Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Department of Cardiac, Thoracic and Vascular Surgery, National University Health System, Singapore, Singapore.
J Vasc Access. 2024 Sep;25(5):1432-1442. doi: 10.1177/11297298231162766. Epub 2023 Mar 27.
Dialysis nurses play a paramount role in vascular access (VA) management. The aim of this study is to evaluate dialysis nurses' knowledge, attitude, practice and self-efficacy (KACP-SE) pertaining to VA cannulation and evaluation.
An anonymous self-administered survey was administered to dialysis nurses from two tertiary hospitals (four dialysis units) and two community dialysis centres from April to May 2022. The 37-items survey consists of four dimensions of questions relating to VA cannulation and management: knowledge, attitude, practice and self-efficacy. The content validity and face validity of the survey was reviewed by three experienced VA professionals and five dialysis nurses respectively. The internal consistency and construct validity of the survey have been assessed with psychometric tests.
There were 23 and 47 nurses, working in the participated community and tertiary hospital dialysis centres respectively, responded to the survey. The internal consistency coefficients indicated acceptable reliability of the instrument (KR-20 coefficient was 0.55 and 0.76 for knowledge and practice domains; Cronbach's α was 0.85 and 0.64 for self-efficacy and attitude domains). In the exploratory factor analysis for attitude and self-efficacy, the instrument could account for 64.0% and 53.0% of the total variance respectively. In the knowledge domain, five out of eight single-select multiple-choice questions were correctly answered by >70% of the participants. Overall, the mean (±SD) of participants' total self-efficacy score was 24.3 (±3.1) over total score of 30. The majority of the participants (82.4%) either agreed or strongly agreed that ultrasound guidance is useful for cannulation.
This KAP-SE instrument can be used to evaluate knowledge, attitude, practice and self-efficacy of dialysis nurses toward VA management. The participants demonstrated acceptable knowledge level, but with some knowledge gaps identified. It also revealed nurses' good self-efficacy level and welcoming attitude towards adopting ultrasound in VA cannulation among the participants.
透析护士在血管通路（VA）管理中起着至关重要的作用。本研究旨在评估透析护士在 VA 置管和评估方面的知识、态度、实践和自我效能（KACP-SE）。
2022 年 4 月至 5 月，对来自两家三级医院（四家透析单位）和两家社区透析中心的透析护士进行了匿名自填式调查。该 37 项调查包括与 VA 置管和管理相关的四个维度的问题：知识、态度、实践和自我效能。该调查的内容效度和表面效度分别由三位有经验的 VA 专业人员和五位透析护士进行了审查。使用心理测量学测试评估了调查的内部一致性和结构效度。
分别有 23 名和 47 名在参与的社区和三级医院透析中心工作的护士对调查做出了回应。内部一致性系数表明该工具具有可接受的可靠性（知识和实践领域的 KR-20 系数分别为 0.55 和 0.76；自我效能和态度领域的 Cronbach's α 分别为 0.85 和 0.64）。在态度和自我效能的探索性因素分析中，该工具可分别解释总方差的 64.0%和 53.0%。在知识领域，八项单项多项选择题中有五项被>70%的参与者正确回答。总的来说，参与者的总自我效能评分的平均值（±SD）为 24.3（±3.1），总分为 30。大多数参与者（82.4%）表示同意或强烈同意超声引导对置管有用。
该 KAP-SE 工具可用于评估透析护士对 VA 管理的知识、态度、实践和自我效能。参与者表现出可接受的知识水平，但也发现了一些知识差距。它还表明，参与者的自我效能水平较高，并且对在 VA 置管中采用超声持欢迎态度。
