5.3 Practice towards probiotics
5.3.6 Practice on probiotics use among skin problems
The present study also reported that pimple (ꭓ2= 7.887, p=0.019), scaly skin (ꭓ2= 17.524, p<0.001) and rash (ꭓ2= 12.384, p=0.002) were significantly associated with practice level towards probiotics. There were only 18.6% and 26.1% of the respondents with pimples and rash had good practice towards probiotics, respectively. Majority of the respondents (60%) with scaly skin had good practice towards probiotics. This result may imply that only minority of respondents with acne and eczema believed that probiotics could help with their skin problem or to prevent the side effects of antibiotics. However, it was not parallel with a study performed by Smollich and Tischner (2022), as the likelihood that respondents would look for additional health information was highly correlated with their beliefs of a potential connection between acne and nutrition. The disparity of results may be explained that low number of respondents being observed in self-reported skin problems resulted nongeneralized outcomes. Therefore, further studies are necessary to confirm the association between practice of probiotics and skin problem.
61 5.4 Correlation between knowledge, attitude and practice
The findings of this study revealed that there was a significant moderate correlation between knowledge-attitude (r=0.48, p<0.001) and knowledge- practice variables (r=0.42, p<0.001). Also, there was a significant weak correlation between attitude-practice (r=0.39, p<0.001) variables. These findings were comparable with Rahmah et al. (2021), as it was reported to have significant weak correlation between attitude-practice and knowledge-attitude variable. This can be explained by the fact that this observational study design precluded the researchers from assessing any respondents’ behavioural development. Since this study found that there was only 8.6% of health science undergraduates have good practice towards probiotics, the correlation results highlighted the needs to provide more evidence-based probiotics’ information to improve their knowledge level. Furthermore, the healthcare professionals felt that inadequate knowledge was the primary obstacle to not prescribing probiotics, which is in line with previous research (Ensminger and Haque, 2011;
Chukwu et al., 2015; Wilson and Whitehead, 2019; Ababneh et al., 2020). A greater understanding of probiotics will provide healthcare professionals more confidence to treat patients in a safe and effective manner (Wilson and Whitehead, 2019). In addition, individuals who have optimal beliefs on probiotics, not necessarily will consume probiotics supplementation due to several circumstances, such as household income, parental influence and availability of probiotics products. Nonetheless, these findings are consistent with a research from India that found that healthcare professionals’ attitudes and knowledge of probiotics influence their current practice (Soni et al., 2018).
62 5.5 Significance of results
Although numerous studies reported that consumption of probiotics could yield favourable response, healthcare professionals still have concerns while prescribing probiotics due to the inadequate understanding of how probiotics work, accessibility of the products and the abundance information offered by companies about the advantages of their probiotic supplement products (Chukwu et al., 2015; Amarauche, 2016; Fijan et al., 2019). It is more difficult for healthcare professionals to accurately choose and recommend the suitable probiotic supplements that will be effective for their patient because of the large array of probiotic supplements with strain-specific benefits, despite the rapidly expanding scientific data supporting the benefits of probiotics (Fijan et al., 2019).
Therefore, the stepping stone in creating more healthcare professionals who are conscious of the health benefits of probiotics is to provide the latest and yet evidence-based academic program that is tailored according to health science courses about the utilization of probiotics in clinical practice. Moreover, more focus has to be placed on the topic of gut-skin axis to ensure that health science undergraduates are equipped with sufficient knowledge in order to effectively manage patients’ skin problems and educate the public in the future. Hence, effort should be taken to regularly check and update the safety and efficacy of probiotics in order to offer correct health information to patients.
63 5.6 Limitations of study
This cross-sectional study was not designed to observe the external factors that influence health science undergraduates’ health behaviours and perceptions towards probiotics; it was designed to determine whether or not the sociodemographic variables are associated with knowledge, attitude and practice variables. Hence, it is inappropriate to draw conclusions about causal relationship and probable mechanisms behind the results of our study based on the information we obtained from respondents. Future research is needed to address these issues. Additionally, because the convenience sampling approach was used, the outcomes of this study might not be generalizable. Hence, there was a significant disproportionate distribution of demographic characteristics within the categories, such as age, ethnicity, year of study and undergraduate programme. As a result, it could further hamper the plausibility of the results.
Since the validated questionnaire from the published literature was administered to the respondents through social platforms, it poses a challenge for us to keep track of them while filling up the questionnaire. Therefore, that may introduce a bias in the results due to the use of self-reported data and possibility of several interpretations of the questions, which could skew the accuracy of the results.
64 5.7 Recommendation for future studies
More research has to be done in order to strengthen the findings of future research, according to the findings and discussions of this study project. The following are some suggestions for the forthcoming projects:
i. Further cross-sectional studies can be performed in other local and private institutions to increase the accuracy and dependability of research focusing on the aspects of KAP towards probiotics related to gut-skin axis among health science undergraduates.
ii. A population may be more accurately represented by considering the use of stratified random sampling, which divides the population into smaller subgroups known as strata, and then random sampling techniques are used on each subpopulation to produce a test group.
iii. Data collection using paper surveys under supervision may help to reduce the likelihood of response bias, survey fraud, and data errors.
65 CHAPTER 6
CONCLUSION
The respondents showed a good level of knowledge, moderate attitude and poor practice towards probiotics for gut-skin axis. Despite majority of the respondents were aware of probiotics, more than half of them were lacking of knowledge regarding the health benefits of probiotics consumption that may help with epidermal homeostasis and skin barrier function. Most respondents were also sceptical about the application of probiotics as an adjunct for the management of skin disorders. The purpose of probiotics consumption among the respondents was likely to improve their gastrointestinal health instead of skin health. The integration of scientific evidence about probiotics tailored to health science undergraduate programmes may enhance students' knowledge and perception of probiotics, especially when coupled with the expanding research and information from diverse sources regarding the utilization and health benefits of probiotics, thereafter can expediently translate into practice. Henceforth, comparable research and further studies evaluating factors associated to each component of knowledge, attitude, and practice about probiotics may be entailed to assist in raising the likelihood of probiotic usage for the management of skin problems.
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73 Appendix A
Ethical Approval for Research from UTAR
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75 Appendix B
Normality Test in SPSS Software
76 Appendix C
Online Questionnaire of Study
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90 Appendix D
FM-IAD-005 Form