Development And Application Of The ICU Nurses’ Knowledge-Attitude-Practice Questionnaire For Acute Skin Failure

ObjectiveTo develop the current situation of ICU nurses’ knowledge,attitude and practice about acute skin failure,and to analyze the factors influencing the current situation of ICU nurses’ knowledge,attitude and practice about acute skin failure,in order to provide reference for the development of a standardized training and management program.Methods1.Questionnaire development: Applying the knowledge,attitude and practice theory,we used literature research and semi-structured interview method to construct a pool of entries of ICU nurses’ knowledge and belief line questionnaire on acute skin failure,and the pool was screened and modified by Delphi expert correspondence and small sample pre-survey.A total of 277 ICU nurses were selected to conduct the questionnaire,and the extreme value method,homogeneity test and exploratory factor analysis were applied to screen and analyze the items to form the preliminary questionnaire.276 ICU nurses were selected for the survey,and the internal consistency,fold-and-half reliability,retest reliability,content validity and structural validity of the questionnaire were used to test the reliability of the questionnaire and form the official questionnaire.2.Status quo survey: Convenience sampling method was used to select 410 ICU nurses from five tertiary level A hospitals in Qingdao who met the inclusion and exclusion criteria.The general information questionnaire and the self-prepared "ICU nurses’ knowledge-attitude-practice about acute skin failure questionnaire" were used to investigate and collect data,and SPSS22.0 software was used for statistical analysis.Two independent samples t-test and one-way ANOVA were used to compare different demographic characteristics,training experience and other basic information,and multiple linear stepwise regression was used to analyze the influencing factors.Results1.Questionnaire development and reliability testing(1)A pool of 47 questionnaire entries was formed through literature research and semi-structured interview method.Twenty experts were selected for consultation,and the positive coefficients of experts were 100% in both rounds,the percentages of experts giving opinions were 50% and 10%,the authority coefficients of experts were 0.83 and0.84,and the degrees of coordination of experts were 0.200 and 0.301,respectively(P<0.001).Three entries were deleted,three entries were added,six entries were modified,and the statements were adjusted after expert correspondence,resulting in a questionnaire containing three dimensions and 47 entries.A small sample of 30 ICU nurses was selected for the pre-survey,and no modifications were made to the questionnaire.Seven entries were deleted by item analysis and exploratory factor analysis to form the preliminary questionnaire.(2)The preliminary questionnaire was tested for reliability: the overall Cronbach’s alpha coefficient of the questionnaire was 0.965,the fold-half reliability was 0.821,and the retest reliability was 0.939.The content validity of the questionnaire,I-CVI:0833-1.000,S-CVI/UA: 0.920,and S-CVI/Ave: 0.933.The validated factor analysis fit was generally satisfactory with χ~2/df=3.688,RMSEA=0.099,GFI=1.000,CFI=0.870,IFI=0.870,TLI=0.857.The final formal questionnaire of ICU nurses’ knowledge and beliefs about acute skin failure was formed with 3 dimensions,containing knowledge(14entries),attitude(12 entries),and practice(14 entries)with a total of 40 entries.2.Results of the current status survey(1)The mean score of the knowledge section of the "ICU nurses’ knowledge-attitude-practice about acute skin failure questionnaire" was(47.68 ± 12.26),with a score rate of 68.11%;the mean score of the attitude section was(51.39 ± 7.27),with a score rate of 85.65%;the mean score of the practice section was(52.31 The mean score of the practice section(52.31 ± 11.97)was 74.43%.(2)The main factors affecting the scores of ICU nurses’ knowledge of acute skin failure were: years of experience in wound specialty care,skin care training level,and highest education level(P < 0.05);the main factors affecting the scores of ICU nurses’ attitude toward acute skin failure were: years of experience in wound specialty care,skin care training level,and highest education level(P < 0.05);the main factors affecting the scores of ICU nurses’ acute skin failure The main factors affecting the behavioral scores of ICU nurses in acute skin failure were: years of experience in wound specialty care,skin care training level(P < 0.001).(3)Pearson correlation analysis showed a positive correlation between ICU nurses’ knowledge,attitude,and behavior toward acute skin failure(r = 0.494,0.532,0.688,P <0.001).Conclusions1.The reliability of the "ICU nurses’ knowledge-attitude-practice of acute skin failure questionnaire" developed in this study is good,and it can be used as a scientific tool to evaluate the level of ICU nurses’ knowledge and trustworthiness of acute skin failure.2.The knowledge of ICU nurses about acute skin failure needs to be further improved,the attitude of learning and practicing about acute skin failure is positive,and the practice of nursing measures related to acute skin failure needs to be strengthened.The number of years of wound specialty care,skin care training level,and the highest education level are the influential factors affecting ICU nurses’ knowledge and trust behavior scores on acute skin failure.