Ni Weiwei, Zhu Shichao, Zou Huihuang, Jiao Xinwei, Ma Yulei
Nursing Department, Weifang Key Laboratory for Clinical Nursing Research, Affiliated Hospital of Shandong Second Medical University, Weifang, China.
Intensive Care Unit, Intensive Care Key Laboratory, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China.
BMC Nurs. 2025 Jul 24;24(1):967. doi: 10.1186/s12912-025-03626-4.
Enteral nutrition (EN) is essential for ICU patients, but EN-associated diarrhea (ENAD) affects 48.6-89.0% of them, increasing complications and healthcare costs. ICU nurses' knowledge, attitudes, and behavior in ENAD management significantly influence patient outcomes.
We evaluated ICU nurses' knowledge, attitudes, and behavior in ENAD management and explored their interrelationships using a social cognitive and behavior change framework.
From June 2022 to March 2023, 371 ICU nurses from 11 Chinese ICUs completed a validated questionnaire. We analyzed data using descriptive statistics, regression, and structural equation modeling.
Knowledge (mean = 63.57, SD = 15.04), attitudes (mean = 44.19, SD = 4.76), and behaviors (mean = 56.32, SD = 9.15) were moderate. Knowledge was positively correlated with attitudes (ρ = 0.42, p < 0.001) and behaviors (ρ = 0.58, p < 0.001), and attitudes strongly correlated with behaviors (ρ = 0.65, p < 0.001). Attitudes mediated the knowledge-behavior relationship (β = 0.14, 95% CI [0.08, 0.21], p < 0.001). Master's Degree (β = 0.10, p = 0.049), training participation (β = 0.18, p = 0.002), and frequent training (4 times/year, β = 0.22, p < 0.001) predicted better knowledge, while training and age (31-35 years) enhanced attitudes (p < 0.05).
Knowledge gaps hinder ICU nurses' ENAD management, with attitudes critically mediating the translation of knowledge into practice. Targeted interventions, such as quarterly workshops and scenario-based simulations, are recommended to enhance knowledge, foster positive attitudes, and standardize behaviors, thereby improving patient care quality.
肠内营养（EN）对重症监护病房（ICU）患者至关重要，但肠内营养相关性腹泻（ENAD）影响着48.6%至89.0%的患者，增加了并发症和医疗成本。ICU护士在ENAD管理方面的知识、态度和行为对患者的预后有显著影响。
我们评估了ICU护士在ENAD管理方面的知识、态度和行为，并使用社会认知和行为改变框架探讨了它们之间的相互关系。
2022年6月至2023年3月，来自中国11个ICU的371名ICU护士完成了一份经过验证的问卷。我们使用描述性统计、回归分析和结构方程模型对数据进行了分析。
知识（均值=63.57，标准差=15.04）、态度（均值=44.19，标准差=4.76）和行为（均值=56.32，标准差=9.15）处于中等水平。知识与态度呈正相关（ρ=0.42，p<0.001），与行为呈正相关（ρ=0.58，p<0.001），态度与行为高度相关（ρ=0.65，p<0.001）。态度在知识-行为关系中起中介作用（β=0.14，95%可信区间[0.08，0.21]，p<0.001）。硕士学位（β=0.10，p=0.049）、参加培训（β=0.18，p=0.002）和频繁培训（每年4次，β=0.22，p<0.001）预测知识水平更高，而培训和年龄（年龄范围31-35岁）增强态度（p<0.05）。
知识差距阻碍了ICU护士对ENAD的管理，态度在将知识转化为实践方面起着关键的中介作用。建议采取有针对性的干预措施，如每季度举办研讨会和基于情景的模拟，以增强知识、培养积极态度并规范行为，从而提高患者护理质量。
