{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T09:10:01Z","timestamp":1790673001210,"version":"4.1.0"},"reference-count":18,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing Open"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To examine the indirect association between subsyndromal delirium knowledge and clinical behaviour among psychiatric nurses, with attitude as a linking factor.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A cross\u2010sectional survey design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean scores for SSD self\u2010perceived knowledge, attitudes, and practices were 17.32\u2009\u00b1\u20096.66, 32.55\u2009\u00b1\u20094.54, and 30.11\u2009\u00b1\u20096.08, respectively. All three variables showed positive correlations (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Attitudes exhibited a significant association within the knowledge\u2010practice relationship. The direct association between knowledge and behaviour (81.0%) proved to be more robust than the indirect association (19.0%). The moderating role of professional title was not statistically significant (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.058). Given the cross\u2010sectional design, the direct and indirect comparisons are descriptive only and should not be interpreted causally.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Attitude showed a relatively small indirect association with SSD knowledge and behaviour among psychiatric nurses, though the direct association was considerably more robust. Despite favourable attitudes, self\u2010perceived knowledge levels remained notably low. The findings suggest that system\u2010level behavioural triggers (e.g., electronic health record prompts, standardized handover checklists) and knowledge education both offer potentially promising directions for future intervention research, though their relative effectiveness requires further investigation. However, the convenience sample was predominantly composed of tertiary hospital nurses (73.2%), limiting generalizability to primary\u2010level settings. Due to the cross\u2010sectional nature of this study, the findings indicate associations and necessitate longitudinal validation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for the Profession and\/or Patient Care<\/jats:title>\n                    <jats:p>The direct knowledge\u2013behaviour association suggests that system\u2010level workflow factors may be relevant intervention targets. Low self\u2010perceived knowledge scores also indicate a continued need for knowledge education as a complementary goal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>The predominance of the direct knowledge\u2013behaviour association over the attitudinal pathway suggests that system\u2010level workflow factors may play a key role in sustaining clinical practices, whereas self\u2010perceived knowledge deficits point to the continued need for knowledge education. These findings provide empirical support for considering both system\u2010level and educational approaches in SSD nursing care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Reporting Method<\/jats:title>\n                    <jats:p>This study adhered to the STROBE guidelines for cross\u2010sectional studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>No patient or public contribution.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/nop2.70835","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T04:35:47Z","timestamp":1789533347000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Direct and Indirect Statistical Associations Between Knowledge, Attitudes, and Behaviours Regarding Subsyndromal Delirium in Psychiatric Nurses: A Cross\u2010Sectional Study"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-0175-6517","authenticated-orcid":false,"given":"Lihua","family":"Liu","sequence":"first","affiliation":[{"name":"Clinical Department 1 Beijing Huilongguan Hospital, Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongmei","family":"Xu","sequence":"additional","affiliation":[{"name":"Nursing Department Beijing Huilongguan Hospital, Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuqi","family":"Li","sequence":"additional","affiliation":[{"name":"Clinical Department 6 Beijing Huilongguan Hospital, Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Zhan","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Xiamen Xianyue Hospital  Xiamen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanting","family":"Li","sequence":"additional","affiliation":[{"name":"Hospital Office Beijing Huilongguan Hospital, Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengqian","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Psychology Beijing Huilongguan Hospital, Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangling","family":"Shi","sequence":"additional","affiliation":[{"name":"Intensive Care Medicine Department Nanjing Brain Hospital  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4836-8205","authenticated-orcid":false,"given":"Na","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Huzhou Third People's Hospital  Huzhou 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