Cui Cui, Li Shuangzi, Zhou Hengyu, Chen Wenjin, Xiao Changmin, Fan Mingping, Zheng Xianlan
Department of Nursing, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, 400014, China.
Department of Neurology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child, Chongqing, 400014, China.
Heliyon. 2024 Jun 26;10(13):e33774. doi: 10.1016/j.heliyon.2024.e33774. eCollection 2024 Jul 15.
To gain insight into the readiness for evidence-based practice of self-management support during transition for adolescents with epilepsy among pediatric nurses, and to explore the promoting and hindering factors.
A mixed-methods design with an explanatory sequential approach was employed.
Three specialty children's hospitals in southwest regions of China.
In phase 1, a total of 126 participants were included in the Survey of Clinical Readiness of Evidence-Based Nursing Assessment (CREBNA) from Dec 2022 to Feb 2023. Total scale and subscale scores were calculated. In phase 2, we developed the interview outline based on the analysis of the quantitative results. In-depth interviews (n = 15) were conducted from Feb 2023 to Apr 2023 to explain and supplement the quantitative phase results.
The total score of CREBNA indicated that teams have good readiness and capacity for implementation of evidence-based nursing practice Compared with the norm. The scores of the three subscales of evidence factors, organizational environment, and promoting factors were normal. In subsequent interviews and integration, we extracted four themes based on the Knowledge-To-Action (KTA) framework: 1. organization barriers (incentive mechanism, interdisciplinary cooperation process, information aids); 2. operational barriers (Exemplary evidence-based practice, time pressure, gaps in patient and family understanding of evidence); 3. individual-level barriers (evidence-based and professional knowledge reserve, professional autonomy, shared decision-making roles, dependence on habitual clinical behaviors); and 4. facilitating factors (leadership commitment, self-management identity, transition service needs, patient- and family-centered care culture). A conceptual model was constructed based on the KTA.
It is feasible to carry out evidence-based practice of nurse-led self-management support in transition preparation. Nursing researchers and managers should carry out knowledge selection and tailoring based on barriers at the organizational, operational, and individual levels to promote favorable factors and improve the smooth transition of adolescents with chronic diseases.
了解儿科护士对癫痫青少年患者过渡期间自我管理支持的循证实践准备情况，并探索促进因素和阻碍因素。
采用具有解释性序列法的混合方法设计。
中国西南地区的三家儿童专科医院。
在第一阶段，2022年12月至2023年2月期间，共有126名参与者纳入循证护理评估临床准备情况调查（CREBNA）。计算总分和子量表得分。在第二阶段，我们根据定量结果分析制定访谈提纲。2023年2月至2023年4月进行了15次深入访谈，以解释和补充定量阶段的结果。
CREBNA总分表明，与标准相比，团队在实施循证护理实践方面具有良好的准备情况和能力。证据因素、组织环境和促进因素三个子量表的得分均正常。在后续访谈和整合中，我们基于知识到行动（KTA）框架提取了四个主题：1.组织障碍（激励机制、跨学科合作流程、信息辅助工具）；2.操作障碍（示范性循证实践、时间压力、患者及家属对证据理解的差距）；3.个人层面障碍（循证和专业知识储备、专业自主性、共同决策角色、对习惯性临床行为的依赖）；4.促进因素（领导承诺、自我管理认同、过渡服务需求、以患者和家庭为中心的护理文化）。基于KTA构建了一个概念模型。
在过渡准备中开展以护士为主导的自我管理支持的循证实践是可行的。护理研究人员和管理人员应根据组织、操作和个人层面的障碍进行知识选择和调整，以促进有利因素，改善慢性病青少年的顺利过渡。
