Abstract:

Objective To investigate and analyze the gap between the current clinical practice and guidelines of insulin injection knowledge，attitude and practice，and to provide a basis for further construction of an intervention program for insulin injection knowledge，attitude and practice that conform to the actual situation in China. Methods The stratified random convenience sampling method was used to investigate 5550 nurses from 3 primary，7 secondary and 11 tertiary hospitals from July 28 to August 30，2019，using the general information questionnaire and the questionnaire of nurses’ knowledge，attitude and practice on insulin injection.SPSS26.0 was used for independent sample T test，variance analysis and correlation analysis on the influencing factors of knowledge，attitude and practice，and Mplus8.3 was used to analyze the path of influencing factors of knowledge，attitude and practice. Results The scores of nurse knowledge, attitude and practice on insulin injection were 68.17±15.76，87.22±13.34 and 93.74±7.97，respectively. There was a positive correlation between nurses’ insulin injection knowledge and attitude，knowledge and practice，attitude and practice scores（r=0.321，0.298，0.561，P<0.001）. Gender and professional title were the main influencing factors of nurses’ insulin injection knowledge scores. Knowledge，hospital level，number of beds，professional title，department，and the last time you engaged in insulin injection were the main influencing factors of nurses’ attitude score of insulin injection. Hospital level，education，knowledge and belief were the main influencing factors of nurses’ insulin injection practice score. Attitude played a partially mediating role in knowledge and nurses’ insulin injection practice. The total effect value was 0.299；the indirect effect was 0.163；the intermediary effect accounted for 54.5% of the total effect value. Conclusion There is still a big gap between clinical practice and guidelines of nurse knowledge，attitude and practice on insulin injection. Nursing managers should strengthen the evaluation of hospital nurses’ knowledge，attitude and practice of insulin injection，and take intervention measures according to the characteristics and influencing factors of nurses’ knowledge，attitude and practice of insulin injection to improve their knowledge，attitude and practice.

Key words: Diabetes Mellitus, Insulin injection, Knowledge, Attitude and Practice, Root Cause Analysis, Path Analysis, Nursing Care

摘要：

目的 调查并分析护士胰岛素注射知信行临床实践与指南的差距，为进一步构建中国临床护士的胰岛素注射知信行干预方案提供依据。 方法 采用分层随机抽样法抽取医院，采用便利抽样法抽取护士，于2019年7月28日—8月30日采用一般资料调查表、护士胰岛素注射知信行问卷对上海市3所一级医院、7所二级医院和11所三级医院的5 550名护士进行调查。采用SPSS 26.0对知信行影响因素进行独立样本t检验、方差分析，并对知信行进行相关性分析，采用Mplus 8.3对知信行影响因素进行路径分析。 结果 护士胰岛素注射知信行标准分得分分别为（68.17±15.76）、（87.22±13.34）、（93.74±7.97）分。护士胰岛素注射知识与信念、知识与行为、信念与行为得分呈正相关（r=0.321、0.298、0.561，均P<0.001），性别、职称是护士胰岛素注射知识的主要影响因素；知识、医院级别、科室床位数、职称、科室、最近1次从事胰岛素注射工作的时间是护士胰岛素注射信念的主要影响因素；医院级别、学历、胰岛素注射知识、胰岛素注射信念是护士胰岛素注射行为的主要影响因素；护士胰岛素注射信念在知识和行为间起部分中介作用，总效应值为0.299，间接效应为0.163，中介效应占总效应值的54.5%。 结论 护士胰岛素注射知信行的临床实践与指南仍存在较大差距。护理管理者应加强对护士胰岛素注射知信行的评估，同时针对护士胰岛素注射知信行特征及影响因素采取干预措施，以提高其知信行水平。

关键词: 糖尿病, 胰岛素注射, 知信行, 影响因素分析, 路径分析, 护理