The Status And Influencing Factors Of Knowledge,Attitudes And Practices Of Early Mobilization:a Survey Of Center ICU Registered Doctors And Nurses In Sichuan Tertiary-level General Hospital

Objective1 To describe the level of center ICU registered doctors and nurses’ knowledge,attitudes,practices about early mobilization of patients in Sichuan general tertiary-level hospitals.2 To identify the correlation among the center ICU registered doctors and nurses’ knowledge,attitudes and practices regarding the early mobilization of patients in Sichuan general tertiary-level hospitals.3 To identify the influencing factors of the center ICU registered doctors and nurses’ knowledge,attitudes and practices regarding the early mobilization of patients in Sichuan general tertiary-level hospitals.MethodsEarly mobilization knowledge scale,early mobilization attitude scale and early mobilization practice scale were used to investigate nurses and doctors from twenty general tertiary-level hospitals.A purposive sampling method was used.All the data collected were analyzed using the SPSS version 22.0.Results1 Early mobilization knowledge(1)The average early mobilization knowledge questionnaire score of 601 doctors and nurses was 12.23±3.35,7.8% doctors and nurses’ early mobilization knowledge score was at the low level,66.7% at the middle level,25.5% at the high level.(2)The three lowest items of early mobilization knowledge scale were“Early mobilization refers to the physical exercise which is implemented to patients in ICU by Medical staff within a week after admission(0.31±0.46)”,“Cycle ergometer can be used in patients with active activities,can also be used for passive mobilization(0.34±0.48))”,“MRC-score can be used to diagnose the ICU acquired weakness(0.35±0.48)”.(3)There is a significant difference among medical staff who have the different ages(P<0.01),years of working experience(P<0.01),years of working experience in ICU(P<0.01),educational level(P<0.01),professional title(P<0.01),doctors or nurses(P<0.01),hospital class(P<0.01),and whether accepted the training on the early mobilization(P<0.01)by univariate analysis.Training,doctors or nurse,professional title,hospital class was the mainly influencing factor of early mobilization knowledge score by multivariate analysis.2 Early mobilization attitudes(1)The average early mobilization attitude questionnaire score of 601 doctors and nurses was 35.66±4.48,no one was at the low level,56.1% at the middle level,42.9% at the high level.(2)The three lowest items of early mobilization attitude scale were “I am interested in the knowledge of early mobilization(2.86±0.61)”,“It is safe and feasible to carry out early mobilization for patients in ICU(3.07±0.67)”,“I am willing to carry out early mobilization for patients in ICU(3.08±0.63)”。(3)There is a significant difference among medical staff who have the different ages(P<0.01),years of working experience(P<0.01),years of working experience in ICU(P<0.01),educational level(P<0.01),professionaltitle(P<0.01),doctors or nurses(P<0.01),hospital class(P<0.01),and whether accepting the training on the early mobilization(P<0.01)by univariate analysis.Training,hospital class,doctor or nurse was the mainly influencing factor of early mobilization attitude score by multivariate analysis.3 Early mobilization practices(1)The average early mobilization practice questionnaire score of 601 doctors and nurses was 26.29±3.68,4.66% at the low level,94.51% at the middle level,0.83% at the high level.(2)The three lowest items of early mobilization practice scale were “In daily work,assist the patient who is using the ventilator to get out of bed(1.13±0.44)”,“In daily work,assist the patient who isn’t using the ventilator to get out of bed(1.23±0.48)”,“In daily work,assist the patient to sit on the edge of the bed(1.53±0.63)”.(3)There is a significant difference among medical staff who have the different ages(P<0.01),years of working experiences(P<0.01),years of working experiences in ICU(P<0.01),educational level(P<0.01),professional title(P<0.01),hospital class(P<0.01),and whether accepting the training on the early mobilization(P<0.01)by univariate analysis.Training,hospital class was the mainly influencing factor of early mobilization practice score by multivariate analysis.4 The correlation among the knowledge,attitudes and practices of early mobilizationThe knowledge was significantly correlated with the attitude(r=0.340,P<0.01),the attitude was significantly correlated with the practice(r=0.443,P<0.01),the knowledge was significantly correlated with the practice(r=0.275,P<0.01).5 The influence factors of early mobilization learning and implementation(1)The top three factors that influence the doctors and nurses’ knowledge learning of early mobilization are lack of training,time and energy,incentive mechanism.(2)The top three factors which doctors and nurses perceived in regard of patients to implementation of early mobilization are: the patient’s condition is unstable,there is a risk of the shift of the line pipeline of instruments which are used to monitor and treatment patients,patients with tracheal intubation.(3)The top three factors which doctors and nurses perceived in regard of themselves to implementation of early mobilization are:whether the staff is adequate;Availability of relevant instrument;Professional training related to early mobilization.Conclusion:1 The center ICU doctors and nurses’ knowledge of early mobilization is insufficient,they are not familiar with the time to start early mobilization,the new technique,and the diagnostic of ICU-acquired weakness.2 The center ICU doctors and nurses approve early mobilization,however,because of the concern that early mobilization may bring safety risks to patients,they expressed reluctance on implementation of early mobilization.3 The emplementation of early mobilization in critically ill patients remains under-utilised,especially active exercise.4 The nurses and doctors who have different professional title were at the different level of knowledge.The level of medium-grade and senior professional title doctors and nurses’ knowledge of early mobilization ishigher.5 ICU doctors have a higher level of early knowledge and attitude than ICU nurses.6 The level of early mobilization knowledge,attitude,practice of ICU doctors and nurses in grade Ⅲ A hospital was higher than that of ICU doctors and nurses of grade Ⅲ B.7 Training can improve the level of early mobilization knowledge,attitude and practice of ICU doctors and nurses.8 The knowledge,attitudes and practices of early mobilization were positively correlated.9 The top three factors that influence the doctors and nurses’ knowledge learning of early mobilization are lack of training,time and energy,incentive mechanism.10 The top three factors which doctors and nurses perceived in regard of patients to implementation of early mobilization are the patient’s condition is unstable,there is a risk of the shift of the line pipeline of instruments which are used to monitor and treatment patients,patients with tracheal intubation.11 The top three factors which doctors and nurses perceived in regard of themselves to implementation of early mobilization are whether the staff is adequate;Availability of relevant instrument;Professional training related to early mobilization.