2026 Volume 46 Pages 215-226
Purpose: This study aimed to examine a sequential mediation model that explains the perceived difficulties nurses encounter in preventing medical device-related pressure ulcers (MDRPU) in Neonatal Intensive Care Units (NICU). We hypothesized a pathway in which self-efficacy (professional situations) influences perceived difficulties through resilience (interpersonal skills) and negative mood.
Methods: A cross-sectional, web-based survey was conducted among NICU nurses in Japan. The survey assessed self-efficacy, resilience, negative mood, and perceived difficulties in MDRPU prevention. The relationships among these variables were examined through path analysis.
Results: A total of 354 valid responses were obtained, with 248 nurses (70.1%) reporting difficulties in MDRPU prevention. Perceived difficulties were not significantly associated with demographic factors such as clinical experience but were significantly related to psychological factors. Path analysis demonstrated significant associations: self-efficacy (professional situations) was positively related to resilience (interpersonal skills), which in turn was negatively related to negative mood. Furthermore, negative mood was the only variable with a significant direct effect on perceived difficulties (β = –0.135, p = .045).
Conclusion: The hypothesized sequential mediation effect was not significant. However, perceived difficulties were directly associated with negative mood, suggesting the importance of psychological factors. The findings suggest that integrated support aimed at strengthening self-efficacy and cultivating interpersonal skills, extending beyond knowledge-based training, may be effective for reducing difficulties.
