Knowledge, attitudes and practices regarding the use of spirometry among healthcare professionals in South-south Nigeria: a cross-sectional study

Abstract

Context: Spirometry is the gold standard pulmonary function test for diagnosing and monitoring obstructive and restrictive airway diseases. Despite its established utility, its use remains suboptimal in Nigeria. This study assessed the knowledge, attitudes and practices regarding spirometry among healthcare professionals and identified independent predictors of good spirometry practice.

Methods: A descriptive cross-sectional study was conducted among 210 healthcare professionals from tertiary, secondary, primary and private hospitals across Nigeria using purposive sampling. A structured, pre-tested, self-administered questionnaire assessed knowledge of spirometry indications and diagnostic criteria, attitudes towards its clinical utility across seven indications and self-reported practice frequency. Good spirometry practice was defined as using spirometry sometimes or often/always. Bivariate associations were examined using chi-square and Mann-Whitney U tests and independent predictors were identified by binary logistic regression. Data were analysed using IBM SPSS Statistics version 27.0.

Results: The mean age of respondents was 41.6 ± 8.5 years; 54.8% were males. Registrars constituted 59.0% and 60.5% practiced in tertiary hospitals. Medical school was the dominant knowledge source (81.0%). Self-assessed knowledge was good or excellent in 83.8%. Attitudes were strongly positive, with 94.8% rating spirometry very important for diagnosis. However, only 25.2% used spirometry often or always and 50.0% were only slightly confident in interpretation. Spirometers were unavailable in 65.2% of hospitals. On logistic regression, good or excellent self-assessed knowledge (AOR=11.60; 95% CI: 3.91–34.37; p<0.001) and registrar cadre (AOR=0.23; 95% CI: 0.09–0.61; p=0.003) were the independent predictors of good spirometry practice.

Conclusion: Nigerian healthcare professionals demonstrate positive attitudes but a significant practice gap in spirometry use. Self-assessed knowledge is the strongest independent predictor of good practice. Targeted post-qualification training and the urgent procurement of spirometers are essential.