Knowledge, attitudes and practices toward discharge preparation among parents of newborns hospitalized in the NICU: A multi-center cross-sectional study

BACKGROUND: This study aimed to assess the knowledge, attitudes, and practices (KAP) of parents regarding the discharge preparation of newborns hospitalized in neonatal intensive care units (NICUs). METHODS: This multi-center cross-sectional study was conducted between October 2023 and February 2024 across six NICUs in Shenzhen. Data were collected using a structured, expert-developed questionnaire with verified reliability and internal consistency. RESULTS: A total of 549 valid questionnaires were included in the final analysis. Among the respondents, 340 (61.93%) were male. The mean scores for knowledge, attitude, and practice were 20.74 ± 7.29 (possible range: 0-40), 42.64 ± 3.66 (range: 10-50), and 44.86 ± 6.71 (range: 11-55), respectively. Multivariate linear regression identified that being female, urban residence, having one or two children, and prior caregiving experience were significantly associated with higher knowledge scores. Knowledge (β = 0.147, P < 0.001) and various forms of caregiving support were positively associated with attitudes, while longer distance to hospital was associated with lower attitude scores. Knowledge (β = 0.304, P < 0.001), attitude (β = 0.801, P < 0.001), and prior caregiving experience were independently associated with practice. Path analysis confirmed that knowledge had direct effects on both attitude (β = 0.314, P = 0.013) and practice (β = 0.348, P = 0.010), and also an indirect effect on practice mediated by attitude (β = 0.138, P = 0.011). CONCLUSION: While parents demonstrated positive attitudes and proactive practices, a significant gap in knowledge persists regarding NICU discharge preparation. Tailored educational strategies are necessary to enhance parental readiness and promote safer transitions from hospital to home care.