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Background <p>Enteral nutrition (EN) is essential for ICU patients, but EN-associated diarrhea (ENAD) affects 48.6–89.0% of them, increasing complications and healthcare costs. ICU nurses’ knowledge, attitudes, and behavior in ENAD management significantly influence patient outcomes.</p> Objective <p>We evaluated ICU nurses’ knowledge, attitudes, and behavior in ENAD management and explored their interrelationships using a social cognitive and behavior change framework.</p> Methods <p>From June 2022 to March 2023, 371 ICU nurses from 11 Chinese ICUs completed a validated questionnaire. We analyzed data using descriptive statistics, regression, and structural equation modeling.</p> Results <p>Knowledge (mean = 63.57, SD = 15.04), attitudes (mean = 44.19, SD = 4.76), and behaviors (mean = 56.32, SD = 9.15) were moderate. Knowledge was positively correlated with attitudes (ρ = 0.42, <i>p</i> &lt; 0.001) and behaviors (ρ = 0.58, <i>p</i> &lt; 0.001), and attitudes strongly correlated with behaviors (ρ = 0.65, <i>p</i> &lt; 0.001). Attitudes mediated the knowledge-behavior relationship (β = 0.14, 95% CI [0.08, 0.21], <i>p</i> &lt; 0.001). Master’s Degree (β = 0.10, <i>p</i> = 0.049), training participation (β = 0.18, <i>p</i> = 0.002), and frequent training (4 times/year, β = 0.22, <i>p</i> &lt; 0.001) predicted better knowledge, while training and age (31–35 years) enhanced attitudes (<i>p</i> &lt; 0.05).</p> Conclusion <p>Knowledge gaps hinder ICU nurses’ ENAD management, with attitudes critically mediating the translation of knowledge into practice. Targeted interventions, such as quarterly workshops and scenario-based simulations, are recommended to enhance knowledge, foster positive attitudes, and standardize behaviors, thereby improving patient care quality.</p>

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Knowledge, attitudes, and behaviors of ICU nurses for enteral nutrition-related diarrhea management: a cross-sectional study

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  • 出版模式：

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  • 发表日期：

    2025年7月24日

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  • Weiwei Ni,
  • Shichao Zhu,
  • Huihuang Zou,
  • Xinwei Jiao,
  • Yulei Ma

摘要

Background

Enteral nutrition (EN) is essential for ICU patients, but EN-associated diarrhea (ENAD) affects 48.6–89.0% of them, increasing complications and healthcare costs. ICU nurses’ knowledge, attitudes, and behavior in ENAD management significantly influence patient outcomes.

Objective

We evaluated ICU nurses’ knowledge, attitudes, and behavior in ENAD management and explored their interrelationships using a social cognitive and behavior change framework.

Methods

From June 2022 to March 2023, 371 ICU nurses from 11 Chinese ICUs completed a validated questionnaire. We analyzed data using descriptive statistics, regression, and structural equation modeling.

Results

Knowledge (mean = 63.57, SD = 15.04), attitudes (mean = 44.19, SD = 4.76), and behaviors (mean = 56.32, SD = 9.15) were moderate. Knowledge was positively correlated with attitudes (ρ = 0.42, p < 0.001) and behaviors (ρ = 0.58, p < 0.001), and attitudes strongly correlated with behaviors (ρ = 0.65, p < 0.001). Attitudes mediated the knowledge-behavior relationship (β = 0.14, 95% CI [0.08, 0.21], p < 0.001). Master’s Degree (β = 0.10, p = 0.049), training participation (β = 0.18, p = 0.002), and frequent training (4 times/year, β = 0.22, p < 0.001) predicted better knowledge, while training and age (31–35 years) enhanced attitudes (p < 0.05).

Conclusion

Knowledge gaps hinder ICU nurses’ ENAD management, with attitudes critically mediating the translation of knowledge into practice. Targeted interventions, such as quarterly workshops and scenario-based simulations, are recommended to enhance knowledge, foster positive attitudes, and standardize behaviors, thereby improving patient care quality.