services are currently available in Sri Lanka, but it is centralized within a narrow geographic area and primarily restricted only to certain services. No information can be derived on the trend of teleaudiology in Sri Lanka due to the lack of evidence in the existing literature. This study sheds a light on current knowledge and practices of teleaudiology with an emphasis on factors affecting it, which will assist in improving services further.