van Hooft Susanne, Berger Elke, van Torenburg Cailey, van Staa AnneLoes
Research Centre Innovations in Care, Rotterdam University of Applied Sciences, P.O Box 25035, 3001 HA Rotterdam, the Netherlands.
Franciscus Academy, Franciscus Gasthuis & Vlietland, Kleiweg 500, 3045 PM, Rotterdam, the Netherlands.
Int J Nurs Stud Adv. 2024 Dec 5;8:100279. doi: 10.1016/j.ijnsa.2024.100279. eCollection 2025 Jun.
Self-management support is widely considered a critical aspect of nursing. Still, many studies indicate that nurses frequently experience difficulties in daily practice.
To gain a deeper understanding of the factors perceived by nurses to impede or promote their support of patients' self-management within the dynamic environment of the in-patient hospital setting.
Mixed methods design.
Nurses ( = 269) working in a teaching hospital in the Netherlands completed a questionnaire. Subsequently, 38 nurses participated in interviews.
The SEPSS-36 questionnaire assessed nurses' self-efficacy and performance in self-management support. Semi-structured interviews were conducted to address salient results from the questionnaire, focusing on factors influencing self-management support, goal setting, follow-up care, and the nurse's role in a hospital setting.
the response rate for the questionnaire study was 62 %. A paired t-test revealed a significant mean difference of 6.30 95 % CI [5.91-6.69] ≤ 0.001 between nurses' perceived self-efficacy (mean = 18.34/24) and their actual performance (mean = 12.03/24) in self-management support. The interviews revealed that nurses typically focus on medical procedures and maintaining patients' functional status. Spending time with patients to offer emotional support was viewed as 'something extra' rather than a core part of their job. High patient turnover hindered nurses from having meaningful conversations with patients.
Short-term priorities such as 'getting the work done' dominate nurses' daily tasks in hospital wards, leading them to overlook often the benefits of supporting patient self-management. This narrow view of their responsibilities can hinder patient care, whereas adopting a broader perspective on the patient journey could be very beneficial.
自我管理支持被广泛认为是护理工作的一个关键方面。然而，许多研究表明，护士在日常实践中经常遇到困难。
更深入地了解护士认为在住院医院环境的动态背景下阻碍或促进其对患者自我管理支持的因素。
混合方法设计。
荷兰一家教学医院的护士（n = 269）完成了一份问卷。随后，38名护士参与了访谈。
SEPSS - 36问卷评估了护士在自我管理支持方面的自我效能感和表现。进行了半结构化访谈，以探讨问卷中的显著结果，重点关注影响自我管理支持、目标设定、后续护理以及护士在医院环境中角色的因素。
问卷研究的回复率为62%。配对t检验显示，护士在自我管理支持方面的感知自我效能感（均值 = 18.34/24）与实际表现（均值 = 12.03/24）之间存在显著的平均差异6.30 95% CI [5.91 - 6.69]，p ≤ 0.001。访谈表明，护士通常专注于医疗程序和维持患者的功能状态。花时间陪伴患者提供情感支持被视为“额外之事”，而非其工作的核心部分。患者周转频繁阻碍了护士与患者进行有意义的对话。
诸如“完成工作”等短期优先事项主导了护士在医院病房的日常任务，导致他们常常忽视支持患者自我管理的益处。这种对其职责的狭隘看法可能会妨碍患者护理，而对患者就医过程采取更广泛的视角可能会非常有益。
