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...

Full description

Saved in:
Bibliographic Details
Main Authors: Weiwei Ni, Shichao Zhu, Huihuang Zou, Xinwei Jiao, Yulei Ma
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Nursing
Subjects:
Online Access:https://doi.org/10.1186/s12912-025-03626-4
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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.
ISSN:1472-6955