The relationship between knowledge, attitude, and performance with the competence of nurses caring for patients with COVID-19 regarding crisis management: A structural equation modeling approach

Abstract

Abstract Background The outbreak of COVID-19 as a global crisis has required nurses, first-line providers of safe and quality care to patients with this disease, to have a high level of competence, which demands an acceptable level of knowledge, attitude, and performance. Therefore, this study was conducted to model the relationship between knowledge, attitude, and performance with the competence of nurses caring for patients with COVID-19 regarding crisis management. Methods This descriptive-correlational study was conducted on 291 hospital nurses using the structural equation modeling approach in three provinces of Iran, including Kerman, Hormozgan, and Fars, from June to December 2021. Data were collected via self-administered or electronic records and a questionnaire that provided information on demographics, knowledge, attitude, performance, and competence regarding crisis management. Data analysis was performed in SPSS and AMOS software and included descriptive and inferential statistics. Moreover, to test the proposed model of the relationship between knowledge, attitude, and performance with nurses’ competence, the structural equation modeling method was based on the covariance. Results The results showed that nurses’ mean knowledge, attitude, performance, and competence scores were average and higher. There was a statistically significant difference between nurses’ age and knowledge, attitude and performance; education level and performance; gender and knowledge and attitude; position and knowledge, attitude and performance; work experience and knowledge, attitude and competence (P < .05). Moreover, obstacles to upgrading their competence include a lack of expert personnel in the nursing field in crisis and organizational support, nurses’ limited role in crisis management and insufficient authorized educational resources. A positive and significant relationship between knowledge, attitude, and performance with nurses’ competencies is found (P < .05). Furthermore, the coefficient of determination of nurses’ competence in the modified structural model indicates that exogenous variables, namely knowledge, attitude, and performance, could predict 36% of the changes in nurses’ competence. Finally, the path coefficient of the effect of knowledge, attitude, and performance on nurses’ competence is higher than 1.96. Conclusions Nurses caring for patients with COVID-19 require managers’ comprehensive support and need to participate in exercises and maneuvers. Identifying and prioritizing educational needs and learning preferences according to nurses’ cultural differences and backgrounds are also emphasized.