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说出来还是不说出来:资源受限地区这种行为背后的组织和个体先行因素

To Speak Up or Not to Speak Up, Organisational and Individual Antecedents That Undergird This Behaviour in Resource Constrained Region.

作者信息

Asante Kwadwo

机构信息

Tomas Bata University in Zlin, Zlin, Czech Republic.

出版信息

J Adv Nurs. 2025 Jun;81(6):2990-3002. doi: 10.1111/jan.16446. Epub 2024 Sep 4.

DOI:10.1111/jan.16446
PMID:39230255
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12080099/
Abstract

AIM

To examine the organisational (i.e., perceived organisational support and psychologically safe environment) and individual (i.e., value, belief and norm) antecedents that strengthen healthcare workers' speaking-up behaviour in a developing economy.

DESIGN

The study uses a cross-sectional design to gather the same data from healthcare workers within the Ashanti Region of Ghana.

METHODS

The data collection happened between 15 June and 30 August 2023. A sample of 380 healthcare workers was selected from 20 facilities in the Ashanti Region of Ghana. A configurational approach, a fussy-set qualitative comparative analysis, was used to identify the configurations that caused high and low speaking-up behaviour among the study sample.

RESULTS

The study results reveal that whereas four configurations generate high speaking-up behaviour, three configurations, by contrast, produce low speaking-up behaviour among healthcare workers.

CONCLUSION

Results suggest that in so far as organisational support systems which take the form of a psychologically safe environment and perceived organisational support are vital in relaxing the hierarchical boundaries in a healthcare setting to improve healthcare workers' speaking-up behaviour, the individual value-based factors that take the form of values, beliefs and norms are indispensable as it provides the healthcare workers with the necessary inner drive to regard speaking-up behaviour on patient safety and care as a moral duty.

IMPACT

Healthcare workers' speaking-up behaviour is better achieved when organisational support systems complement the individual norms, values and beliefs of the individual.

REPORTING METHOD

Adhered to Strengthening Reporting of Observational Studies in Epidemiology guidelines.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

摘要

目的

探讨在发展中经济体中,强化医护人员发声行为的组织因素(即感知到的组织支持和心理安全环境)和个体因素(即价值观、信念和规范)。

设计

本研究采用横断面设计,从加纳阿散蒂地区的医护人员中收集相同的数据。

方法

数据收集于2023年6月15日至8月30日进行。从加纳阿散蒂地区的20家医疗机构中选取了380名医护人员作为样本。采用组态方法,即模糊集定性比较分析,来识别研究样本中导致高发声行为和低发声行为的组态。

结果

研究结果表明,有四种组态会产生高发声行为,相比之下,有三种组态会导致医护人员的低发声行为。

结论

结果表明,以心理安全环境和感知到的组织支持形式存在的组织支持系统,对于放宽医疗环境中的等级界限以改善医护人员的发声行为至关重要;而以价值观、信念和规范形式存在的基于个体价值观的因素也不可或缺,因为它为医护人员提供了必要的内在动力,使其将关于患者安全和护理的发声行为视为一种道德责任。

影响

当组织支持系统补充个体的规范、价值观和信念时,医护人员的发声行为能得到更好的实现。

报告方法

遵循加强流行病学观察性研究报告指南。

患者或公众贡献

无患者或公众参与。

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本文引用的文献

1
Predicting nurses' safety compliance behaviour in a developing economy, using the theory of planned behaviour: A configurational approach.运用计划行为理论预测发展中经济体中护士的安全合规行为:一种构型方法。
J Adv Nurs. 2024 Mar;80(3):1097-1110. doi: 10.1111/jan.15846. Epub 2023 Sep 11.
2
Speaking up as an extension of socio-cultural dynamics in hospital settings: a study of staff experiences of speaking up across seven hospitals.在医院环境中发声是社会文化动态的一种延伸:一项对七个医院工作人员发声经历的研究。
J Health Organ Manag. 2022 Nov 15;ahead-of-print(ahead-of-print):245-71. doi: 10.1108/JHOM-04-2022-0129.
3
When niceness becomes toxic, or, how niceness effectively silences nurses and maintains the status quo in nursing.
当友善变得有害时,或者说,友善如何有效地让护士保持沉默并维持护理行业的现状。
J Adv Nurs. 2022 Oct;78(10):e113-e114. doi: 10.1111/jan.15407. Epub 2022 Aug 5.
4
Motivators and inhibitors of nurses' speaking up behaviours: A descriptive qualitative study.护士直言行为的激励因素和抑制因素:描述性定性研究。
J Adv Nurs. 2022 Oct;78(10):3398-3408. doi: 10.1111/jan.15343. Epub 2022 Jun 28.
5
A state-of-the-art review of speaking up in healthcare.医疗保健中直言不讳的最新综述。
Adv Health Sci Educ Theory Pract. 2022 Oct;27(4):1177-1194. doi: 10.1007/s10459-022-10124-8. Epub 2022 Jun 6.
6
Interprofessional model on speaking up behaviour in healthcare professionals: a qualitative study.跨专业模式在医疗保健专业人员中的直言行为:一项定性研究。
BMJ Lead. 2022 Mar;6(1):15-19. doi: 10.1136/leader-2020-000407. Epub 2021 Apr 26.
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Speaking up in resource-constrained settings: how to secure safe surgical care in the moment and in the future?在资源有限的环境中发声:如何确保当下及未来的安全手术治疗?
BMJ Qual Saf. 2022 Sep;31(9):631-633. doi: 10.1136/bmjqs-2021-014624. Epub 2022 Mar 15.
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Whistleblowing over patient safety and care quality: a review of the literature.关于患者安全与护理质量的举报:文献综述
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Jt Comm J Qual Patient Saf. 2019 Oct;45(10):694-705. doi: 10.1016/j.jcjq.2019.07.005. Epub 2019 Aug 27.
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Safety Culture and Patient Safety Outcomes in East Asia: A Literature Review.东亚的安全文化与患者安全结果:文献综述。
West J Nurs Res. 2020 Mar;42(3):220-230. doi: 10.1177/0193945919848755. Epub 2019 May 23.