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中国中部地区医护人员在呼吸支持方面的知识、态度、实践及职业倦怠:一项结构方程模型研究

Knowledge, attitudes, practices, and burnout related to respiratory support among healthcare professionals in central China: a structural equation modeling study.

作者信息

Cui Tao, Lui Jie, Chen Bin, Yu Chuangwei, Hu Yunli, Bao Chuanfei, Zhao Shuguang

机构信息

Emergency Medicine Department of Taihe County People's Hospital, 236600, Anhui Fuyang, Anhui Province, China.

出版信息

BMC Med Educ. 2025 May 20;25(1):735. doi: 10.1186/s12909-025-07302-8.


DOI:10.1186/s12909-025-07302-8
PMID:40394549
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12093867/
Abstract

BACKGROUND: Burnout, marked by emotional exhaustion and reduced clinical performance, may impair the effective application of noninvasive respiratory support (NIRS) and timely transition to invasive methods, potentially affecting patient outcomes. This study aims to identify the impact of burnout on the knowledge, attitudes, and practices (KAP) of healthcare professionals in the application of respiratory support, and further explore how other factors may influence these areas. METHOD: A cross-sectional study was conducted from November 15, 2023, to December 14, 2023, at multiple hospitals in central China, involving key departments such as emergency, respiratory, cardiology, and critical care. Demographic information, alongside scores measuring KAP was gathered through the dissemination of questionnaires. Knowledge was assessed using a scoring system (range: 0-24), while attitude and practice were measured using 5-point Likert scales, with score ranges of 8-40 and 8-56, respectively. The Chinese version of the Maslach Burnout Inventory General Survey (MBI-GS) was used to assess occupational burnout. RESULTS: A total of 517 valid questionnaires were enrolled, including 284 (54.9%) nurses, and 269 (52%) had worked for less than 10 years. The median scores for knowledge, attitude, practice, and burnout were 20, 26, 38, and 40, respectively. Participants from private hospitals exhibited burnout scores higher than 50. Burnout was negatively correlated with both attitude (r = -0.289) and practice (r = -0.206). Multivariate logistic regression showed that practice, as the dependent variable, was independently associated with a knowledge score below 20 (OR = 0.441, 95% CI: [0.297, 0.657]), an attitude score below 26 (OR = 0.493, 95% CI: [0.335, 0.724]), and burnout scores below 40 (OR = 0.539, 95% CI: [0.364-0.796]) were independently associated with practice. Age above 40 years (OR = 0.470, 95% CI: [0.264, 0.837]), being a nurse (OR = 0.627, 95% CI: [0.424, 0.928]), and lack of recent training in respiratory support (OR = 0.590, 95% CI: [0.403, 0.866]) were also associated with lower practice scores. CONCLUSIONS: Healthcare professionals had sufficient knowledge, positive attitudes, and proactive practices regarding the application of respiratory support. However, the impact of burnout must not be overlooked, even for those scoring below the threshold (50 points), as burnout can still significantly affect clinical performance. Healthcare institutions should prioritize continuous education and training programs focusing on respiratory support, especially for high stress environment professionals, to enhance clinical practice and patient outcomes. CLINICAL TRIAL NUMBER: not applicable.

摘要

背景:职业倦怠以情绪耗竭和临床绩效下降为特征,可能会损害无创呼吸支持(NIRS)的有效应用以及向有创方法的及时转换,从而可能影响患者的治疗结果。本研究旨在确定职业倦怠对医护人员在呼吸支持应用方面的知识、态度和实践(KAP)的影响,并进一步探讨其他因素可能如何影响这些方面。 方法:于2023年11月15日至2023年12月14日在中国中部多家医院开展了一项横断面研究,涉及急诊科、呼吸科心脏病科和重症监护等关键科室。通过发放问卷收集人口统计学信息以及KAP评分。知识采用评分系统进行评估(范围:0 - 24分),态度和实践则使用5点李克特量表进行测量,分数范围分别为8 - 40分和8 - 56分。采用中文版的马氏职业倦怠量表通用调查(MBI - GS)来评估职业倦怠。 结果:共纳入517份有效问卷,其中护士284名(54.9%),工作年限不足10年的有269名(52%)。知识、态度、实践和职业倦怠的中位数得分分别为20分、26分、38分和40分。来自私立医院的参与者职业倦怠得分高于50分。职业倦怠与态度(r = -0.289)和实践(r = -0.206)均呈负相关。多因素逻辑回归显示以实践作为因变量时,知识得分低于20分(OR = 0.441,95%CI:[0.297, 0.657])、态度得分低于26分(OR = 0.493,95%CI:[0.335, 0.724])以及职业倦怠得分低于40分(OR = 0.539,95%CI:[0.364 - 0.796])均与实践独立相关。年龄在40岁以上(OR = 0.470,95%CI:[0.264, 0.837])、为护士(OR = 0.627,95%CI:[0.424, 0.928])以及近期缺乏呼吸支持培训(OR = 0.590,95%CI:[0.403, 0.866])也与较低的实践得分相关。 结论:医护人员在呼吸支持应用方面具备足够的知识、积极的态度和主动的实践。然而,职业倦怠的影响不容忽视,即使对于得分低于阈值(50分)的人员也是如此,因为职业倦怠仍可显著影响临床绩效。医疗机构应优先开展针对呼吸支持的持续教育和培训项目,尤其是针对处于高压力环境的专业人员,以提高临床实践水平和患者治疗效果。 临床试验编号:不适用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b73/12093867/a25e3136f754/12909_2025_7302_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b73/12093867/a25e3136f754/12909_2025_7302_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b73/12093867/a25e3136f754/12909_2025_7302_Fig1_HTML.jpg

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