A comparison of Knowledge, attitude and practice (KAP) of nurses on nursing Post-stroke dysphagia patients between iii-A and ii-A hospitals in China: a propensity score-matched analysis

Abstract

Background Whether knowledge, attitude and practice of nurses on nursing post-stroke dysphagia patients varies between different ranking hospitals is still unknown. This study aimed to compare the knowledge, attitude and practice level of nurses on nursing post-stroke dysphagia patients between iii-A and ii-A hospitals in China. Design A cross-sectional study design was used. Methods Data were collected from eighteen hospitals in Wuhan, Hubei in May–July 2020, and a total of 824 nurses were recruited by convenient sampling. After propensity score matching, 205 participants in iii-A hospitals were matched with 205 participants in ii-A hospitals. Results There were no statistically differences in the socio-demographic characteristics between two groups after propensity score matching. Before matching, the regression coefficients between hospital ranking and knowledge, attitude, practice were -0.415, -0.718 and -1.855, respectively. After matching, the coefficients changed to -0.394, -0.824 and -1.278. Nurses from iii-A hospitals had higher knowledge and attitude scores than nurses from ii-A hospitals, but no significant practice scores difference was observed between various rankings of hospitals. Conclusions The KAP of nurses on nursing post-stroke dysphagia patients were different in iii-A and ii-A hospitals. Administrators should strengthen management, provide more learning resources and trainings to meet nurses’ needs about methods to deal with and recognize dysphagia, so as to further improve the quality of post-stroke dysphagia management.

Knowledge, Attitude and Practice of the Community General Practice Teams on Dysphagia Complicated with Aspiration Pneumonia after Stroke

“…In Sichuan (China), Luo et al [18] reported that although the dysphagia attitudes and practices of geriatrics nurses were acceptable, their knowledge was low. More specifically, in post-stroke dysphagia, a study in Wuhan (China) showed that the KAP of nurses (working in neurology, neurosurgery, rehabilitation, or geriatrics departments) was low, especially in lower-grade hospitals [19]; similar results were observed in Beijing of neurological nurses [29]. Similar results regarding aspiration pneumonia KAP were observed for neurological nurses in Burkina Faso [20] and among nurses and residents in Saudi Arabia [21].…”

“…Three previous studies in China showed that the hospital level was the main factor affecting the KAP of post-stroke dysphagia in nurses [18,19,29]. In the multivariable analyses, the knowledge and attitude scores were associated with better practice scores.…”

“…GPs must be aware of the risk of dysphagia complicated with aspiration pneumonia after stroke and must be able to recognize a case of aspiration pneumonia and initiate the proper care promptly [15,16]. Some studies examined the knowledge and practice of healthcare providers, including physicians, nurses, and residents, toward dysphagia management [17,18], post-stroke dysphagia [19,20], and aspiration pneumonia [21], generally revealing low or moderate knowledge and practice. However, there are no studies on the KAP of GPs toward dysphagia complicated with aspiration pneumonia after stroke.…”