ICU后综合征知信行现状及影响因素研究

Analysis of current status and influencing factors of knowledge, attitude, and practice of post-intensive care syndrome

  • 摘要:
    调查重症监护室(ICU)医务人员对ICU后综合征(PICS)的知识、信念与行为(知信行)现状并探讨其影响因素。
    采用分层抽样横断面调查研究方法。2024年6—9月,以重庆、北京、陕西、江苏和甘肃5个地区综合性医院ICU医务人员为调查对象,以电子问卷形式发放《ICU后综合征知信行调查量表》。观察指标:(1)问卷调查结果。(2)ICU医务人员一般资料。(3)PICS知信行得分及各维度相关性。(4)PICS知信行的影响因素分析。正态分布的计量资料两组间比较采用独立样本t检验,多组间比较采用单因素方差分析,两两比较采用事后LSD检验。计数资料组间比较采用χ²检验。相关性分析采用Pearson相关性分析。单因素和多因素分析采用多元线性回归分析。
    (1)问卷调查结果。共发放并回收问卷410份,其中有效问卷408份,有效率为99.512%(408/410)。(2)ICU医务人员一般资料。408位ICU医务人员中,男79位,女329位;年龄<25岁、25~35岁、36~40岁、>40岁分别为8、248、132、20位;初级执业者、初级职称、中级职称、高级职称分别为10、130、228、40位;学历大专、本科、硕士及以上分别为34、347、27位;所在医院属二级医院、三级医院分别为25、383位;所在ICU类别是专科ICU、综合ICU分别为181、227位;ICU工作年限<5年、5~10年、>10年分别为41、207、160位。(3)PICS知信行得分及各维度相关性。408位ICU医务人员的PICS知信行总得分为(88.7±14.2)分,其中知识维度得分为(40.2±9.2)分、信念维度得分为(22.0±5.6)分、行为维度得分为(26.5±6.3)分。Pearson相关分析结果显示:ICU医务人员PICS知识维度与信念维度、行为维度均呈正相关(r=0.15,0.69,P<0.05);信念维度与行为维度呈正相关(r=0.23,P<0.05)。(4)PICS知信行的影响因素分析。多因素分析结果显示:年龄(25~35岁、36~40岁、>40岁),学历,所在医院等级是影响ICU医务人员PICS知信行的独立因素(t=2.23、1.97、2.84、0.15、2.04,P<0.05)。
    ICU医护人员的PICS知信行水平较好,实践能力仍需提高。年龄、学历、所在医院等级是影响ICU医务人员PICS知信行的独立因素。

     

    Abstract:
    Objective To investigate the current status of knowledge, attitude, and practice (KAP) of intensive care unit (ICU) medical staff for post-intensive care syndrome (PICS) and explore its influencing factors.
    Methods The cross-sectional investigation study with stratified sampling was conducted. From June to September 2024, ICU medical staff from general hospitals in 5 regions (Chongqing, Beijing, Shaanxi, Jiangsu, and Gansu) were selected as the research subjects. The KAP of PICS questionnaire was distributed in the form of an electronic questionnaire. Observation indicators: (1) results of the questionnaire survey; (2) general information of ICU medical staff; (3) KAP scores of PICS and the correlation among various dimensions; (4) analysis of influencing factors for KAP of PICS. Comparison of measurement data with normal distribution between groups was conducted using the independent samples t test. One-way analysis of variance (ANOVA) was applied for com-parison among multiple groups, and post-hoc LSD test was used for pairwise comparison. Comparison of count data between groups was conducted using the chi-square test. Pearson correlation analysis was adopted for correlation analysis. Multiple linear regression analysis was used for univariate and multivariate analyses.
    Results (1) Results of questionnaire survey. A total of 410 questionnaires were distributed and retrieved, among which 408 were valid, with an effective rate of 99.512%(408/410). (2) General information of ICU medical staff. Among the 408 ICU medical staff, there were 79 males and 329 females. Eight cases were under 25 years old, 248 cases were 25-35 years old, 132 cases were 36-40 years old, and 20 cases were over 40 years old. In terms of professional title, there were 10 junior nurses, 130 junior nurse practitioners, 228 intermediate nurse practitioners, and 40 senior nurse practitioners. About the educational background, 34 cases had a junior college degree, 347 cases had a bachelor's degree, and 27 cases had a master's degree or above. Regarding the hospital level, 25 nurses worked in secondary hospitals and 383 cases in tertiary hospitals. In terms of ICU type, 181 cases were from specialized ICU and 227 cases from general ICU. About working experience in ICU, 41 nurses had less than 5 years, 207 cases had 5-10 years, and 160 cases had more than 10 years. (3) KAP scores of PICS and the correlation among various dimensions. The total KAP score of PICS among the 408 ICU medical staff was 88.7±14.2, with 40.2±9.2 for the knowledge dimension, 22.0±5.6 for the attitude dimension, and 26.5±6.3 for the practice dimension. Pearson correlation analysis showed that the knowledge dimension of PICS among ICU medical staff was significantly positively correlated with both the attitude dimension and the practice dimension (r=0.15, 0.69, P<0.05); the attitude dimension was positively correlated with the practice dimension (r=0.23, P<0.05).(4) Analysis of influencing factors for KAP of PICS. Results of multivariate analysis showed that age (25-35 years old, 36-40 years old, over 40 years old), educational background and hospital level were independent influencing factors for the KAP of PICS among ICU medical staff (t=2.23, 1.97, 2.84, 0.15, 2.04, P<0.05).
    Conclusions The KAP of PICS among ICU medical staff is relatively good, while their practical ability still needs to be improved. Age, educational background, and hospital level are independent influencing factors for the KAP of PICS among ICU medical staff.

     

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