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基于自我决定理论的临床实习对护生治疗性沟通技巧的影响:一项前后测研究。

The influence of a self-determination theory grounded clinical placement on nursing student's therapeutic relationship skills: A pre-test/post-test study.

作者信息

Perlman Dana, Moxham Lorna, Patterson Christopher, Tapsell Amy, Keough Emily

机构信息

School of Education: Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia.

Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia.

出版信息

Int J Ment Health Nurs. 2022 Apr;31(2):305-312. doi: 10.1111/inm.12957. Epub 2021 Nov 24.

Abstract

For undergraduate nursing students, an integral mode of learning is their clinical placements. Learning within the clinical setting is influenced by factors such as the facilitators, peers, unit, or department the student is placed on. What is not known is the role of a social context that is grounded in Self-Determination Theory and how this influences the development of therapeutic relationship skills among undergraduate nursing students. The aim of this study was to examine the role of autonomy support in the professional learning of undergraduate nursing students. This study employed a two-group pre-test and post-test design, with undergraduate nursing students placed in either an autonomy-supportive group or a comparison group in an Australian context. Therapeutic relationship skills were assessed at the beginning and end of their compulsory mental health clinical placement. Participants were 210 (n = 210) Australian undergraduate nursing students. Using a tertile split, 140 students were placed into one of two groups based on their perception of autonomy support at the post-test time point. Pre- and post-test therapeutic relationship data were collected for both groups. A repeated measures analysis of variance was used to examine whether engagement in different clinical placements would illicit significant differences in therapeutic relationship skills. Undergraduate nursing students who were engaged in the autonomy-supportive setting had significantly higher scores associated with the therapeutic relationship subscales: Positive Collaboration and Positive Clinical Input. The importance of the social context is underscored, which is strongly influenced by the educational leader, typically referred to as a nurse facilitator.

摘要

对于本科护理专业学生而言,一种不可或缺的学习模式是临床实习。在临床环境中的学习会受到多种因素影响,比如学生所在实习科室的带教老师、同伴、科室或部门等。目前尚不清楚的是,基于自我决定理论的社会环境所起的作用,以及这如何影响本科护理专业学生治疗性沟通技巧的发展。本研究的目的是探讨自主支持在本科护理专业学生专业学习中的作用。本研究采用两组前测和后测设计,在澳大利亚的背景下,将本科护理专业学生分为自主支持组或对照组。在他们必修的心理健康临床实习开始和结束时,对治疗性沟通技巧进行评估。研究对象为210名澳大利亚本科护理专业学生(n = 210)。采用三分位数划分法,根据学生在测试后时间点对自主支持的感知,将140名学生分为两组。收集两组前测和后测的治疗性沟通数据。采用重复测量方差分析来检验参与不同临床实习是否会在治疗性沟通技巧上产生显著差异。参与自主支持环境实习的本科护理专业学生在治疗性沟通分量表“积极协作”和“积极临床投入”上的得分显著更高。这凸显了社会环境的重要性,而社会环境很大程度上受教育领导者(通常称为带教护士)的影响。

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