23 June 2026 : Original article
Development and Validation of an Early Post-Liver Transplant Activity Knowledge, Attitude, and Practice Questionnaire for Intensive Care Unit Nurses: A Multicenter Study
Shuo Li ACEF 1, Lixia Zhong BDF 2, Yulin Zheng BDF 3, Yanhong Jin BDF 4*DOI: 10.12659/AOT.952175
Ann Transplant 2026; 31:e952175
Table 2 Results of exploratory factor analysis of KAP Questionnaire for ICU Nurses on early mobilization in critically ill patients after liver transplantation (n=334).
| Item | Knowledge | Attitude | Practice |
|---|---|---|---|
| K1: Concept of early mobilization in critically ill patients after liver transplantation | 0.834 | 0.066 | 0.246 |
| K2: Indications and contraindications for early mobilization in critically ill patients after liver transplantation | 0.834 | 0.056 | 0.268 |
| K3: Critically ill patients after liver transplantation should engage in early passive or active limb mobilization despite having various monitoring lines | 0.860 | 0.128 | 0.265 |
| K4: The principles of early mobilization in critically ill patients after liver transplantation are to ensure patient safety and personal safety, improve functional impairment, and prioritize tasks, with the main goals of lung function recovery, sitting, and standing for conscious patients, and prevention of complications (eg, lung infections, pressure injuries, deep vein thrombosis, joint contractures, and muscle atrophy) for unconscious patients | 0.879 | 0.152 | 0.251 |
| K5: The professional team implementing early mobilization in critically ill patients after liver transplantation includes doctors, nurses, rehabilitation therapists, and nutritionists, with comprehensive management through multidisciplinary collaboration | 0.845 | 0.112 | 0.239 |
| K6: Consensus recommends that daily assessments of consciousness, muscle strength, and cooperation ability be conducted for critically ill patients after liver transplantation, along with the formulation of goals and plans for individualized activity to achieve the goal of daily activity | 0.854 | 0.103 | 0.257 |
| K7: The indications for early mobilization initiation in critically ill patients after liver transplantation include stable cardiovascular, neurological, and respiratory systems, with patent drainage tubes in place | 0.888 | 0.119 | 0.243 |
| K8: Early mobilization in critically ill patients after liver transplantation focuses on exercises for respiratory function, limb muscle strength, joint mobility, and activities of daily living (ADL) | 0.885 | 0.117 | 0.257 |
| K9: The mobilization plan for critically ill patients after liver transplantation should be progressive, including supine training, transfer training, sitting training, standing training, and walking training | 0.885 | 0.077 | 0.243 |
| K10: Pain management after liver transplantation is divided into preventive and multimodal analgesia, with personalized pain relief based on individual differences and a focus on post-treatment pain assessment to create conditions for implementing early mobilization | 0.885 | 0.070 | 0.265 |
| K11: Safety risk assessment indicators during early mobilization in critically ill patients after liver transplantation: monitoring basic vital signs (eg, heart rate, respiration, blood pressure, and blood oxygen saturation), assessing surgical-related complications (eg, wound bleeding, abdominal bleeding, and bile leakage), closely monitoring drainage fluid color, blood routine, liver function, coagulation routine, biochemical indicators, and subjective feelings of patients | 0.911 | 0.094 | 0.240 |
| K12: Common safety risks during early mobilization in critically ill patients after liver transplantation: unplanned extubation, falls, falling off bed, pressure injuries, and hemodynamic changes | 0.890 | 0.101 | 0.251 |
| K13: Emergency plans for common safety risks during early mobilization in critically ill patients after liver transplantation: risk assessment, safety measures, and personnel arrangements | 0.880 | 0.089 | 0.215 |
| K14: Indications for early mobilization suspension in critically ill patients after liver transplantation: hemodynamic instability, abnormal respiratory rhythm and frequency, changes in symptoms, abnormal consciousness, and patient intolerance | 0.872 | 0.098 | 0.234 |
| K15: Outcome indicators for critically ill patients after liver transplantation: the incidence of complications, physical function (eg, muscle strength), hospital stays, ICU stays, duration of mechanical ventilation, and ADL scores | 0.878 | 0.064 | 0.247 |
| K16: Main surgical methods for liver transplantation: classic orthotopic liver transplantation, classic piggyback liver transplantation, split liver transplantation, and assisted liver transplantation. Main postoperative complications: intra-abdominal bleeding, bile leakage, bile duct obstruction, infection, liver graft dysfunction, vascular complications, rejection reactions, and metabolic complications | 0.848 | 0.060 | 0.252 |
| K17: Prolonged bed rest for critically ill patients after liver transplantation increases the risks of lung function impairment, inadequate tissue oxygenation, and lower limb venous thrombosis, with a higher incidence of complications and longer ICU and hospital stays | 0.901 | 0.078 | 0.256 |
| A1: I am willing to assist critically ill patients after liver transplantation in engaging in early mobilization | 0.149 | 0.911 | 0.151 |
| A2: I believe it is crucial for ICU nurses to master the relevant knowledge of early mobilization in critically ill patients after liver transplantation | 0.123 | 0.944 | 0.205 |
| A3: I think ICU nurses should master postoperative pain management methods and the effectiveness assessments for critically ill patients after liver transplantation | 0.083 | 0.943 | 0.234 |
| A4: I believe that common safety risks during early mobilization in critically ill patients after liver transplantation can be prevented through medical efforts | 0.111 | 0.929 | 0.198 |
| A5: I think ICU nurses should conduct emergency drills for common emergencies during early mobilization in critically ill patients after liver transplantation | 0.092 | 0.933 | 0.220 |
| A6: I believe ICU nurses should master the content and methods for assessing the effectiveness of early mobilization in critically ill patients after liver transplantation | 0.078 | 0.947 | 0.229 |
| A7: I think the benefits of early mobilization after liver transplantation outweigh the risks and can help restore gastrointestinal motility, improve postoperative tolerance, reduce pulmonary complications, and prevent postoperative atelectasis | 0.085 | 0.943 | 0.219 |
| A8: I believe early mobilization in critically ill patients after liver transplantation is of great significance and value | 0.099 | 0.953 | 0.227 |
| A9: I think that planned and purposeful early mobilization in critically ill patients after liver transplantation is safe and effective | 0.087 | 0.952 | 0.223 |
| A10: I believe ICU nurses should make scientific, prudent, and effective nursing decisions following evidence-based guidance to care for and guide rehabilitation for critically ill patients after liver transplantation | 0.094 | 0.956 | 0.223 |
| P1: I will proactively learn about early mobilization-related knowledge for critically ill patients after liver transplantation and accept relevant training | 0.302 | 0.172 | 0.733 |
| P2: I will assess the vital signs, consciousness, muscle strength, cooperation ability, and catheterization of each tube for critically ill patients after liver transplantation daily as needed | 0.328 | 0.226 | 0.833 |
| P3: I will continuously monitor the graft function status of critically ill patients after liver transplantation | 0.283 | 0.235 | 0.831 |
| P4: I will actively communicate with critically ill patients after liver transplantation to provide psychological support and help them build confidence | 0.290 | 0.290 | 0.859 |
| P5: I will proactively educate critically ill patients after liver transplantation and their family members and actively implement early mobilization after obtaining their informed consent | 0.270 | 0.255 | 0.872 |
| P6: I will assist other medical staff in the professional team to develop individualized mobilization plans based on each patient’s characteristics | 0.269 | 0.215 | 0.840 |
| P7: I will make adequate preparations for early mobilization, including auxiliary equipment, rescue devices, and medications | 0.247 | 0.232 | 0.886 |
| P8: I will help critically ill patients after liver transplantation engage in activities during early mobilization using professional assistance facilities | 0.271 | 0.250 | 0.895 |
| P9: I will gradually implement early mobilization, starting with passive bedside exercise and transitioning to active bedside exercise, 1 to 2 times a day for 5 to 10 min each time while fully considering the patient’s tolerance and making personalized adjustments based on daily goals | 0.330 | 0.185 | 0.849 |
| P10: I will closely monitor vital signs, catheter patency, pain levels, and drainage fluid status during early mobilization and report any abnormalities to doctors in a timely manner | 0.319 | 0.209 | 0.854 |
| P11: I will proactively assess the wound, subjective feelings, and effects of early mobilization for patients after implementing early mobilization | 0.313 | 0.203 | 0.860 |
| P12: I will proactively learn about the surgical methods for liver transplantation in critically ill patients and promptly identify complications related to surgery and early mobilization | 0.313 | 0.170 | 0.874 |
| P13: I am able to correctly implement emergency measures for unexpected events | 0.305 | 0.181 | 0.854 |
| Characteristic value | 22.280 | 4.278 | 8.183 |
| Variance contribution (%) | 35.477 | 24.108 | 27.267 |
| Cumulative variance contribution (%) | 35.477 | 59.585 | 86.852 |