Zheng Yanmin, Cui Nianqi, Sha Ruiqin, Yu Wenfan, Tan Yapeng, Guan Xueyan, Huang Yaruo, Hu Rui, Huang Zexi, Tian Ying
Department of Nursing, First Affiliated Hospital of Kunming Medical University, Kunming, China.
School of Nursing, Kunming Medical University, Kunming, China.
Nurs Crit Care. 2025 Mar;30(2):e13280. doi: 10.1111/nicc.13280.
Postextubation dysphagia is common in the ICU, with varying incidence rates. However, few studies have focused on ICU nurses' knowledge, attitudes and practices regarding postextubation dysphagia, as well as the various influencing factors.
To investigate ICU nurses' knowledge, attitudes and practices regarding postextubation dysphagia and provide suggestions for improvement.
This was a multicentre cross-sectional survey. Data were collected using a validated questionnaire to assess knowledge, attitudes and practices regarding postextubation dysphagia.
A total of 510 valid questionnaires were analysed. The median scores with interquartile ranges for knowledge, attitudes and practices regarding postextubation dysphagia were 8 (7, 9), 8 (7, 9) and 4.9 (3.8, 6.2), respectively. Multivariate analysis revealed that knowledge scores were significantly influenced by education level, ICU experience and managerial role (p < .05). Nurses with a bachelor's degree (OR = 3.636; 95% CI: 1.587-8.33) or a master's degree and above (OR = 7.742; 95% CI: 1.968-30.465) demonstrated higher knowledge scores than those with a postsecondary diploma. Nurses in managerial roles had higher scores (OR = 1.924; 95% CI: 1.053-3.515). Attitude (OR = 1.616; 95% CI: 1.092-2.39) and practice scores (OR = 4.079; 95% CI: 2.692-6.182) were significantly impacted by targeted PED training (p < .05). The correlation analysis revealed a weak but significant correlation only between knowledge and attitudes (τb = 0.196, p < .001).
Education level, ICU experience, managerial role and targeted PED training may enhance knowledge, attitudes or practices individually but do not lead to cohesive improvement across all three areas. Relying on knowledge alone is far from sufficient to drive behavioural change, indicating the need for comprehensive interventions to bridge these gaps.
To bridge this gap, comprehensive interventions beyond standard training are essential. These may include applying an implementation science strategy to ensure that ICU nurses' enhanced knowledge and positive attitudes are consistently translated into clinical practice.
拔管后吞咽困难在重症监护病房（ICU）很常见，发病率各不相同。然而，很少有研究关注ICU护士关于拔管后吞咽困难的知识、态度和实践，以及各种影响因素。
调查ICU护士关于拔管后吞咽困难的知识、态度和实践，并提出改进建议。
这是一项多中心横断面调查。使用经过验证的问卷收集数据，以评估关于拔管后吞咽困难的知识、态度和实践。
共分析了510份有效问卷。拔管后吞咽困难的知识、态度和实践得分的中位数及四分位间距分别为8（7，9）、8（7，9）和4.9（3.8，6.2）。多变量分析显示，知识得分受教育水平、ICU工作经验和管理角色的显著影响（p < 0.05）。拥有学士学位（OR = 3.636；95%可信区间：1.587 - 8.33）或硕士及以上学位的护士（OR = 7.742；95%可信区间：1.968 - 30.465）的知识得分高于大专文凭的护士。担任管理角色的护士得分更高（OR = 1.924；95%可信区间：1.053 - 3.515）。针对性的拔管后吞咽困难培训对态度（OR = 1.616；95%可信区间：1.092 - 2.39）和实践得分（OR = 4.079；95%可信区间：2.692 - 6.182）有显著影响（p < 0.05）。相关性分析仅显示知识与态度之间存在微弱但显著的相关性（τb = 0.196，p < 0.001）。
教育水平、ICU工作经验、管理角色和针对性的拔管后吞咽困难培训可能分别提高知识、态度或实践，但不会在所有三个方面带来协同改进。仅依靠知识远远不足以推动行为改变，这表明需要采取综合干预措施来弥合这些差距。
为弥合这一差距，除标准培训外的综合干预措施至关重要。这些措施可能包括应用实施科学策略，以确保ICU护士增强的知识和积极的态度能够持续转化为临床实践。
