Knowledge, attitude and practice of nurses toward peak expiratory flow meter in primary health care centers in Kuwait

Available online 15 September 2011

Peer review under responsibility of Alexandria University Faculty of Medicine

Figures & data

Table 1 Sociodemographic characteristics of nurses.

Character	Number (n = 516)	%
Age
Min–max	20–60
Mean ± SD	35.2 ± 7.8
Sex
Male	110	21.3
Female	406	78.7
Nationality
Kuwaiti	39	7.6
Non-Kuwaiti	477	92.4
Marital status
Single	58	11.2
Married	438	84.9
Divorced/widowed	20	3.9
Qualification
Bachelor degree	462	89.5
Master/Ph.D.	54	10.5
Job
Nurse	167	32.3
Staff nurse	349	67.7
Years at work
Min–max	1–33
Mean ± SD	11.0 ± 7.5
Income
<1000 KD	479	92.8
>1000 KD	37	7.2
Family history of asthma
Yes	80	15.5
No	436	84.5

Table 2 Opinion and practice of nurses toward peak expiratory flowmetry.

Opinion and practice	Number	%
Opinion
Approximate percentage of suffering from BA or COPD
Min–max	6–95
Mean ± SD	55.4 ± 21.8
Median	57.5
Percent of those in need of PEFM
Min–max	0–100
Mean ± SD	45.3 ± 26.7
Median	40.0
Percent of those having PEFM at home
Min–max	0–90
Mean ± SD	14.8 ± 16.6
Median	10.0
Approximate percentage of smokers
Min–max	0−100
Mean ± SD	60.9 ± 25.8
Median	70.0
Advising patients to use PEFM	114	22.1
There is a bad need for PEFM in the health center	204	39.1
It is easy to use PEFM correctly at home	384	74.4
Practice
There is a PEFM in the center	117	22.7
Receiving training about use of PEFM	109	21.1
Measuring PEF of patients at the health center	71	13.8

Table 3 Knowledge of nurses about peak expiratory flowmetry.

Knowledge	Number (n = 516)	%
Benefits of PEFM use
Indicates degree of treatment success	465	90.1
Indicates when to add or stop a medicine	365	70.7
Indicates the urgent need to go to a hospital	392	76.0
It can diagnose precipitating factors	313	60.7
Helps spread knowledge about BA	420	81.4
Helps to diagnose exercise asthma	468	90.7
Mean ± SD (Median)	78.3 ± 19.5 (83.3)
Steps of use
Put the indicator at the base of the scale	65	12.6
Stand up	16	3.1
Take a deep breath	173	33.5
Tightly encircle your lips around the device	185	35.9
Expire air as fast and deep as you can	362	70.2
Write down the reading	315	61.0
Repeat the previous steps twice	225	43.6
Register the largest reading you got of the here trials	269	52.1
Mean ± SD (Median)	39.0 ± 24.4 (25.0)
Defining normal level of PEFR
It is better to define PEFR using age, height and sex	58	11.2
It is better to define PEFR for each person in particular	486	94.2
To estimate PEFR, take measurements for two weeks	253	49.0
To estimate PEFR, take measurements for day and night	272	52.7
To estimate PEFR, take measurements before and after bronchodilator	451	87.4
Mean ± SD (median)	58.9 ± 17.3 (60.0)
Concepts of measurements
If reading to = 100% of normal there is no need to change treatment	428	82.9
If reading = 90% of normal; treatment may be insufficient	284	55.0
If reading less than 90%, consult your physician immediately	204	39.5
The device can be used during an asthma attack	160	31.0
There should be a registration board	479	92.8
Registration chart is graded from 5–300	351	68.0
Mean ± SD (median)	55.6 ± 15.4 (50.0)
Indicators for use of PEFM
Bronchial asthma	514	99.6
COPD	479	92.8
Chronic bronchitis	417	80.8
Emphysema	284	55.0
Mean ± SD (median)	82.1 ± 20.5 (75.0)
General concepts about PEFM
Proper management is better than the reading itself	476	92.2
Plan of therapy is directly defined according to the registered reading	443	85.9
It is enough to wash the device with water to clean it	287	55.6
Generally speaking, it is very easy to use PEFM	423	82.0
There is no contraindications to use PEFM	272	52.7
Adults and children use the same PEFM	402	77.9
Mean ± SD (median)	74.4 ± 17.3 (66.7)
Instructions for learning of patients about PEFM
Using the device	513	99.4
Cleaning and storing the device	502	97.3
Recording in the registration chart	487	94.4
Contraindications of use of the device	462	89.5
Changing plan of therapy	388	75.2
Advising others about the device	451	87.4
Mean ± SD (median)	78.1 ± 12.0 (83.3)
Total Mean ± SD (median)	64.7 ± 7.3 (65.9)

Table 4 Factors affecting domains of knowledge about PEF among nurses.

Character	K1	K2	K3	K4	K5	K6	K7	Total
Sex
Male	78.8 ± 20.3	45.3 ± 27.4	58.6 ± 17.9	55.2 ± 17.5	83.2 ± 22.0	73.8 ± 15.6	79.4 ± 8.4	66.1 ± 7.7
Female	78.1 ± 19.3	37.3 ± 23.3	59.0 ± 17.1	55.7 ± 14.8	81.8 ± 20.1	74.6 ± 17.8	77.7 ± 12.8	64.3 ± 7.2
P	0.69	0.008^*	0.92	0.56	0.28	0.62	0.56	0.07
Nationality
Kuwaiti	75.6 ± 17.9	49.4 ± 24.7	56.9 ± 17.5	53.4 ± 14.4	76.9 ± 23.9	69.2 ± 18.6	78.2 ± 12.2	64.5 ± 7.5
Non Kuwaiti	78.5 ± 19.6	38.2 ± 24.2	59.1 ± 17.3	55.7 ± 15.5	82.5 ± 20.2	74.8 ± 17.2	78.1 ± 12.0	64.7 ± 7.3
P	0.26	0.005^*	0.41	0.37	0.17	0.06	0.96	0.94
Qualification
Bachelor	77.9 ± 19.2	38.0 ± 24.7	58.6 ± 17.2	55.6 ± 15.2	82.0 ± 20.3	74.8 ± 17.4	78.0 ± 12.4	64.4 ± 7.4
Higher	81.2 ± 21.7	47.7 ± 19.6	61.5 ± 18.2	55.6 ± 17.4	82.4 ± 22.1	71.0 ± 16.6	79.0 ± 7.4	66.8 ± 6.5
P	0.12	0.001^*	0.31	0.93	0.71	0.14	0.68	0.07
Job
Nurse	76.5 ± 21.1	41.7 ± 25.8	59.0 ± 18.9	58.4 ± 17.1	81.0 ± 24.6	71.7 ± 15.8	77.2 ± 12.2	64.7 ± 8.2
Staff nurse	79.1 ± 18.7	37.7 ± 23. 7	58.9 ± 16.5	54.2 ± 14.4	82.6 ± 18.3	75.7 ± 17.9	78.5 ± 11.9	64.7 ± 6.9
P	0.25	0.13	0.80	0.02^*	0.66	0.006^*	0.07	0.53
PEFM in center
Yes	80.7 ± 18.3	41.8 ± 22.2	60.0 ± 16.6	60.7 ± 13.4	83.0 ± 20.2	75.9 ± 17.4	78.2 ± 11.6	65.1 ± 7.2
No	69.9 ± 21.2	38.2 ± 25.0	55.2 ± 19.1	54.1 ± 15.6	78.9 ± 21.4	69.1 ± 16.1	78.1 ± 13.3	63.2 ± 7.6
P	<0.001^*	0.04^*	0.005^*	<0.001^*	0.05	<0.001^*	0.83	0.02^*
Training
Yes	81.1 ± 19.3	38.0 ± 24.2	59.5 ± 17.9	56.7 ± 16.6	83.3 ± 19.9	74.5 ± 17.2	82.4 ± 5.9	65.1 ± 7.7
No	67.9 ± 16.3	42.8 ± 25.1	56.7 ± 14.8	51.4 ± 8.5	77.5 ± 22.3	73.9 ± 17.8	76.9 ± 12.9	63.1 ± 5.5
P	<0.001^*	0.09	0.10	<0.001^*	0.01^*	0.44	<0.001^*	0.001^*
Measuring
Yes	80.5 ± 15.2	40.2 ± 24.9	63.9 ± 17.8	56.6 ± 13.9	82.0 ± 22.0	80.5 ± 15.9	81.0 ± 7.1	65.6 ± 4.4
No	77.9 ± 20.1	31.3 ± 19.5	58.1 ± 17.2	55.4 ± 15.6	82.1 ± 20.3	73.4 ± 17.4	77.6 ± 12.6	64.6 ± 7.7
P	0.50	0.006^*	0.01^*	0.58	0.81	0.001^*	0.04^*	0.19

P: of Mann-Whitney Z < 0.05.

K1 to K7: Knowledge domains.

* Significant.