Medical device-related pressure injuries: The mediating role of attitude in the relationship between ICU nurses' knowledge levels and self-efficacy

This study examines the mediating role of attitude towards preventing pressure injuries (PIs) in the effect of knowledge about Medical Device-Related Pressure Injuries (MDRPI) on self-efficacy in PI management among Turkish intensive care unit (ICU) nurses. A descriptive, cross-sectional study was conducted with 302 ICU nurses in Turkey from October 15, 2023, to April 30, 2024. Data were collected using the Nurse Information Form, Medical Device Related Pressure Injury Knowledge Assessment Test (MDRPI-KAT), Attitude towards Pressure Ulcer Prevention Instrument (APuP), and the Pressure Ulcer Management Self-Efficiency Scale (PUMSES). ICU nurses had a knowledge score of 9.20±2.32, with a correct response rate of 57.5%. Their attitude score was 42.41±5.46, with 76.5% showing a satisfactory attitude (≥75%). The self-efficacy score for PI management was 60.59±21.03. Knowledge level positively and significantly affected attitude (B=0.963, 95% CI 0.720-1.206), and attitude positively and significantly affected self-efficacy (B=0.837, 95% CI 0.370-1.304). The direct effect of knowledge on PI management self-efficacy was non-significant without a mediator (B=0.339; p=0.542; 95% CI -0.756-1.435), but the indirect effect through attitude was significant (B=0.806; 95% CI 0.289-1.399). The study found that Turkish ICU nurses' knowledge of MDRPIs was below desired levels, though their self-efficacy was slightly above average and their attitudes were satisfactory. Attitude fully mediated the relationship between knowledge and self-efficacy, suggesting that enhancing nurses' knowledge and attitudes can improve their self-efficacy in managing PIs. • Intensive care unit (ICU) nurses have insufficient knowledge regarding medical device-related pressure injuries (MDRPIs), but they have a positive attitude toward the prevention of pressure injuries (PIs). • ICU nurses have self-efficacy levels regarding pressure injuries that are slightly above average. • The knowledge regarding MDRPIs positively affects attitudes towards PI prevention. • The attitude towards PI prevention positively affects PI management self-efficacy. • The knowledge regarding MDRPIs has an indirect positive effect on PI management self-efficacy. • The attitude towards PI prevention mediates the relationship between knowledge of MDRPIs and PI management self-efficacy.