Xueting Yao, Zonglin Rao, Taobin Liu, Yi Gao
In this regional, multicenter sample, ICU healthcare professionals reported positive attitudes and relatively high self-reported practice in sleep management for delirium, but important conceptual knowledge gaps and limited training persisted. The findings suggest caution in interpreting high self-reported practice as equivalent to high-fidelity clinical implementation and support the need for targeted education and future studies using more objective measures of practice.
OBJECTIVE: To apply a knowledge, attitude, and practice (KAP) framework to assess ICU healthcare professionals' knowledge, attitudes, and self-reported practices regarding sleep management as one component of delirium prevention and care in the ICU.
METHODS: This multicenter cross-sectional study was conducted from December 2025 to January 2026 in seven hospitals in Jiangxi Province, China, with ICU healthcare professionals. A self-designed questionnaire on sleep and delirium, developed through literature review, expert review, and pilot testing, was used to collect demographic data and assess KAP.
RESULTS: The analysis included 509 questionnaires. The mean scores were 14.07±2.27 for knowledge (82.8% of the maximum score), 63.38±6.26 for attitude (90.5%), and 49.52±8.59 for self-reported practice (82.5%). Knowledge gaps were identified: only 44.8% of participants correctly recognized that delirium is not a chronic mental disorder; uncertainty persisted on several sleep-related items; and 53.6% reported no prior delirium-related training. Knowledge showed a modest positive association with attitude (β=0.099, 95% CI 0.014-0.185; P=0.023), but knowledge was not associated with self-reported practice (P=0.824 and P=0.260), while attitude was associated with self-reported practice (β=0.528, 95% CI 0.465-0.591; P<0.001); those results must be considered cautiously because of model saturation.
CONCLUSION: In this regional, multicenter sample, ICU healthcare professionals reported positive attitudes and relatively high self-reported practice in sleep management for delirium, but important conceptual knowledge gaps and limited training persisted. The findings suggest caution in interpreting high self-reported practice as equivalent to high-fidelity clinical implementation and support the need for targeted education and future studies using more objective measures of practice.