Knowledge, attitudes and practices of ICU nurses regarding postextubation dysphagia in tracheal intubation patients in 25 hospitals in China: A multicentre cross-sectional survey.

Abstract

Background: Postextubation dysphagia is common in the ICU, with varying incidence rates. However, few studies have focused on ICU nurses' knowledge, attitudes and practices regarding postextubation dysphagia, as well as the various influencing factors.

Aims: To investigate ICU nurses' knowledge, attitudes and practices regarding postextubation dysphagia and provide suggestions for improvement.

Study design: This was a multicentre cross-sectional survey. Data were collected using a validated questionnaire to assess knowledge, attitudes and practices regarding postextubation dysphagia.

Results: A total of 510 valid questionnaires were analysed. The median scores with interquartile ranges for knowledge, attitudes and practices regarding postextubation dysphagia were 8 (7, 9), 8 (7, 9) and 4.9 (3.8, 6.2), respectively. Multivariate analysis revealed that knowledge scores were significantly influenced by education level, ICU experience and managerial role (p < .05). Nurses with a bachelor's degree (OR = 3.636; 95% CI: 1.587-8.33) or a master's degree and above (OR = 7.742; 95% CI: 1.968-30.465) demonstrated higher knowledge scores than those with a postsecondary diploma. Nurses in managerial roles had higher scores (OR = 1.924; 95% CI: 1.053-3.515). Attitude (OR = 1.616; 95% CI: 1.092-2.39) and practice scores (OR = 4.079; 95% CI: 2.692-6.182) were significantly impacted by targeted PED training (p < .05). The correlation analysis revealed a weak but significant correlation only between knowledge and attitudes (τb = 0.196, p < .001).

Conclusion: Education level, ICU experience, managerial role and targeted PED training may enhance knowledge, attitudes or practices individually but do not lead to cohesive improvement across all three areas. Relying on knowledge alone is far from sufficient to drive behavioural change, indicating the need for comprehensive interventions to bridge these gaps.

Relevance to clinical practice: To bridge this gap, comprehensive interventions beyond standard training are essential. These may include applying an implementation science strategy to ensure that ICU nurses' enhanced knowledge and positive attitudes are consistently translated into clinical practice.