title: Knowledge, attitudes, and practice behaviors (KAPb) of nurses and the effectiveness of a training program in psychosocial cancer care.
abstract: OBJECTIVE
  Psychosocial distress in oncology patients may significantly interfere with their health outcomes and quality of life. Nurses work closely with their patients and are in the best position to screen for distress and provide timely intervention. It is thus important for nurses working in oncology settings to be equipped and prepared to address distressing psychosocial issues. The present study aims to investigate the impact of a training program in psychosocial care on nurses' knowledge, attitudes, and clinical practice behaviors.
  
  
  METHODS
  A total of 180 nurses working in medical oncology and radiation oncology departments at the National University Cancer Institute Singapore underwent a training program in psychosocial care as part of their continuing nursing education curriculum. One hundred fifty four of these nurses completed a self-designed questionnaire on nurses' knowledge, attitudes, and practice behaviors (KAPb) at all four time points: baseline, post-training, and at 6 and 12 weeks post-training, respectively.
  
  
  RESULTS
  The self-designed KAPb questionnaire proved adequate for this study. Positive gains on applied knowledge and practice behaviors were sustained over a 12-week period. There were no changes in theoretical knowledge. A decreasing trend in attitudes was noted, although this was specific to the participants' attitudes toward the importance of emotional concerns as compared to physical concerns in cancer treatment. Enrolled nurses seemed to have higher starting levels of theoretical knowledge than their registered counterparts were. There were no other differences on demographic variables in relation to the efficacy of the training program.
  
  
  CONCLUSIONS
  The training program was successful in improving the applied knowledge and practice behaviors of nurses in providing psychosocial care for cancer patients. However, further refinement to the program, with particular attention to nurses' existing training and years of clinical nursing experience, would enhance staff empowerment and care improvement.
authors.affiliation: Department of Psychological Medicine, National University Hospital, NUHS Tower Block, Level 9, 1E Kent Ridge Road, Singapore, Singapore, 119228, pcmrathi@nus.edu.sg.
authors.forename: Rathi
authors.initials: R
authors.lastname: Mahendran
authors.forename: Joanne
authors.initials: J
authors.lastname: Chua
authors.forename: Chao Xu
authors.initials: CX
authors.lastname: Peh
authors.forename: Haikel A
authors.initials: HA
authors.lastname: Lim
authors.forename: Emily N K
authors.initials: EN
authors.lastname: Ang
authors.forename: Siew Eng
authors.initials: SE
authors.lastname: Lim
authors.forename: Ee Heok
authors.initials: EH
authors.lastname: Kua
mesh_terms: D001291:Attitude of Health Personnel; D004509:Education, Nursing, Continuing / Q000379:methods*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000451:nursing* / Q000523:psychology*; D009726:Nurses / Q000523:psychology*; D009859:Oncology Nursing / Q000193:education*; D012846:Singapore; D011795:Surveys and Questionnaires