Yue Xiaomin, Guo Wenzhi, Chang Jianjun, Li Lizhi, Zhao Jianjun, Fan Yong, Lei Yajuan
Department of Anesthesiology, Shanxi Academy of Medical Sciences, Shanxi Bethune Hospital, Taiyuan, Shanxi, 030032, People's Republic of China.
Department of Anesthesiology, The Seventh Medical Center of PLA General Hospital, Beijing, 100700, People's Republic of China.
J Multidiscip Healthc. 2025 Sep 9;18:5651-5662. doi: 10.2147/JMDH.S543832. eCollection 2025.
Enhanced recovery after surgery (ERAS) has been popularized in clinical settings, and perioperative anesthetic management under the ERAS concept in orthopedic surgery is increasingly emphasized. This study aimed to assess the knowledge, attitudes, and practices (KAP) of orthopedic surgical healthcare professionals regarding perioperative anesthetic management.
This cross-sectional study included orthopedic surgical healthcare professionals at four hospitals between January and December 2023. A self-administered questionnaire was developed to collect participants' socio-demographic information and KAP scores. Structural equation modeling (SEM) was applied to assess direct and indirect associations among KAP dimensions.
Totally, 386 participants were included, with a mean age of 36.17±8.34 years. The KAP scores were 23.23±5.88 (possible range: 0-30), 46.99±4.38 (possible range: 11-55), and 33.13±7.46 (possible range: 9-45), respectively. Multivariate logistic analysis revealed that age, employment in the anesthesiology department, ERAS training experience within the past year, and number of orthopedic surgeries in the past year were independently associated with good knowledge. Knowledge score, master's degree or above, and work experience were independently associated with a positive attitude. Knowledge score, attitude score, and employment in the anesthesiology department were independently associated with proactive practice. SEM further indicated positive associations between knowledge and attitude (β=0.29, P<0.001), between knowledge and practice (β=0.54, P<0.001), and between attitude and practice (β=0.30, P<0.001).
Orthopedic surgical healthcare professionals showed a positive attitude, while their knowledge and practice of perioperative anesthetic management remained at a moderate level. Educational and behavioral interventions are recommended for those with young age, shorter work experience, less surgical caseload, and lower educational levels.
术后加速康复（ERAS）已在临床中得到推广，骨科手术中基于ERAS理念的围手术期麻醉管理日益受到重视。本研究旨在评估骨科手术医护人员对围手术期麻醉管理的知识、态度和实践（KAP）情况。
这项横断面研究纳入了2023年1月至12月期间四家医院的骨科手术医护人员。自行设计了一份问卷来收集参与者的社会人口学信息和KAP得分。应用结构方程模型（SEM）来评估KAP维度之间的直接和间接关联。
共纳入386名参与者，平均年龄为36.17±8.34岁。KAP得分分别为23.23±5.88（可能范围：0 - 30）、46.99±4.38（可能范围：11 - 55）和33.13±7.46（可能范围：9 - 45）。多因素逻辑分析显示，年龄、麻醉科工作、过去一年的ERAS培训经历以及过去一年的骨科手术例数与良好的知识水平独立相关。知识得分、硕士及以上学位和工作经验与积极态度独立相关。知识得分、态度得分和麻醉科工作与积极实践独立相关。SEM进一步表明知识与态度之间存在正相关（β = 0.29，P < 0.001）、知识与实践之间存在正相关（β = 0.54，P < 0.001）以及态度与实践之间存在正相关（β = 0.30，P < 0.001）。
骨科手术医护人员态度积极，但其围手术期麻醉管理的知识和实践仍处于中等水平。建议对年龄较小、工作经验较短、手术病例数较少以及教育水平较低的人员进行教育和行为干预。
