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急诊科的恢复力与护理质量:2024年在伊朗克尔曼沙赫医院开展的一项研究

Resilience and nursing care quality in emergency departments: a 2024 study in Kermanshah, Iran hospitals.

作者信息

Vaisi-Raygani Aliakbar, Moradi Mojgan, Salari Nader, Fattahi Zakariya, Hadadian Fateme

机构信息

Department of Emergency and Critical Care Nursing, Faculty of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Department of Emergency and Critical Care Nursing, Kermanshah University of Medical Sciences, Kermanshah, Iran.

出版信息

BMC Nurs. 2025 Sep 2;24(1):1152. doi: 10.1186/s12912-025-03749-8.


DOI:10.1186/s12912-025-03749-8
PMID:40898286
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12403539/
Abstract

BACKGROUND: Emergency department (ED) nurses play a critical role in delivering urgent healthcare services and ensuring patient safety. The quality of nursing care in the ED significantly influences patient outcomes, satisfaction, and the overall performance of the healthcare system. Given the high-stress nature of the ED environment, nurses need to possess resilience—the capacity to adapt and cope effectively with challenging situations. This resilience is crucial for maintaining the well-being and professional satisfaction of ED nurses. AIM: This study aims to investigate the relationship between nursing care quality and resilience among ED nurses in educational hospitals in Kermanshah city, Iran, during the years 2023–2024 METHODS: This descriptive-analytical cross-sectional study was conducted with the participation of 228 nurses working in the emergency departments of hospitals affiliated with Kermanshah University of Medical Sciences. Data were collected using a demographic questionnaire, the Connor-Davidson Resilience Scale (CD-RISC), and the Quality of Nursing Care (QUALPAC) questionnaire. Statistical analyses were performed using SPSS version 25. The normality of the data distribution was assessed using the Kolmogorov-Smirnov test, which indicated a non-normal distribution of scores. Therefore, non-parametric tests, specifically the Mann-Whitney U and Kruskal-Wallis tests, were used to compare groups. Relationships between variables were examined using Spearman’s rank correlation coefficient. Additionally, stepwise multiple linear regression analysis controlling for confounding variables was conducted to identify predictors of nursing care quality. RESULTS: Out of 256 invited nurses, 228 completed valid questionnaires (response rate 89%). The mean age of participants was 29.5 ± 5.4 years. The mean nursing care quality score was 96.1 ± 17.0 (moderate level), and the mean resilience score was 66.7 ± 15.1. Nursing care quality scores differed significantly by gender ( = 0.007), age group ( = 0.007), and employment status ( = 0.001) but not by marital status ( = 0.563). Male nurses had higher nursing care quality scores (d = 0.39), while female nurses showed higher resilience ( = 0.001, d = 0.39). Spearman’s correlation showed significant positive associations between resilience and overall nursing care quality ( = 0.275), as well as its psychosocial ( = 0.280) and communication ( = 0.215) dimensions (all  < 0.001). Multiple linear regression controlling for gender, age, and employment status was significant (F = 10.210,  < 0.001), explaining 15.5% of the variance in nursing care quality. Resilience (β = 0.314,  < 0.001) and gender (β = 0.247,  < 0.001) were significant predictors. Age approached significance (β = −0.139,  = 0.051), while employment status was not a significant predictor ( = 0.961). CONCLUSION: This study demonstrated a significant positive association between resilience and the quality of nursing care among emergency department nurses. Enhancing resilience appears crucial for improving care quality and supporting nurses’ mental health in demanding clinical environments. Therefore, it is recommended to incorporate resilience-building strategies into nursing education and professional development programs. Additionally, organizational interventions aimed at fostering a supportive work environment and managing workload should be prioritized. Assigning more experienced nurses, particularly those over 30 years of age who exhibit higher resilience, to emergency departments may further promote care quality. These measures have the potential to improve both patient outcomes and workforce sustainability in high-pressure healthcare settings. CLINICAL TRIAL: Not applicable.

摘要

背景:急诊科护士在提供紧急医疗服务和确保患者安全方面发挥着关键作用。急诊科护理质量显著影响患者预后、满意度以及医疗系统的整体绩效。鉴于急诊科环境压力大的特点,护士需要具备适应力——即有效适应和应对具有挑战性情况的能力。这种适应力对于维持急诊科护士的身心健康和职业满意度至关重要。 目的:本研究旨在调查2023 - 2024年伊朗克尔曼沙赫市教学医院急诊科护士的护理质量与适应力之间的关系。 方法:本描述性分析横断面研究由克尔曼沙赫医科大学附属医院急诊科的228名护士参与。数据通过人口统计学问卷、康纳 - 戴维森适应力量表(CD - RISC)和护理质量(QUALPAC)问卷收集。使用SPSS 25版进行统计分析。数据分布的正态性通过柯尔莫哥洛夫 - 斯米尔诺夫检验评估,结果显示分数呈非正态分布。因此,采用非参数检验,特别是曼 - 惠特尼U检验和克鲁斯卡尔 - 沃利斯检验来比较组间差异。使用斯皮尔曼等级相关系数检验变量之间的关系。此外,进行控制混杂变量的逐步多元线性回归分析以确定护理质量的预测因素。 结果:在256名受邀护士中,228名完成了有效问卷(回复率89%)。参与者的平均年龄为29.5±5.4岁。护理质量平均得分为96.1±17.0(中等水平),适应力平均得分为66.7±15.1。护理质量得分在性别( = 0.007)、年龄组( = 0.007)和就业状况( = 0.001)方面存在显著差异,但在婚姻状况方面无显著差异( = 0.563)。男护士的护理质量得分更高(d = 0.39),而女护士的适应力更高( = 0.001,d = 0.39)。斯皮尔曼相关性显示适应力与整体护理质量( = 0.275)及其心理社会维度( = 0.280)和沟通维度( = 0.215)之间存在显著正相关(均 < 0.001)。控制性别、年龄和就业状况的多元线性回归具有显著性(F = 10.210, < 0.001),解释了护理质量变异的15.5%。适应力(β = 0.314, <

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本文引用的文献

[1]
Resilience and Flexibility for Clinical Nurses: A Latent Class Analysis.

J Nurs Manag. 2024-5-20

[2]
Improving Hospital Efficiency and Cost Management: A Systematic Review and Meta-Analysis.

Cureus. 2024-10-17

[3]
Exploring resilience among hospital workers: a Bayesian approach.

Front Public Health. 2024

[4]
Resilience in the face of pandemic: exploring the influence of psychological flexibility on turnover intentions and burnout among critical care nurses in COVID-19 hospitals.

BMC Nurs. 2024-7-10

[5]
The Impact of Nurses' Work Environment on Mental Health and Suicide.

Crit Care Nurse. 2024-6-1

[6]
The moral distress and resilience among emergency nurses in Arar city: Saudi Arabia.

Int Emerg Nurs. 2024-6

[7]
Quality communication can improve patient-centred health outcomes among older patients: a rapid review.

BMC Health Serv Res. 2023-8-22

[8]
Psychometric evaluation of the Connor-Davidson Resilience Scale among Iranian population.

BMC Psychiatry. 2023-2-7

[9]
Workload and quality of nursing care: the mediating role of implicit rationing of nursing care, job satisfaction and emotional exhaustion by using structural equations modeling approach.

BMC Nurs. 2022-10-8

[10]
A workplace organisational intervention to improve hospital nurses' and physicians' mental health: study protocol for the Magnet4Europe wait list cluster randomised controlled trial.

BMJ Open. 2022-7-28

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