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重症监护护士的心理弹性及对临终关怀态度的相关因素

Factors related to resilience and attitudes towards care of the dying among critical care nurses.

作者信息

Kondo Akiko, Oki Tomomi, Eckhardt Ann L

机构信息

International Nursing Development, Tokyo Medical and Dental University, Tokyo, Japan.

School of Nursing and Rehabilitation Sciences, Showa University, Yokohama-shi, Japan.

出版信息

Nurs Crit Care. 2025 May;30(3):e13146. doi: 10.1111/nicc.13146. Epub 2024 Aug 22.

Abstract

BACKGROUND

Many critical care nurses provide care to patients who are injured or ill and are at the end-of-life. Therefore, they are at high risk for developing negative emotional responses due to exposure to patient suffering and death.

AIM

To determine the association between attitudes towards care of the dying, resilience, and Sense of Coherence.

STUDY DESIGN

A cross-sectional descriptive approach was used. Head nurses at 74 hospitals in Japan were sent a letter about the study; 29 head nurses agreed to send information to the critical care nurses in their hospital. Demographic factors, attitudes towards care of the dying, resilience, and Sense of Coherence were collected using Google Forms. Structural equation modelling was used to analyze the associations among the variables.

RESULTS

A total of 229 nurses completed the survey. The average years of clinical experience were 10.5 ± 8.4 years. Factors directly related to positive attitudes towards care of the dying were higher resilience, more years of clinical nursing experience, and having a Master's degree. Sense of Coherence was the strongest predictor of resilience. Other predictors for higher resilience included confidence in nursing skills, social support, and religious beliefs towards death. The main predictor for higher Sense of Coherence was workplace satisfaction.

CONCLUSION

Nurses with higher resilience had more positive attitudes about care of the dying. Individual factors, such as a Sense of Coherence, confidence in caring for patients, and religious beliefs were the most important factors related to resilience.

RELEVANCE TO CLINICAL PRACTICE

It is necessary to support newer nurses especially those with lower educational attainment, to increase workplace satisfaction, Sense of Coherence and resilience. It is necessary to develop educational programs focused on care of dying patients and to evaluate their effect so that critical care nurses have a positive response to caring for dying patients.

摘要

背景

许多重症护理护士为受伤或患病且处于生命末期的患者提供护理。因此,由于接触患者的痛苦和死亡,他们产生负面情绪反应的风险很高。

目的

确定对临终护理的态度、心理复原力和连贯感之间的关联。

研究设计

采用横断面描述性研究方法。向日本74家医院的护士长发送了关于该研究的信件;29位护士长同意向其所在医院的重症护理护士发送信息。使用谷歌表单收集人口统计学因素、对临终护理的态度、心理复原力和连贯感。采用结构方程模型分析变量之间的关联。

结果

共有229名护士完成了调查。平均临床经验年限为10.5±8.4年。与对临终护理持积极态度直接相关的因素包括更高的心理复原力、更长的临床护理经验年限以及拥有硕士学位。连贯感是心理复原力最强的预测因素。心理复原力较高的其他预测因素包括对护理技能的信心、社会支持以及对死亡的宗教信仰。连贯感较高的主要预测因素是工作场所满意度。

结论

心理复原力较高的护士对临终护理持更积极的态度。个体因素,如连贯感、对患者护理的信心和宗教信仰,是与心理复原力相关的最重要因素。

与临床实践的相关性

有必要支持新入职护士,尤其是那些教育程度较低的护士,以提高工作场所满意度、连贯感和心理复原力。有必要制定专注于临终患者护理的教育项目并评估其效果,以便重症护理护士对护理临终患者有积极的反应。

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