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考察精神卫生病房中基于证据的实践与护患治疗关系之间的关联:一项横断面研究。

Examining the association between evidence-based practice and the nurse-patient therapeutic relationship in mental health units: A cross-sectional study.

机构信息

Department of Public Health, Mental Health and Maternal and Child Health Nursing, Nursing School, Universitat de Barcelona, L´Hospitalet de Llobregat, Barcelona, Spain.

IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.

出版信息

J Adv Nurs. 2021 Apr;77(4):1762-1771. doi: 10.1111/jan.14715. Epub 2020 Dec 17.

Abstract

AIMS

To examine the relationship between the dimensions of evidence-based practice and the therapeutic relationship and to predict the quality of the therapeutic relationship from these dimensions among nurses working in mental health units.

DESIGN

A cross-sectional design.

METHODS

Data were collected between February-April 2018 via an online form completed by nurses working at 18 mental health units. Multiple linear regressions were used to examine the relationship between the dimensions of evidence-based practice and therapeutic relationship. Questionnaires were completed by 198 nurses.

RESULTS

Higher levels of evidence-based practice were a significant predictor of a higher-quality therapeutic relationship (β: 2.276; 95% CI: 1.30-3.25). The evidence-based practice factor which most influenced an improved therapeutic relationship was the nurses' attitude (β: 2.047; 95% CI: 0.88-3.21). The therapeutic relationship dimension which was most conditioned by evidence-based practice dimensions was agreement on tasks, which was most favourable with a better attitude (β: 0.625; 95% CI: 0.09-1.16) and greater knowledge and skills for evidence-based practice (β: 0.500; 95% CI: 0.08-0.93).

CONCLUSION

In mental health settings, the therapeutic nurse-patient relationship is positively enhanced by evidenced-based practice and the nurse's level of experience, with a great influence on shared decision-making.

IMPACT

This research sought to examine the relationship between the evidence-based practice and the therapeutic relationship in mental health nursing. This study demonstrates that an improved attitude and knowledge of evidence-based practices of mental health nurses increases shared decision-making with patients, which is a basic requirement for person-centred care. Because the therapeutic relationship is considered the backbone of nursing practice in mental health units, this research will have an impact on both mental health nurses and mental health unit managers.

摘要

目的

探讨循证实践的各个维度与治疗关系之间的关系,并从这些维度预测精神卫生单位护士的治疗关系质量。

设计

横断面设计。

方法

2018 年 2 月至 4 月,通过精神卫生单位 18 名护士在线填写的表格收集数据。采用多元线性回归分析探讨循证实践各维度与治疗关系之间的关系。共有 198 名护士完成了问卷。

结果

循证实践水平较高是治疗关系质量较高的一个显著预测因素(β:2.276;95%CI:1.30-3.25)。对改善治疗关系影响最大的循证实践因素是护士的态度(β:2.047;95%CI:0.88-3.21)。受循证实践维度影响最大的治疗关系维度是任务上的共识,而态度越好(β:0.625;95%CI:0.09-1.16)和循证实践知识和技能越高(β:0.500;95%CI:0.08-0.93),共识越有利。

结论

在精神卫生环境中,循证实践和护士的经验水平会积极促进治疗师-患者关系,对共同决策有很大影响。

意义

本研究旨在探讨循证实践与精神卫生护理治疗关系之间的关系。研究表明,提高精神卫生护士对循证实践的态度和知识,增加与患者的共同决策,这是以人为本护理的基本要求。由于治疗关系被认为是精神卫生单位护理实践的核心,因此这项研究将对精神卫生护士和精神卫生单位管理人员产生影响。

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