Wu Junxian, Song Jingru, Zhang Mingfang, Li Lin, Shen Qin
School of Nursing, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
Liver and gallbladder surgery, Jiaxing First Hospital, Jiaxing, 314001, China.
BMC Nurs. 2025 Jan 20;24(1):62. doi: 10.1186/s12912-025-02720-x.
Mid- to senior-level nurses play a pivotal role in healthcare. Their reflective ability is crucial for clinical decision-making and the continuous improvement of nursing practices. Although numerous studies have emphasized the importance of enhancing reflective ability among mid- to senior-level nurses, the specific relationship between off-duty professional growth, dual work stress, and reflective ability remains unclear.
This study aims to investigate the relationship between reflective ability, work stress, and off-duty professional growth among mid- to senior-level nurses in China, and to determine the mediating role of work stress.
A convenience sampling method was used to recruit 534 mid- to senior-level nurses from three tertiary hospitals in Jiaxing, Zhejiang Province. Data were collected and analyzed using a general information questionnaire, the Leisure Crafting Scale, the Challenge-Hindrance Work Stress Scale, and the Clinical Nurse Reflective Ability Scale.
The mean scores for leisure crafting, challenge stress, hindrance stress, and reflective ability among mid- to senior-level nurses were 23.82 ± 9.17, 16.97 ± 6.49, 16.65 ± 5.44, and 56.26 ± 19.09, respectively. Leisure crafting was positively correlated with reflective ability (r = 0.389, P < 0.001), challenge stress (r = 0.399, P < 0.001), and negatively correlated with hindrance stress (r = -0.367, P < 0.001). Reflective ability was positively correlated with challenge stress (r = 0.350, P < 0.001) and negatively correlated with hindrance stress (r = -0.417, P < 0.001). Both challenge-and hindrance stress partially mediated the relationship between leisure crafting and reflective ability, with mediation effects of 19.7% and 30.8%, respectively.
This study demonstrates that the reflective ability of mid- to senior-level nurses in China is currently at a moderately low level. Enhancing Off-duty professional growth, leveraging the beneficial aspects of challenge stress, and reducing the negative effects of hindrance stress can notably improve reflective ability. These efforts can lay a strong foundation for the continuous enhancement of nursing quality.
中高级护士在医疗保健中发挥着关键作用。他们的反思能力对于临床决策和护理实践的持续改进至关重要。尽管众多研究强调了提高中高级护士反思能力的重要性，但业余时间专业成长、双重工作压力与反思能力之间的具体关系仍不明确。
本研究旨在探讨中国中高级护士的反思能力、工作压力与业余时间专业成长之间的关系，并确定工作压力的中介作用。
采用便利抽样法，从浙江省嘉兴市的三家三级医院招募了534名中高级护士。使用一般信息问卷、休闲手工制作量表、挑战性-阻碍性工作压力量表和临床护士反思能力量表收集和分析数据。
中高级护士的休闲手工制作、挑战性压力、阻碍性压力和反思能力的平均得分分别为23.82±9.17、16.97±6.49、16.65±5.44和56.26±19.09。休闲手工制作与反思能力呈正相关（r = 0.389，P < 0.001）、与挑战性压力呈正相关（r = 0.399，P < 0.001），与阻碍性压力呈负相关（r = -0.367，P < 0.001）。反思能力与挑战性压力呈正相关（r = 0.350，P < 0.001），与阻碍性压力呈负相关（r = -0.417，P < 0.001）。挑战性压力和阻碍性压力均部分中介了休闲手工制作与反思能力之间的关系，中介效应分别为19.7%和30.8%。
本研究表明，中国中高级护士的反思能力目前处于中等偏低水平。加强业余时间专业成长，利用挑战性压力的有益方面，减少阻碍性压力的负面影响，可以显著提高反思能力。这些努力可为持续提升护理质量奠定坚实基础。
