The Research On Knowledge,Attitude And Practice Status And Related Factors Of Enhanced Recovery After Surgery Of Flap Transplantation In Microsurgical Nurses

Objective(1)To develop the knowledge,attitude and practice(KAP)questionnaire of Enhanced Recovery After Surgery(ERAS)of flap transplantation in microsurgical nurses,and to evaluate the reliability and validity of it.(2)To investigate the knowledge,attitude and practice of ERAS in flap transplantation among microsurgical nurses in Hunan province,and to analyze the related factors of knowledge,attitude and practice.Methods(1)Initial questionnaire was built through literature review and group discussion.Beta version questionnaire was developed using 2 rounds of Delphi method.A convenience sampling method was taken for pre-survey,to analyze items of the beta version questionnaire and to evaluate the reliability and validity of the formal questionnaire.Item analysis including discrimination analysis method,correlation coefficient method and factor analysis method.Reliability analysis including Cronbach’s α,split-half reliability and test-retest reliability.Content validity was test.(2)Convenience sampling method was carried out in formal investigation.Electronic formal questionnaire was made by Wenjuanxing.Then questionnaires were sent to microsurgical nurses in 14 cities of Hunan province through the Wechat group of Hunan Society of Microsurgery.Descriptive statistical analysis was used to explore the status of knowledge score,attitude score,practice score and item score of nurses.Rank sum test and Spearman correlation analysis were used for single factor analysis.The variables with statistical significance in single factor analysis were incorporated into the generalized linear model for multivariate analysis.α= 0.05.Results(1)The response rates of experts in the first round and the second round of Delphi method were 88.24% and 100.00%,the expert authority coefficients were 0.917 and 0.957,and the expert coordination coefficients were 0.174 and 0.149(P < 0.05).In the first round of Delphi consultation,3 items were deleted,8 items were split,5 items were added,and 31 items were modified.In the second round of Delphi consultation,there were no items added,deleted,merged or split,and 17 items were adjusted.No items were deleted after item analysis.The Cronbach’s α of knowledge,attitude,practice dimensions and the total questionnaire were 0.976,0.974,0.955 and 0.976.The split-half reliability of attitude dimension was 0.949.And the test-retest reliability of the total questionnaire was 0.832.The I-CVI of the questionnaire ranged from 0.86 to 1.00,and the S-CVI was 0.98.The questionnaire contains 50 items,including 16 knowledge items,17 attitude items and 17 practice items.(2)The knowledge score of flap transplantation of ERAS in microsurgical nurse was 62.39 ± 12.48,and the standard score was 77.98.In the item score,knowledge of nutritional risk screening was the lowest.The attitude score was 77.50 ± 9.59,and the standard score was 91.17.In the item score,attitude of fasting before surgery was the lowest.The practice score was 74.22 ± 9.68,and the standard score was 87.32.In the item score,practice of nutritional risk screening was the lowest.(3)The knowledge score of ERAS in microsurgical nurses with ERAS training was higher(b = 0.124,P < 0.001).Taking Changzhutan area as reference,the knowledge score of nurses in Daxiangnan area where the working hospital was located was higher(b = 0.107,P = 0.003).The attitude score of nurses in Daxiangxi area was higher than Changzhutan area(b = 0.044,P = 0.036).Microsurgical nurses with ERAS training scored higher on practice dimensions of ERAS of flap transplantation(b =0.052,P = 0.001).ERAS practice score was higher in male microsurgical nurses compared to female nurses(b = 0.123,P = 0.024).Conclusion(1)“KAP questionnaire of ERAS of flap transplantation surgery in microsurgical nurses” has good reliability and validity.This questionnaire can be used as a tool for exploring the knowledge,attitude and practice of nurses on ERAS of flap transplantation.(2)The attitude of ERAS of flap transplantation in microsurgical nurses in Hunan province is at a relatively high level.The knowledge and practice of nurses need to be improved.Among them,the nutritional risk screening should be focused on.(3)In Hunan province,microsurgical nurses’ ERAS training experience was a correlation factor of ERAS knowledge and practice of flap transplantation,but not related with the attitude.The location of hospital is a related factor of nurses’ knowledge and attitude.