Li M J, Chen H L, Ju Y Y, Zeng L J, Li N
Institute of Burn Research, State Key Laboratory of Trauma and Chemical Poisoning, the First Affiliated Hospital of Army Medical University (the Third Military Medical University), Chongqing 400038, China.
Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2023 Sep 20;39(9):874-881. doi: 10.3760/cma.j.cn501225-20220522-00198.
To investigate the status of knowledge, attitude, and behavior of enteral nutrition implemented by nurses in burn intensive care unit (BICU) and analyze its influencing factors. A multi-center cross-sectional survey research method was used. On May 8, 2022, 107 BICU nurses who met the inclusion criteria were selected from the burn departments of the First Affiliated Hospital of Army Medical University (the Third Military Medical University), Guangdong Provincial People's Hospital, the First Affiliated Hospital of Guangxi Medical University, the Affiliated Hospital of Qinghai University, the Second Affiliated Hospital of Air Force Medical University, the Affiliated Hospital of Nantong University, Guiyang Steel Factory Staff Hospital, and the Second Affiliated Hospital of Kunming Medical University. The self-made nurses' enteral nutrition nursing knowledge-attitude-behavior questionnaire for severely burned patients was used to investigate the nurses' gender, age, working years, professional title, position, highest educational background, and whether they received systematic training in knowledge of enteral nutrition, the scores of each factor, and the total scores of knowledge, attitude, and behavior dimensions of enteral nutrition in nurses. The nurses were classified according to the general data, and the total scores of their knowledge, attitude, and behavior of enteral nutrition were calculated. Data were statistically analyzed with independent sample test, one-way analysis of variance, Mann-Whitney test, and Kruskal-Wallis test. According to the results of univariate analysis and combined with clinical experience and significance, the generalized linear model analysis was carried out to screen the independent influencing factors of the total scores of knowledge, attitude, and behavior of enteral nutrition in BICU nurses. A total of 107 nurses were surveyed, and 107 valid questionnaires were collected, with an effective recovery rate of 100%. In the BICU nurses' enteral nutrition knowledge-attitude-behavior questionnaire, the total scores of knowledge, attitude, and behavior were 44±13, 87±15, and 70±19, respectively. Most of the BICU nurses in this survey were female, aged 22-48 (31±6) years, and the number of nurses worked for 1-5, 6-10, and ≥11 years was evenly distributed. The majority of the professional titles of nurses were nurses, positions were responsible nurses, and the highest educational background was undergraduate. Forty-four nurses received systematic training in knowledge of enteral nutrition. There were statistically significant differences in the total scores of knowledge of enteral nutrition among BICU nurses with different ages, working years, professional titles, positions, highest educational background, and whether they received systematic training in knowledge of enteral nutrition (with values of 27.36, 15.27, and 10.19, respectively, values of -3.33, -2.59, and -6.46, respectively, <0.05). There were no statistically significant differences in the total scores of attitude and behavior of enteral nutrition among BICU nurses with different gender, ages, working years, professional titles, positions, highest educational background, and whether they received systematic training in knowledge of enteral nutrition (>0.05). Age (26-30, 31-35, and ≥36 years old), highest educational background (undergraduate), and the systematic training received in enteral nutrition knowledge were the independent influencing factors for the total score of knowledge of enteral nutrition in BICU nurses (with 95% confidence intervals of 0.12-0.36, 0-0.30, 0.03-0.31, 0.01-0.32, and 0.19-0.40, respectively, standardized regression coefficients of 0.24, 0.15, 0.17, 0.17, and 0.29, respectively, <0.05). There were no independent influencing factors for the total scores of enteral nutrition attitude and behavior of BICU nurses in different characteristics (0.05). The BICU nurses have low cognitive level in the implementation of enteral nutrition, their concept needs to be updated in time, and their behavior needs to be further standardized. Age (26-30, 31-35, and ≥36 years old), highest educational background (undergraduate), and the systematic training received in enteral nutrition knowledge were the independent influencing factors for the knowledge of enteral nutrition in BICU nurses.
调查烧伤重症监护病房(BICU)护士实施肠内营养的知识、态度和行为现状,并分析其影响因素。采用多中心横断面调查研究方法。2022年5月8日,从陆军军医大学第一附属医院(第三军医大学)、广东省人民医院、广西医科大学第一附属医院、青海大学附属医院、空军军医大学第二附属医院、南通大学附属医院、贵阳钢厂职工医院、昆明医科大学第二附属医院的烧伤科选取107名符合纳入标准的BICU护士。采用自行编制的重度烧伤患者护士肠内营养护理知识-态度-行为问卷,调查护士的性别、年龄、工作年限、职称、岗位、最高学历以及是否接受过肠内营养知识系统培训、各因素得分和护士肠内营养知识、态度、行为维度的总分。根据一般资料对护士进行分类,计算其肠内营养知识、态度和行为的总分。采用独立样本t检验、单因素方差分析、Mann-Whitney U检验和Kruskal-Wallis H检验进行统计学分析。根据单因素分析结果,结合临床经验及意义,进行广义线性模型分析,筛选BICU护士肠内营养知识、态度和行为总分的独立影响因素。共调查107名护士,回收有效问卷107份,有效回收率为100%。在BICU护士肠内营养知识-态度-行为问卷中,知识、态度和行为的总分分别为44±13、87±15和70±19。本次调查的BICU护士大多为女性,年龄22 - 48(31±6)岁,工作1 - 5年、6 - 10年和≥11年的护士人数分布均匀。护士职称大多为护士,岗位为责任护士,最高学历为本科。44名护士接受过肠内营养知识系统培训。不同年龄、工作年限、职称、岗位、最高学历以及是否接受过肠内营养知识系统培训的BICU护士,其肠内营养知识总分差异有统计学意义(F值分别为27.36、15.27和10.19,t值分别为 - 3.33、 - 2.59和 - 6.46,P<0.05)。不同性别、年龄、工作年限、职称、岗位、最高学历以及是否接受过肠内营养知识系统培训的BICU护士,其肠内营养态度和行为总分差异无统计学意义(P>0.05)。年龄(26 - 30岁、31 - 35岁和≥36岁)、最高学历(本科)以及接受的肠内营养知识系统培训是BICU护士肠内营养知识总分的独立影响因素(95%置信区间分别为0.12 - 0.36、0 - 0.30、0.03 - 0.31、0.01 - 0.32和0.19 - 0.40,标准化回归系数分别为0.24、0.15、0.17、0.17和0.29,P<0.05)。不同特征的BICU护士肠内营养态度和行为总分无独立影响因素(P>0.05)。BICU护士在实施肠内营养方面认知水平较低,观念需及时更新,行为有待进一步规范。年龄(26 - 30岁、31 - 35岁和≥36岁)、最高学历(本科)以及接受的肠内营养知识系统培训是BICU护士肠内营养知识的独立影响因素。