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基于结构方程模型的骨科护士营养知信行研究

Research on nutritional knowledge,attitude,and practice of clinical orthopedics nurses based on Structural Equation Model

摘要:

目的 探讨骨科护士营养知识、态度、行为现状及其影响因素,分析知信行3者之间的相互关系,为有效提高骨科护士营养护理水平提供参考依据.方法 采用重点调查法,2016年3—5月运用自行设计的骨科护士营养知信行问卷对武汉市6所三级甲等综合医院骨科护士进行调查.使用SPSS 23.0软件对营养知信行现状及影响因素进行单因素分析和多元线性回归分析,运用结构方程模型探讨3者之间的路径关系,特别使用AMOS 23.0中的Bootstrap技术检验3者之间的直接效应和间接效应.结果 逐步多元线性回归结果表明:影响骨科护士营养知识得分的关键因素为业务学习频率、是否优秀护士、目前人事状况、职称(R2=0.798,P<0.01);影响营养态度得分的关键因素为业务学习频率、是否责任护士、最高学历、月收入(R2=0.118,P<0.01);影响营养行为得分的关键因素为业务学习频率、是否优秀护士、是否责任护士(R2=0.213,P<0.01).营养知识对营养行为的直接效应为0.240,间接效应为0.173,总效应为0.414,营养态度具有部分中介效应.营养态度对营养行为的直接效应为0.702,无间接效应.结论 骨科护士营养知识不足,营养态度有待加强,营养行为有待提高,提高营养知识水平是提升骨科护士营养知信行水平的关键.依据影响营养知识的关键因素制定方案,可以有效提高营养知识水平,进而强化营养态度和营养行为水平,提高骨科护士营养护理整体水平.

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abstracts:

Objective To explore the status quo of knowledge,attitude,and practice(KAP)of orthopedic nurses and its influencing factors,and to analyze the relationship among knowledge,attitude and behavior,so as to provide reference for effectively improving the nutritional nursing level of orthopedic nurses.Methods A self-designed questionnaire of nutritional KAP was used to investigate orthopedics nurses from the 6 Class Ⅲ Grade A hospitals in Wuhan from March to May 2016.SPSS 23.0 was used to analyze the status of nutritional KAP and their respective influencing factors.A Structural Equation Model (SEM) was constructed to explore causal relationship among nutritional KAP by Bootstrap in AMOS 23.0,especially to verify the direct and indirect effects among KAP.Results The key factors influencing nutritional knowledge were professional learning frequency,excellent nurse,personnel status,and professional title (R2=0.798,P< 0.001).The key factors influencing nutritional attitude were professional learning frequency,primary nurse,highest education,and monthly income (R2=0.118,P< 0.001).The key factors influencing nutritional practice were professional learning frequency,excellent nurse,and primary nurse (R2=0.213,P<0.001).The direct effect of nutritional knowledge toward nutritional practice was 0.240,indirect effect was 0.173,and total effect was 0.414,which meant that nutritional attitude had partial mediation effect.The direct effect of nutritional attitude toward nutritional practice was 0.702,and the indirect effect was 0.Conclusions Nutrition knowledge of orthopedic nurses is insufficient,nutritional attitude needs to be strengthened and nutritional behavior needs to be improved.Improving nutritional knowledge level is the key to improving nutritional KAP level of orthopedic nurses.According to the key factors affecting nutritional knowledge,formulating programs can effectively improve the level of nutritional knowledge,and then strengthen the level of nutritional attitude and behavior,and improve the overall level of nutritional nursing of orthopedic nurses.

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