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护士在住院成人营养管理中的知识、态度与实践:一项混合方法研究。

Nurses' Knowledge, Attitude and Practice in Nutrition Management of Hospitalised Adults: A Mixed-Methods Study.

作者信息

Ang Wei Lin Sandy, Zhang Di, Cai Huimei, Chew Han Shi Jocelyn

机构信息

Sengkang General Hospital, Singapore.

Alice Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

出版信息

J Clin Nurs. 2025 May;34(5):1665-1690. doi: 10.1111/jocn.17629. Epub 2025 Jan 23.

Abstract

AIM(S): To examine nurses' knowledge, attitude and practice regarding nutrition management in hospitalised adults and explore their views on it.

DESIGN

A mixed-method approach combining cross-sectional and descriptive qualitative methods.

METHODS

379 enrolled/registered nurses working in acute or intensive units of a tertiary hospital were recruited between 24th August 2023 and 3rd December 2023. Participants completed a questionnaire on their sociodemographic profile, knowledge, attitude and practice (KAP) regarding nutrition management. Data analysis was conducted using R software, reporting levels of KAP and its associations with sociodemographic factors. Mann-Whitney U and Kruskal-Wallis tests were used for non-normally distributed knowledge and practice scores (reported as median and interquartile range). Two-sample t-tests and ANOVA were used for normally distributed attitude scores (reported as mean and standard deviation). 21 of the participants from the quantitative study were either purposively sampled or snowballed from the quantitative study to undergo semi-structured interviews (physically or virtually face-to-face), which were transcribed verbatim and analysed using content analysis.

RESULTS

The mean scores on KAP were 61.6, 19.4 and 22.8, respectively. Knowledge varied significantly by educational level (p < 0.001), while attitudes also differed based on education (p = 0.001) and years of employment (p = 0.019). Practice scores showed differences based on subspeciality (p = 0.032), nursing rank (p < 0.001) and years of employment (p = 0.004). Findings identified barriers to effective nutrition management, including prioritisation issues, varying professional roles, limited autonomy and resource shortages. It also emphasises nurses' roles in nutrition management and strategies such as nurses' autonomy and family members involvement to improve nutrition management.

CONCLUSION

Sociodemographic factors significantly influence nurses' KAP in nutrition management, revealing knowledge deficits, low prioritisation and time constraints. Tailored education and training, increased autonomy, resource expansion and greater family involvement can enhance nurses' KAP in nutrition management.

摘要

目的

调查护士在成人住院患者营养管理方面的知识、态度和实践情况,并探讨他们对此的看法。

设计

采用横断面研究和描述性定性研究相结合的混合方法。

方法

在2023年8月24日至2023年12月3日期间,招募了379名在一家三级医院的急症或重症监护病房工作的注册护士。参与者完成了一份关于其社会人口统计学特征、营养管理知识、态度和实践(KAP)的问卷。使用R软件进行数据分析,报告KAP水平及其与社会人口统计学因素的关联。对于非正态分布的知识和实践得分(报告为中位数和四分位间距),使用曼-惠特尼U检验和克鲁斯卡尔-沃利斯检验。对于正态分布的态度得分(报告为均值和标准差),使用两样本t检验和方差分析。从定量研究的参与者中,通过目的抽样或滚雪球抽样选取21人进行半结构化访谈(面对面或虚拟面对面),访谈内容逐字转录并采用内容分析法进行分析。

结果

KAP的平均得分分别为61.6、19.4和22.8。知识得分因教育水平差异显著(p<0.001),态度得分也因教育程度(p=0.001)和工作年限(p=0.019)而有所不同。实践得分因亚专业(p=0.032)、护理等级(p<0.001)和工作年限(p=0.004)而存在差异。研究结果确定了有效营养管理的障碍,包括优先级问题、不同的专业角色、有限的自主权和资源短缺。研究还强调了护士在营养管理中的作用以及护士自主权和家庭成员参与等改善营养管理的策略。

结论

社会人口统计学因素显著影响护士在营养管理方面的KAP,揭示了知识缺陷、优先级低和时间限制等问题。量身定制教育培训、增加自主权、扩大资源和加强家庭参与可以提高护士在营养管理方面的KAP。

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