Relationships among Nurses’ Personnel Factors, Knowledge, Attitudes, and Lower Extremities Deep Vein Thrombosis Prophylaxis Practices in Patients undergoing Surgery
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Abstract
Deep vein thrombosis (DVT) is a condition in which blood clots adhere within the veins, most commonly found in the distal veins of the lower extremities. This condition is prevalent among surgical patients. Several contributing factors including prolonged surgery lasting more than 30 minutes, administration of general anesthesia, vascular injury during surgery, and prolonged bed rest due to restricted mobility after surgery. Currently, hospitals have developed practices to prevent DVT from the preoperative to the postoperative stages. Therefore, continuous nursing care can help reduce the incidence of DVT after surgery, as well as avoid potential harm to patients, especially sudden death after surgery. However, there remains a notable deficiency in research that explores the factors influencing nursing practices related to the prevention of lower extremity DVT in patients undergoing surgery. Addressing this knowledge gap is essential for the development of effective nursing interventions aimed at preventing DVT within surgical settings.
This descriptive correlational study examined relationships among nurses’ personal factors, knowledge of DVT, attitude toward DVT prevention, and DVT prophylaxis practices in patients undergoing surgery. The researcher applied the Nursing Role Effectiveness Model (NREM) along with a literature review as the conceptual framework for the study. The NREM assesses the quality of nursing care by defining components that are more specific to the nursing context: consisting of structure, process, and outcomes. Internal factors within the structural components of nursing influence the nursing process, which, in turn, impacts patient outcomes. The sample consisted of 93 full-time registered nurses from surgical nursing units with at least one year of experience in postoperative surgical patient care, working in inpatient departments at two tertiary care hospitals under the Royal Thai Navy, Ministry of Defense. Participants were selected using purposive sampling based on inclusion criteria. Data were collected between September and November 2024. The sets of questionnaires included the demographic questionnaire, the nurses’knowledge about DVT questionnaires, the nurses’ attitudes toward DVT prophylaxis questionnaire, and the nurses’ practices on DVT prophylaxis for patients undergoing surgery questionnaire. Data were analyzed using descriptive statistics, Spearman’s rank correlation coefficients, and point-biserial correlation coefficients.
The results demonstrated that participants had a mean age of 31.92 years, with an average of 9.02 years of work experience in postoperative surgical patient care. The mean scores showed a relatively good level of knowledge about DVT, a positive attitude toward DVT prophylaxis, and satisfactory DVT prophylaxis practices. Significant low positive correlations were found among years of working experience (r = .22, p < .05), DVT training (r = .21, p < .05), nurses’ knowledge of DVT, (r = .25, p < .05), and DVT prophylaxis practices. Moreover, nurses’ attitudes toward DVT prevention showed a statistically significant moderate positive correlation with nurses’ lower extremities DVT prophylaxis practices (r = .33, p < .01). The results in this study can be served as foundational data for nursing care planning to enhance the effectiveness of nursing interventions in preventing lower extremity deep vein thrombosis in surgical patients. Furthermore, it can be utilized to reinforce attitudes, promote knowledge, and improve surgical nurses’ skills regarding lower extremity deep vein thrombosis prevention.
Keywords: Attitude, Deep vein thrombosis prophylaxis practices, Knowledge, Personnel factors, Surgical nurses
Author contributions:
WP: Conceptualization, method and design, tool validation, data collection and analysis, and writing and revising the manuscript
PY: Conceptualization, method and design, data analysis, writing, revising, and editing the manuscript, and corresponding with the editor-in-chief
SC: Conceptualization, method and design, data analysis, revising the manuscript
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
บทความ ข้อมูล เนื้อหา รูปภาพ ฯลฯ ที่ได้รับการตีพิมพ์ในรามาธิบดีพยาบาลสาร ถือเป็นลิขสิทธิ์ของวารสาร หากบุคคลหรือหน่วยงานใดต้องการนำทั้งหมดหรือส่วนหนึ่งส่วนใดไปเผยแพร่หรือเพื่อกระทำการใด ใด จะต้องได้รับอนุญาตเป็นลายลักษณ์อักษรจากรามาธิบดีพยาบาลสารก่อนเท่านั้น
References
Al-Mugheed KA, Bayraktar N. Knowledge and practices of nurses on deep vein thrombosis risks and prophylaxis: A descriptive cross-sectional study. J Vasc Nurs. 2018;36(2):71-80. doi: 10.1016/j.jvn.2018.02.001.
Alyousef HA, Badawi SEA, Elghoneimy YA, Alameri RA, Almutairi AM. Nurses’ knowledge and practices regarding the prevention of deep vein thrombosis in Saudi Arabia: descriptive cross-sectional study. Med Arch. 2022;76(6):447-53. doi: 10.5455/medarh.2022. 76.447-453.
Norasan S, Gajasen C. Venous thrombosis embolism. In Norasan S, editors. Trama nursing 1st ed. Bangkok: Idea Instant Printing; 2020. p.306-48. (in Thai)
Nicholson M, Chan N, Bhagirath V, Ginsberg J. Prevention of venous thromboembolism in 2020 and beyond. J Clin Med. 2020;9(8):2467-94. doi: 10.3390/jcm9082467.
Stubbs MJ, Maria M, Mari T. Deep vein thrombosis. BMJ 2018 [cite 2024 Fab 22]; 1-6. Available from NIH database. doi: 10.1136/bmj.k351.
Kim SM. Clinical presentation of isolated calf deep vein thrombosis in inpatients and prevalence of associated pulmonary embolism. J Vasc Surg Venous Lymphat Disord. 2022;10(5):1037-43. doi: 10.1016/j.jvsv. 2022.02.011.
Lorchaivej S, Suprasert P, Srisuwan T, Rujiwetpongstorn J. Prevalence and risk factor of post-operative lower extremities deep vein thrombosis in patients undergoing gynecologic surgery:a single-institute cross-sectional study. Thromb J. 2022;20(1):14. doi: 10.1186/s12959-022-00376-0.
Bartlett MA, Mauck KF, Stephenson CR, Ganesh R, Daniels PR. Perioperative venous thromboembolism prophylaxis. Mayo Clin Proc. 2020;95(12):2775-98. doi: 10.1016/j.mayocp.2020.06.015.
Fu Y-H, Liu P, Xu X, Wang P-F, Shang K, Ke C, et al. Deep vein thrombosis in the lower extremities after femoral neck fracture: a retrospective observational study. J Orthop Surg. 2020;28(1): 2309499019901172. doi: 10.1177/2309499019901172.
Yesuf NN, Abebe T, Adane R, Lelisa R, Asefa M, Tessema M, et al. Nurses knowledge and practice towards prevention on deep vein thrombosis in University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. Int J Afr Nurs Sci. 2021;15:100357-63.
Kiflie AM, Mersha AT, Workie MM, Admass BA, Ferede YA, Bizuneh YB. Assessment of knowledge, attitude, practice and associated factors of venous thromboembolism prophylaxis among health professionals. a cross-sectional study. Int J Surg Open. 2022;39:100436-46. doi:10.1016/j.ijso.2021.100436
Wang Y, Wu X-J, Ma Y-F, Xu Y, Wang X-J, Zhu C, et al. Chinese orthopaedic nurses’ knowledge, attitude and venous thromboembolic prophylactic practices: a multicentric cross-sectional survey. J Clin Nurs. 2021;30(5-6):773-82. doi: 10.1111/jocn.15615.
Bloom, BS. Taxonomy of educational objectives: The classification of educational goals. Handbook 1. New York: David McKay Company; 1956.
Ajzen I. From intentions to actions: a theory of planned behavior. In J. Kuhl & J. Beckmann (Eds.), Action control: from cognition to behavior. Berlin, Heidelber, New York: Springer-Verlag.; 1985.
Pender NJ, Murdaugh CL, Parsons MA. Health promotion in nursing practice. 4th ed. Upper Saddle River, NJ: Pearson; 2002.
Irvine D, Sidani S, Hall LM. Linking outcomes to nurses’ roles in health care. Nurs Econ. 1998;16(2):58-87.
Ma YF, Xu Y, Chen YP, Wang XJ, Deng HB, He Y, et al. Nurses’ objective knowledge regarding venous thromboembolism prophylaxis: a national survey study. Medicine (Baltimore). 2018;97(14). doi: 10.1097/MD.0000000000010338.
Oh H, Boo S, Lee JA. Clinical nurses’ knowledge and practice of venous thromboembolism risk assessment and prevention in South Korea: a cross-sectional survey. J Clin Nurs. 2017;26(3-4):427-35. doi: 10.1111/jocn.13424.
Zhou X, Dai M, Sun L, Li C, Xiang W, Lin Y, et al. Ophthalmic nurses’ knowledge, attitude, and practice toward venous thromboembolic prevention: a dual-center cross-sectional survey. Peer J. 2023;11:15947-63. doi: 10.7717/peerj.15947.
Antony AM, Moly KT, Dharan DR. Assessment of knowledge and self-reported clinical practice on prevention of deep vein thrombosis among staff nurses. IOSR-JNHS. 2016;5(1):18-24.
Yan T, He W, Hang C, Qin L, Qian L, Jia Z, et al. Nurses’ knowledge, attitudes, and behaviors toward venous thromboembolism prophylaxis: how to do better. Vascular. 2021;29(1):78-84. doi: 10.1177/1708538 120933782.
Xu Y, Wang W, Zhen K, Zhao J. Healthcare professionals’ knowledge, attitudes, and practices regarding graduated compression stockings: a survey of China’s big-data network. BMC Health Serv Res. 2020;20(1):1078-85. doi: 10.1186/s12913-020-05933-9.
Tolera BD, Gebremedhin KB. Nurses’ knowledge and practice regarding venous-thromboembolism prevention in tertiary hospitals of Addis Ababa, Ethiopia: a cross-sectional study. J Vasc Nurs. 2024;42(2):123-30. doi: 10.1016/j.jvn.2024.02.005.
Yohannes S, Abebe T, Endalkachew K, Endeshaw D. Nurses’ knowledge, perceived practice, and their associated factors regarding deep venous thrombosis prevention in Amhara region comprehensive specialized hospitals, Northwest Ethiopia, 2021: a cross-sectional study. Crit Care Res Pract 2022 [cited 2024 Fab 22]; 1-9. Available from NIH database.
Gajasen C, Jaihow R, Norasan S, Singhatas P. A survey study of knowledge, assessment and prevention of venous thromboembolism among registered nurses working in surgical intensive and semi- intensive care units in Ramathibodi Hospital. Journal of Nursing Division. 2020;47(3):26-37. (in Thai)
Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175-91.
Wiratchai N. The reform process for learning quality development: evaluation and assurance. Bangkok: VTC Communication; 2002. (in Thai)
Xu Y, Wang W, Zhao J, Wang J, Zhao T. Knowledge, attitude, and practice of healthcare professionals toward clinically applying graduated compression stockings: results of a Chinese web-based survey. J Thromb Thrombolysis. 2019;47(1):102-8. doi: 10.1007/s11239-018-1749-4.
Srisuphon W, Khuwatsamrit K, Youngcharoen P. Relationships among nurses’ personal factors, knowledge, attitudes, and acute pain management for trauma patients in emergency department. Ramathibodi Nursing Journal. 2565;28(2):228-39. (in Thai)
Susan K. Grove NB, Jennifer Grey. The practice of nursing research: appraisal, synthesis, and generation of evidence. Nurs Stand. 2013;27(31):30.
Hebeshy MI, Hansen DM, Broome B, Abou Abdou S, Murrock C, Bernert D. Development of the nurses’ intention to use deep vein thrombosis preventive measures questionnaire. J Nurs Meas. 2020;28(3):216-32. doi: 10.1891/JNM-D-19-00011.
Benner P. From novice to expert excellence and power in clinical nursing practice. Am J Nurs. 1984;84(12). doi:10.1097/00000446-198412000-00025.
Wang D, Bao F, Li Q, Teng Y, Li J. Semiautomatic intermittent pneumatic compression device applied to deep vein thrombosis in major orthopedic surgery. Biomed Eng. 2018;17(1):78. doi: 10.1186/s12938-018-0513-5.
Yimjaraen P, Puttapitukpol S, Sriussadaporn P. The role development towards being in-charge nurses of pediatric surgery department at a government university hospital in Bangkok metropolis. Thai Journal of Cardio-Thoracic Nursing. 2019;30(1):117-30. (in Thai)
Kasemsuk K, Ritudom B. Health promotion of middle adulthood development: nurses’ roles. Regional Health Promotion Center 9 Journal. 2023;64(3):101-7. (in Thai)
Lee J-A, Grochow D, Drake D, Johnson L, Reed P, van Servellen G. Evaluation of hospital nurses’ perceived knowledge and practices of venous thromboembolism assessment and prevention. J Vasc Nurs. 2014;32(1):18-24. doi: 10.1016/j.jvn.2013.06.001.
