Ganchuluun Sambuu, Kondo Akiko, Ukuda Megumi, Hirai Hiroki, Wen Jieru
International Nursing Development, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Mongolia-Japan Hospital, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia.
J Nurs Manag. 2023 Oct 11;2023:1741721. doi: 10.1155/2023/1741721. eCollection 2023.
Although individual factors play a vital role in determining professional autonomy, their specific impact during the coronavirus disease 2019 (COVID-19) pandemic has not been studied. This study aimed to compare nurses' professional autonomy when caring for patients with COVID-19 and for other patients and explore factors related to autonomy when caring for these patients. A paper-based questionnaire survey was conducted from June to August 2022 among nurses working at a university hospital in Japan. The survey included demographic factors (10 items, including, age, section, years of nursing experience, position, educational background, ladder level, and having certified nurse specialists or certified nurse qualifications) and individual experience factors (4 items: number of COVID-19 patients experienced, frequency and contents of searching for the latest information about COVID-19, frequency of using scientific sources, and frequency of training/study sessions on COVID-19 attended at the hospital). Additionally, basic knowledge of COVID-19 was evaluated. The scale for nurses' professional autonomy was developed based on a previous study. A paired -test and stepwise multiple linear regression were used for the analyses. Overall, 241 nurses participated in the survey. The average length of nursing experience was 10.3 ± 9.2 years. The total scores for nurses' professional autonomy in all 5 factors 27 items were significantly lower ( = -12.1, < 0.001) when caring for COVID-19 patients than when caring for other patients. Specifically, Factor 1 (Cognition) exhibited the most decreased scores when caring for COVID-19 patients than when caring for other patients. Factor 4 (Abstract judgment) differed the least between caring for COVID-19 and for other patients, but the average score was the lowest. More years of nursing experience ( = 0.208, = 0.001) and a higher number of patients with COVID-19 cared for ( = 0.140, = 0.026) were associated with higher autonomy scores. In conclusion, to enhance professional autonomy during an unprecedented pandemic, nurses must enhance cognition and abstract judgment. In the event of a future pandemic, nurses need to create an environment in which they routinely access and utilize the latest information and scientific evidence to provide high-quality nursing care based on their professional judgment and competence.
尽管个体因素在决定职业自主性方面起着至关重要的作用，但在2019年冠状病毒病（COVID-19）大流行期间其具体影响尚未得到研究。本研究旨在比较护士在护理COVID-19患者和其他患者时的职业自主性，并探讨护理这些患者时与自主性相关的因素。2022年6月至8月，对日本一家大学医院的护士进行了纸质问卷调查。调查包括人口统计学因素（10项，包括年龄、科室、护理经验年限、职位、教育背景、职级以及是否拥有专科护士或护士资格证书）和个人经验因素（4项：接触过的COVID-19患者数量、搜索COVID-19最新信息的频率和内容、使用科学资料的频率以及在医院参加的COVID-19培训/学习课程的频率）。此外，还评估了对COVID-19的基本知识。护士职业自主性量表是基于先前的一项研究制定的。分析采用配对检验和逐步多元线性回归。总体而言，241名护士参与了调查。护理经验的平均时长为10.3±9.2年。与护理其他患者相比，护士在护理COVID-19患者时，所有5个因素27项的职业自主性总分显著更低（t=-12.1，P<0.001）。具体而言，与护理其他患者相比，护理COVID-19患者时，因素1（认知）得分下降最多。在护理COVID-19患者和其他患者之间，因素4（抽象判断）的差异最小，但平均分最低。护理经验年限越长（t=0.208，P=0.001）以及护理的COVID-19患者数量越多（t=0.140，P=0.026），自主性得分越高。总之，为了在前所未有的大流行期间提高职业自主性，护士必须增强认知和抽象判断能力。在未来发生大流行时，护士需要营造一个环境，使他们能够常规获取和利用最新信息及科学证据，以便基于专业判断和能力提供高质量的护理服务。
