| Objective:1.To develop a questionnaire suitable for evaluating knowledge,attitude and practice of comprehensive geriatric assessment of health care workers in medical and nursing institutions.2.To investigate the level of knowledge,attitude and practice of comprehensive geriatric assessment of health care workers in medical and nursing institutions,analyze its influencing factors,and propose corresponding countermeasures.Method:1.Questionnaire development:The initial questionnaire,"Questionnaire of Knowledge,Attitude and Practice of Comprehensive Geriatric Assessment of Health Care Workers in Medical and Nursing Institutions",was formed through literature review,semi-structured interviews and research group discussions.The Delphi method was applied to form the questionnaire to be tested.The stratified cluster sampling method was used to survey 275 health care workers in medical and nursing institutions,and the project analysis,reliability and validity testing were conducted to form the official version of the questionnaire.2.Status survey:From August to October 2021,395 health care workers in medical and nursing institutions were surveyed by convenience sampling method,using the official version of "Questionnaire of Knowledge,Attitude and Practice of Comprehensive Geriatric Assessment of Health Care Workers in Medical and Nursing Institutions".SPSS 21.0 statistical software was used for data analysis.(1)the measurement data conformed to a normal distribution and were expressed as mean±standard deviation,and the count data were described by frequency and percentage;(2)t-test,univariate analysis of variance,multiple linear regression analysis,and correlation analysis were applied to evaluate the status of knowledge,attitude and practice of comprehensive geriatric assessment of health care workers in medical and nursing institutions,and analyze its influencing factors.Results:1.Questionnaire development:in the first and second round expert inquiries,the positive coefficients were 100%,and the coefficient of the degree of authority of experts’ opinions was 0.95.The mean range of the importance rating of each item was between 4.20 and 5.00 in the first round expert inquiries,and the coefficient of variation was between 0.00 and 0.24.The mean range of the importance rating of each item was between 4.60 and 5.00 in thesecond round expert inquiries,and the coefficient of variation was between 0.00 and 0.12.The coefficients of the degree of coordination of experts’ opinions were 0.504 and 0.254 in the two rounds respectively.The questionnaire to be tested,"Questionnaire of Knowledge,Attitude and Practice of Comprehensive Geriatric Assessment of Health Care Workers in Medical and Nursing Institutions",covers 45 items,including three dimensions of knowledge,attitude,and practice,with 18 items for both the knowledge and attitude dimensions and 9 items for the practical dimension.2.Item analysis,reliability and validity test:(1)Item analysis:t-value>3.00 for all items,correlation coefficient r>0.40(P<0.05),no deleted items.(2)Reliability test:The overall Chronbach’s alpha coefficient of the questionnaire was 0.975,and the Chronbach’s alpha coefficients of each dimension of knowledge,attitude,and practice were 0.973,0.967,and 0.956 respectively;the overall half coefficient of the questionnaire was 0.848,and the half coefficients of the three dimensions of knowledge,attitude,and practice were 0.935,0.943,and 0.860respectively.(3)Validity test:the I-CVI of each entry-level ranged from 0.9 to 1,the S-CVI/ave was 0.998,and the S-CVI/UA was 0.978;the KMO value was 0.893,and Bartlett’s spherical test value was 15755.073(df=990,P<0.001),limited to extracting three common factors,with a cumulative variance explained of 71.589%,and all item loadings were greater than 0.50.3.The current situation results:395 questionnaires were sent out in this study,and 367 questionnaires were effectively returned,with a valid return rate of 92.91%.The results are as follows:(1)Overall score of the questionnaire:the overall score of the questionnaire for health care workers in medical and nursing institutions was(171.77±29.34),with a scoring rate of 76.30%.Univariate analysis of variance showed that statistically significant factors included age,gender,residence,occupation,job title,years of work,type of medical and nursing institutions,nature of medical and nursing institutions,level of medical and nursing institutions,and whether or not they had received comprehensive geriatric assessment training(P<0.05).After further comparison,it was found that the total score of CGA questionnaire was higher for the medical staff who were male,lived in urban areas,were doctors,had longer working years,had the title of vice senior or above,had the type of nursing institution,had the nature of public institution,had the higher level of institution and had received training.Multiple linear stepwise regression analysis showed a statistically significant difference in the total knowledge-attitude-practice scores of health care workers in medical and nursing institutions by gender,job title,nature of medical and nursing institutions,and whether they had received comprehensive geriatric assessment training(P<0.05).(2)Knowledge dimension:the total score of the knowledge dimension was 90,and the average score was(66.65±12.24),with a scoring rate of 74.10%.The results of the univariate analysis showed that statistically significant factors included:age,gender,occupation,job title,geographic location of the medical and nursing institutions,nature of the medical and nursing institutions,type of medical and nursing institutions,level of medical and nursing institutions,and whether they had received comprehensive geriatric assessment training(P<0.05).After further comparison,it was found that the score of CGA knowledge dimension was higher for the medical staff who were male,were doctors,were 20-30 years old,had the title of vice senior or above,located in urban area,had the type of nursing institution,had the nature of public institution,had the higher level of institution and had received training.Multiple linear stepwise regression analysis showed that health care workers in medical and nursing institutions with different ages,gender,job title,occupation,nature of medical and nursing institutions,level of medical and nursing institutions,and whether they had received comprehensive geriatric assessment training had statistically significant scores in the knowledge dimension(P<0.05).(3)Attitude dimension:the total score of the attitude dimension was 90,and the mean score was(77.05±14.66),with a scoring rate of 85.60%.The results of the univariate analysis showed that statistically significant factors included:age,place of residence,job title,years of work,type of medical and nursing institutions,nature of medical and nursing institutions,and level of medical and nursing institutions(P<0.05).After further comparison,it was found that the CGA belief dimension score was higher for the medical staff who lived in urban areas,aged between 20 and 30 years old,had a longer working life,had a title of deputy senior or above,had a nursing institution,had a public institution,and had a higher institution level.Multiple linear stepwise regression analysis showed that health care workers in medical and nursing institutions with different job titles and nature of medical and nursing institutions had statistically significant scores in the attitude dimension(P<0.05).(4)Practical dimension:the total score of the practical dimension was 45,and the average score was(28.07±8.76),with a scoring rate of 62.40%.The results of the univariate analysis showed that statistically significant factors included such aspects as age,gender,place of residence,occupation,professional title,experience in general hospitals,working years,type of medical and nursing institutions,nature of medical and nursing institutions,level of medical and nursing institutions,and whether or not they had received comprehensive geriatric assessment training(P<0.05).After further comparison,it was found that the CGA behavioral dimension score of medical staff with male,urban residence,age between 20 and 30 years old,longer working years,title of deputy senior or above,working experience in general hospital,institution type of nursing center,institution nature of public,institution level and training was higher.Multiple linear stepwise regression analysis showed statistically significant scores on practical dimensions among health care workers in medical and nursing institutions with different genders,ages,job titles,places of residence,nature of medical and nursing institutions,and whether they had received comprehensive geriatric assessment training(P<0.05).(5)The results of correlation analysis showed that there were positive correlations between knowledge and attitude,knowledge and practice,and attitude and practice among health care workers in medical and nursing institutions,with correlation coefficients r of 0.513,0.582,and 0.431,respectively(P<0.001).Conclusion:1.The reliability and validity of the "Questionnaire of Knowledge,Attitude and Practice of Comprehensive Geriatric Assessment of Health Care Workers in Medical and Nursing Institutions"prepared was good.2.The overall level of knowledge,attitude and practice of comprehensive geriatric assessment of health care workers in medical and nursing institutions was moderate,where knowledge was moderate,attitude was well,practice was relatively poor.There was a positive correlation among the knowledge,attitude and practice of comprehensive geriatric assessment of health care workers in medical and nursing institutions.3.Different genders,occupations,whether they have received comprehensive geriatric assessment training,and the nature of medical and nursing institutions are the main factors influencing knowledge,attitude and practice of comprehensive geriatric assessment of health care workers in medical and nursing institutions.It is recommended that targeted training and interventions be adopted to improve the level of knowledge,attitude and practice of comprehensive geriatric assessment of health care workers in medical and nursing institutions.Moreover,it is required to increase the support for private medical and nursing institutions through various ways to carry out comprehensive geriatric assessment effectively and thus promote healthy aging for the elderly. |
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