Evidence map›Paper›PMID 40654168›Full record

ArticleJournal of clinical nursing2026

Impact of Nurses' Knowledge, Self-Efficacy and Clinical Reasoning Competency on Difficulties in Caring for Patients With Delirium in the Intensive Care Unit: A Cross-Sectional Study.

Jing Dong, Weijing Sui, Xiaoyan Gong, Li Wang, Qiqi Ni, Ran Yan, Jia Yi, Ying Ding, Yiyu Zhuang

Abstract read
In one paragraph

Article in Journal of clinical nursing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Jing DongNursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.ORCID 0000-0001-5568-4399
Weijing SuiNursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Xiaoyan GongNursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Li WangNursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Qiqi NiNursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Ran YanNursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Jia YiNursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Ying DingDepartment of Intensive Care Unit, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Yiyu ZhuangNursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Funding

Science and Technology Department of Zhejiang Province LTGY24H090006
6 · The paper itself

Abstract

aimTo examine the impact of critical care nurses' delirium knowledge, self-efficacy and clinical reasoning competency on delirium care difficulties based on the information-motivation-behavioural (IMB) skills model from a behavioural perspective.

designCross-sectional study.

methodsA total of 440 critical care nurses from five hospitals in China were selected using convenience sampling and invited to complete an online questionnaire for measurement. Data were collected in November 2024 and analysed using SPSS/AMOS with descriptive statistics, Pearson's correlation coefficient and multiple regression. Structural equation modelling was constructed to test the hypothesised relationships among the variables, with bootstrapping to assess mediation effects.

resultsThe level of delirium care difficulties was moderated. Delirium care difficulties were negatively correlated with delirium knowledge, self-efficacy and clinical reasoning competency. Clinical reasoning competency partly mediated delirium knowledge and self-efficacy with regard to delirium care difficulties.

conclusionDelirium knowledge, self-efficacy and clinical reasoning competency are essential for improving critical care nurses' delirium care competencies. The role of clinical reasoning competency in the relationship between the other two variables and delirium care difficulties was highlighted. Establishing multifaceted innovative delirium education programmes, emphasising individuals' sense of competence and enhancing clinical reasoning competency as behavioural skills were supported. Exploring these pathways using a nurse behaviour change-based perspective is critical. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Critical care managers should value nurses' delirium care competencies. Enhancing continuing professional development through system-level support with high reliability and multiform professional education, including innovative theoretical and practical training; advancing policies that increase work motivation and self-planning to stimulate self-efficacy; and exercising critical and reflective thinking to improve clinical reasoning competency may enhance nurses' delirium recognition and care competencies, including prioritisation, potentially improving delirium care dilemmas and patient outcomes. REPORTING

methodThe STROBE checklist was used as a guideline. PATIENT OR PUBLIC CONTRIBUTION: Nurses completed questionnaires.

trial registrationChinese Clinical Trial Registry (ChiCTR2400092177). https://www.chictr.org.cn/bin/project/edit?pid=249216.

Indexed as

Clinical CompetenceClinical ReasoningCritical Care NursingDeliriumHealth Knowledge, Attitudes, PracticeNursing Staff, HospitalSelf EfficacyAdultChinaCross-Sectional StudiesFemaleHumansIntensive Care UnitsMaleMiddle AgedSurveys and Questionnairesclinical reasoningdeliriumdifficultyintensive care unitknowledgeself‐efficacy

Identifiers

PMID40654168
PMCPMC12779172

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.