title: [Survey of knowledge, attitude and behavior regarding safe injection among health practitioners in Shandong, China].
abstract: OBJECTIVE
  To assess the knowledge, attitude and behavior of health practitioners (HPs) about safe injection in Shandong, China and to clarify risk factors related to unsafe injection and improper handling of used disposable syringes.
  
  
  METHODS
  A cross-sectional study of 497 HPs in three-levels of health units (village clinic, township health center, and county hospital) in two areas of Shandong, China was carried out using a questionnaire.
  
  
  RESULTS
  468 HPs returned completed questionnaires. The proportion that did not receive formal medical education in the village (21.5%) was higher than in the township (9.9%) and in the county (2.5%). Proportions of HPs who only used disposable syringes were 97.0% in the county, 81.1% in the township and 69.0% in the village. Scores for safe injection knowledge among village HPs were significantly lower than those with township and county HPs (P < 0.001). Rate of unsafe injection practice was 6.2%, rate of improper handling of used disposable syringes was 7.6%, and both of which were significantly greater at the village level. Four factors were found to be significantly related to unsafe injection practice (P < 0.05): lower than middle level professional grade; knowledge scores of < 15 (full score 18); thinking that AIDS is not a terrible disease; and thinking that patients would accept the practice of sharing the same syringe for different persons. Four factors were found to be significantly related to improper handling of used disposable syringes (P < 0.05): working in the village; knowledge scores of < 15; thinking that patients would accept the practice of sharing the same syringe for different persons; and unwillingness to properly handle used disposable syringes.
  
  
  CONCLUSIONS
  HPs working in village clinics had comparatively high rates of unsafe injection practice and improper handling of used disposable syringes, and a lower level of knowledge about safe injection. Lack of knowledge about safe injection was a risk factor for both unsafe injection and improper handling of used disposable syringe. Therefore, interventions should focus on this insufficient level of safe injection knowledge.
authors.affiliation: Department of Public Health, Graduate School of Medicine, University of Tokyo.
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.forename: Yasuki
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Aiqiang
authors.initials: A
authors.lastname: Xu
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Chiba
authors.forename: Lizhi
authors.initials: L
authors.lastname: Song
authors.forename: Zuokui
authors.initials: Z
authors.lastname: Xiao
authors.forename: Li
authors.initials: L
authors.lastname: Zhang
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002681:China; D003430:Cross-Sectional Studies; D004209:Disposable Equipment / Q000706:statistics & numerical data; D017743:Equipment Reuse / Q000706:statistics & numerical data; D005260:Female; D015438:Health Behavior; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012449:Safety; D011795:Surveys and Questionnaires