| Objectives:1.Preparation the KAP questionnaire of Prone Position in ICU nurses for ARDS patients;The reliability and validity of the questionnaire were tested.2.Use a prepared questionnaire,To investigate the status of the KAP questionnaire of Prone Position in ICU nurses for ARDS patients;And analyze relevant influencing factors.To provide a theoretical basis for promoting the safe,effective and standardized implementation of prone ventilation in ARDS patients.Methods:1.Initial entry pool build:Through theoretical analysis and expert interviews,referring to relevant literature at home and abroad,according to the theoretical model of knowledge,faith and action and the principle of scale compilation,build the initial entry pool.2.Letter from Delphi Experts:By selecting 26 experts experienced in the field,apply the Delphi method of expert correspondence for correspondence inquiries,by asking the experts how active they are,the degree of authority of correspondence experts,reliability analysis of the coordination degree of experts’ opinions by correspondence;According to the degree of concentration of expert opinions,combined with advice from experts on modification,addition and deletion,determine the pre-survey questionnaire.3.Reliability and validity analysis:Using convenience sampling,a total of 416 ICU nurses from 13 tertiary general hospitals in Anhui Province were selected as the research objects;Use SPSS23.0,the results were analyzed by discriminant analysis method;Cronbach’s a coefficient,retest reliability ’and split and half reliability were used to analyze the questionnaire reliability;Questionnaire validity was analyzed by content validity and exploratory factor analysis;Use AMOS23.0,confirmatory factor analysis was used to judge the standardized factor load of each item and the combination reliability,convergence validity and discriminant validity of the questionnaire.4.Analysis of relevant factors:Using SPSS 23.0,using independent sample T-test or ANOVA,the scores and total scores of ICU nurses with different characteristics on the KAP of prone ventilation in ARDS patients were compared;Pearson analysis and multiple linear regression analysis were used to explore the influencing factors of ICU nurses on the status of prone ventilation in ARDS patients.Results:1.Determination of the questionnaire item pool:Referring to relevant literature at home and abroad,through theoretical analysis and expert interviews,according to the principle of scale preparation,form a questionnaire item pool,it contains 66 items,including 25 knowledge dimensions,16 belief dimensions and 25 behavior dimensions.2.Letter from Delphi Experts:In this study,after two rounds of expert letter consultation,the recovery rate of the questionnaire was 100%,and the advice rate of the experts was 53.85%and 30.77%respectively;The expert authority coefficient（Cr）of the two rounds of letter consultation was 0.921;Kendall’s W of each dimension and total amount table was significant in the two rounds of correspondence inquiries,P<0.05;In the first round of expert letter consultation,31 items were revised,In the second round of expert letter consultation,10 items were revised;Finally,56 items were determined,including 17 knowledge dimensions,16 belief dimensions and 23 behavior dimensions.3.Content validity:（1）Item content validity（I-CVI）was 0.808-1.00,and the scale average content validity（S-CVI/Ave）was 0.975;（2）Structure validity:KMO test and Bartlett sphericity test,KMO=0.974,Bartlett sphericity test χ2=21283.683,P<0.001;Three common factors were extracted by exploratory factor analysis,and the cumulative variance contribution rate was 63.687%.4.Reliability analysis:（1）Cronbach’s a coefficient:The Cronbach’s α coefficient of each dimension is 0.961,0.960 and 0.975,respectively,The Cronbach’s a coefficient of the total amount table is 0.977,which is greater than 0.9;（2）Retest reliability:Pearson correlation coefficient was used to test,the retest reliability coefficients of each dimension were 0.996,0.996,0.994,respectively,and the retest reliability coefficients of the total amount table were 0.997,all of which were significant（P<0.01）;（3）Split-half reliability:the split-half reliability coefficients of each dimension are 0.954,0.941 and 0.942 respectively,and the split-half reliability coefficients of the total amount table are 0.825.5.Confirmatory factor analysis:The χ2/df was 2.554,less than 3,the mean square and square root of progressive residual（RMSEA）was 0.061,less than 0.08,and the root mean square residual（RMR）was 0.022,less than 0.1,all reaching the standard values;The standardized factor load of each item is between 0.701 and 0.914,which are all greater than 0.45;The combined reliability CR values of each dimension were 0.93,0.94 and 0.94,respectively,which were all greater than 0.7,indicating that the combined reliability of questionnaire was good;The AVE values of the mean variance extraction volume of each dimension were 0.56,0.60 and 0.61,respectively,which were all greater than 0.5,indicating that the questionnaire had good convergence validity;The AVE square root is greater than the correlation coefficient of the row and column,and the questionnaire has good discriminant validity.6.Cross-sectional survey results:（1）Each dimension and total score in the middle and below level are,knowledge dimension 83.65%,belief dimension 56.97%,behavior dimension 62.02%,total score 69.23%;（2）Single factor analysis of variance results in the ICU nurses’age,highest education,professional and technical titles and posts,ICU working fixed number of year,whether intensive specialist nurses,standardized operation flow and execution department presence of prone position ventilation conditions,presence of prone position ventilation department implementation checklist（checklist）and verification of ICU nurses in ARDS patients prone position The influencing factors of ventilatory knowledge,confidence and action level（P<0.01）;（3）Multiple linear regression analysis shows:Professional and technical title,critical care specialist nurse,prone ventilation standardization operation process and implementation of departments,prone ventilation implementation checklist and verification of departments were the main influencing factors of knowledge dimension score（P<0.05）,ΔR2=0.252;The main influencing factors of the score of belief dimension were ICU working years,professional and technical titles,critical care specialist nurse,prone ventilation standardized operation process and implementation of department,prone ventilation implementation checklist and verification of department（P<0.05）,ΔR2=0.367;ICU working years,professional and technical titles,whether there is a critical care specialist nurse,whether there is a prone ventilation standardized operation process and implementation of the department,whether there is a prone ventilation implementation checklist and verification of the department are the main influencing factors of behavioral dimension score（P<0.05）,ΔR2=0.329.Conclusion:1.This study completed the KAP questionnaire of Prone Position in ICU nurses for ARDS patients.2.The KAP questionnaire of Prone Position in ICU nurses for ARDS patients has good reliability and validity,and meets the basic requirements of the questionnaire.3.The KAP of Prone Position in ICU nurses for ARDS patients is at a moderate level.Among them,ICU working years,professional and technical titles,whether a critical care specialist nurse,whether a prone ventilation standardized operation process and implementation of the department,whether a prone ventilation implementation checklist and verification of the department are the main influencing factors for ICU nurses to the KAP level of prone ventilation in ARDS patients;According to the main influencing factors,training of theoretical skills and knowledge in a planned and focused way,and the formulation of standardized operation procedures and an implementation checklist can improve the ICU nurses’ KAP level of prone ventilation in ARDS patients,and promote the safe,effective and standardized implementation of prone ventilation in ARDS patients. |
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