| Objective1.To develop a knowledge,attitude and practice questionnaire for ICU nurses on aspiration prevention for patients undergoing enteral nutrition support,and to test it’s reliability and validity.2.Using the "knowledge,attitude and practice questionnaire for ICU nurses on aspiration prevention for patients undergoing enteral nutrition support",the current status of knowledge,attitude and practice of ICU nurses in Shandong Province on the prevention of aspiration prevention for patients receiving enteral nutrition support and its impact factor were investigated.MethodsQuestionnaire preparation stage:1.literature research: based on theory of knowledge,through literature review,attitude and practice,and refer to the guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine(SCCM)and American society for parenteral and enteral nutrition(A.S.P.E.N.),guidelines for the diagnosis and treatment of hospital-acquired pneumonia and ventilator-associated pneumonia in Chinese adults(2018 edition).2.Qualitative research: Conduct semi-structured interviews with 13 ICU nursing experts.Use Colaizzi phenomenological analysis method to collate and analyze data.Extracted from the interview data the relevant content of the knowledge,attitude and practice for ICU nurses on aspiration prevention for patients undergoing enteral nutrition support,combined with the results of the literature search,and preliminarily compile the item pool of the knowledge,attitude and practice for ICU nurses on aspiration prevention for patients undergoing enteral nutrition support.3.Delphi expert method: 20 experts with high academic level in the field of enteral nutrition aspiration prevention management and nursing were selected.Entry screening adopts the boundary value method(importance assignment mean boundary value,importance assignment full score frequency and variation coefficient boundary value),the initial questionnaire item pool was further optimized and screened to form the knowledge,attitude and practice initial questionnaire for ICU nurses on aspiration prevention for patients undergoing enteral nutrition support.4.Small sample pre-survey method: 20 ICU nurses who meet the inclusion criteria of this study were selected,and they were pre-surveyed and interviewed with their feelings when filling out the questionnaire.According to the feedback of the pre-survey ICU nurses,the knowledge,attitude and practice predictive questionnaire for ICU nurses on aspiration prevention for patients undergoing enteral nutrition support.5.Large sample reliability and validity test: through the convenience sampling method,applied the knowledge,attitude and practice predictive questionnaire for ICU nurses on aspiration prevention for patients undergoing enteral nutrition support to survey 220 ICU nurses who met the inclusion criteria in 3 tertiary A hospitals in Shandong Province.The Excel table presents the general information of the survey subjects,and uses SPSS 21.0statistical software to analyze the collected clinical data.Use item analysis,content validity,structure validity,internal consistency reliability,external stability reliability and other methods to test the reliability and validity of the questionnaire.Finally,based on the analysis results,the knowledge,attitude and practice formal questionnaire for ICU nurses on aspiration prevention for patients undergoing enteral nutrition support.Status investigation stage:Through the convenience sampling method,applied the knowledge,attitude and practice formal questionnaire for ICU nurses on aspiration prevention for patients undergoing enteral nutrition support to survey 218 ICU nurses who met the inclusion criteria in 5 tertiary A hospitals in Shandong Province.The Excel table presents the general information of the survey subjects,and uses SPSS 21.0 statistical software to analyze the collected clinical data.Specific methods include descriptive statistics,one-way analysis of variance,T test,Pearson correlation analysis and multiple linear regression analysis.ResultsQuestionnaire preparation stage:1.Preliminary questionnaire compilation results: By referring to relevant guidelines,literature review and the interview results of 13 ICU nursing experts,an initial knowledge,attitude and practice questionnaire for ICU nurses on aspiration prevention for patients undergoing enteral nutrition support with 52 items in 3 dimensions was initially developed.2.Delphi expert consultation and pre-survey results: Through 2 rounds of expert correspondence consultation and pre-survey,10 items were deleted,5items were merged,and 2 items were modified,the knowledge,attitude and practice predictive questionnaire for ICU nurses on aspiration prevention for patients undergoing enteral nutrition support with 39 items in 3 dimensions has been formed.3.Item analysis and screening results: After project analysis,a total of 2items were deleted,and finally the knowledge,attitude and practice formal questionnaire for ICU nurses on aspiration prevention for patient undergoing enteral nutrition support was formed,which included 3 dimensions,namely knowledge(14 items)and attitude(9 items),practice(14 items).4.Reliability test results: The total Cronbach’s α coefficient of the knowledge,attitude and practice formal questionnaire for ICU nurses on aspiration prevention for patients undergoing enteral nutrition support was 0.963,and the Cronbach’s α coefficients for the dimensions of knowledge,attitude,and practice were 0.965,0.972,and 0.963 respectively;the total questionnaire was half of the total.The reliability coefficient was 0.963,the unequal length half-half reliability coefficients of the first part and the second part were 0.931 and 0.921,respectively;the total test-retest coefficient of the questionnaire was 0.988,and the test-retest coefficients of the knowledge,attitude and practice dimensions were 0.800,0.704,0.776,respectively,Indicating that the reliability of this questionnaire was good.5.Validity test results: content validity: The content validity index(S-CVI)of the overall knowledge,attitude and practice formal questionnaire for ICU nurses on aspiration prevention for patients undergoing enteral nutrition support was 0.92,and the content validity index(I-CVI)of each item level was 0.80～1.00.Structural validity: after 1 exploratory factor analyses,a total of 3 common factors were extracted,the cumulative variance contribution rate was 68.187%,and the Pearson correlation coefficient between the 3 factors was 0.756 ～ 0.800,and the Pearson correlation coefficient between each factor and the total questionnaire was 0.572～0.776,and the difference is statistically significant(P<0.01).Status investigation stage:ICU nurses had an average score of(125.24±15.01)points for the prevention of aspiration in patients undergoing enteral nutrition support,which was generally at a medium level;the average score of knowledge dimension was(57.81±8.20)points,which was at a medium level.Multiple linear regression analysis showed,The highest degree of education,ICU working years,whether to participate in enteral nutrition aspiration prevention training has an impact on its score(P<0.01);the average score of attitude dimension is(39.59±4.46)points,which is at a high level,multiple linear regression analysis shows,Gender,professional title,and whether they have participated in enteral nutrition aspiration prevention training have an impact on their scores(P<0.01);the average score of behavioral dimensions is(55.09±7.83)points,which is at a medium level.Multiple linear regression analysis shows that ICU work The number of years,whether to participate in enteral nutrition aspiration prevention training,whether to deal with enteral nutrition support patients with aspiration has an impact on their scores(P<0.01);Pearson correlation analysis results show that there is a positive correlation between knowledge,attitude and behavior dimensions,and the correlation is statistically significant(P<0.01).Conclusion1.The "knowledge,attitude and practice questionnaire for ICU nurses on aspiration prevention for patients undergoing enteral nutrition support" compiled in this study has good reliability and validity,and can be used as a science,effective tool for evaluating knowledge,attitude and practice questionnaire for ICU nurses on aspiration prevention for patients undergoing enteral nutrition support.2.The ICU nurses of tertiary A-level hospitals in Shandong Province are more active in the prevention of aspiration in patients undergoing enteral nutrition support,and their knowledge and behavior are at a moderate level and need to be improved. |
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