Abstract
BACKGROUND: Enteral feeding interruption (EFI) is a frequent issue in ICU settings, affecting nutritional adequacy and delaying recovery in critically ill patients. While tools exist to assess patients' nutritional status, no instrument evaluates ICU staff's knowledge, attitude and practice (KAP) in EFI management. AIM: To develop a reliable and valid EFI management scale for ICU medical staff based on the KAP model. STUDY DESIGN: This instrument development study followed the STROBE guidelines, utilizing a cross-sectional, multi-centre approach in Wuhan. A convenience sample of 400 ICU staff from eight tertiary A hospitals and two tertiary B hospitals was included between May 2021 and March 2022. A preliminary scale was constructed through literature review, interviews and expert consultations. The sample was used to assess the scale's reliability and validity. RESULTS: The final EFI management scale comprised 41 items across three dimensions, with cumulative variance contributions of 70.341%, 70.437% and 66.550%. Cronbach's α ranged from 0.919 to 0.947, with test-retest reliability between 0.488 and 0.836. The total scale had a Cronbach's α of 0.953 and test-retest reliability of 0.977. Content validity indices (I-CVI) ranged from 0.800 to 1.000, and the scale-level CVI was 0.975. CONCLUSIONS: The EFI Management KAP Scale is a valid, reliable tool for assessing ICU medical staff's management of EFI. RELEVANCE TO CLINICAL PRACTICE: The EFI Management KAP Scale addresses a critical gap in the standardized evaluation of critical care nurses' knowledge, attitudes and practices regarding enteral feeding interruptions. By providing a validated tool, this scale enables the identification of specific barriers and facilitators to optimal enteral nutrition delivery in critically ill patients. Its application can guide targeted educational interventions, inform policy adjustments and enhance multidisciplinary collaboration in the ICU. Ultimately, this scale supports improved enteral nutrition management, reducing complications associated with feeding interruptions and contributing to better patient outcomes in critical care settings.