Laur Celia, Marcus Hannah, Ray Sumantra, Keller Heather
School of Public Health and Health Systems, Faculty of Applied Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada.
The Need for Nutrition Education/Innovation Programme, c/o MRC Elsie Widdowson Laboratory, University of Cambridge, Cambridge CB1 9NL, UK.
Healthcare (Basel). 2016 Oct 20;4(4):79. doi: 10.3390/healthcare4040079.
Understanding the knowledge, attitudes, and practices (KAP) of hospital staff is needed to improve care activities that support the detection/prevention/treatment of malnutrition, yet quality measures are lacking. The purpose was to develop (study 1) and assess the administration and discriminative potential (study 2) of using such a KAP measure in acute care. In study 1, a 27-question KAP questionnaire was developed, face validated (n = 5), and tested for reliability (n = 35). Kappa and Intraclass Correlation (ICC) were determined. In study 2, the questionnaire was sent to staff at five diverse hospitals (n = 189). Administration challenges were noted and analyses completed to determine differences across sites, professions, and years of practice. Study 1 results demonstrate that the knowledge/attitude (KA) and the practice (P) subscales are reliable (KA: ICC = 0.69 95% CI 0.45-0.84, F = 5.54, < 0.0001; P: ICC = 0.84 95% CI 0.68-0.92, F = 11.12, < 0.0001). Completion rate of individual questions in study 2 was high and suggestions to improve administration were identified. The KAP mean score was 93.6/128 (range 51-124) with higher scores indicating more knowledge, better attitudes and positive practices. Profession and years of practice were associated with KAP scores. The KAP questionnaire is a valid and reliable measure that can be used in needs assessments to inform improvements to nutrition care in hospital.
为了改进支持营养不良检测/预防/治疗的护理活动，需要了解医院工作人员的知识、态度和行为（KAP），但目前缺乏相关质量指标。本研究旨在开发（研究1）并评估在急性护理中使用此类KAP指标的管理情况和区分潜力（研究2）。在研究1中，编制了一份包含27个问题的KAP问卷，进行了表面效度验证（n = 5）并测试了信度（n = 35）。确定了卡方值和组内相关系数（ICC）。在研究2中，将问卷发送给五家不同医院的工作人员（n = 189）。记录了管理方面的挑战并完成分析，以确定不同地点、职业和工作年限之间的差异。研究1结果表明，知识/态度（KA）和行为（P）分量表是可靠的（KA：ICC = 0.69，95%CI 0.45 - 0.84，F = 5.54，P < 0.0001；P：ICC = 0.84，95%CI 0.68 - 0.92，F = 11.12，P < 0.0001）。研究2中单个问题的完成率很高，并确定了改进管理的建议。KAP平均得分为93.6/128（范围51 - 124），得分越高表明知识越多、态度越好和行为越积极。职业和工作年限与KAP得分相关。KAP问卷是一种有效且可靠的指标，可用于需求评估，为改善医院营养护理提供依据。
