Development and validation of the incontinence associated dermatitis knowledge, attitude and practice questionnaire

Pattern analysis of hospital nurses' knowledge, attitudes, and practices regarding incontinence-associated dermatitis

PURPOSE

To analyze hospital nurses' knowledge, attitudes, and practices regarding incontinence-associated dermatitis (KAP-IAD).

METHODS

This study utilized responses from hospital nurses to the Knowledge, Attitudes, and Practices of Incontinence-Associated Dermatitis Questionnaire (KAP-IAD-Q). Three clustering methods, Hierarchical Clustering on Principal Components (HCPC), K-means, and Partitioning Around Medoids (PAM), were applied to analyze the correlations of KAP-IAD. A classification method was used to explain the underlying behavioral patterns behind these correlations.

RESULTS

Two clusters were found to be most appropriate. Decision attributes (D) were generated for the KAP-IAD data using the three clustering methods: HCPC, K-means, and PAM. Three datasets with categorical labels were generated, and predictive models and decision rules were established for each dataset using the Rough Set (RS) method. The PAM method demonstrated the highest accuracy among the three datasets. After five rounds of stochastic modeling, 57 decision rules were generated. Additionally, patterns or rules with a support threshold of 50 or more, as discussed by domain experts, were considered the primary behaviors or rules.

CONCLUSIONS

Our study suggests clear decision rules for KAP-IAD nursing practice, which have been absent in previous research. The key variables and rules identified can serve as a guide for KAP-IAD nursing practice, as well as for recognizing the etiology, risk factors, and key influences of dermatitis associated with KAP-IAD in nursing practice. This study provides an important management approach for the prevention and treatment of incontinence-associated dermatitis.

Turkish nurses' knowledge, attitudes and practices in the management of incontinence associated dermatitis: A descriptive and cross-sectional study

OBJECTIVE

This study aimed to determine nurses' current knowledge, attitudes, and practices in adult intensive care units and palliative care clinics regarding incontinence-associated dermatitis (IAD).

MATERIALS AND METHODS

This descriptive cross-sectional study was conducted with 355 nurses in adult intensive care and palliative services at two hospitals. Data were collected between 5.03.2022 and 15.06.2022 using the" Nurse Demographic Form" and the "Knowledge, Attitude and Practice of Nurses in Managing Incontinence-Associated Dermatitis Questionnaire".

RESULTS

The nurses' mean scores for "Knowledge of IAD Etiology and Diagnosis" were 19.11 (SD 3.29), mean scores for "Knowledge of IAD Risk Factors" were 23.82 (SD 4.27), mean scores for "Attitude Toward IAD Prevention" were 10.1 (SD 2.49), and mean scores for "Practices for IAD Prevention" were 23.71 (SD 3.97). It was found that nurses who used a risk assessment tool to diagnose IAD (p = 0.001), had a procedure or protocol (p = 0.001), and received training on IAD (p < 0.001) had significantly higher "Attitude Towards Prevention of IAD" scores. There was a positive correlation between the number of patients with IAD cared for by the nurses participating in the study and the scores of ''Practices to Prevent IAD'' and ''Knowledge of IAD Risk Factors'', ''Knowledge of IAD Etiology and Diagnosis'' and ''Attitude Towards Preventing IAD'' (p < 0.001).

CONCLUSION

This study found that intensive care and palliative care nurses' knowledge, attitudes, and practices regarding IAD were insufficient. Considering that IAD is encountered more frequently in these units, it is essential to provide continuous and practical training to nurses about IAD, use risk assessment tools to prevent and treat IAD, determine protocols, establish clinical guidelines, and implement and standardize them.

Development and validation of a questionnaire to assess knowledge, attitudes, and practices regarding the addictive and detrimental effects of novel psychoactive substances among university students

BACKGROUND

The misuse of novel psychoactive substances (NPSs) is highly prevalent among university students, leading to significant public health and social safety concerns. To improve our drug education efforts related to NPSs, we developed a knowledge, attitudes and practices (KAP)-based questionnaire for university students.

METHODS

We developed a KAP-based questionnaire after performing a comprehensive literature review and consulting experts. The questionnaire was then administered to randomly selected college students in Fujian Province. The items were evaluated using the critical ratio, correlation analysis, and Cronbach's α coefficient. Furthermore, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to assess the construct validity of the questionnaire. Subsequently, the convergent validity, discriminant validity, and reliability of the questionnaire were evaluated.

RESULTS

A total of 587 college students were enrolled, including 280 (47.7%) males and 550 (93.7%) students who had received anti-drug education. Item analysis revealed that 3 items did not meet the t value (t < 4) or correlation coefficient thresholds (r < 3) or that Cronbach's α coefficient increased after removing these items. After conducting EFA, 7 items with multiple loading factors above 0.4 or loading factors below 0.4 were removed, and 5 subdimensions were observed. CFA indicated that the questionnaire model exhibited a strong fit and acceptable convergent validity. However, there were some limitations in discriminant validity. The Cronbach's α coefficients for the overall questionnaire and each dimension exceeded 0.9, indicating excellent internal consistency. Additionally, the questionnaire exhibited excellent split-half reliability (Cronbach's α coefficients > 0.8, Spearman-Brown value = 0.982).

CONCLUSION

The questionnaire developed herein exhibited high levels of reliability and validity, making it a suitable KAP-based tool for evaluating NPS-related addiction and harm among university students. These findings can guide the development of drug education and behavioral interventions.

Knowledge, attitudes, practices, and barriers of oncology nurses in promoting physical activity in cancer survivors: a cross-sectional survey in China

PURPOSE

To explore the knowledge, attitudes, and practices of Chinese nurses in promoting physical activity among cancer survivors and the relationships between these attributes and to identify the factors hindering nurses' clinical practice.

METHODS

Nurses from oncology-related departments of 10 public tertiary hospitals in Shandong Province completed self-administered questionnaires that included information about demographics; knowledge, attitudes, and practices of physical activity promotion; and barriers to clinical practice. The STROBE statement for observational studies was applied.

RESULTS

A total of 502 valid questionnaires were obtained. The average standardized scores of knowledges, attitudes, and practice were 75.33%, 82.36%, and 62.60%, respectively. Oncology specialist nurses and nurses who had received relevant training had higher levels of knowledge, nurses from general hospitals reported higher levels of practice, and nurses who had learned the relevant guidelines were better in terms of knowledge, attitude, and level of practice. Attitude had a statistically significant mediating effect between knowledge and practice. Lack of time, lack of multidisciplinary clinical teams, and lack of clear guidelines were the most frequently reported barriers to practice.

CONCLUSION

In China, nurses have a moderate level of knowledge and practice in promoting physical activity among cancer survivors, but a positive attitude. Numerous barrier factors present challenges in nurses' clinical practice. Attitude plays a partial mediating role between knowledge and practice.

Delphi Technique on Nursing Competence Studies: A Scoping Review

This scoping review was conducted under the Joanna Briggs Institute (JBI) framework. It included primary studies published until 30 April 2023, obtained through a systematic search across PubMed, Web of Science, CINAHL, and MEDLINE databases. The review focused on primary studies that used the Delphi technique in nursing competence research, especially those related to defining core competency frameworks and developing instruments to assess professional competence. The goal was to analyze the different methodological approaches used by authors, synthesize them, and propose recommendations to enhance methodological rigor, reliability, and validity in the application of the Delphi technique. For this purpose, the following review question was established: "What is the available evidence on the use of the Delphi technique in the study of professional competence in nursing?". The extracted textual elements underwent a content analysis, resulting in dimensions established through an inductive approach. Twenty studies were included, yielding insights into diverse methodological options for conducting Delphi studies, organised around a set of dimensions: (1) preparatory procedures; (2) procedures for accessing and selecting experts; (3) acquisition of expert input; (4) data analysis and consensus; and (5) ethical and legal procedures and guarantees. The study's limitations include the inability to include certain studies due to a lack of response to requests for clarification from corresponding authors. Additionally, the primary studies' methodological quality was not assessed, which is another relevant aspect. The study's results offer valuable insights for researchers intending to utilise the Delphi technique within the context of the research referenced in the included studies. This information encompasses important methodological choices, highlighting their potential benefits and associated risks. The review was prospectively registered on the Open Science Framework (Registration No: osf.io/kp2vw).

Evaluating Intensive Care Nurses' Knowledge of Incontinence-Associated Dermatitis: A Multicenter Cross-sectional Study

OBJECTIVE

To determine the knowledge levels of nurses working in the ICU about incontinence-associated dermatitis (IAD).

METHODS

A descriptive cross-sectional study was conducted in adult ICUs at two private and three public hospitals in a province in Turkey. The study included 296 nurses who agreed to participate in the research. Researchers used the "Nurse Identification Form" and the "IAD Knowledge Test" to collect data on nurses' IAD knowledge. Data analysis included the use of percentage distribution and the Mann-Whitney U, Kruskal-Wallis, and Spearman correlation tests.

RESULTS

The mean age of the nurses was 26.55 ± 3.89 years (range, 20-47 years), and the duration of working in the ICU was 2.71 ± 2.55 years (range, 1-22 years). Of the nurses, 183 (61.8%) worked in general ICUs. Of those, 69 (23.3%) received IAD training. Nurses achieved a 49.8% correct response rate on the IAD knowledge test. Nurses working in tertiary and general ICUs demonstrated higher IAD knowledge levels (Ps = .003 and .047, respectively). There were no relationships between age, career length, institution, ICU type, and IAD knowledge level.

CONCLUSIONS

Nurses' knowledge level of IAD was low in intensive care. To remedy this, IAD should be added to intensive care nursing certificate programs as content, and the use of IAD risk assessment and diagnosis scales in ICUs should be expanded.

Development and assessment of a knowledge, attitude, and practice (KAP) questionnaire for genetic counselees with preimplantation genetic testing (PGT) indications

Background

Preimplantation genetic testing (PGT) can reduce the risk of familial genetic diseases, chromosome abnormalities, and recurrent abortions. It is unclear whether genetic counselees with PGT indications understand and accept the implications of PGT. A well-developed and validated tool is needed to evaluate the knowledge, attitude, and practice (KAP) levels of genetic counselees with PGT indications. The purpose of this study was to develop and validate a PGT KAP questionnaire (PGT-KAP-Q) for genetic counselees with PGT indications.

Methods

First, we established an item pool based on a literature review and qualitative interviews. Second, we developed the PGT-KAP-Q using the Delphi method. Third, we evaluated the quality of the questionnaire using item analysis and psychometric evaluation. The item analysis included extreme value comparison, application of the correlation and Cronbach's alpha (α) coefficient methods, and factor analysis. We also evaluated the content and structural validity of the questionnaire, as well as the internal consistency, test-retest reliability, and split-half reliability.

Findings

After the literature review and interviews, and based on three rounds of expert consultations, we formed a 43-item questionnaire. In the validity analysis, the item's content validity index (I-CVI) and the average scale level CVI (S-CVI/Ave) values (>0.78 and >0.95, respectively) confirmed the questionnaire's content validity. Exploratory factor analysis showed that all 43 items had strong factor loadings (>0.4), and the three factors of the PGT-KAP-Q explained 51.97 % of the total variance. The Cronbach's α coefficient for the questionnaire was 0.95 (p < 0.05), the split-half reliability was 0.76 (p < 0.05) and the test-retest reliability coefficient was 0.78 (p < 0.05).

Interpretation

The 43-item PGT-KAP-Q for genetic counselees with PGT indications is reliable and valid. It contains a moderate number of items, is easy for patients to understand and accept, and can be used for clinical research and applications.

Knowledge, attitude, and practice of psoriasis patients toward their diseases: a web-based, cross-sectional study

Objective

To investigate the knowledge, attitude, and practice (KAP) of psoriasis patients toward the disease.

Methods

A web-based cross-sectional study was conducted among psoriasis patients who were diagnosed at the outpatient of Shaanxi Provincial People's Hospital in March 2023. A self-designed questionnaire was administered for data collection and KAP assessment.

Results

A total of 526 valid questionnaires were included, including 257 males (48.86%) psoriasis patients. Their mean KAP scores were 8.09 ± 3.60 (possible range: 0-12), 31.94 ± 4.61 (possible range: 10-50), and 51.92 ± 8.83 (possible range: 15-75), respectively. Pearson's correlation analysis showed a positive correlation between knowledge and attitude (r = 0.186, p < 0.001), a positive correlation between knowledge and practice (r = 0.313, p < 0.001), and a negative correlation between attitude and practice (r = -0.181, p < 0.001). Moreover, structural equation model showed that medication (β = 2.74, 95% CI: 2.17, 3.32, p < 0.001) has significantly positive effect on knowledge. Education (β = 0.56, 95% CI: 0.31, 0.81, p < 0.001) and duration of psoriasis (β = 1.01, 95% CI: 0.54, 1.49, p < 0.001) have significantly positive effect on attitude. Knowledge (β = 1.03, 95% CI: 0.80, 1.26, p < 0.001) and medication (β = 4.59, 95% CI: 2.78, 6.40, p < 0.001) has significantly positive effect on practice, while attitude (β = -0.41, 95% CI: -0.57, -0.26, p < 0.001) and duration of psoriasis (β = -2.53, 95% CI: -3.49, -1.57, p < 0.001) exhibit significantly negative effect on practice.

Conclusion

Psoriasis patients have good knowledge, positive attitude, and proactive practice toward the disease. Education, medication, duration of psoriasis might have effect on their KAP.

Incontinence-Associated Dermatitis: Prevalence in Intensive Care Units and Knowledge, Attitudes, and Practices of Nurses

BACKGROUND

Incontinence-associated dermatitis (IAD) is a major concern among hospitals, especially in intensive care units (ICUs).

PURPOSE

To describe ICU nurses' knowledge, attitudes, and practices of IAD and to examine the relationships with IAD prevalence in the ICU setting.

METHODS

A descriptive correlational design was used including the Knowledge, Attitudes and Practices of Incontinence-Associated Dermatitis Questionnaire and 1-month IAD prevalence data.

RESULTS

The prevalence of IAD in ICUs was 6.89%. A positive correlation was found between IAD prevalence and nurses' IAD knowledge and attitudes. Nurses working in the ICU for more than 7 years, caring for patients at high risk for or having IAD, and thinking IAD-related nursing practices were sufficient had significantly higher IAD knowledge, attitudes, and practices.

CONCLUSIONS

Findings indicate that ICU nurses learned about IAD through clinical experience and have inadequate training on IAD. A standardized evidence-based care protocol for IAD should be developed.

Clinician Knowledge of Incontinence-Associated Dermatitis: A Multisite Survey of Healthcare Professionals in Acute and Subacute Settings

PURPOSE

This study examined clinicians' knowledge of incontinence-associated dermatitis (IAD) using the Barakat-Johnson Incontinence-Associated Dermatitis Knowledge Tool (Know-IAD).

DESIGN

A cross-sectional multicenter survey.

SUBJECTS AND SETTING

The setting was 6 hospitals across 5 health districts in New South Wales, Australia. The participants were nurses (registered nurses and enrolled nurses), physicians, allied health (occupational therapists, dietitians, and physiotherapists), and students (nursing and allied health).

METHODS

Data about IAD knowledge were collected from November 2019 to January 2020. The Know-IAD, an 18-item validated instrument that measures knowledge of IAD in 3 domains (etiology and risk, classification and diagnosis, and prevention and management), was administered to a cross section of eligible clinicians. The participants anonymously completed hard copy surveys. Descriptive and exploratory analyses were conducted to quantify clinicians' knowledge about the etiology and risk, classification and diagnosis, and prevention and management of IAD. A mean knowledge score of 70% was considered to be satisfactory.

RESULTS

Four hundred twelve respondents completed the survey. One hundred twenty nine respondents (31.3%) achieved 70% correct responses and greater for the entire set of items. For the etiology and risk domain, 348 respondents (84.5%) obtained a score of 70% correct responses and greater, 67 respondents (16.3%) achieved 70% correct responses and greater for the classification and diagnosis domain, and 84 respondents (20.4%) achieved 70% correct responses and greater for the prevention and management domain.

CONCLUSION

Clinicians tend to have low knowledge and recognition of IAD, particularly in the areas of classification and diagnosis along with prevention and management. They tend to have higher knowledge of how IAD is caused and the risk factors. This study has identified knowledge gaps for further education that can improve assessment, prevention, and management of IAD.

Establishment of incontinence-associated dermatitis rat models and assessment of the therapeutic effects of zinc oxide, painless skin protective film and silicone dressing

The aim of the present study was to construct incontinence-associated dermatitis (IAD) rat models and observe the therapeutic effects of zinc oxide, painless skin protective film and silicone dressing on IAD. A total of 54 rats were randomly divided into nine groups: i) Control group; ii) trypsin model group; iii) model + zinc oxide group; iv) model + painless skin protective film group; v) model + silicon dressing group; vi) synthetic urine combined with trypsin model group (joint model group); vii) joint model + zinc oxide group; viii) joint model + painless skin protective film group; and ix) joint model + silicone dressing group. A total of 4 days after applying the zinc oxide, protective film or silicon dressing intervention, IAD scores and pH values in skin tissues were examined. Skin tissues and blood samples were collected. Hematoxylin and eosin staining, immunohistochemical staining of major histocompatibility complex class II (MHC-II) and western blot analysis of MHC-II, NF-κB/p65, phosphorylated (p)-NF-κB/p65, STAT1 and p-STAT1 were carried out in skin tissue. Serum IFN-γ, IL-1β, IL-2 and TNF-α levels were determined using ELISA. The results demonstrated that IAD scores and pH values were both higher in the model groups than the control, which were significantly ameliorated by silicone dressing. The skin tissue structure of IAD rats both in trypsin model group and joint model group was severely damaged, the wounds were not covered by epidermis, and numerous inflammatory cell infiltrations were observed. After treatment, dermatitis was improved. Skin tissue from the trypsin and joint IAD models had higher MHC-II, NF-κB p65, p-NF-κB p65, STAT1 and p-STAT1 expression than controls, which was decreased by protective film and silicon dressing. Zinc oxide reduced NF-κB p65, p-NF-κB p65, STAT1 and p-STAT1 expression. However, no significant differences were observed in NF-κB/p-NF-κB ratio and STAT1/p-STAT1 ratio among groups. Furthermore, serum IFN-γ, IL-1β, IL-2 and TNF-α levels were significantly elevated in trypsin and joint IAD rats. The upregulation of these cytokines was significantly inhibited after all three treatments. Among the three treatment methods, silicone dressing had the best therapeutic effect. Thus, these findings revealed that zinc oxide, painless skin protective film and silicone dressing could ameliorate the severity of IAD rat models, and that silicone dressing possessed the best therapeutic effect.