Xiang Ya School of Nursing of Central South University, Changsha, Hunan, China.
Nursing Department, Xiangya Hospital of Central South University, Changsha, Hunan, China.
J Clin Nurs. 2020 Sep;29(17-18):3311-3324. doi: 10.1111/jocn.15358. Epub 2020 Jul 14.
To determine the level of and factors in nurses' knowledge, attitudes and behaviours towards pressure injury (PI) prevention.
Although there has been a declining trend in global PI prevalence and hospital-acquired rates in recent years, this has not been the case in China. Evidence in the literature indicates the importance of nurses' knowledge, attitudes and behaviours for promoting PI prevention.
Cross-sectional study.
A total of 1,806 nurses from 10 tertiary general hospitals in Hunan Province, China, participated in this study. Nurses' knowledge and attitudes were assessed using Pieper's Pressure Ulcer Knowledge Test and Attitude towards Pressure Ulcer Prevention Instrument, respectively, and behaviours were measured using a researcher self-designed questionnaire. Multiple logistic regression analysis determined factors affecting the nurses' PI-prevention knowledge, attitudes and behaviours. A STROBE checklist was used to report findings.
Among all nurses involved in this study, 41.7% had insufficient PI-prevention knowledge, 46.6% had negative PI-prevention attitudes, and 21.8% had poor PI-prevention behaviour. Nurses with a bachelor's degree or above were more likely to have adequate PI-prevention knowledge. Increased PI-prevention training frequency increased the nurses' positive attitude scores for PI prevention; longer years of service and a higher number of PI-prevention trainings attended predicted better PI-prevention behaviours.
Chinese nurses' PI-prevention knowledge and attitudes in this study were unsatisfactory, while their PI-prevention behaviour was acceptable. Increasing PI-prevention training frequency can help improve Chinese nurses' PI-prevention attitudes and further behaviour. Having a minimum of a bachelor degree may be beneficial to Chinese nurses' PI-prevention knowledge, but more evidence is needed.
Chinese nurses have insufficient knowledge about PI-repositioning, inadequate practices in PI nutrition assessment, and low confidence in their personal competence regarding PI-prevention. The key solution for the above issues is to promote ongoing education and training based on strong clinical leadership.
确定护士对压疮（PI）预防的知识、态度和行为水平以及相关因素。
尽管近年来全球 PI 患病率和医院获得率呈下降趋势，但中国并非如此。文献中的证据表明，护士的知识、态度和行为对于促进 PI 预防至关重要。
横断面研究。
本研究共纳入来自中国湖南省 10 家三级综合医院的 1806 名护士。使用 Pieper 的压疮知识测试和压疮预防态度量表评估护士的知识和态度，使用研究者自行设计的问卷评估行为。采用多因素逻辑回归分析确定影响护士 PI 预防知识、态度和行为的因素。采用 STROBE 清单报告研究结果。
在参与本研究的所有护士中，41.7%的护士 PI 预防知识不足，46.6%的护士对 PI 预防持消极态度，21.8%的护士 PI 预防行为较差。具有本科及以上学历的护士更有可能具备充足的 PI 预防知识。增加 PI 预防培训频率会提高护士对 PI 预防的积极态度得分；服务年限较长和参加过更多的 PI 预防培训预测 PI 预防行为更好。
本研究中，中国护士的 PI 预防知识和态度不尽如人意，而 PI 预防行为尚可。增加 PI 预防培训频率有助于改善中国护士的 PI 预防态度，并进一步改善行为。至少具有本科学历可能对中国护士的 PI 预防知识有益，但需要更多证据支持。
中国护士对 PI 翻身、PI 营养评估等方面的知识不足，PI 预防实践不足，对个人预防 PI 的能力缺乏信心。解决上述问题的关键是在强有力的临床领导力基础上，推行持续教育和培训。
