Abstract：
BACKGROUND: There are an increasing number of evidence-based recommendations for managing dysphagia in post-stroke patients. However, it is unclear whether nurses adopt these recommendations in their daily nursing practices.
OBJECTIVE: This study aimed to explore nurses\' adherence, barriers, facilitators and views on dysphagia screening and assessment of post-stroke dysphagia.
METHODS: In this study, multiple methods were adopted. In Phase 1, a general information questionnaire and a knowledge-attitude-practice and barriers/facilitators questionnaire for dysphagia screening and assessment were distributed in 55 hospitals online. In Phase 2, semi-structured interviews were conducted to explore nurses\' views on barriers. Descriptive and one-way variance analyses were used to analyse the quantitative data, while content analysis was used to analyse the qualitative data. This study adheres to STROBE and COREQ guidelines.
RESULTS: Nine hundred and forty-two completed questionnaires were collected. Only 36.52% of the nurses screened for swallow function in patients as a guideline. The biggest barrier was \'memory, attention and decision process\', with an average score of 3.22 (.74). The different stages of implementation had various types and degrees of barriers (p < .001). Five themes were extracted after interviews, namely \'Inadequate environment and resource support\', \'Increased workload\', \'Professional value perception\', \'Organisational culture\', and \'Poor knowledge and skill\'.
CONCLUSIONS: Nurses\' practice of dysphagia screening and assessment of patients with dysphagia after stroke were inadequate, and the barriers originated from patients, leadership and the nurses themselves.
CONCLUSIONS: This research extracted five barriers of guidance adherence for post-stroke dysphagia screening and assessment and identified the different kinds and degrees of barriers in five implementation stages, providing a basis for nursing managers to break through the bottleneck of guideline implementation.
UNASSIGNED: The nurses recruited in this study completed validated questionnaires in the survey and suggestive answers in interviews.
OBJECTIVE: This study aimed to explore nurses\' adherence, barriers, facilitators and views on dysphagia screening and assessment of post-stroke dysphagia.
METHODS: In this study, multiple methods were adopted. In Phase 1, a general information questionnaire and a knowledge-attitude-practice and barriers/facilitators questionnaire for dysphagia screening and assessment were distributed in 55 hospitals online. In Phase 2, semi-structured interviews were conducted to explore nurses\' views on barriers. Descriptive and one-way variance analyses were used to analyse the quantitative data, while content analysis was used to analyse the qualitative data. This study adheres to STROBE and COREQ guidelines.
RESULTS: Nine hundred and forty-two completed questionnaires were collected. Only 36.52% of the nurses screened for swallow function in patients as a guideline. The biggest barrier was \'memory, attention and decision process\', with an average score of 3.22 (.74). The different stages of implementation had various types and degrees of barriers (p < .001). Five themes were extracted after interviews, namely \'Inadequate environment and resource support\', \'Increased workload\', \'Professional value perception\', \'Organisational culture\', and \'Poor knowledge and skill\'.
CONCLUSIONS: Nurses\' practice of dysphagia screening and assessment of patients with dysphagia after stroke were inadequate, and the barriers originated from patients, leadership and the nurses themselves.
CONCLUSIONS: This research extracted five barriers of guidance adherence for post-stroke dysphagia screening and assessment and identified the different kinds and degrees of barriers in five implementation stages, providing a basis for nursing managers to break through the bottleneck of guideline implementation.
UNASSIGNED: The nurses recruited in this study completed validated questionnaires in the survey and suggestive answers in interviews.
摘要：
背景：有越来越多的基于证据的建议用于治疗卒中后患者的吞咽困难。然而,目前尚不清楚护士是否在日常护理实践中采纳这些建议.
目的：本研究旨在探讨护士的依从性，障碍,关于吞咽困难筛查和卒中后吞咽困难评估的促进者和观点。
方法：在本研究中，采用多种方法。在第1阶段，在线在55家医院中分发了用于吞咽困难筛查和评估的一般信息问卷和知识态度实践和障碍/促进者问卷。在第2阶段，进行了半结构化访谈，以探索护士对障碍的看法。描述性和单向方差分析用于分析定量数据，而内容分析法用于分析定性数据。本研究遵循STROBE和COREQ指南。
结果：收集了9242份完整的问卷。只有36.52％的护士对患者的吞咽功能进行了筛查。最大的障碍是记忆，注意和决策过程，平均得分为3.22（.74）。实施的不同阶段有各种类型和程度的障碍(p<.001)。采访后提取了五个主题，即\'环境和资源支持不足\'，\'增加的工作负载\',\'专业价值感知\'，“组织文化”，和“知识和技能贫乏”。
结论：护士对卒中后吞咽困难患者的吞咽困难筛查和评估的实践是不充分的，障碍源于患者，领导和护士自己。
结论：本研究提取了卒中后吞咽困难筛查和评估指导依从性的5个障碍，并在5个实施阶段确定了不同种类和程度的障碍。为护理管理者突破指南实施瓶颈提供依据。
UNASSIGNED：本研究中招募的护士在调查中完成了经过验证的问卷，在访谈中完成了暗示性的回答。
目的：本研究旨在探讨护士的依从性，障碍,关于吞咽困难筛查和卒中后吞咽困难评估的促进者和观点。
方法：在本研究中，采用多种方法。在第1阶段，在线在55家医院中分发了用于吞咽困难筛查和评估的一般信息问卷和知识态度实践和障碍/促进者问卷。在第2阶段，进行了半结构化访谈，以探索护士对障碍的看法。描述性和单向方差分析用于分析定量数据，而内容分析法用于分析定性数据。本研究遵循STROBE和COREQ指南。
结果：收集了9242份完整的问卷。只有36.52％的护士对患者的吞咽功能进行了筛查。最大的障碍是记忆，注意和决策过程，平均得分为3.22（.74）。实施的不同阶段有各种类型和程度的障碍(p<.001)。采访后提取了五个主题，即\'环境和资源支持不足\'，\'增加的工作负载\',\'专业价值感知\'，“组织文化”，和“知识和技能贫乏”。
结论：护士对卒中后吞咽困难患者的吞咽困难筛查和评估的实践是不充分的，障碍源于患者，领导和护士自己。
结论：本研究提取了卒中后吞咽困难筛查和评估指导依从性的5个障碍，并在5个实施阶段确定了不同种类和程度的障碍。为护理管理者突破指南实施瓶颈提供依据。
UNASSIGNED：本研究中招募的护士在调查中完成了经过验证的问卷，在访谈中完成了暗示性的回答。
