Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #114670

Andriene S. Grant, MSc, Elizabeth Ward, MBBS, MSc, and Deanna Ashley, MBBS, DPH, DM. Health Promotion and Protection Division, Ministry of Health, 2-4 King Street, Kingston, Jamaica W.I., Jamaica, (876) 967-1100-1 Ext. 2540, granta@moh.gov.jm

Objective: To assess the knowledge of health-care workers on blood pressure measurement and diagnostic criteria for diabetes and hypertension. Knowledge was assessed against the Ministry of Health management protocols for diabetes and hypertension. Design and Methods: A cross-sectional survey was conducted with physicians, family nurse practitioners and staff nurses employed to Jamaican government health centres. Descriptive statistics such as means and proportions were computed. Independent sample t-tests were used to analyze differences between means. Two-way cross tabulations were done and tested for independence using chi-squared tests. Multinomial logistic regression was carried out on associated variables to determine the strength of the association. Factors analyzed included identification of correct hypertension/diabetes diagnosis with occupation, age and year of graduation. Definitions: A correct diabetes diagnosis was defined as a response naming any or all of the following: (i) capillary finger prick: fasting whole blood >= 6.1 mg/dl or 2 hour post-prandial >=10 mg/dl; (ii) laboratory: fasting venous blood >= 7.0 mg/dl or 2 hour post-prandial >= 11.1 mg/dl) (iii) random plasma glucose >= 11.1 on 2 occasions, with symptoms. A blood pressure reading greater than or equal to 140/90 mm Hg on two/three 3 occasions was defined as the correct diagnostic definition for hypertension. Results: Analysis included 173 respondents (34% physicians, 34% family nurse practitioners and 32% staff nurses). The correct diagnosis of diabetes was given by 22% respondents (38% doctors, 14% family nurse practitioners, 11% staff nurses) and the correct diagnosis of hypertension was given by 42% respondents (53% doctors, 38% family nurse practitioners, 34% staff nurses). Doctors were more likely to identify the correct diagnostic definitions for diabetes mellitus than family nurse practitioners (OR = 3.22, p = 0.01). Seventy-two percent of all health care workers reported being familiar with Ministry of Health protocols. Familiarity with the protocols was associated with the correct diagnosis of hypertension (p=0.002). Two-thirds (67%) of all respondents reported rounding blood pressure to the nearest 2 mm Hg. One quarter (24%) of staff nurse respondents also reported rounding blood pressure measurement to the nearest 10 mm Hg. Conclusion: The results highlight the importance of continuing medical education, especially for the correct diagnosis of diabetes and hypertension. Training based on the management protocols using interactive methodologies is required.

Learning Objectives: At the conclusion of the session, the participant (learner)

• Will be sensitized to factors which influence the management of hypertensive and diabetic patients in the Jamaican context.
• Should be able to recognize the importance of continuing medical education.

Keywords: Diabetes, Health Care Workers

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.