Knowledge, Attitude, and Practices of Mothers Working as Nurses Toward Multidrug-Resistant [Letter]

Dear editor

The research entitled “Knowledge, Attitude, and Practices of Mothers Working as Nurses Toward Multidrug-Resistant” really caught our attention. Researchers have proven that the implemented educational program can actually increase the knowledge, attitudes and practices of neonatal nurses regarding multidrug-resistant organisms (MDROs). In this case, the details of the number of items that increased significantly after the educational program was carried out are as follows: knowledge = 18 of 20 items (80%), attitude = 12 of 12 items (100%) and practice = 4 of 11 items that can be measured (36.4%).¹

Referring to health behavior theory both in understanding concepts and practice,² the flow of effects of the intervention provided in this study is: 1) educational programs increase knowledge about MDROs as the first effect; 2) increased knowledge will form a positive attitude towards MDROs as a second effect; 3) a positive attitude will build better practices regarding MDROs as a third effect. The first effect was proven by the significant difference in knowledge between before and after the intervention; the second effect is proven by the significant correlation between post-knowledge and post-attitude; while the third effect (correlation between post-attitude and post-practice) could not be analyzed because coincidentally the post-practice scores of all respondents were the same, so this variable became constant.

With the fact that post-practice has become a constant variable, researchers should not use post-intervention data (post-knowledge, post-attitude and post-practice), but instead switch to using delta scores (the difference between post-intervention and pre-intervention) or in other words, it is a score of increased knowledge, attitudes and practices after being given an educational program. After obtaining the delta-knowledge, delta-attitude and delta-practice scores; then the analysis of the second and third effects can be carried out easily.

Based on the problems above, we respectfully request that the editor give researchers the opportunity to re-analyze the second and third effects based on the delta score, to be published again in this journal as a response to our letter.