| Objective:(1)To develop the questionnaire on nurses' knowledge,attitude and practice of bundles of care after tracheotomy,and make sure that the questionnaire has good reliability and validity.(2)To understand the current situation of five tertiary general hospitals in Taiyuan about nurses' knowledge,attitude and practice of bundles of care after tracheotomy via questionnaire.To compare the differences of different demography and put forward reasonable suggestions according to the existing problems.Methods:(1)Based on the Knowledge-Attitude-Practice Theory,a questionnaire of “nurses' knowledge,attitude and practice of bundles of care after tracheotomy” was developed through literature review and Delphi experts consultation.101 nurses from a tertiary general hospital in Taiyuan were selected by convenient sampling method for pre-investigation in May 2019.SPSS 23.0 and Amos 24.0 were used to analyze the items,and tested the reliability and validity,which purpose was to modify the items and establish the final questionnaire.(2)In August 2019,a cross-sectional survey was conducted among 542 nurses from neurosurgery,neurology,ENT,respiratory,ICU and emergency departments in five tertiary general hospitals in Taiyuan.SPSS 23.0 was used to analyze single factorvariance,multiple linear regression and person correlation analysis to explore the influencing factors of nurses' knowledge,attitude and behavior and the relationship among them.Results:(1)Results of Delphi experts consultation: The positive degree of the two rounds of experts consultation were 84% and 86%;the authority coefficient were 0.865 and 0.870;the Kendall's coordination coefficient were 0.115 and 0.135(P<0.001);and the coefficient of variation fluctuated between 0.13 to 0.29 for round 1and 0.09 to 0.20 for round 2.(2)Results of reliability and validity assessment: Questionnaire of nurses' knowledge,attitude and practice of bundles of care after tracheotomy was formed,which including three dimensions and 28 items.Six common factors were extracted by exploratory factor analysis,and the cumulative variance contribution rate was 67.237%.The ratio of chi square to freedom in confirmatory factor analysis was 2.927,RMSEA was 0.097,CFI was 0.745.The overall content validity of the questionnaire was 0.93,and the content validity of each item is 0.78~1.00.The overall Cronbach's ? coefficient of the questionnaire was 0.801,the half reliability was 0.683,and the retest reliability was 0.933.(3)Results of questionnaire survey: Only 7.38% of nurses knew much about bundles of care,25.46% knew nothing about it,35.98% and 31.18% of nurses had heard of or generally understood bundles of care.There were significant differences in the understanding of bundles of care among nurses of different ages,highest degree,departments,working years,professional titles and positions(P<0.05).The total score of nurses' knowledge,belief and practice of bundles of care after tracheotomy was(94.17±11.37),and the full score of 118 was 0.55%.The score of nurses' knowledge was(39.72±6.96),and the full score of 54 was 2.21%.The score of nurses' attitude was(42.97±6.49),and the full score of 50 was 28.41%.The score of nurses' practice was(11.48±1.73),and the full score of 14 was 11.99%.There were significant differences in the total scores of knowledge,belief and practice of bundles of care after tracheotomy among nurses in different departments and positions(P<0.05).There were significant differences in nurses' knowledge scores among different highest degree,departments and positions(P<0.05).There were significant differences in attitude scores of nurses in different departments(P<0.05),and in behavior scores of nurses in different departments and positions(P<0.05).In the multiple linear regression analysis,the position of nurse was included in the regression equation of total score(F=6.225,P<0.05),the department and position of nurse were included in the regression equation of knowledge score(F=4.949,P<0.05),and the position of nurse was included in the regression equation of practice score(F=8.204,P<0.05).There was a positive correlation between knowledge and attitude,attitude and practice,knowledge and practice of nurses in bundles of care,and the correlation coefficients were 0.256(P<0.01),0.293(P<0.01)and 0.245(P<0.01).Conclusion:(1)The questionnaire on nurses' knowledge,attitude and practice of bundles of care after tracheotomy is scientific and reasonable with good reliability and validity.It can be used as an evaluation tool to evaluate nurses' knowledge,attitude and practice level after tracheotomy.(2)At the present stage,nurses in Taiyuan have a wide range of ways to understand the bundles of care after tracheotomy,but the awareness rate is low.Nurses' knowledge level is good,attitude is positive,practice compliance is poor,and the rate of reaching the standard of bundles of care is low.Nurses' knowledge,attitude and practice of bundles of care after tracheotomy showed a positive correlation,but the correlation between knowledge and practice was the weakest,and there was a phenomenon of disunity between knowledge and practice. |
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