Canonical Correlation between Knowledge-Barriers/Facilitators for Pressure Ulcer Prevention Nursing Variables and Attitude-Performance Variables

Abstract

Objectives: Knowledge, barriers/facilitators for pressure ulcer prevention nursing are correlated with attitude and performance of staff nurses. It can be helpful to utilize barriers and facilitators for enhancing the attitude and performance of nurses, there is a gap in the empirical study. The aim of this study was to investigate the relationship between knowledge-barriers/facilitators for Pressure Ulcer (PU) prevention variable set and attitude-nursing performance variable set. Methods: This study employed a cross-sectional descriptive design using structured survey in 9 hospitals. Data were collected from August to November 2018 and analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and Canonical correlation. Results: The correct answer rates of knowledge for PU risk factor was 75%. Perceived barriers of prevention was 5.03 ± 1.40 and facilitators was 5.87 ± 1.28. The mean score of attitude for PU prevention was 3.53 ± 0.30 and that of nursing performance for PU prevention was 1.42 ± 0.33. The significant pair of canonical variate indicated that more perceived barriers (0.75), less facilitators (-0.51), low knowledge level for risk factor of pressure ulcer (-0.31), and high knowledge level for pressure ulcer prevention (0.59) were associated with poor nursing performance for pressure ulcer prevention (-0.96). Conclusions: To enhance the nursing performance for PU prevention, developing nurse-centered educational program and standardized protocol should be needed. Also, planning sheet for PU prevention can increase the nursing performance.

Effects of Attitude, Barriers/Facilitators, and Visual Differentiation on Oral Mucosa Pressure Ulcer Prevention Performance Intention

“…This is in line with the findings that attitude affects intention to perform skin PU prevention [ 16 ] and actual performance [ 19 ]. Previous research has also shown a positive relationship between facilitators and performance, which corroborates the current study’s results [ 21 ]. Attitude was defined as behavioral intent and the amount of regard for or against an object, which is affected by knowledge [ 13 ].…”

“…The mean score of attitudes toward oral mucosa PU prevention was similar to that of skin PU prevention in previous studies [ 19 , 21 ]. According to recent studies, oral mucosa PU is a common MDRPU [ 4 ], it improves in 2–3 days, and relapses frequently compared to skin PUs [ 5 ].…”

“…Barriers and facilitators from the oral mucosa PU prevention scale developed by Kim and Ryu [ 21 ] were employed after modification. The themes of the barriers include seven items, and those of facilitators include six items.…”

“…We employed a numeric rating scale from 0 (not at all) to 10 (always). Cronbach’s alphas in a previous study were 0.81 for barriers, and 0.78 for facilitators [ 21 ]. In this study, Cronbach’s alphas for barriers and facilitators were 0.92 and 0.88, respectively.…”

“…Therefore, negative attitudes toward PU prevention may negatively affect preventive care performance [ 20 ]. Furthermore, an individual’s attitude has a direct impact on PU prevention performance intention [ 16 ], and is regarded as an outcome variable, similar to performance intention [ 21 ]. However, a positive attitude alone is not sufficient to ensure PU prevention, and other factors should also be considered alongside it [ 22 ].…”