Front Med (Lausanne). 2026 Apr 20;13:1817376. doi: 10.3389/fmed.2026.1817376. eCollection 2026.
ABSTRACT
BACKGROUND: Inhaled therapy is critical for treating chronic airway diseases, yet the competency of respiratory nurses in providing guidance remains inconsistent. Few studies have explored the systemic competency disparities that are driven by a hierarchical distribution of healthcare resources. The aim of this study is to assess self-reported inhaled therapy guidance (ITG) competency among respiratory nurses across multiple-tier healthcare institutions, as well as to explore factors that affected such competency.
METHODS: A total of 962 respiratory nurses at multilevel hospitals in Jiangsu Province, Eastern China were investigated. We developed an ITG competency scale and evaluated its reliability and validity. Nurses rated themselves on a structured questionnaire that was designed to collect data on ITG competency in this population. The associated factors were determined using a descriptive statistical analysis, a correlation analysis, and a hierarchical multiple regression analysis. We followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross-sectional studies.
RESULTS: The ITG competency average score for respiratory nurses was (73.90 ± 9.42). Significant competency disparities were observed across all hospital tiers (p < 0.001), with the primary hospitals demonstrating higher rates of poor and lower proportions of good ratings than secondary/tertiary hospitals. For the knowledge dimension, tertiary hospitals had the fewest poor ratings, while primary hospitals exhibited the highest prevalence of poor ratings, although the proportion of good skill ratings remained comparable across all tiers (p > 0.05). Educational attainment, hospital grade, and training methodologies were associated with respiratory nurses’ competency at ITG.
CONCLUSION: The respiratory nurses exhibited moderate levels of ITG competency, with a notable gap between their knowledge and skills. This gap was more pronounced in primary hospitals, suggesting an association with institutional resource contexts. These results highlight the need for training strategies tailored to each hospital tier, as well as enhanced resource support from tertiary centers to primary care. This would help promote more standardized training programs and reduce competency disparities across hospital tiers.
PMID:42089050 | PMC:PMC13135959 | DOI:10.3389/fmed.2026.1817376
