engleski

Therapeutic impact of the attitude and new knowledge about disease: a questionnaire study

The aim of the study was to investigate the attitude towards alcoholism and patients with alcoholic cirrhosis and to assess the knowledge of pathophysiology, and treatment of ascites in liver cirrhosis in the physicians from hospitals in Atlanta and Zagreb. Internists and internal medicine residents were asked to fill-out a questionnaire containing 14 questions on the attitude towards alcoholism and patients with alcoholic cirrhosis, and on the knowledge of ascites pathophysiology and treatment. The study was conducted at University Departments of Medicine at Sestre milosrdnice University Hospital and Zagreb University Hospital Center from Zagreb, Croatia (n=40), and Emory School of Medicine from Atlanta, Georgia, USA (n=30). In the Zagreb group there were significantly more internists (p=0.025), with significantly more years of specialist service (p=0.006). Significant difference between the two groups was recorded in their answers to questions on alcoholism (p=0.006), correct concept of pathophysiology of ascites formation (p<0.001), cardiac output in liver cirrhosis (p<0.001), plasma aldosterone concentration on upright posture test in preascitic liver cirrhosis (p=0.030), atrial natriuretic peptide (p<0.001), therapeutic impact of spironolactone (p=0.005), and paracentesis (p=0.009), as well as in the frequency of correct answers to questions on alcoholism (p=0.002), cardiac output in liver cirrhosis (p=0.001), plasma aldosterone concentration on upright posture test in preascitic liver cirrhosis (p=0.005) with the Zagreb group scoring worse, and according to sex also in the knowledge of the century of Leonardo da Vinci's birth (p=0.018). Negative attitude towards alcoholism and alcoholic cirrhosis in the Zagreb respondents, and the lack of knowledge about the basic patophysiological mechanism of ascites formation and new treatment algorithms in liver cirrhosis were recorded in both groups. The attitude and knowledge influence treatment decisions. The clinicinans' knowledge about the effectiveness of a novel or established treatment protocol including modification in the indications or method and its timing is indispensable.

liver cirrhosis; therapy; liver cirrhosis; complications; ascites etiology; ascites prevention and control; questionnaires; data collection

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