Knowledge, Attitudes, and Self‑Reported Practices Regarding Sleep‑Focused Delirium Prevention Among ICU Professionals: A Multicenter Survey in Jiangxi, China
TL;DR
The findings suggest caution in interpreting high self-reported practice in sleep management for delirium as equivalent to high-fidelity clinical implementation and support the need for targeted education and future studies using more objective measures of practice.
Abstract
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.