College of Nursing, University of Saskatchewan, Regina, Saskatchewan, Canada.
College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
J Clin Nurs. 2019 May;28(9-10):1664-1679. doi: 10.1111/jocn.14772. Epub 2019 Jan 22.
To empirically test a conceptual model of confidence and competence in rural and remote nursing practice.
The levels of competence and confidence of nurses practising in rural settings have been highlighted as essential to the quality of health outcomes for rural peoples. However, there is limited research exploring these constructs in the context of rural/remote nursing practice.
Structural equation modelling was used to verify the conceptual model with data from the cross-sectional pan-Canadian Nursing Practice in Rural and Remote Canada II Survey. The STROBE guidelines for cross-sectional research were followed in the design/reporting of this analysis. The sample consisted of 2,065 registered nurses and nurse practitioners who were working in direct rural/remote nursing practice.
The maximum likelihood ratio χ = 0.0822, df = 2, p = 0.959 indicated model fit, with final model estimates explaining 53% of the variance in work confidence and 17% of the variance in work competence. The model also accounted for 40% of the variance in work engagement, 39% of the variance in burnout and 15% of the variance in perceived stress. The complexity of competence and confidence in rural nursing practice was evident, being influenced by nursing experience in rural settings, rural work environment characteristics, community factors and indicators of professional well-being.
The factors influencing nurses' competence and confidence in rural/remote nursing practice are more complex than previously understood. Our model, created and tested using structural equation modelling, merits further research, to extend our understanding of how nurses can be prepared and supported for practice in rural and remote settings.
This study highlights the importance of supporting new nurses' exposure to rural nursing experiences, reducing professional isolation and improving decision-making support for those who are working at a greater distance from colleagues and/or those with fewer opportunities for interprofessional collaboration.
实证检验农村和偏远地区护理实践中信心和能力的概念模型。
在农村环境中执业的护士的能力和信心水平被认为是农村人民健康结果质量的关键。然而，在农村/偏远地区护理实践的背景下，探索这些结构的研究有限。
使用结构方程模型，使用来自加拿大农村和偏远地区护理实践 II 横断面泛加拿大调查的数据验证概念模型。本分析的设计/报告遵循 STROBE 关于横断面研究的指南。样本包括 2065 名在直接农村/偏远地区护理实践中工作的注册护士和执业护士。
最大似然比 χ = 0.0822，df = 2，p = 0.959 表明模型拟合，最终模型估计解释了工作信心方差的 53%和工作能力方差的 17%。该模型还解释了工作投入方差的 40%、倦怠方差的 39%和感知压力方差的 15%。农村护理实践中能力和信心的复杂性显而易见，受到农村环境中的护理经验、农村工作环境特征、社区因素和专业幸福感指标的影响。
影响农村/偏远地区护理实践中护士能力和信心的因素比以前理解的更为复杂。我们使用结构方程模型创建和测试的模型值得进一步研究，以扩展我们对如何为农村和偏远地区的实践准备和支持护士的理解。
本研究强调了支持新护士接触农村护理经验、减少职业孤立和改善对那些距离同事更远或较少有机会进行跨专业合作的人的决策支持的重要性。
