Contact Author Attitudes are a construct of internal beliefs and value systems.
Received Jan 8; Accepted Jan This article has been cited by other articles in PMC. Abstract Background Bowel management protocols have the potential to minimize complications for critically ill patients.
Targeted implementation can increase the uptake of protocols by clinicians into practice. Methods A descriptive before and after survey using a self-administered questionnaire sent to nursing Attitudes beliefs and intentions medical staff working within three intensive care units before and after implementation of our bowel management protocol pre: May — June ; post: Feb — May Results Participants had significantly higher knowledge scores post-implementation of our protocol pre mean score Post-implementation there was a significant increase in: Conclusion This evaluation, informed by the theory of planned behaviour, has provided useful insights into factors that influence clinician intentions to perform evidence-based bowel management practices in intensive care.
Addressing factors such as knowledge, attitudes and beliefs can assist in targeting implementation strategies to positively affect clinician behaviour change.
Electronic supplementary material The online version of this article doi: Bowel management, Intensive care, Nursing, Theory of planned behaviour, Questionnaire Background Bowel management in intensive care Maintenance of normal bowel function for a critically ill patient, although often viewed as a low care priority in the highly technical intensive care unit ICU environment, is imperative to avoid complications that can delay discharge [ 1 - 4 ].
Critically ill patients are at increased risk of complications from bowel dysfunction due to factors such as reduced mobility, underlying disease process or illness, mechanical ventilation, and the use of continuous or intermittent analgesics [ 3 - 5 ]. Complications include constipation, diarrhoea, delays in mechanical ventilation weaning, greater length of stays, dehydration, and bowel obstruction or perforation [ 36 - 9 ].
Protocols can improve bowel management within ICU; guiding clinicians in care provision, ensuring that timely treatment or intervention is instigated, and to minimise complications [ 110 - 13 ].
Bowel management protocols BMPs have been developed for specific use with ICU patients, with initial evaluations demonstrating a reduction in constipation and diarrhoea [ 10 - 15 ].
Most evaluations of BMP have however only assessed impact on patient outcomes and clinician practices within single site studies; e. Despite the potential for BMPs to standardise care and improve outcomes for critically ill patients, use of protocols is low.
Two national surveys in the United Kingdom UK found that only 3. This survey also identified bowel management as a practice clinicians viewed as a neglected area [ 16 ], similar to findings in the UK [ 1 ].
One common limitation with these studies was the lack of detail about the implementation strategies used and the evaluation process. Implementation of protocols Protocols should not be presented to clinicians in isolation, but instead, be introduced with evidence-based implementation strategies to increase their uptake into practice [ 1718 ].
A number of implementation strategies have been described and evaluated in the literature that have demonstrated some effectiveness in changing clinician practices in a variety of settings. These include education, audit and feedback, reminders, mass media, and use of local opinion leaders [ 19 - 22 ].
Central to the process of implementing protocols into clinical practice is clinician behaviour change [ 23 ].
Implementation of a protocol requires understanding of what clinicians already do in practice, how the protocol could be adopted within routine practice, and whether clinicians would need to change their practices or behaviours.
In addition, behaviour intention is a reliable proxy for actual behaviour when estimating actual clinician practice [ 24 ]. Identifying factors that may influence clinician intention to perform behaviours is important for eliciting behaviour change [ 2425 ]. Assessing clinician attitudes and beliefs related to specific behaviours facilitates identification of predictors of behaviour intention and behaviour change.
This construct of perceived behavioural control PBC can directly influence behaviour, bypassing behaviour intention [ 2627 ]. The control factors of the PBC construct can be either internal or external, with some authors arguing the presence of two distinct constructs or sub-constructs; self-efficacy perceived difficulty ; and controllability perceived control [ 2829 ].
These sub-constructs are seen by some to reflect beliefs about both internal and external factors [ 30 ], while others suggest that self-efficacy reflects internal factors and controllability reflects external factors [ 2831 ].
While the effects of these two PBC sub-constructs have differed across studies, self-efficacy does appear to be a significant positive predictor of behaviour intention [ 31 ].
The TPB has been previously used in studies in ICU; to examine the influences of nurse behaviour intention to perform hemodynamic assessment using a pulmonary artery catheter [ 32 ], and for changing clinician behaviour with the introduction of care bundles [ 33 ].
Methods Aim To evaluate the effect of implementing a BMP on the knowledge, attitudes, subjective norms, perceived behavioural control, behaviour intention and role perceptions for ICU nursing and medical staff using three bowel management practices.attitudes, beliefs and intentions regarding abortion provision.
METHODS: Surveys about abortion attitudes, beliefs and practice intentions were conducted in and among 1, medical school students attending the University of Cape Town and Walter Sisulu University in South. Dec 20, · Attitudes arise from an inner framework of values and beliefs, developed over time.
Carl Jung, in his essay on psychological types, defines attitude as "the readiness of the psyche to act or react in a certain way," alphabetnyc.coms: Attitudes.
alphabetnyc.comer attitudes are a composite of a consumer’s (1) beliefs about, (2) feelings about, (3) and behavioral intentions toward some object- . The purpose of this study was to examine the experiences, attitudes, intentions, and beliefs of college physical education majors regarding the use of exercise as punishment, using the framework of the theory of reasoned action.
Dec 20, · Attitudes arise from an inner framework of values and beliefs, developed over time. Carl Jung, in his essay on psychological types, defines attitude as "the readiness of the psyche to act or react in a certain way," alphabetnyc.coms: Attitudes, beliefs, and intentions People have attitudes for almost everything about living from religion, politics, fashion, music, movies to even food.
Attitudes put us in a frame of mind to like or dislike an object, moving away or towards it.