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新毕业重症监护护士的现实冲击及其与护理缺失的关系:关怀能力的中介作用。

Reality shock in newly graduated critical care nurses and its association with missed nursing care: The mediating role of caring ability.

机构信息

Marcella Niehoff School of Nursing, Loyola University Chicago, USA.

出版信息

Intensive Crit Care Nurs. 2024 Feb;80:103554. doi: 10.1016/j.iccn.2023.103554. Epub 2023 Oct 12.

DOI:10.1016/j.iccn.2023.103554
PMID:37837835
Abstract

OBJECTIVES

This study is a report assessing the intermediary role of caring ability in the association between reality shock in newly graduated nurses and missed nursing care.

RESEARCH METHODOLOGY/DESIGN: This descriptive study involved 286 newly graduated nurses working in various critical care units. Three standardized scales were used to collect data, including the Missed Nursing Care Scale, the Environmental Reality Shock-Related Issues and Concerns (ERS-RIC) Scale, and the Caring Ability Inventory (CAI). The Hayes' PROCESS macro in SPSS (Model 4) was utilized to perform mediation testing. The data was collected from March 2022 to July 2022.

SETTING

Critical care units in seven Philippine hospitals.

RESULTS

Newly graduated critical care nurses reported moderate levels of reality shock (mean = 50.31). Reality shock was directly associated with missed nursing care (β = 0.0493, p = 0.0066). Caring ability partially mediated the association between reality shock and missed nursing care through caring ability (β = 0.0042, SE = 0.0027).

CONCLUSIONS

Newly graduated critical care nurses experience reality shock during the initial two years of employment. Reality shock diminishes the caring abilities of the newly graduated nurses, leading to a higher incidence of missed nursing care.

IMPLICATIONS FOR CLINICAL PRACTICE

Institutional strategies aimed at facilitating a smooth transition for newly graduated nurses should be prioritized to prevent a decline in their caring abilities and ultimately reduce compromises in nursing care.

摘要

目的

本研究旨在评估关怀能力在新毕业护士现实冲击与护理缺失之间的中介作用。

研究方法/设计:本描述性研究纳入了在各重症监护病房工作的 286 名新毕业护士。使用了三个标准化量表来收集数据,包括护理缺失量表、环境现实冲击相关问题和关注点量表(ERS-RIC)以及关怀能力量表(CAI)。使用 SPSS 中的 Hayes' PROCESS 宏(模型 4)进行中介检验。数据收集时间为 2022 年 3 月至 7 月。

设置

菲律宾七家医院的重症监护病房。

结果

新毕业的重症监护护士报告了中度的现实冲击(平均值=50.31)。现实冲击与护理缺失直接相关(β=0.0493,p=0.0066)。关怀能力通过关怀能力部分中介了现实冲击与护理缺失之间的关系(β=0.0042,SE=0.0027)。

结论

新毕业的重症监护护士在就业的头两年会经历现实冲击。现实冲击会降低新毕业护士的关怀能力,导致护理缺失的发生率更高。

临床意义

应优先考虑机构策略,以促进新毕业护士的顺利过渡,防止他们的关怀能力下降,并最终减少护理方面的妥协。

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