University Centre for Nursing and Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, De Pintelaan 185, 9000 Ghent, Belgium.
University Centre for Nursing and Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, De Pintelaan 185, 9000 Ghent, Belgium; School of Health Sciences, Faculty of Health & Medical Sciences, Duke of Kent Building, University of Surrey Guildford Surrey, GU2 7XH, United Kingdom.
Int J Nurs Stud. 2017 Sep;74:120-127. doi: 10.1016/j.ijnurstu.2017.06.010. Epub 2017 Jun 24.
Chronic conditions put a heavy burden on healthcare in every country. Supporting persons with a chronic illness to take an active role in the management of their condition is a core component in the Chronic Care Model. It implies confidence and good skills from professionals. To date, there is no evidence on final year nursing students' performance in supporting patients' self-management, nor on factors associated with this performance.
To explore self-reported performance of supporting patients' self-management by final year nursing students, and person-related factors associated with this performance.
A correlational multi-centre study of final year nursing students (N=256) from eight nursing schools.
Students were recruited from a convenience sample of eight nursing schools. All final year students were invited to participate. Data were collected between January 2015 and May 2016 using self-administered validated questionnaires. Theoretical behavioural frameworks were used to select hypothesized associated factors for self-management support: self-efficacy to perform self-management support and socio-structural factors (Social Cognitive Theory); needs for autonomy, competence and relatedness, and patient-invested contingent self-esteem (Self-Determination Theory); and attitudes towards supporting patients' self-management (Theory of Planned Behaviour).
Final year nursing students (N=256) reported an overall low level of performance in delivering self-management support during internship. Students lacked mainly competencies in collaborative goal setting and shared decision making. Students reported a significant gap between their confidence and their actual performance in self-management support (p<0.001). About 33% of the variance in students' performance is predicted by four person-related factors, i.e. self-efficacy to perform self-management support, general feeling of competency on internship, belief on patients' knowledge about condition management, and contingency of a student's professional self-esteem upon patients' achievements.
Final year nursing students are actually not ready to support patients' self-management even though they will soon be in practice as qualified nurses. Nursing curricula should be further attuned to the complex competencies of self-management support. Special attention is needed to broaden the perspective on self-management support. Learning opportunities can be introduced in classroom activities and on internship.
慢性病给每个国家的医疗保健系统带来了沉重的负担。支持慢性病患者积极参与自身疾病的管理是慢性病护理模式的核心组成部分。这需要专业人员具备信心和良好的技能。迄今为止，尚无关于护理专业最后一年学生在支持患者自我管理方面的表现的证据，也没有关于与这种表现相关的因素的证据。
探讨护理专业最后一年学生支持患者自我管理的自我报告表现，以及与该表现相关的个体因素。
一项多中心相关性研究，研究对象为来自八所护理学校的最后一年护理专业学生（N=256）。
从八所护理学校的便利样本中招募学生。邀请所有最后一年的学生参加。研究数据于 2015 年 1 月至 2016 年 5 月间通过自填式已验证问卷收集。使用理论行为框架选择与自我管理支持相关的假设因素：执行自我管理支持的自我效能感和社会结构因素（社会认知理论）；自主、能力和相关的需求，以及患者投入的 contingent 自尊（自我决定理论）；以及支持患者自我管理的态度（计划行为理论）。
护理专业最后一年的学生（N=256）报告在实习期间提供自我管理支持的整体水平较低。学生主要缺乏共同制定目标和共同决策方面的能力。学生报告说，他们在自我管理支持方面的信心和实际表现之间存在显著差距（p<0.001）。学生表现的 33%左右的差异可以由四个个体相关因素预测，即执行自我管理支持的自我效能感、实习期间对自身能力的普遍感觉、对患者对疾病管理知识的信念，以及学生专业自尊取决于患者的成就。
尽管护理专业最后一年的学生即将成为合格的护士开始实践，但他们实际上还没有准备好支持患者的自我管理。护理课程应进一步调整以适应自我管理支持的复杂能力。特别需要关注拓宽自我管理支持的视角。可以在课堂活动和实习中引入学习机会。
