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已发表论文
重症监护室医生对急性肾损伤预防和管理的知识、态度和实践：与职业倦怠的关系
Authors Zhang R, Li L, Zheng Z, Dong L
Received 5 June 2025
Accepted for publication 5 December 2025
Published 10 December 2025 Volume 2025:18 Pages 7933—7947
DOI https://doi.org/10.2147/JMDH.S545020
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Ruijuan Zhang,1 Lang Li,2 Zhencang Zheng,1 Liang Dong1
1Department of Critical Care Medicine, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, 318000, People’s Republic of China; 2Department of Postgraduate Education, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, 318000, People’s Republic of China
Correspondence: Liang Dong, Department of Critical Care Medicine, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, 318000, People’s Republic of China, Tel +86-15906762790, Email dongliang@tzc.edu.cn
Background: Acute kidney injury (AKI) poses significant challenges to patient outcomes in intensive care units (ICUs). This study aims to examine the knowledge, attitudes, and practices (KAP) of ICU physicians regarding AKI prevention and management, as well as to explore the potential association between burnout levels and KAP performance.
Methods: : We conducted a cross-sectional study among physicians working at 18 ICUs in Taizhou, Zhejiang Province, from 26 September 2023 to 18 March 2024. Data were collected using a self-administered KAP questionnaire (knowledge: 18 items [score range: 18– 36]; attitude: 8 items [score range: 8– 40]; practice: 13 items [score range: 13– 65]) and the Maslach Burnout Inventory-General Scale (MBI-GS).
Results: The study enrolled 220 ICU physicians with valid questionnaires. The mean scores were: knowledge 29.92± 3.42, attitude 30.94± 5.49, practice 46.28± 5.65, and burnout 2.13± 0.63. Physicians certified by the Chinese Critical Care Certified Course (5C) demonstrated significantly higher KAP levels (K: 30.46± 3.20, p=0.008; A: 31.37± 5.40, p< 0.001; P: 46.76± 5.35, p=0.013) despite higher burnout levels (2.18± 0.63, p=0.002). Those with resignation intentions had significantly lower KAP scores (K: 27.78± 3.81, P=0.001; A: 28.48± 4.97, P=0.023; P: 43.83± 5.35, p=0.027) and higher burnout (2.51± 0.44, p=0.003). Correlation analyses revealed that knowledge was significantly associated with both attitude (r=0.614, p< 0.001) and practice (r=0.538, p< 0.001). Total Burnout was negatively correlated with attitude (r = − 0.223, p < 0.001) and practice (r = − 0.238, p < 0.001). Multivariable logistic regression further confirmed that attitude was the strongest modifiable independent predictor of practice behaviors (OR = 1.413, p < 0.001).
Conclusion: ICU physicians demonstrate adequate knowledge, positive attitude and proactive practices toward AKI prevention and management, despite experiencing moderate burnout levels. Attitude is the strongest modifiable predictor of practice, underscoring the importance of fostering positive attitudes to enhance AKI management among ICU physicians. Targeted interventions aimed at enhancing knowledge, fostering positive attitudes, and addressing burnout are needed for effective AKI management in ICU settings.
Keywords: knowledge, attitude, practice, ICU physician, acute kidney injury, burnout, maslach burnout inventory-general scale, MBI-GS
1Department of Critical Care Medicine, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, 318000, People’s Republic of China; 2Department of Postgraduate Education, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, 318000, People’s Republic of China
Correspondence: Liang Dong, Department of Critical Care Medicine, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, 318000, People’s Republic of China, Tel +86-15906762790, Email dongliang@tzc.edu.cn
Background: Acute kidney injury (AKI) poses significant challenges to patient outcomes in intensive care units (ICUs). This study aims to examine the knowledge, attitudes, and practices (KAP) of ICU physicians regarding AKI prevention and management, as well as to explore the potential association between burnout levels and KAP performance.
Methods: : We conducted a cross-sectional study among physicians working at 18 ICUs in Taizhou, Zhejiang Province, from 26 September 2023 to 18 March 2024. Data were collected using a self-administered KAP questionnaire (knowledge: 18 items [score range: 18– 36]; attitude: 8 items [score range: 8– 40]; practice: 13 items [score range: 13– 65]) and the Maslach Burnout Inventory-General Scale (MBI-GS).
Results: The study enrolled 220 ICU physicians with valid questionnaires. The mean scores were: knowledge 29.92± 3.42, attitude 30.94± 5.49, practice 46.28± 5.65, and burnout 2.13± 0.63. Physicians certified by the Chinese Critical Care Certified Course (5C) demonstrated significantly higher KAP levels (K: 30.46± 3.20, p=0.008; A: 31.37± 5.40, p< 0.001; P: 46.76± 5.35, p=0.013) despite higher burnout levels (2.18± 0.63, p=0.002). Those with resignation intentions had significantly lower KAP scores (K: 27.78± 3.81, P=0.001; A: 28.48± 4.97, P=0.023; P: 43.83± 5.35, p=0.027) and higher burnout (2.51± 0.44, p=0.003). Correlation analyses revealed that knowledge was significantly associated with both attitude (r=0.614, p< 0.001) and practice (r=0.538, p< 0.001). Total Burnout was negatively correlated with attitude (r = − 0.223, p < 0.001) and practice (r = − 0.238, p < 0.001). Multivariable logistic regression further confirmed that attitude was the strongest modifiable independent predictor of practice behaviors (OR = 1.413, p < 0.001).
Conclusion: ICU physicians demonstrate adequate knowledge, positive attitude and proactive practices toward AKI prevention and management, despite experiencing moderate burnout levels. Attitude is the strongest modifiable predictor of practice, underscoring the importance of fostering positive attitudes to enhance AKI management among ICU physicians. Targeted interventions aimed at enhancing knowledge, fostering positive attitudes, and addressing burnout are needed for effective AKI management in ICU settings.
Keywords: knowledge, attitude, practice, ICU physician, acute kidney injury, burnout, maslach burnout inventory-general scale, MBI-GS