Abstract
BACKGROUND: Nebulization inhalation therapy is widely utilized in pediatric clinical practice, and treatment compliance plays a critical role in determining clinical outcomes. This study aimed to assess the compliance of preschool children with outpatient nebulization inhalation therapy, with the goal of providing actionable insights for clinical nursing practice. METHODS: Preschool children who had received nebulization inhalation therapy in the pediatric outpatient department of our hospital from February 2025 to July 2025 were included. Selfe designed Preschool Children’s Outpatient Nebulization Inhalation Therapy Compliance Scale were used for survey. Clinical trial number: not applicable. RESULTS: A total of 528 preschool children undergoing nebulization inhalation therapy were included in the study. The overall mean score for nebulization therapy compliance was (51.36 ± 9.82), with only 142 cases (26.9%) demonstrating high compliance. The scores across the four dimensions, ranked in descending order, were: treatment cognition and attitude, treatment persistence, treatment behavior norms, and treatment cooperation. Multivariate logistic regression analysis revealed that being 5-<6 years old (P = 0.001, OR = 2.28, 95%CI = 1.45–3.58), having guardians with good cognition of nebulization therapy (P = 0.001, OR = 2.81, 95%CI = 1.72–4.59), experiencing a comfortable treatment environment (P = 0.002, OR = 2.21, 95%CI = 1.34–3.65), and receiving good doctor-patient communication (P = 0.005, OR = 1.98, 95%CI = 1.22–3.22) were independent protective factors for high compliance (all P < 0.05). CONCLUSION: Preschool children receiving outpatient nebulization inhalation therapy exhibit moderately low treatment compliance, a phenomenon shaped by multiple interrelated factors such as chronological age, guardians’ understanding of nebulization therapy, and ambient treatment conditions. While nursing interventions involving individualized psychological support, caregiver education initiatives, and environmental adjustments hold potential to enhance compliance, their efficacy requires further verification through dedicated interventional studies to ensure reliable therapeutic effects. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12912-026-04493-3.