Knowledge, attitudes and practices of nurses and doctors about
          the vertical transmission of hepatitis B

Gonçalves, Isabela Cristina de Miranda; Gonçalves, Maria Jacirema Ferreira

doi:10.1590/S0104-11692013000500004

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Original Articles • Rev. Latino-Am. Enfermagem 21 (05) • Sept-Oct 2013 • https://doi.org/10.1590/S0104-11692013000500004 copy

Knowledge, attitudes and practices of nurses and doctors about the vertical transmission of hepatitis B

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE:

to identify knowledge, attitudes and practices of physicians and nurses of the Family Health Strategy and a maternity hospital unit about vertical transmission of hepatitis B.

METHOD:

a cross-sectional study with a self-administered questionnaire applied to professionals. The data were analyzed according to professional category and site of action, whose differences were tested by χ² and significance <5%.

RESULTS:

professionals recognize viral hepatitis as a disease of compulsory notification; however, not everyone knows its mechanisms of transmission. A large portion of professionals requested serological tests, specifying the marker, especially physicians. The majority of family health nurses did not indicate hepatitis B vaccine for pregnant women, although they knew the immunization schedule. The majority of physicians on the maternity unit had proper knowledge about prevention of vertical transmission.

CONCLUSION:

the differences in the knowledge, attitudes and practices about vertical transmission of hepatitis B revealed that the population is at risk, since not all the professionals involved know or properly perform control strategies for vertical transmission of hepatitis B. Nurses dominated vaccination aspects and physicians dominated aspects related to the management of cases with positive serology.

Health Knowledge, Attitudes, Practice; Infectious Disease Transmission; Vertical; Hepatitis B; Health Personnel

Characteristics		FHS*		Maternity unit		Total		χ²(p-value)
Characteristics		n=68	%	n=99	%	n=167	%	χ²(p-value)
Sex
	Male	20	29.4	25	25.3	45	26.9	0.354
	Female	48	70.6	74	74.7	122	73.1	(0.55)
Age group (years)
	<30	1	1.5	3	3.0	4	2.4	4.331
	30 - 39	41	60.3	47	47.5	88	52.7	(0.36)
	40 - 49	16	23.5	28	28.3	44	26.3
	≥50	8	11.8	12	12.1	20	12.0
	Not reported	2	2.9	9	9.1	11	6.6
Time since graduation (years)
	1 - 5	0	0.0	5	5.1	5	3.0	18.186
	5 - 9	33	48.5	19	19.2	52	31.1	(<0.01)
	≥10	35	51.5	75	75.8	110	65.9
Graduation
	Medicine	33	48.5	50	50.5	83	49.7	0.062
	Nursing	35	51.5	49	49.5	84	50.3	(0.80)
Additional Education
	None	11	16.2	2	2.0	13	7.8	34.702
	Residency	3	4.4	43	43.4	46	27.5	(<0.01)
	Specialization	54	79.4	66	66.7	120	71.9
	Postgraduate stricto sensu	2	3.0	1	1.0	3	1.8

Attitudes and Practices		Family Health Strategy
		Nurse		Physician		Total		χ²(p-value)
		n=35	%	n=33	%	n=68	%	χ²(p-value)
Need for testing for disease transmission in prenatal care
	Incorrect	1	2.9	0	0.0	1	1.5	0.956
	Correct	34	97.1	33	100.0	67	98.5	(1.00)*
Requests test of vertical disease transmission in prenatal care
	Incorrect	1	2.9	0	0.0	1	1.5	0.956
	Correct	34	97.1	33	100.0	67	98.5	(1.00)*
Which diseases are investigated
	Incorrect	1	2.9	0	0.0	1	1.5	1.142
	Partially correct	3	8.6	2	6.1	5	7.4	(1.00)
	Correct	31	88.6	31	93.9	62	91.2
Requests HBV serology specifying the marker
	Incorrect	14	40.0	5	15.2	19	27.9	5.208
	Correct	21	60.0	28	84.8	49	72.1	(0.02)
What marker is requested to investigate HBV in prenatal care
	Incorrect	4	19.0	5	17.9	9	18.4	0.011
	Correct	17	81.0	23	82.1	40	81.6	(0.91)
Indicates hepatitis B vaccine in pregnant women without previous contact
	Incorrect	26	74.3	18	54.5	44	64.7	2.898
	Correct	9	25.7	15	45.5	24	35.3	(0.08)

Knowledge		Family Health Strategy					Maternity unit					Total
		Nurse		Physician		χ²(p-value)	Nurse		Physician		χ²(p-value)	Family Health Strategy		Maternity unit		χ²(p-value)
		n=35	%	n=33	%	χ²(p-value)	n=49	%	n=50	%	χ²(p-value)	n=68	%	n=99	%	χ²(p-value)
Hepatitis - disease of compulsory notification
	Incorrect	3	8.6	3	9.1	0.005	3	6.1	1	2.0	1.084	6	8.8	4	4.0	1.638
	Correct	32	91.4	30	90.9	(0.94)	46	93.9	49	98.0	(0.29)	62	91.2	95	96.0	(0.20)
Mechanisms of HBV transmission
	Incorrect	1	2.9	1	3.0	3.839	1	2.0	0	0.0	24.543	2	2.9	1	1.0	0.996
	Partially correct	22	62.9	13	39.4	(0.147)	36	73.5	13	26.0	(<0.01)	35	51.5	49	49.5	(0.60)
	Correct	12	34.3	19	57.6		12	24.5	37	74.0		31	45.6	49	49.5
Mechanisms of HDV transmission
	Incorrect	2	5.7	0	0.0	2.49	4	8.2	0	0.0	35.904	2	2.9	4	4.1	0.37
	Partially correct	17	48.6	14	42.4	(0.28)	33	67.4	8	16.0	(<0.01)	31	45.6	41	41.4	(0.83)
	Correct	16	45.7	19	57.6		12	24.5	42	84.0		35	51.5	54	54.5
Function adjuvant to having HDV
	Incorrect	17	48.6	8	24.2	4.324	37	75.5	12	24.0	26.267	25	36.8	49	49.5	2.647
	Correct	18	51.4	25	75.8	(0.03)	12	24.5	38	76.0	(<0.01)	43	63.2	50	50.5	(0.10)
Immunization schedule
	Incorrect	6	17.1	13	39.4	4.176	19	38.8	33	66.0	7.355	19	27.9	52	52.5	9.968
	Correct	29	82.9	20	60.6	(0.04)	30	61.2	17	34.0	(<0.01)	49	72.1	47	47.5	(0.002)
Preventive practices in the newborn
	Incorrect	16	45.7	7	21.2	4.55	-	-	-	-		23	33.8	-	-
	Correct	19	54.3	26	78.8	(0.03)	-	-	-	-		45	66.2	-	-

Attitudes and Practices		Family Health Strategy					Maternity unit					Total
		Nurse		Physician		χ²(p-value)	Nurse		Physician		χ²(p-value)	Family Health Strategy		Maternity unit		χ²(p-value)
		n=35	%	n=33	%	χ²(p-value)	n=49	%	n=50	%	χ²(p-value)	n=68	%	n=99	%	χ²(p-value)
Prevention of vertical transmission in newborn
	Incorrect	14	40	12	36.4	1.810	12	24.5	0	0	13.938	26	38.2	12	12.1	16.786
	Partially correct	16	45.7	12	36.4	(0.40)	21	42.9	28	56.0	(0.001)	28	41.2	49	49.5	(<0.01)
	Correct	5	14.3	9	27.3		16	32.7	22	44.0		14	20.6	38	38.4
Confirmatory immunity marker after vaccination in NB
	Incorrect	27	77.1	18	54.5	3.875	33	67.3	28	56.0	1.347	45	66.2	61	61.6	0.361
	Correct	8	22.9	15	45.5	(0.04)	16	32.7	22	44.0	(0.24)	23	33.8	38	38.4	(0.54)
Uses handbook on viral hepatitis
	Yes	25	71.4	14	42.4	5.841	38	77.6	31	62.0	2.833	39	57.4	69	69.7	2.688
	No	10	28.6	19	57.6	(0.01)	11	22.4	19	38.0	(0.09)	29	42.6	30	30.3	(0.10)

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E-mail: rlae@eerp.usp.br

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[1] Corresponding Author: Isabela Cristina de Miranda Gonçalves Universidade do Estado do Amazonas Av. Carvalho Leal, 1777 Bairro: Cachoeirinha CEP: 69083-030, Manaus, AM, Brasil E-mail: isabela_cmg@yahoo.com.br