| Objective: The aim of this paper is to develop a questionnaire about the knowledge,belief and behavior of ICU nurses on the indication of mechanical ventilation evacuation.The questionnaire was applied to ICU nurses in a third class general hospitals and other hospitals in Guizhou Province so as to test its reliability and validity.The current situation of ICU nurses' knowledge,belief and behavior of evacuation in several general hospitals in Guizhou Province was investigated and the main factors influencing the questionnaire were analyzed.The problems were found for hospital managers,and the formulation and implementation phases were discussed in order to improve the current situation of ICU nurses' withdrawal.We need to improve the education and training measures.Methods: The first part: from July2018 to October 2018,based on the theoretical framework of knowledge belief or attitude behavior mode,consulting a large number of relevant domestic and foreign literature,guidelines and referring to the relevant questionnaires,the paper formed a framework of "knowledge,attitude and behavior" of ICU nurses on the withdrawal indicators of patients with invasive mechanical ventilation.From November 2018 to December 2018,10 ICU nurses from a hospital in Guizhou Province were selected for brainstorming,and a pool of "knowledge,attitude and behavior" questionnaire items about the indication of invasive mechanical ventilation withdrawal was preliminarily drafted by ICU nurses.From January 2019 to March 2019,Delphi method was used for expert consultation,that is,15 experts in Guiyang,Guangzhou,Xi'an,Chongqing,Wuhan and Dalian were sent Delphi expert questionnaire by email or face-to-face to determine the corresponding items.Two rounds of inquiry were conducted,and the preliminary questionnaire of Zhixin bank was finally determined according to the results of inquiry.From April 2019 to June 2019,184 ICU nurses from a hospital and its affiliated hospital in Guizhou Province were resurveyed to test the reliability and validity of the questionnaire.The questionnaire recovery rate,authority coefficient(CR),variation coefficient(CV)and Kendall's W were used to judge the experts' enthusiasm,authority and opinion coordination.Cronbach's ?,retest reliability,content validity and structure validity were used to evaluate the reliability and validity of the questionnaire.The second part: from July 2019 to December 2019,345 ICU nurses from 11 hospitals in Guizhou Province were investigated by convenience sampling method.The results were analyzed by frequency and composition ratio,independent sample t-test,one-way ANOVA,multiple linear stepwise regression analysis and Pearson correlation coefficient analysis.P<0.05 was statistically significant.Results: The first part: 1.Two rounds of expert correspondence,the first round of recovery rate is 93.75%,the second round of recovery rate is 100%,which shows that experts have high enthusiasm.Cr in the first round is 0.85 and Cr in the second round is 0.87,which indicates that the authority of experts is high.Kendall's W coefficients were 0.207 and 0.372(P < 0.01).2.186 questionnaires and 184 valid questionnaires were distributed in the resurvey,with a recovery rate of 98.92%.Six common factors were extracted by exploratory factor analysis,with a cumulative factor contribution rate of 59.099%.The questionnaire consists of three dimensions(six sub dimensions)and 29 items in total: the knowledge dimension includes the parameters of the ventilator,the patient's own situation and the knowledge related to the ventilator withdrawal;the attitude dimension includes the attitude related to the ventilator withdrawal The behavior dimension includes the initiative behavior and the need behavior.Cronbach's ? coefficient is 0.894,and the retest reliability is 0.823.The second part: 1.A total of 360 questionnaires were sent out and 345 valid questionnaires were recovered.The effective recovery rate was 95.83%.2.ICU nurses were divided into(47.64 ? 37.94)points in the knowledge standard,(64.51 ? 24.51)points in the attitude standard,and(63.46 ? 18.24)points in the behavior standard.3.ICU nurses with different ages,working years in nursing,working years in critical care and working pressure had significant differences in knowledge dimension,attitude dimension,behavior dimension and total score of knowledge,trust and behavior(P<0.05).In addition,there were statistical differences in the knowledge dimensions of different professional titles,hospital grades,gender and education background(P<0.05).There were significant differences in attitude dimensions among different professional titles(P<0.05).Hospital grade,department type,professional titles and whether they are clinical teachers have influence on behavior dimension(P<0.05).Employment form and department type have influenceon the total score of KAP questionnaire(P<0.05).Multiple linear stepwise regression analysis showed that the factors influencing knowledge mastery were age,hospital grade,professional title and work pressure;the factors influencing attitude were work pressure and age;the factors influencing behavior were department,whether it was clinical teaching teacher,working year limit and work pressure of critical care;the factors influencing the total score of knowledge,information and practice were work pressure,age,department and employment In form.4.The results of correlation analysis of knowledge and attitude,attitude and behavior,knowledge and behavior of ICU nurses were 0.629,0.224 and 0.151,respectively,P<0.01.Conclusion:1.The questionnaire can be used as a tool to investigate the current situation of ICU nurses' knowledge and practice of invasive mechanical ventilation withdrawal,and further provide a basis for ICU nurses to evaluate invasive mechanical ventilation withdrawal.2.The knowledge,attitude and behavior of ICU nurses on the indication of invasive mechanical ventilation withdrawal are in the middle level,among which the attitude is more positive but still needs to be further strengthened.The overall level of ICU nurses' knowledge,belief and practice of invasive mechanical ventilation withdrawal indications needs to be further improved.3.There was a positive correlation between ICU nurses' knowledge,attitude and behavior of invasive mechanical ventilation withdrawal. |
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