Jiang X S, Xu L, Li L, Zhang L Q
Department of Surgery, School of Nursing, Fujian Medical University, Fuzhou 350108, China.
Zhonghua Shao Shang Za Zhi. 2018 Oct 20;34(10):731-735. doi: 10.3760/cma.j.issn.1009-2587.2018.10.016.
To explore the difference between the nursing needs of burn patients and nurses' cognition in order to adjust the nursing service behavior and improve the nursing quality. The convenience sampling method was adopted to select 400 burn inpatients admitted to the Department of Burns of the 180th Hospital of the People's Liberation Army from January to September 2017, and 38 nurses from the same department were selected by cluster sampling method. On the day of or the day before hospital discharge after instruction to discharging patients, the self-designed questionnaire was adopted to investigate the nursing needs of patients during hospitalization. The cognitive differences between patients and nurses in the overall level and specific dimensions of nursing needs were compared, and items of the nursing needs of patients which were higher than the cognition of nurses with statistically significant differences were recorded. The five most important nursing needs items considered by both patients and nurses were recorded and compared. Data were processed with independent sample test. The effective recovery rates of questionnaire for patients and nurses were 94.8% (379/400) and 100.0% (38/38), respectively. The total score of patients' nursing needs was (3.9±0.4) points, which was similar to (4.1±0.5) points of nurses' cognition of patients' nursing needs (=1.611, >0.05). The scores of patients' physiological needs and self-esteem needs dimensions were (4.0±0.6) and (3.9±0.6) points, respectively, significantly lower than (4.2±0.4) and (4.3±0.5) points of nurses (=-2.476, -4.160, <0.05 or <0.01). The scores of patients' safety needs, love and belonging needs, and self-realization needs dimensions were similar to those of nurses (=0.228, 1.356, -1.010, >0.05). The scores of the patients in nursing needs items of the introduction of patients in the same room, medical staff accompanying them during the examination, leisure and recreational activities, the theoretical and technical proficiency of nurses, the guidance of anti-scar exercise, and the propaganda of drug knowledge were respectively (4.2±0.9), (3.3±1.2), (4.2±0.9), (4.5±0.7), (4.2±0.9), and (4.0±1.0) points, significantly higher than (3.5±0.9), (2.7±1.0), (3.5±1.3), (4.1±0.8), (3.8±1.0), and (3.6±0.9) points of the nurses (=4.147, 3.515, 3.374, 3.282, 2.546, 2.265, <0.05 or <0.01). The five most important items for patients and nurses were pain nursing, the theoretical and technical proficiency of nurses, treating patients equally, instruction to discharging patients, timely visiting wards and privacy protection, pain nursing, introduction of medical staff, introduction of safety issues, getting the daily expenses listing, respectively. Only pain nursing was the same between patients and nurses. There are some differences between burn patients and nurses in the dimensions and items of nursing needs and the most important items of nursing needs. Nursing staff should focus on improving the nursing service items with insufficient cognition, adjusting the service supply, meeting the reasonable needs of patients, and improving the nursing satisfaction of patients.
为探讨烧伤患者护理需求与护士认知之间的差异,以调整护理服务行为,提高护理质量。采用便利抽样法选取2017年1月至9月解放军第180医院烧伤科收治的400例烧伤住院患者,并采用整群抽样法选取该科室38名护士。在对出院患者进行出院指导当天或前一天,采用自行设计的问卷对患者住院期间的护理需求进行调查。比较患者与护士在护理需求总体水平及具体维度上的认知差异,记录患者护理需求中高于护士认知且差异有统计学意义的项目。记录并比较患者和护士共同认为的五项最重要的护理需求项目。数据采用独立样本t检验进行处理。患者和护士问卷的有效回收率分别为94.8%(379/400)和100.0%(38/38)。患者护理需求总分为(3.9±0.4)分,与护士对患者护理需求的认知得分(4.1±0.5)分相近(t = 1.611,P>0.05)。患者生理需求和自尊需求维度得分分别为(4.0±0.6)分和(3.9±0.6)分,显著低于护士的(4.2±0.4)分和(4.3±0.5)分(t = -2.476,-4.160,P<0.05或P<0.01)。患者安全需求、爱与归属需求和自我实现需求维度得分与护士相近(t = 0.228,1.356,-1.010,P>0.05)。患者在同室患者介绍、检查时有医护人员陪同、休闲娱乐活动、护士理论技术水平、抗瘢痕锻炼指导、药物知识宣传等护理需求项目上的得分分别为(4.2±0.9)分、(3.3±1.2)分、(4.2±0.9)分、(4.5±0.7)分、(4.2±0.9)分和(4.0±1.0)分,显著高于护士的(3.5±0.9)分、(2.7±1.0)分、(3.5±1.3)分、(4.1±0.8)分、(3.8±1.0)分和(3.6±0.9)分(t = 4.147,3.515,3.374,3.282,2.546,2.265,P<0.05或P<0.01)。患者和护士共同认为的五项最重要的项目分别是疼痛护理、护士理论技术水平、平等对待患者、出院指导、及时查房和隐私保护,以及疼痛护理、医护人员介绍、安全问题介绍、获取每日费用清单。患者和护士仅在疼痛护理这一项上相同。烧伤患者与护士在护理需求维度、项目及最重要护理需求项目方面存在一些差异。护理人员应重点改进认知不足的护理服务项目,调整服务供给,满足患者合理需求,提高患者护理满意度。