Introduction
Methods
Study design and setting
Sample recruitment and survey conduction
Development of the questionnaire
Variables
Sepsis knowledge
Ability to recognize sepsis as an emergency and urgency ratings of medical situations
Health information seeking behaviour
Health literacy
Analysis
Results
Participants
Variables | Descriptive statistics |
---|---|
Female gender, n (%) | 355 (48.0) |
Age in years, mean ± SD | 56.6 ± 13.2 |
Education level, n (%) | |
Low | 174 (23.5) |
Intermediate | 291 (39.3) |
High | 275 (37.2) |
Employment status, n (%) | |
Unemployed | 379 (51.2) |
Employed | 360 (48.7) |
Health insurance, n (%) | |
Private | 86 (11.6) |
Statutory | 651 (88.0) |
Comorbidities | |
None, n (%) | 197 (26.6) |
At least one, n (%), among them | 543 (73.4) |
Cancer, n (%) | 157 (28.9) |
Type 1 diabetes, n (%) | 55 (10.1) |
Type 2 diabetes, n (%) | 74 (13.6) |
Chronic heart failure, n (%) | 67 (12.3) |
Chronic bronchitis, n (%) | 70 (12.9) |
Chronic renal failure, n (%) | 1 (0.2) |
Chronic liver disease, n (%) | 47 (8.7) |
Chronic neurological disease, n (%) | 1 (0.2) |
Overweight, n (%) | 19 (3.5) |
Severe rheumatic disease, n (%) | 52 (9.6) |
Severe psoriasis, n (%) | 50 (9.2) |
HIV infection, n (%) | 81 (14.9) |
Asplenia, n (%) | 0 (0.0) |
Autoimmune disease, n (%) | 2 (0.4) |
Health Information Seeking Behaviour | |
Frequency of health information seeking, n (%)a | |
< 1 × per month | 334 (45.1) |
1 × per month | 158 (21.4) |
1 × per week | 122 (16.5) |
> 1 × per week | 123 (16.6) |
No. of sources of health information, mean ± SD | 3.5 ± 2.1 |
Health literacy, mean ± SD | 2.68 ± 0.80 |
Urgency rating of medical situations, mean ± SDb | 0.90 ± 0.33 |
Sepsis knowledge
Solved correctly by n (%) participants | Sumscore Mean ± SD | Meanscore (% correctly solved items) Mean ± SD | |
---|---|---|---|
Sepsis knowledge (36 items) | 15.88 ± 7.25 | 44.1 ± 20.1 | |
Definition & Epidemiology (12 items) | 5.60 ± 2.70 | 46.7 ± 22.5 | |
Please decide whether the following statements regarding sepsis are true! | |||
Sepsis is a serious allergic reaction. (F) | 336 (45.4) | ||
Sepsis is primarily caused by killer germs in the hospital. (F) | 427 (57.7) | ||
Sepsis is a serious defensive reaction of the body to an infection. (T) | 562 (75.9) | ||
Sepsis can be caused by pneumonia. (T) | 187 (25.3) | ||
Sepsis can be caused by influenza. (T) | 132 (17.8) | ||
Sepsis can be caused by COVID-19. (T) | 150 (20.3) | ||
Sepsis can be caused by the spread of pathogens in the bloodstream. (T) | 650 (87.8) | ||
Breast cancer is more common than sepsis. (F) | 144 (19.5) | ||
More people die from heart attacks than from sepsis. (T) | 75 (10.1) | ||
Sepsis leads to failure of vital organs, which is why sepsis patients are often treated in the intensive care unit. (T) | 555 (75.0) | ||
Long-lasting sequelae such as chronic fatigue, kidney failure or pain are common after sepsis. (T) | 311 (42.0) | ||
Without immediate medical treatment, the risk of dying from sepsis increases. (T) | 617 (83.4) | ||
General prevention (3 items) | 1.93 ± 0.90 | 64.3 ± 29.8 | |
Please decide whether the following statements regarding sepsis are true! | |||
Some of the most common infections that cause sepsis can be prevented by vaccination. (T) | 228 (30.8) | ||
Some types of sepsis can be prevented by wound and hand hygiene. (T) | 564 (76.2) | ||
Timely response to an infection can prevent it from developing into sepsis. (T) | 634 (85.7) | ||
Symptoms (7 items) | 3.51 ± 2.08 | 50.1 ± 29.7 | |
Which of the following features increase the risk of developing sepsis? | |||
High heart rate (T) | 441 (59.6) | ||
Weakness in one arm or leg (F) | 185 (25.0) | ||
Confusion or disorientation (T) | 358 (48.4) | ||
Fever, shivering, or severe chills (T) | 573 (77.4) | ||
Shortness of breath (T) | 268 (36.2) | ||
Chest pain radiating to the left arm or shoulder (F) | 301 (40.7) | ||
Extreme pain or extreme discomfort (T) | 471 (63.6) | ||
Risk factors (7 items) | 3.10 ± 1.71 | 44.3 ± 24.5 | |
Which of the following are common warning signs of sepsis? | |||
Age 65 years or older (T) | 346 (46.8) | ||
Arteriosclerosis (hardening of the blood vessels) (F) | 178 (24.1) | ||
Smoking (T) | 205 (27.7) | ||
Chronic diseases such as diabetes, lung diseases, cancer, kidney diseases (T) | 457 (61.8) | ||
Weakened immune system (T) | 590 (79.7) | ||
Veganism (pure vegetable diet) (F) | 380 (51.4) | ||
Age younger than one year in children (T) | 136 (18.4) | ||
Sepsis-specific Vaccination (7 items) | 1.74 ± 2.05 | 24.9 ± 29.3 | |
Do the following vaccinations protect against sepsis or reduce the risk of severe sepsis? | |||
Vaccination against human papillomaviruses (viruses that can cause benign and malignant tumours). (F) | 252 (34.1) | ||
Vaccination against influenza viruses (T) | 146 (19.7) | ||
Vaccination against Haemophilus influenzae B (bacteria that can cause meningitis or pneumonia) (T) | 215 (29.1) | ||
Vaccination against pneumococcus (bacteria that can cause pneumonia, for example) (T) | 207 (28.0) | ||
Vaccination against meningococci (bacteria which can cause, e.g. meningitis) (T) | 180 (24.3) | ||
Vaccination against borreliosis (bacteria transmitted by ticks) (F) | 132 (17.8) | ||
Vaccination against the Corona virus (Covid-19) (T) | 158 (21.4) | ||
Ability to recognize sepsis as an emergency (overall)b | 1.33 ± 1.27 | 26.6 ± 25.5 | |
What would you do in the following situations or what should your loved ones do for you? | |||
I have the flu, feel increasingly worse and have very difficulty breathing (shortness of breath) | 107 (14.5) | ||
The pain in the kidney area is so severe that I can hardly move. In addition, I have chills and a burning sensation when urinating | 207 (28.0) | ||
Yesterday, I cut myself with a knife. Today, the wound looks red and inflamed. I feel very sick, weak, and can hardly leave the bed | 168 (22.7) | ||
I have had a cough and fever for two days. Since today, I am confused and can no longer orient myself in my own living environment | 368 (49.7) | ||
Sometime after a cat bite in the garden, I feel intense pain, am feverish, and have chills | 132 (17.8) |
Ability to recognize sepsis as an emergency
Predictors of sepsis knowledge
Predictors | Model 1 | Model 2 | Model 3 | Model 4 | ||||
---|---|---|---|---|---|---|---|---|
β [95% CI] | Demographics-value | β [95% CI] | Demographics-value | β [95% CI] | Demographics-value | β [95% CI] | Demographics-value | |
Demographics | ||||||||
Chronic disease: yes | 2.428* [1.147, 3.709] | 0.000 | 1.345* [0.111, 2.578] | 0.033 | 2.659* [1.365, 3.953] | 0.000 | 1.479* [0.216, 2.742] | 0.022 |
Age (per 10 years) | 0.993* [0.477, 1.509] | 0.000 | 0.496 [− 0.016, 1.008] | 0.057 | 1.018* [0.500, 1.535] | 0.000 | 0.520* [0.010, 1.030] | 0.047 |
Gender: female | 2.219* [1.185, 3.253] | 0.000 | 1.403* [0.402, 2.405] | 0.006 | 2.170* [1.138, 3.201] | 0.000 | 1.407* [0.406, 2.409] | 0.006 |
Education level Ref.: low | ||||||||
Intermediate | 0.586 [− 0.811, 1.982] | 0.411 | 0.542 [− 0.782, 1.865] | 0.423 | 0.608 [− 0.773, 1.990] | 0.388 | 0.551 [− 0.769, 1.871] | 0.413 |
High | 2.391* [0.984, 3.798] | 0.001 | 2.388* [1.061, 3.715] | 0.000 | 2.388* [0.995, 3.781] | 0.001 | 2.385* [1.062, 3.708] | 0.000 |
Employment state: employed | 0.844 [− 0.340, 2.027] | 0.162 | 0.823 [− 0.330, 1.976] | 0.162 | 0.755 [− 0.438, 1.948] | 0.215 | 0.788 [− 0.370, 1.946] | 0.182 |
Health information seeking behaviour | ||||||||
Frequency of health information seeking behavioura Ref.: < 1 × per month | ||||||||
1 × per month | 0.273 [− 1.033, 1.579] | 0.682 | 0.294 [− 1.008, 1.597] | 0.658 | ||||
1 × per week | 1.505 [0.002, 3.008] | 0.050 | 1.532* [0.026, 3.038] | 0.046 | ||||
> 1 × per week | 3.237* [1.674, 4.800] | 0.000 | 3.268* [1.721, 4.814] | 0.000 | ||||
Variety of sources of health information | 0.587* [0.305, 0.868] | 0.000 | 0.553* [0.268, 0.838] | 0.000 | ||||
Health literacy | 0.779* [0.105, 1.452] | 0.023 | 0.341 [− 0.309, 0.991] | 0.303 | ||||
R2 | 0.063* | 0.000 | 0.139* | 0.000 | 0.071* | 0.000 | 0.141* | 0.000 |
Incremental R2 | – | 0.076* | 0.000 | 0.008* | 0.023 | 0.078* | 0.000 |
Predictors of the ability to recognize sepsis as an emergency
Predictors | Model 1 | Model 2 | Model 3 | Model 4 | Model 5 | Model 6 | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
β [95% CI] | p value | β [95% CI] | p value | β [95% CI] | p value | β [95% CI] | p value | β [95% CI] | p value | β [95% CI] | p value | |
Demographics | ||||||||||||
Chronic disease: yes | − 0.720 [− 0.983, − 0.457] | 0.000 | − 0.863* [− 1.124, − 0.602] | 0.000 | − 0.604* [− 0.864, − 0.344] | 0.000 | − 0.754* [− 1.017, − 0.490] | 0.000 | − 0.544* [− 0.781, − 0.307] | 0.000 | − 0.544* [− 0.790, − 0.297] | 0.000 |
Age (per 10 years) | − 0.029 [− 0.118, 0.059] | 0.516 | − 0.081 [− 0.173, 0.011] | 0.083 | − 0.017 [− 0.101, 0.067] | 0.691 | − 0.043 [− 0.133, 0.047] | 0.348 | − 0.081 [− 0.168, 0.005] | 0.065 | − 0.100* [− 0.184, − 0.016] | 0.020 |
Gender: female | 0.169 [− 0.010, 0.349] | 0.065 | 0.072 [− 0.112, 0.257] | 0.442 | 0.145 [− 0.030, 0.319] | 0.104 | 0.139 [− 0.041, 0.319] | 0.131 | 0.097 [− 0.075, 0.269] | 0.270 | 0.018 [− 0.153, 0.189] | 0.834 |
Education level Ref.: low | ||||||||||||
Intermediate | − 0.023 [− 0.263, 0.217] | 0.851 | − 0.033 [− 0.268, 0.203] | 0.785 | − 0.012 [− 0.248, 0.225] | 0.923 | − 0.031 [− 0.269, 0.207] | 0.798 | − 0.074 [− 0.294, 0.146] | 0.508 | − 0.070 [− 0.284, 0.145] | 0.525 |
High | − 0.210 [− 0.464, 0.044] | 0.105 | − 0.212 [− 0.463, 0.040] | 0.099 | − 0.212 [− 0.459, 0.036] | 0.094 | − 0.243 [− 0.499, 0.013] | 0.063 | − 0.287* [− 0.526, − 0.048] | 0.019 | − 0.286* [− 0.521, − 0.051] | 0.017 |
Employment state: employed | 0.006 [− 0.200, 0.212] | 0.894 | − 0.003 [− 0.203, 0.197] | 0.978 | − 0.039 [− 0.238, 0.159] | 0.699 | − 0.006 [− 0.211, 0.199] | 0.958 | − 0.031 [− 0.226, 0.165] | 0.759 | − 0.069 [− 0.252, 0.114] | 0.461 |
Health information seeking behaviour | ||||||||||||
Frequency of health information seekinga Ref.: < 1 × per month | ||||||||||||
1 × per month | 0.023 [− 0.224, 0.270] | 0.856 | 0.016 [− 0.213, 0.245] | 0.891 | ||||||||
1 × per week | − 0.142 [− 0.423, 0.138] | 0.320 | − 0.167 [− 0.430, 0.095] | 0.211 | ||||||||
> 1 × per week | − 0.105 [− 0.439, 0.229] | 0.538 | − 0.202 [− 0.486, 0.120] | 0.191 | ||||||||
Variety of sources of health information | 0.138* [0.083, 0.194] | 0.000 | 0.095* [0.040, 0.150] | 0.001 | ||||||||
Health literacy | 0.391* [0.285, 0.496] | 0.000 | 0.362* [0.256, 0.468] | 0.000 | ||||||||
Sepsis knowledge | 0.014* [0.002, 0.026] | 0.025 | 0.002 [− 0.010, 0.015] | 0.717 | ||||||||
Urgency rating | 1.160* [0.868, 1.452] | 0.000 | 1.264* [0.968, 1.560] | 0.000 | ||||||||
Sepsis knowledge x urgency rating | 0.050* [0.013, 0.087] | 0.007 | ||||||||||
R2 | 0.063 | 0.000 | 0.102* | 0.000 | 0.122* | 0.000 | 0.076* | 0.000 | 0.142* | 0.000 | 0.233* | 0.000 |
Incremental R2 | – | 0.039* | 0.000 | 0.059* | 0.000 | 0.013* | 0.025 | 0.079* | 0.000 | 0.170* | 0.000 |