Sah Pavan Kumar, Lai Wenyi, Gupta Neelam, Bist Bimal Singh, Gautam Sanjib, Sapkota Khem Raj, Koirala Bipin, Kong Zhuo Ileana, Sesay Morlai, Guan Ying
Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China.
Department of Pediatrics, Paropakar Maternity and Women's Hospital, Kathmandu, Nepal.
Front Public Health. 2025 Jul 25;13:1623868. doi: 10.3389/fpubh.2025.1623868. eCollection 2025.
Pre-hospital emergency care is crucial for improving patient outcomes, especially in low- and middle-income countries (LMICs) where trauma is a leading cause of death. In Nepal, inadequate pre-hospital care contributes to approximately 16,600 preventable deaths annually. This study assessed the knowledge, attitudes, and practices (KAP) of healthcare providers in pre-hospital care to identify factors influencing their preparedness.
A quantitative, descriptive cross-sectional design was employed, utilizing a 35-item questionnaire based on a 5-point Likert scale. Data were collected via an online survey (Google Forms) from 517 healthcare providers (doctors, nurses, and paramedics) across 16 hubs and 76 satellite hospitals in Nepal's seven provinces based on a systematic randomization technique. Data were described with median and interquartile range. Nonparametric analysis, rank Spearman's rank correlation, and ordinal regression were used to analyze the data.
The study revealed that 62% of providers had good knowledge, 66% exhibited positive attitudes, but only 25% demonstrated good practice. Significant variations were observed by gender, profession, and workplace, with males, doctors, and private hospital providers scoring higher in knowledge and practice. Moderate correlations were found between knowledge, attitude, and practice (rs = 0.420-0.562, < 0.001). Ordinal logistic regression indicated significant associations between demographic factors and KAP levels.
Despite good knowledge and positive attitudes, only 25% demonstrated good practice, indicating practical implementation of pre-hospital care remains suboptimal. Targeted training programs, simulation-based learning, and continuous professional development will be needed to bridge the gap between knowledge and practice.
院前急救对于改善患者预后至关重要，尤其是在中低收入国家（LMICs），创伤是主要死因。在尼泊尔，院前护理不足每年导致约16,600例可预防死亡。本研究评估了医疗保健提供者在院前护理方面的知识、态度和实践（KAP），以确定影响其准备情况的因素。
采用定量、描述性横断面设计，使用基于5点李克特量表的35项问卷。基于系统随机化技术，通过在线调查（谷歌表单）从尼泊尔七个省的16个中心和76家卫星医院的517名医疗保健提供者（医生、护士和护理人员）收集数据。数据用中位数和四分位间距描述。使用非参数分析、Spearman秩相关和有序回归分析数据。
研究表明，62%的提供者有良好的知识，66%表现出积极的态度，但只有25%表现出良好的实践。在性别、职业和工作场所方面观察到显著差异，男性、医生和私立医院提供者在知识和实践方面得分更高。知识、态度和实践之间存在中等相关性（rs = 0.420 - 0.562， < 0.001）。有序逻辑回归表明人口统计学因素与KAP水平之间存在显著关联。
尽管有良好的知识和积极的态度，但只有25%表现出良好的实践，这表明院前护理的实际实施仍不理想。需要有针对性的培训计划、基于模拟的学习和持续的专业发展来弥合知识与实践之间的差距。
