Knowledge, attitudes and practices of intensive care unit physicians towards the management of acute respiratory distress syndrome in China: a cross-sectional survey

BMJ Open. 2025 Jan 27;15(1):e092069. doi: 10.1136/bmjopen-2024-092069.

Abstract

Objectives: This study aimed to assess the knowledge, attitudes and practices (KAP) of intensive care unit (ICU) physicians in China towards acute respiratory distress syndrome (ARDS).

Design: A cross-sectional study was conducted between September and November 2022.

Participants: A total of 497 ICU physicians participated, with 258 (51.91%) being male and the majority aged 30-40 years (56.74%).

Interventions: Participants were surveyed to evaluate their KAP regarding ARDS, with mediation analysis employed to elucidate the association between demographic characteristics and KAP scores.

Primary and secondary outcome measures: The mean scores for KAP were 11.89±2.64 (range: 0-17), 44.73±4.85 (range: 12-60) and 18.26±3.43 (range: 1-48), respectively. Pearson correlation analysis showed positive correlations between knowledge and attitude (0.367), knowledge and practice (0.582) and attitude and practice (0.314) (all p<0.001).

Results: Mediation analysis indicated that attitude (β=0.07, p<0.001) and hospital type (β=-0.84, p=0.005) had direct effects on practice, while knowledge had significant direct (β=0.68, p<0.001) and indirect (β=0.03, p=0.019) effects. Additionally, education (β=0.47, p<0.001), work experience (β=0.25, p<0.001), hospital classification (β=-0.91, p<0.001), ICU type (β=-0.61, p=0.001) and ARDS experience (β=-1.57, p<0.001) showed various indirect effects on practice.

Conclusions: ICU physicians in China exhibited inadequate knowledge, moderate attitudes and suboptimal practices regarding ARDS management. Enhancing education and work experience is crucial, along with practical, scenario-based training, to improve KAP in ARDS management.

Keywords: Attitude; Education, Medical; Emergency Service, Hospital; Knowledge.

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • China
  • Cross-Sectional Studies
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Intensive Care Units*
  • Male
  • Middle Aged
  • Physicians* / psychology
  • Practice Patterns, Physicians'* / statistics & numerical data
  • Respiratory Distress Syndrome* / therapy
  • Surveys and Questionnaires