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

Abstract

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. Key words: Hospital, orthopedics; Nutrition; Knowledge, attitude and practice; Structural equation model; Mediator effect