叙事护理认知、自我效能感和社会支持对中国注册护士实践的影响：一项结构方程模型分析

Impact of narrative nursing cognition, self-efficacy, and social support on the practices of registered nurses in China: a structural equation modeling analysis.

作者信息

Zhang Li, Han Qiang, Nan Lin, Yang Huiyun

机构信息

Department of Geriatric Digestive Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.

Cancer Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.

出版信息

BMC Nurs. 2024 Sep 5;23(1):624. doi: 10.1186/s12912-024-02292-2.

DOI:10.1186/s12912-024-02292-2

PMID:39238016

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11378382/

Abstract

BACKGROUND

Narrative nursing is a novel approach according with humanistic care, which has been shown to be effective in improving health outcomes for both patients and nurses. Nevertheless, few studies have investigated the status of narrative nursing practice among nurses, and a comprehensive understanding of factors influencing this practice remains elusive.

DESIGN

This was an observational, cross-sectional study using convenience sampling method.

METHODS

After obtaining the informed consent, a total of 931 registered nurses from three hospitals in China were investigated. Data were collected using the Social Support Rating Scale, the General Self-efficacy Scale, and the Knowledge-Attitude-Practice Survey of Clinical Nurses on Narrative Nursing. All the scales were validated in the Chinese population. The questionnaire results were verified by an independent investigator. Factors influencing narrative nursing practice were determined through a series of analyses, including independent sample t-tests, one-way ANOVA, and Pearson correlations. Subsequently, path analysis was performed and a structural equation model was established.

RESULTS

The score of narrative nursing practice in this study was 30.26 ± 5.32. The structural equation model showed a good fit, with a Root Mean Square Error of Approximation (RMSEA) of 0.007 (90%CI: 0.000, 0.047). Both social support and narrative nursing attitude could directly affect narrative nursing practice (βsocial support = 0.08, P < 0.001; βattitude = 0.54, P < 0.001) and indirectly influence it via self-efficacy (β = 0.04, P < 0.001; β = 0.06, P < 0.001). In addition, narrative nursing knowledge (β = 0.08, P < 0.001) and the nurses' growth environment (β=-0.06, P < 0.001) also affected the practice of narrative nursing.

CONCLUSION

Narrative nursing in China is at a medium level and could be influenced by several personal and environmental factors. This study highlighted the critical role of nursing management in the advancement of narrative nursing practices. Nurse managers should prioritize specialized training and cultivate supportive environments for nurses to improve their narrative nursing practices.

摘要

背景

叙事护理是一种符合人文关怀的新型方法，已被证明在改善患者和护士的健康结局方面有效。然而，很少有研究调查护士中叙事护理实践的现状，对影响这种实践的因素的全面理解仍然难以捉摸。

设计

这是一项采用便利抽样方法的观察性横断面研究。

方法

在获得知情同意后，对来自中国三家医院的931名注册护士进行了调查。使用社会支持评定量表、一般自我效能量表和临床护士叙事护理知识-态度-实践调查问卷收集数据。所有量表均在中国人群中进行了验证。问卷结果由一名独立调查员进行核实。通过一系列分析确定影响叙事护理实践的因素，包括独立样本t检验、单因素方差分析和Pearson相关性分析。随后，进行路径分析并建立结构方程模型。

结果

本研究中叙事护理实践的得分为30.26±5.32。结构方程模型显示拟合良好，近似均方根误差（RMSEA）为0.007（90%CI：0.000，0.047）。社会支持和叙事护理态度均可直接影响叙事护理实践（β社会支持=0.08，P<0.001；β态度=0.54，P<0.001），并通过自我效能间接影响叙事护理实践（β=0.04，P<0.001；β=0.06，P<0.001）。此外，叙事护理知识（β=0.08，P<0.001）和护士的成长环境（β=-0.06，P<0.001）也影响叙事护理实践。