Knowledge, Belief, and Practice Study on the Use of Smart Nursing Devices by Nurses in Neurology and Rehabilitation Departments: From the Perspective of the Technology Acceptance Model (TAM)

Abstract Background Smart nursing devices can improve safety and quality of care for patients with neurological-rehabilitation conditions. Nevertheless, nurses’ knowledge-attitude-practice (KAP) regarding these devices has rarely been explored using an integrated theoretical framework. This study aimed to investigate nurses’ knowledge, attitudes and usage behaviours towards smart nursing devices based on the Technology Acceptance Model (TAM)-KAP framework, and identify influencing factors and practical barriers. Methods A cross-sectional survey was performed among 219 registered nurses from neurology and rehabilitation departments of 20 hospitals across 16 Chinese provinces from January to May 2026. Self-administered questionnaires covered general information, knowledge, TAM-based attitude-intention, actual usage behaviour and usage barriers. Questionnaire reliability and validity were tested in a pilot survey. Statistical analyses included descriptive statistics, correlation analysis and hierarchical multiple linear regression using SPSS 26.0. Results Nurses held positive usage attitudes (3.98 ± 0.79 per item) but showed insufficient knowledge (2.88 ± 1.08), with a notable intention-behaviour gap in device application. Perceived usefulness was the strongest predictor of usage attitude (β = 0.846, P < 0.001) and behavioural intention (β = 0.796, P < 0.001). Both behavioural intention and knowledge directly predicted actual usage behaviour. Higher training frequency was associated with higher total KAP scores (H = 29.862, P < 0.001). Major barriers included device instability (41.1%), workflow mismatch (39.7%), and poor patient cooperation caused by cognitive impairment (38.8%). Conclusions Despite favourable attitudes, insufficient knowledge and contextual obstacles hinder nurses from translating positive intentions into practice. Targeted training and device optimisation are required to narrow the intention-behaviour gap. These findings provide evidence for training design and equipment management within neuro-rehabilitation nursing.