Huang Lijie, Zhang Xiangsheng, Wang Feijie, Zhang Songbo, Chang Xiaoxia, Chu Yinping, Wang Lu, Jia Wenwen, Zhang Beibei
Department of Urinary Surgery, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, Henan, 450003, China.
Department of Andrology and Energy Medicine, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, Henan, 450003, China.
BMC Nurs. 2024 Nov 26;23(1):858. doi: 10.1186/s12912-024-02534-3.
Nursing is crucial for delivering healthcare services; however, nursing shortages pose a significant global challenge, which the high turnover rate of junior nurses is expected to exacerbate. Enhancing nurses' professional identities is likely to be an effective strategy for reducing turnover rates.
We recruited 865 junior clinical nurses from three tertiary hospitals in Henan Province, China. The participants completed a demographic questionnaire along with the Reflective Ability Scale for Clinical Nurses, the Nursing Profession Self-efficacy Scale, the Nursing Staff Self-learning Ability Evaluation Scale, and the Professional Identity Scale for Nurses. The relationships between reflective ability, self-directed learning, self-efficacy, and professional identity were evaluated using SPSS26.0, with PROCESS version 3.5 used to construct a chain-mediation model.
Positive correlations were found between reflective ability, self-directed learning, self-efficacy, and professional identity. Chain mediation model analysis showed that reflective ability, self-directed learning, and self-efficacy directly and positively affected professional identity (β = 0.22, β = 0.30, β = 0.66, all p < 0.001). Self-directed learning and self-efficacy exerted a significant chain mediating effect between reflective ability and professional identity (95% confidence interval [CI]: 0.06-0.13). The total effect of reflective ability on the professional identity of clinical nurses was 0.51 (p < 0.001, 95%CI: 0.42-0.59), the direct effect was 0.22 (p < 0 0.001, 95%CI: 0.14-0.29), and the indirect effect was 0.29 (p < 0.001, 95%CI: 0.22-0.37).
Self-directed learning and self-efficacy partially mediated the relationship between reflective ability and professional identity. Multifaceted strategies targeted at enhancing reflective ability, self-directed learning, and self-efficacy are recommended to improve junior clinical nurses' professional identities.
护理对于提供医疗保健服务至关重要；然而，护理人员短缺构成了重大的全球挑战，预计初级护士的高离职率会加剧这一挑战。增强护士的职业认同感可能是降低离职率的有效策略。
我们从中国河南省的三家三级医院招募了865名初级临床护士。参与者完成了一份人口统计学调查问卷，以及临床护士反思能力量表、护理职业自我效能量表、护理人员自主学习能力评价量表和护士职业认同量表。使用SPSS26.0评估反思能力、自主学习、自我效能和职业认同之间的关系，采用PROCESS版本3.5构建链式中介模型。
反思能力、自主学习、自我效能和职业认同之间存在正相关。链式中介模型分析表明，反思能力、自主学习和自我效能直接且正向影响职业认同（β = 0.22，β = 0.30，β = 0.66，均p < 0.001）。自主学习和自我效能在反思能力和职业认同之间发挥了显著的链式中介作用（95%置信区间[CI]：0.06 - 0.13）。反思能力对临床护士职业认同的总效应为0.51（p < 0.001，95%CI：0.42 - 0.59），直接效应为0.22（p < 0.001，95%CI：0.14 - 0.29），间接效应为0.29（p < 0.001，95%CI：0.22 - 0.37）。
自主学习和自我效能部分中介了反思能力与职业认同之间的关系。建议采取多方面策略来增强反思能力、自主学习和自我效能，以提高初级临床护士的职业认同感。
