神经外科重症监护室医护人员镇痛镇静知信行现状及影响因素分析

Current status and influencing factors of knowledge-attitude-practice of analgesia and sedation among medical staff in neurosurgical intensive care unit

目的探讨神经外科重症监护室(NICU)医护人员镇痛镇静知信行现状并分析其影响因素。方法选取2022年4月20日至4月30日贵州省6所三级甲等综合医院169名NICU医护人员为研究对象,通过问卷方式对其镇痛镇静知信行现状进行调查,采用单因素方差分析和广义线性模型分析其影响因素。结果回收有效问卷169份。28名NICU医师知识、态度、行为及问卷总分的平均得分分别为(6.79±2.78)、(33.57±5.07)、(17.57±3.34)、(57.93±9.97)分;141名NICU护士知识、态度、行为及问卷总分的平均得分分别为(5.45±3.06)、(36.62±5.86)、(18.49±2.71)、(60.56±7.96)分。单因素方差分析结果显示,不同工作年限和职称的医师镇痛镇静知识得分比较,差异有统计学意义(P<0.05);不同年龄、工作年限、职称、受教育程度的护士镇痛镇静知识得分比较,差异有统计学意义(P<0.05)。不同知识得分的医师镇痛镇静态度得分比较,差异有统计学意义(P<0.05);不同年龄、职称、是否接受过培训的护士镇痛镇静态度得分比较,差异有统计学意义(P<0.05);不同工作年限、知识和态度得分的医师镇痛镇静行为得分比较,差异有统计学意义(P<0.05);不同年龄、职称、是否接受过培训、知识和态度得分的护士镇痛镇静行为得分比较,差异有统计学意义(P<0.05)。不同工作年限、受教育程度、知识、态度和行为得分的医师镇痛镇静总分比较,差异有统计学意义(P<0.05);不同工作年限、职称、知识、态度和行为得分的护士镇痛镇静总分比较,差异有统计学意义(P<0.05)。广义线性模型分析结果显示,工作年限、受教育程度、知识、态度和行为得分是医师镇痛镇静知信行水平的影响因素(β值分别为66.00、65.57、67.73、66.79、64.19,P<0.05)。工作年限、职称、知识、态度和行为得分是护士镇痛镇静知信行水平的影响因素(β值分别为64.35、63.07、63.79、64.09、62.62,P<0.05)。结论NICU医护人员镇痛镇静知信行现状总体不理想。应强化相关知识的培训,培养医护人员对知信行三者间的相互促进结合能力,以提高临床镇痛镇静质量,促进患者康复。

Objective To explore the current situation of knowledge-attitude-practice of analgesia and sedation among the medical staff in Neurosurgical Intensive Care Unit(NICU)and analyze its influence factors.Methods A total of 169 NICU medical staff from 6 hospitals which come from tertiary hospitals in Guizhou Province from April 20 to April 30,2022 were selected as the research objects.The current situation of knowledge-attitude-practice of analgesia and sedation were investigated by questionnaire.And the single factor ANOVA and generalized linear model were used to analyze the influence factors.Outcome A total of 169 valid questionnaires were collected.The average scores of 28 NICU doctors of knowledge,attitude,practice were(5.45±3.06),(36.62±5.86),(18.49±2.71)points,respectively and the total score of the questionnaire of 28 NICU doctors were(57.93±9.97)points.The average scores of 141 NICU nurses of knowledge,attitude,practice were(5.45±3.06),(36.62±5.86),(18.49±2.71)points,respectively and total score of the questionnaire of 141 NICU nurses were(60.56±7.96)points.The results of single factor ANOVA show that there were statistically significant differences in the knowledge scores of analgesia and sedation among physicians with different working years and professional titles(P<0.05).There were statistically significant differences in the knowledge scores of analgesia and sedation among nurses with different ages,working years,professional titles and education levels(P<0.05).There were statistically significant differences in the scores of physicians'attitudes toward analgesia and sedation with different knowledge scores(P<0.05).There were statistically significant differences in the scores of attitudes toward analgesia and sedation among nurses with different ages,professional titles and whether they had received training(P<0.05).There were statistically significant differences in the scores of analgesia and sedation behavior among physicians with different working years,knowledge and attitude scores(P<0.05).There were statistically significant differences in the scores of analgesia and sedation behavior of nurses with different ages,professional titles,whether they had received training,knowledge and attitude scores(P<0.05).There were statistically significant differences in the total scores of analgesia and sedation among physicians with different working years,education levels,knowledge,attitude and practice scores(P<0.05).There were statistically significant differences in the total scores of analgesia and sedation of nurses with different working years,professional titles,knowledge,attitude and practice scores(P<0.05).The results of generalized linear model analysis show that working years,education levels,knowledge,attitude and practice scores are the influence factors of knowledge-attitude-practice of analgesia and sedation in doctors(β=66.00,65.57,67.73,66.79,64.19,P<0.05).Working years,professional titles,knowledge,attitude and practice scores are the influence factors of knowledge-attitude-practice of analgesia and sedation in nurses(β=64.35,63.07,63.79,64.09,62.62,P<0.05).Conclusion To sum up,the current situation of knowledge-attitude-practice of analgesia and sedation among NICU medical staff is not ideal.In order to improve the effect of analgesia and sedation and to promote the rehabilitation of patients,it is necessary to strengthen the training of professional knowledge and cultivate the mutual promotion and combination ability of knowledge-attitude-practice among medical staff.