影响中国护理实践中证据应用的因素。
Factors influencing the implementation of evidence in Chinese nursing practice.
作者信息
Cheng Lei, Broome Marion E, Feng Sheng, Hu Yan
机构信息
School of Nursing, Fudan University, Shanghai, China.
School of Nursing, Duke University, Durham, NC, USA.
出版信息
J Clin Nurs. 2017 Dec;26(23-24):5103-5112. doi: 10.1111/jocn.14053. Epub 2017 Oct 10.
AIMS AND OBJECTIVES
To explore the influencing factors from staff nurses, nurse managers, nursing directors and a physician involved in nursing evidence implementation in Mainland China.
BACKGROUND
Although the need for evidence-based nursing is well recognised, continuous efforts are needed to strive for closing the gap from evidence to action. Previous studies have explored influencing factors from individual and organisational perspectives in Western countries. However, it remains unclear what the influences (i.e., context and culture) in the developing countries as China.
DESIGN
A grounded theory design using in-depth individual interviews was conducted.
METHODS
Interviews with 56 participants from 24 evidence-based nursing implementation projects were conducted in Mainland China. Constant comparative analysis was used to discover the concepts describing the influencing factors during the implementation process.
RESULTS
Factors that influenced implementation of evidence-based practice in the Chinese context were identified. These included the leaders of the projects, the nature of the evidence, practising nurses, patients involved in the projects, the system where the projects were implemented, as well as the influence from outside of the system.
CONCLUSIONS
A variety of factors influencing evidence implementation in Chinese nursing context were identified and further explored from the perspective of different project leaders and culture influence. There is apparently a strong demand for a supportive system, targeted strategies to facilitate various evidence implementations and integrated core elements of evidence-based practice at the point care.
RELEVANCE TO CLINICAL PRACTICE
The blurred boundaries and complexity of influencing factors call for a systematic and dynamic perspective during implementation. The competitive priorities emphasise the importance of integration between clinical nursing care and evidence-based practice.
目的与目标
探讨中国大陆参与护理证据实施的一线护士、护士长、护理主任及一名医生的影响因素。
背景
尽管循证护理的必要性已得到广泛认可，但仍需持续努力以缩小从证据到行动的差距。以往研究已从西方国家的个人和组织角度探讨了影响因素。然而，在中国等发展中国家，其影响因素（即背景和文化）仍不明确。
设计
采用深入个人访谈的扎根理论设计。
方法
对中国大陆24个循证护理实施项目的56名参与者进行访谈。运用持续比较分析法，找出描述实施过程中影响因素的概念。
结果
确定了在中国背景下影响循证实践实施的因素。这些因素包括项目负责人、证据的性质、执业护士、项目涉及的患者、项目实施的系统以及系统外部的影响。
结论
识别并从不同项目负责人和文化影响的角度进一步探讨了中国护理背景下影响证据实施的多种因素。显然，迫切需要一个支持系统、促进各种证据实施的针对性策略以及在护理现场整合循证实践的核心要素。
与临床实践的相关性
影响因素的界限模糊且复杂，这要求在实施过程中采用系统和动态的视角。竞争重点强调了临床护理与循证实践整合的重要性。
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