Nursing Department, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.
ICU, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.
PLoS One. 2024 Jun 14;19(6):e0304734. doi: 10.1371/journal.pone.0304734. eCollection 2024.
The intensive care unit (ICU) is a department with a high risk of MDR bacteria, and ICU nurses and physicians play critical roles in bacterial multidrug resistance (MDR) prevention.
To explore the knowledge, attitudes, and practice (KAP) towards bacterial MDR among ICU nurses and physicians.
A self-designed questionnaire was administered to collect data. Structural equation modeling (SEM) was applied to assess the associations among study variables.
A total of 369 questionnaires were collected; 43 questionnaires were excluded due to self-contradictory on the trap question or the obviously repeated pattern. Finally, 326 (88.35%) valid questionnaires were included in the analysis. The knowledge, attitudes, and practice were 13.57 ± 1.69 (90.47%, possible range: 0-15), 38.75 ± 2.23 (96.88%, possible range: 8-40), and 47.40 ± 3.59 (94.80%, possible range: 10-50). The SEM showed that knowledge had a direct effect on attitude with a direct effect value of 0.61 (P < 0.001) and a direct negative effect on practice with a direct effect value of -0.30 (P = 0.009). The direct effect of attitude on practice was 0.89 (P < 0.001); the indirect effect of knowledge through attitude on practice was 0.52 (P < 0.001). Job satisfaction had a direct effect on attitude and practice, with an effect value of 0.52 (P = 0.030) and 0.75 (P = 0.040). Being a physician (OR = 0.354, 95%CI: 0.159-0.790, P = 0.011), 5-9.9 years of practice (OR = 4.534, 95%CI: 1.878-8.721, P < 0.001), and ≥ 10 years of practice (OR = 3.369, 95%CI: 1.301-8.721, P = 0.012) were independently associated with good knowledge. The attitude scores (OR = 1.499, 95%CI: 1.227-1.830, P < 0.001), male gender (OR = 0.390, 95%CI: 0.175-0.870, P = 0.022), and 5-9.9 years of experience (OR = 0.373, 95%CI: 0.177-0.787, P = 0.010) were independently associated with proactive practice.
Nurses and physicians in the ICU showed good knowledge, positive attitudes, and proactive practice toward bacterial MDR. Nurses and physicians' knowledge had a direct effect on their attitude, while attitude might directly influence the practice and also play a mediating role between knowledge and practice. Job satisfaction might directly support the positive attitude and practice toward bacterial MDR.
重症监护病房（ICU）是一个具有高度耐多药细菌风险的科室，ICU 护士和医生在预防细菌多重耐药性（MDR）方面发挥着关键作用。
探讨 ICU 护士和医生对细菌 MDR 的知识、态度和实践（KAP）。
采用自行设计的问卷收集数据。应用结构方程模型（SEM）评估研究变量之间的关联。
共收集了 369 份问卷；由于陷阱问题或明显重复模式的自相矛盾，排除了 43 份问卷。最终，纳入了 326 份（88.35%）有效问卷进行分析。知识、态度和实践分别为 13.57 ± 1.69（90.47%，可能范围：0-15）、38.75 ± 2.23（96.88%，可能范围：8-40）和 47.40 ± 3.59（94.80%，可能范围：10-50）。SEM 显示，知识对态度有直接影响，直接效应值为 0.61（P<0.001），对实践有直接负向影响，直接效应值为-0.30（P=0.009）。态度对实践有直接影响，直接效应值为 0.89（P<0.001）；知识通过态度对实践的间接影响为 0.52（P<0.001）。工作满意度对态度和实践有直接影响，效应值分别为 0.52（P=0.030）和 0.75（P=0.040）。医生（OR=0.354，95%CI：0.159-0.790，P=0.011）、5-9.9 年工作经验（OR=4.534，95%CI：1.878-8.721，P<0.001）和 10 年以上工作经验（OR=3.369，95%CI：1.301-8.721，P=0.012）与良好的知识独立相关。态度得分（OR=1.499，95%CI：1.227-1.830，P<0.001）、男性（OR=0.390，95%CI：0.175-0.870，P=0.022）和 5-9.9 年工作经验（OR=0.373，95%CI：0.177-0.787，P=0.010）与积极的实践独立相关。
ICU 护士和医生对细菌 MDR 具有良好的知识、积极的态度和积极的实践。护士和医生的知识对他们的态度有直接影响，而态度可能直接影响实践，并在知识和实践之间发挥中介作用。工作满意度可能直接支持对细菌 MDR 的积极态度和实践。
