Knowledge, attitudes, and behaviors of ICU nurses for enteral nutrition-related diarrhea management: a cross-sectional study
Abstract 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...
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BMC
2025-07-01
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| Series: | BMC Nursing |
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| Online Access: | https://doi.org/10.1186/s12912-025-03626-4 |
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| author | Weiwei Ni Shichao Zhu Huihuang Zou Xinwei Jiao Yulei Ma |
| author_facet | Weiwei Ni Shichao Zhu Huihuang Zou Xinwei Jiao Yulei Ma |
| author_sort | Weiwei Ni |
| collection | DOAJ |
| description | Abstract 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. |
| format | Article |
| id | doaj-art-8ac9e5d3aa3b4efc9a055e5fdad7c7ba |
| institution | DOAJ |
| issn | 1472-6955 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nursing |
| spelling | doaj-art-8ac9e5d3aa3b4efc9a055e5fdad7c7ba2025-08-20T03:04:23ZengBMCBMC Nursing1472-69552025-07-012411910.1186/s12912-025-03626-4Knowledge, attitudes, and behaviors of ICU nurses for enteral nutrition-related diarrhea management: a cross-sectional studyWeiwei Ni0Shichao Zhu1Huihuang Zou2Xinwei Jiao3Yulei Ma4Nursing Department, Weifang Key Laboratory for Clinical Nursing Research, Affiliated Hospital of Shandong Second Medical UniversityIntensive Care Unit, Intensive Care Key Laboratory, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou UniversityIntensive Care Unit, Intensive Care Key Laboratory, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou UniversityCollege of Clinical Medicine, Affiliated Hospital of Shandong Second Medical UniversityNursing Department, Weifang Key Laboratory for Clinical Nursing Research, Affiliated Hospital of Shandong Second Medical UniversityAbstract 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.https://doi.org/10.1186/s12912-025-03626-4Enteral nutritionIntensive care unitNursesDiarrheaKnowledgeAttitudes |
| spellingShingle | Weiwei Ni Shichao Zhu Huihuang Zou Xinwei Jiao Yulei Ma Knowledge, attitudes, and behaviors of ICU nurses for enteral nutrition-related diarrhea management: a cross-sectional study BMC Nursing Enteral nutrition Intensive care unit Nurses Diarrhea Knowledge Attitudes |
| title | Knowledge, attitudes, and behaviors of ICU nurses for enteral nutrition-related diarrhea management: a cross-sectional study |
| title_full | Knowledge, attitudes, and behaviors of ICU nurses for enteral nutrition-related diarrhea management: a cross-sectional study |
| title_fullStr | Knowledge, attitudes, and behaviors of ICU nurses for enteral nutrition-related diarrhea management: a cross-sectional study |
| title_full_unstemmed | Knowledge, attitudes, and behaviors of ICU nurses for enteral nutrition-related diarrhea management: a cross-sectional study |
| title_short | Knowledge, attitudes, and behaviors of ICU nurses for enteral nutrition-related diarrhea management: a cross-sectional study |
| title_sort | knowledge attitudes and behaviors of icu nurses for enteral nutrition related diarrhea management a cross sectional study |
| topic | Enteral nutrition Intensive care unit Nurses Diarrhea Knowledge Attitudes |
| url | https://doi.org/10.1186/s12912-025-03626-4 |
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