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不丹护士实施新生儿和儿童疾病综合管理(IMNCI)的影响因素:一项预测性相关性研究。

Factors influencing the implementation of Integrated Management of Neonatal and Childhood Illness (IMNCI) by nurses in Bhutan: A predictive correlational study.

作者信息

Pelden Sonam, Patoomwan Autchareeya, Daramas Tipawan

机构信息

Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Faculty of Nursing, Kasem Bundit University, Bangkok, Thailand.

出版信息

Belitung Nurs J. 2025 Aug 3;11(4):478-486. doi: 10.33546/bnj.3816. eCollection 2025.

Abstract

BACKGROUND

Integrated Management of Neonatal and Childhood Illness (IMNCI) is a critical strategy aimed at improving child health outcomes. In Bhutan, nurses play a frontline role in implementing IMNCI guidelines, yet factors influencing their implementation remain underexplored.

OBJECTIVE

This study aimed to identify the predictors of IMNCI implementation among nurses in selected hospitals in Bhutan.

METHODS

A correlational predictive design was used, involving 107 nurses from nine hospitals across Bhutan. Data on demographics, supplies/resources, supervision, attitude, workload, nurse management skills, and IMNCI implementation were collected between November and December 2023 through structured questionnaires. Multiple linear regression analysis was conducted to determine factors predicting IMNCI implementation.

RESULTS

Nurse management skill was the only significant predictor of IMNCI implementation ( = 0.321, <0.001), while other variables such as supplies/resources, supervision, attitude, years of service, training, and workload showed no significant predictive value. The model explained 16.8% of the variance in IMNCI implementation.

CONCLUSION

Nurse management skills play a pivotal role in effective IMNCI implementation in Bhutanese hospitals. However, the modest explanatory power suggests other factors may influence implementation, warranting further research to enhance child healthcare delivery through strengthened nurse leadership and systemic support.

摘要

背景

新生儿和儿童疾病综合管理(IMNCI)是一项旨在改善儿童健康状况的关键策略。在不丹,护士在实施IMNCI指南方面发挥着一线作用,但影响其实施的因素仍未得到充分探索。

目的

本研究旨在确定不丹选定医院护士中IMNCI实施的预测因素。

方法

采用相关性预测设计,涉及不丹9家医院的107名护士。2023年11月至12月期间,通过结构化问卷收集了有关人口统计学、物资/资源、监督、态度、工作量、护士管理技能和IMNCI实施情况的数据。进行多元线性回归分析以确定预测IMNCI实施的因素。

结果

护士管理技能是IMNCI实施的唯一显著预测因素(β = 0.321,P <0.001),而物资/资源、监督、态度、服务年限、培训和工作量等其他变量均无显著预测价值。该模型解释了IMNCI实施中16.8%的方差。

结论

护士管理技能在不丹医院有效实施IMNCI中起着关键作用。然而,适度的解释力表明其他因素可能影响实施,需要进一步研究以通过加强护士领导力和系统支持来改善儿童医疗服务。

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