Knowledge, attitudes, and practices regarding the Sellick maneuver among healthcare professionals in Bulgaria: a multicenter cross-sectional study.

Authors

Zlatina Stoyanova, Milena Sandeva, Tanya Kitova, Petya Trendafilova, Alexandrina Vodenicharova, Hristo Bozov, Yana Kashilska, Georgi Gelov, Plamen Penchev, Jannis Papathanasiou

Published in

European journal of translational myology. Nov 06, 2026. Epub Nov 06, 2026.

Abstract

The Sellick Maneuver (SM) is used during Rapid Sequence Induction (RSI) to reduce the risk of regurgitation and Pulmonary Aspiration (PA); however, evidence regarding Bulgarian Healthcare Professionals' (HPs) preparedness to perform the SM is limited. This multicenter cross-sectional study assessed knowledge, attitudes, and practices (KAP) regarding the SM and factors associated with Adequate Self-Reported Practical Application (ASRPA). A total of 135 HPs from six Bulgarian institutions completed a 31-item, psychometrically evaluated Bulgarian-language questionnaire comprising Knowledge (15 items; 0-15), Attitudes (8 items; 8-40), and Practices (8 items; 8-40) domains. Internal consistency was assessed using KR-20 and Cronbach's α, factorability using the Kaiser-Meyer-Olkin (KMO) measure and Bartlett's test, and associated factors using multivariable logistic regression. Overall preparedness was moderate in 45.2%, good in 39.3%, and low in 15.6% of participants; 51.1% demonstrated ASRPA. Mean scores were 9.6 ± 3.1 for Knowledge, 30.2 ± 5.4 for Attitudes, and 26.7 ± 6.2 for Practices. Reliability was good for Knowledge (KR-20 = 0.82) and acceptable for Attitudes (α = 0.76) and Practices (α = 0.71). Knowledge demonstrated adequate factorability (KMO = 0.76; Bartlett's P < 0.001), with three factors explaining approximately 54% of variance. ASRPA was independently associated with non-Burgas institutional affiliation adjusted Odds Ratio (aOR), 1.76; 95% Confidence Interval (CI), 1.01-3.08), Previous SM Training (PSMT) (aOR, 1.94; 95% CI, 1.12-3.36), higher Knowledge scores (aOR, 1.15 per point; 95% CI, 1.05-1.27), and higher Attitudes scores (aOR, 1.11 per point; 95% CI, 1.02-1.21). Preparedness was predominantly moderate, supporting structured, simulation-enhanced, competency-based SM training. The Bulgarian KAP instrument showed promising preliminary psychometric properties but requires further independent validation.

PMID:
42992967
Bibliographic data and abstract were imported from PubMed on 06 Nov 2026.

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