الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Hematological disorders are those systemic conditions with malfunction in the production of blood and its components (blood cells and proteins). They are generally classified into three groups: red blood cell (RBC) disorders, white blood cell (WBC) disorders and bleeding disorders. The latter is a group of disorders that share the inability to form a proper blood clot. They are characterized by extended bleeding after injury, surgery, trauma or menstruation. Bleeding disorders may be congenital or acquired. They can be classified as coagulation factor deficiencies, platelet disorders, vascular disorders or fibrinolytic defects. The present study adopted a cross sectional analytical design to assess the knowledge, attitude and reported practices of dentists working in the Ministry of Health (MOH), in Alexandria Governorate, regarding management of patients with bleeding disorders.
The total number of dentists working in the different health districts of Alexandria governorate (1866 dentists) was obtained from the directorate of health affairs. A minimal sample size of 317 dentists was estimated to be representative of the whole MOH dentists’ population, in Alexandria, Egypt. Then, a proportional allocation sample was taken from each district. A list was made containing all governmental healthcare facilities, from which, settings were randomly selected until the predetermined sample size was reached.
Data were collected in six months period from August 2018 to January 2019. The initially approached sample consisted of 400 dentists, only 340 dentists agreed to complete the questionnaire, giving a response rate of 85%. A self-administered questionnaire based on intensive literature review was used and pilot tested to ensure clarity and consistency of the questions.
The questionnaire consisted of 33-items arranged in four sections: demographic data (8 questions), knowledge (15 questions), attitudes (7 statements) and reported practices (3 questions) regarding patients with bleeding disorders and their dental management. An alpha level was set to 5% with a significance level of 95%.
Almost 90% of the sample consisted of females and more than half (56.18%) were between 30 and 40 years old. With regard to qualification, approximately two thirds of the participants were general practitioners having a bachelor’s degree (65%). Of the remaining one third who were specialists, nearly one quarter were oral surgeons (26.05%), followed by pedodontists (22.69%) and dental public health dentists (19.33%).
More than three quarters of the dentists (78.82%) reported that they did not have enough undergraduate courses regarding bleeding disorders. Only 30.29% have already attended continuing education courses mostly about 2-3 courses (46.60%) with 48.54% stating that the courses attended were more than 2 years ago.
Only 3.82% had an excellent level of knowledge, 30.88% showed a good level of knowledge, whereas 58.88% scored fair and only 6.47% had a poor level of knowledge. Almost one quarter (22.35%) of the respondents had an excellent attitude towards bleeding disorders and their management, 60.29% had good attitude, while 13.82% had fair attitude and finally, only 3.53% had poor attitude. Approximately half of the participating dentists (41.76 %) adopted excellent practices regarding bleeding disorders, while 45.88% adopted fair practices, whereas 12.35 % adopted poor practice.
When considering the level of knowledge of the surveyed dentists, it could be seen that dentists aged 50 years or more (7.69%) and specialists (4.20%) had the highest level of knowledge regarding bleeding disorders and their management.
Regarding the relation between the studied dentists’ attitude and the different independent variables, specialists aged 40 to 50 years old showed the topmost positive attitudes towards management of patients with bleeding disorders, with statistically significant difference. (P= 0.03 and P=0.010, respectively).
Concerning practice scores, again specialists with average years of experience of 20 years or more showed excellent practices compared to their counterparts, where P=0.018 and P=0.000, respectively. Pedodontists adopted the best practices followed by public health specialists (P=0.004) which could be attributed to the specialized courses regarding special need patients in their postgraduate curriculum.
As an answer to the main research question, it is safe to report that although the MOH dentists, in Alexandria, might have shown positive attitude and good practice skills towards bleeding disorders and their management, they do lack adequate knowledge regarding the matter.
Reforming measures should be taken by the dental schools curricula to prepare future dentists to face the ongoing challenges of their profession. The MOH authorities should also increase the available resources of their facilities as well as introduce more lectures and workshops to demonstrate the latest updates in information and practical skills to its working force; therefore, helping them to face both current and future expectations.