| ObjectivesTo develope the Venous Thromboembolism(VTE)prevention questionnaire of hospitalized patients among neurosurgery based on the Knowledge,Attitude and Practice model(KAP)and Health Belief Model(HBM).To understand the status of VTE prevention knowledge,belief and behavior level of neurosurgery hospitalized patients,and analyze the influencing factors,In order to lay the foundation for targeted intervention research.Methods(1)Questionnaire preparation:the initial questionnaire item pool was formed through literature research,and the preliminary questionnaire was formed through two rounds of expert letter consultation and through group discussion and small sample predictive test of 10 inpatients of neurosurgery;Then 210 inpatients of neurosurgery were pre-investigated,and the questionnaire items were analyzed and screened by extreme value method,correlation coefficient method and exploratory factor analysis method to form the final questionnaire.Reliability and validity test:The reliability of the questionnaire was evaluated by Cronbach’αcoefficient,retesting and splitting reliability.Amos27.0 software was used for confirmatory factor analysis,and the content validity and structure validity of the questionnaire were evaluated.(2)Cross-sectional survey:386 inpatients of neurosurgery who met the inclusion and exclusion criteria in a grade 3 class A general hospital of Changsha city,Hunan Province from September to November 2021were selected to investigate the status of VTE prevention knowledge,knowledge,practice and practice,using a self-designed questionnaire in this study.SPSS26.0 was used for statistical analysis,and frequency,percentage,mean and the standard deviation were adopted to conduct statistical description;The univariate analysis used two independent samples t-test and ANOVA with completely random design(t test and nonparametric H test were used when the variance was not uniform).Multivariate linear stepwise regression analysis and negative binomial distribution model regression analysis were used for multivariate analysis.Spearman rank correlation analysis was used for correlation analysis.P values<0.05 was considered statistically significant.Results(1)Questionnaire compilation results:the effective recovery rate of expert letter consultation was 100%,the expert authority coefficient was0.94,and the mean of each item in the questionnaire was>3.50 and full marks ratio>20%;Coefficient of variation for items<0.30,kendall coordination coefficient of the two rounds of correspondence consultation were 0.247 and 0.149,respectively.The critical ratio t>0.3 and P<0.05for 96.3%items in the pre-survey;The correlation coefficients between each item and the total score ranged from 0.293 to 0.748.The Exploratory actor analysis results showed that the knowledge and behavior dimensions of each item of factor load coefficient were>0.400,And the cumulative variance contribution rates were 62.576%and63.434%,respectively.Results of questionnaire reliability and validity test:Cronbach’αcoefficients of the total questionnaire,knowledge,belief and behavior dimensions were 0.820,0.851,0.921 and 0.911,respectively;The retest reliability was 0.821,0.791,0.853 and 0.750(P<0.01);In confirmatory factor analysis,four of the seven indicators in the knowledge dimension fitting model reached the general standard((?)~2/df,GFI,AGFI,RMSEA),the overall fitting effect of the model is general;Four of the seven indexes of the belief dimension fitting model reached the good standard((?)~2/df,RMR,IFI,CFI),the overall fitting effect of the model was relatively good.Five of the seven behavioral dimension fitting indexes of the model reached the general standard((?)~2/df,GFI,AGFI,IFI,CFI),the overall fitting effect of the model was general.(2)Cross-sectional survey results:the average score of VTE prevention knowledge belief and behavior of inpatients in neurosurgery were(13.22±11.52),(99.56±10.11),(47.15±5.99),respectively.The scoring rate were 32.24%,71.11%and 78.69%,respectively;The knowledge level was affected by the presence or absence of medical workers in the family,the previous history of VTE,the education level and the main way of obtaining VTE knowledge(P<0.05).Education level,VTE health education,patients’previous history of VTE,surgery,the main way to obtain VTE knowledge,and the way to pay medical expenses affected the belief level(P<0.05).Education level,patients’previous history of VTE,health education of VTE,occupation and main ways of acquiring VTE knowledge affected behavior level(P<0.05).The rank correlation coefficients between VTE prevention knowledge and belief,belief and behavior,knowledge and behavior were 0.652,0.583 and 0.499(P<0.001),respectively.Conclusions(1)The questionnaire prepared in this study has good reliability and validity,which can be used to evaluate the level of VTE prevention in neurosurgery inpatients.(2)The VTE prevention knowledge,belief and behavior of neurosurgery inpatients are of low level,medium level and above level.The education level,the main way to acquire VTE knowledge,and the patient’s previous VTE history have influence on the prevention knowledge,belief and practice of VTE in neurosurgery inpatients.At the same time,the presence or absence of medical workers in patients’homes also have an impact on patients’knowledge level of VTE prevention.The VTE prevention belief level is affected by VTE health education,operation and medical expenses.Receiving VTE health education and occupation have influence on the level of VTE prevention behavior.(3)There is a positive correlation between VTE prevention knowledge belief and behavior of neurosurgery inpatients. |
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