Construction Of A Training Program For Neonatal Nurses On Feeding Intolerance In Preterm Infants

ObjectivesThe aim of this study is to understand the knowledge,attitude,and practice of neonatal nurses in China regarding feeding intolerance in preterm infants.Based on a literature review and semi-structured interviews,the study aims to develop a training program for neonatal nurses on feeding intolerance in preterm infants.The program aims to enhance their knowledge of feeding intolerance,improve their professional attitudes,and standardize their clinical nursing practices.The findings of this study will provide insights for the management of neonatal nursing personnel and serve as a reference for improving the care of preterm infants.Methods1.Survey of Knowledge,Attitude,and Practice of Neonatal Nurses Regarding Feeding Intolerance in Preterm InfantsA questionnaire survey was conducted to assess the levels of knowledge,attitude,and practice related to feeding intolerance in preterm infants among neonatal nurses in selected tertiary and secondary hospitals in Gansu Province.The self-developed "Questionnaire on Knowledge,Attitude,and Practice of Neonatal Nurses Regarding Feeding Intolerance in Preterm Infants" was utilized.Descriptive statistics were used to analyze the general information,knowledge,attitude,practice,and overall scores of the questionnaire using SPSS software version 26.0.Factors influencing the levels of knowledge,attitude,and practice of neonatal nurses regarding feeding intolerance were explored through t-tests,one-way analysis of variance(ANOVA),and multiple linear regression analysis.2.Development of a Training Program for Neonatal Nurses in the Management of Feeding Intolerance in Preterm InfantsBased on a literature review and the theory of knowledge,attitude,and practice(KAP),a preliminary framework for the training program on feeding intolerance in preterm infants for neonatal nurses was established.Semi-structured interviews were conducted with a group of neonatal nurses and subject experts to understand their needs regarding the training program.Combining the questionnaire items,survey results,literature research,and semi-structured interview findings,the training program was developed within the framework.Finally,through two rounds of Delphi expert consultation,the final version of the "Training Program for Neonatal Nurses on Feeding Intolerance in Preterm Infants" was determined.Results1.The self-developed questionnaire demonstrated good reliability and validity.The Cronbach’s α coefficient for the overall questionnaire was 0.91.The content validity index for the scale level was 0.97,with an average content validity index of0.99.Exploratory factor analysis was conducted to further validate the questionnaire’s factor structure.It revealed that both the attitude and practice sections had only one common factor,with cumulative variance contribution rates of 73.969% and 61.577%,respectively.A total of 627 neonatal nurses participated in the survey.The standardized total scores for the knowledge,attitude,and practice dimensions of premature infant feeding intolerance were(56.72±14.15),(12.46±2.56),(18.70±8.31),and(25.57±9.89),respectively.Multifactorial analysis results indicated that hospital level,department category,professional title,years of experience,and level of knowledge/understanding were factors influencing the overall scores of knowledge,attitude,and practice related to premature infant feeding intolerance.Hospital level,department category,professional title,years of experience,and level of knowledge/understanding were factors influencing the knowledge dimension.Hospital level,professional title,and level of knowledge/understanding were factors influencing the attitude dimension.Gender,hospital level,years of experience,department,and level of knowledge/understanding were factors influencing the practice dimension.2.The results of theme extraction based on the theory of Knowledge-Attitude-Practice and literature research were used as a guiding framework,and combined with the items of the questionnaire and semi-structured interview results,the training program was divided into three objective categories:theoretical knowledge,practical skills,and interpersonal care.Based on this,a preliminary draft of the program was formed.Through two rounds of Delphi expert consultation,the authority coefficient of the first-round experts was 0.94,and the authority coefficient of the second-round experts was 0.97.The Kendall’s coordination coefficients(W)for the two rounds of expert consultation were 0.151 and 0.218,respectively(P<0.001),indicating a high level of expert coordination and the reliability of the consultation results.Finally,the "Training Program for Neonatal Nurses on Feeding Intolerance in Preterm Infants" was formulated,including four dimensions: training objectives,training content,training methods,and assessment and evaluation methods,with a total of 7 items for objective classification,28 items for training objectives,29 items for training content,16 items for training methods,and 16 items for assessment and evaluation methods.Conclusion1.The study investigated the knowledge,attitude,and practice levels of neonatal nurses in the management of feeding intolerance in preterm infants using a self-designed questionnaire.The results showed that the overall levels of knowledge,attitude,and practice were moderate to low,with attitude level needing further improvement.Additionally,the factors influencing the knowledge,attitude,and practice levels were identified as gender,hospital level,hospital nature,department category,years of working experience,and level of knowledge about relevant information.2.The study developed a training program for neonatal nurses in the management of feeding intolerance in preterm infants,which includes four dimensions: training objectives,training content,training methods,and assessment methods.The implementation of the training program will focus on the classification of objectives,training objectives,training content,training methods,and assessment methods.Further experimental research is needed to test the effectiveness of the training program.