从护士视角看关怀护理的促进因素和障碍：一项范围综述
Enablers and Barriers of Compassionate Care From a Nurses' Perspective: A Scoping Review.
作者信息
van den Berg Nina M, van der Wal-Huisman Hanneke, van Leeuwen Barbara L, Paans Wolter, Schroevers Maya J
机构信息
Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Department of Surgical Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
出版信息
Scand J Caring Sci. 2025 Mar;39(1):e13319. doi: 10.1111/scs.13319.
AIMS AND OBJECTIVES
To identify and synthesise empirical evidence on the perspectives of nurses regarding factors that enable and/or obstruct the delivery of compassionate care.
METHODOLOGICAL DESIGN AND JUSTIFICATION
A scoping review was chosen for its capacity to perform a broad exploration of the available literature.
ETHICAL ISSUES
This scoping review raises no ethical issues.
RESEARCH METHODS
This review includes studies that report enablers and barriers of compassionate care. Both qualitative and quantitative designs were included. The quality of each study was assessed using the Mixed Method Appraisal Tool (MMAT). A narrative synthesis was employed to summarise the results.
INSTRUMENTS
A search was conducted in the electronic databases of MEDLINE and CINAHL (1975-2021).
OUTCOME MEASURES
Barriers and enablers to compassionate care from nurses' perspectives.
RESULTS
Fifteen empirical studies were included in this review. Four themes of enablers and barriers to compassionate care emerged: (1) personal characteristics, (2) professional characteristics, (3) patient-related factors, and (4) workplace-related factors. Main facilitators were a strong motivation to deliver compassionate care, the managements' support of compassion as a nursing value and operating in a healthy team culture. Main barriers were the absence of education and/or role models for compassionate care, heavy workloads, and the managements' prioritisation of task-centred care.
STUDY LIMITATIONS
This study is limited by the inclusion of qualitative studies with small samples and the absence of data from Northern Europe and North America.
CONCLUSIONS
The findings indicate that policymakers, healthcare leaders, and nursing management play an important role in nurses' ability to provide compassionate care. Through leadership that centralises compassion as a core nursing value, nurses receive greater support in prioritising compassion in patient care. This support is further enhanced by ensuring adequate staffing and manageable schedules, offering comprehensive training in compassionate care skills, and providing resources to support nurses' wellbeing.
TRIAL REGISTRATION
PROSPERO: CRD42022324955 https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=324955.
目的与目标
识别并综合关于护士对促进和/或阻碍提供关怀护理的因素的观点的实证证据。
方法设计与理由
选择进行范围综述是因其有能力对现有文献进行广泛探索。
伦理问题
本范围综述不存在伦理问题。
研究方法
本综述纳入了报告关怀护理的促进因素和障碍的研究。定性和定量设计均有纳入。使用混合方法评估工具（MMAT）评估每项研究的质量。采用叙述性综合法总结结果。
工具
在MEDLINE和CINAHL的电子数据库（1975 - 2021年）中进行检索。
结果指标
从护士角度看关怀护理的障碍和促进因素。
结果
本综述纳入了15项实证研究。出现了关怀护理的促进因素和障碍的四个主题：（1）个人特征，（2）专业特征，（3）患者相关因素，以及（4）工作场所相关因素。主要促进因素是提供关怀护理的强烈动机、管理层对关怀作为护理价值观的支持以及在健康的团队文化中工作。主要障碍是缺乏关怀护理的教育和/或榜样、工作量大以及管理层将以任务为中心的护理置于优先地位。
研究局限性
本研究受到纳入小样本定性研究以及缺乏来自北欧和北美的数据的限制。
结论
研究结果表明，政策制定者、医疗保健领导者和护理管理层在护士提供关怀护理的能力方面发挥着重要作用。通过将关怀作为核心护理价值观的领导力，护士在将关怀置于患者护理优先地位方面获得了更大的支持。通过确保充足的人员配备和可管理的工作安排、提供关怀护理技能的全面培训以及提供支持护士福祉的资源，这种支持得到进一步加强。
试验注册
PROSPERO：CRD42022324955 https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=324955
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