Doctors’ attitudes to and knowledge and usage of growth charts

Abstract

Background: Growth charts have been used worldwide for about 40 years but their use has always been fraught with problems. Methods: A cross-sectional descriptive study was carried out on the reported usage of growth charts and whether there are factors that affect usage by the general practitioners working with children in public hospitals. Data were collected through the use of a self-administered questionnaire. The questionnaire covered four concepts: demographic factors; doctors’ self-reported growth chart usage; doctors’ attitude towards growth monitoring and use of growth charts; and doctors’ knowledge in terms of plotting, interpretation and management of growth patterns. Results: A total of 90 out of 100 doctors completed the questionnaires. More than half (57%) of the doctors had high workloads. Fifty-six (62.2%) doctors thought they were too busy to use growth charts. Only 37 (41%) doctors achieved an acceptable total knowledge score. Although just over two-thirds of (67.8%) doctors reported a positive attitude towards growth monitoring, their reported usage does not reflect it. Fifty-four (60%) doctors plotted weights correctly. Doctors recognised the most probable cause for the given growth patterns. However, most doctors struggled to choose the most appropriate management option. Skill in plotting was associated with more regular usage. Better knowledge and a positive attitude were associated with higher usage whereas a perception of high workload and several years’ experience were associated with lower levels of usage. Conclusions: While doctors reported a positive attitude towards the use of growth charts, they lacked the knowledge to utilize them optimally and reported that the chart was often not used.