三甲医院护士循证护理实践知信行现状及影响因素研究

邢思思; 段晓侠; 袁玥; 陈玲玲

doi:10.16766/j.cnki.issn.1674-4152.003440

三甲医院护士循证护理实践知信行现状及影响因素研究

doi: 10.16766/j.cnki.issn.1674-4152.003440

邢思思^{1, 2},
段晓侠^2, ,,
袁玥^{1, 2},
陈玲玲²

1.
蚌埠医科大学研究生院, 安徽蚌埠 233030
2.
蚌埠医科大学第二附属医院教学科, 安徽蚌埠 233080

基金项目:

安徽省高等学校省级质量工程项目 2021jyxm0946

详细信息

通讯作者:
段晓侠，E-mail：382225677@qq.com

中图分类号: R47 R192.6
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- 文章访问数: 168
- HTML全文浏览量: 47
- PDF下载量: 9
- 被引次数: 0
出版历程
- 收稿日期: 2023-06-05
- 网络出版日期: 2024-05-27

A study on the current situation and influencing factors of evidence-based nursing practice knowledge-attitude-practice among nurses in third Class A hospitals

XING Sisi^{1, 2},
DUAN Xiaoxia^{2
, ,},
YUAN Yue^{1, 2},
CHEN Lingling²

1.
The Graduate School of Bengbu Medical University, Bengbu, Anhui 233030, China

摘要

摘要: 目的探索三级甲等综合医院的临床护士循证护理实践知识技能、态度和行为的能力水平现况及其影响因素。方法采用便利抽样方式，于2023年3月选取蚌埠市3所三级甲等综合医院的251名临床护士为研究对象，采用一般资料调查表、循证实践知信行量表对其开展问卷调查，分析循证护理实践知信行现状并探讨相关影响因素。结果 251名三级甲等综合医院临床护士的循证实践知信行总分为(105.24±20.98)分，条目均分为(4.38±0.87)分，知识技能维度总分为(55.61±11.22)分、均分为(4.27±0.86)分，实践态度维度总分为(22.80±5.15)分、均分为(4.56±1.03)分，实践行为维度总分为(26.82±7.05)分、均分为(4.47±1.17)分。其中，实践态度的均分最高、知识技能的均分最低。单因素分析显示，年龄、职称、工作年限、计算机技能、专科技术水平、职业态度、循证护理知晓程度、循证护理培训经历、循证实践经历、实施个性化护理的能力、循证护理临床实用性均是临床护士循证实践知信行总分的影响因素(P＜0.05)。多元线性回归分析显示，计算机技能、职业态度、循证护理知晓程度、循证实践经历、实施个性化护理的能力均是蚌埠市三级甲等综合医院临床护士循证护理实践知信行水平的影响因素(P＜0.05)。结论三级甲等综合医院的临床护士循证护理实践知信行水平仍有待提高，管理者应根据各种影响因素制定并开展针对性的培训方案，进一步提高医疗护理服务水平。
- 循证护理 /
- 知信行 /
- 影响因素
Abstract: Objective A study was conducted to investigate the current status of capacity levels and factors influencing the knowledge-attitude-practice of evidence-based nursing in Grade 3A general hospital. Methods In March 2023, a convenience sampling method was employed to select 251 clinical nurses as research subjects from three Grade 3A general hospitals in Bengbu City. Questionnaire surveys were conducted using the general information questionnaire and the evidence-based practice questionnaire to analyze the current situation and explore the relevant influencing factors. Results The total scores of evidence-based nursing practice knowledge-attitude-practice among 251 clinical nurses in Grade 3A general hospitals were (105.24±20.98) points. The entry mean score was (4.38±0.87) points. The scores for each dimension were as follows: knowledge skills had a total score (55.61±11.22) points and a mean score of (4.27±0.86) points, attitude towards practice behavior had a total score (22.80±5.15) points and a mean score of (4.56±1.03) points, and practice behavior had a total score of (26.82±7.05) points and a mean score of (4.47±1.17) points. Among these dimensions, practical attitude had the highest mean scores, while knowledge skills had the lowest mean scores. One-way analysis showed significant differences among the 251 clinical nurses in terms of age, title, years of experience, computer skills, specialized technical skills, professional attitudes, knowledge of evidence-based nursing, experience of training in evidence-based nursing, experience of evidence-based practice, ability to implement personalized nursing care, and the practicality of evidence-based nursing practice (P<0.05). Multiple linear regression analysis indicated that computer skills, professional attitude, knowledge of evidence-based nursing, experience of evidence-based practice, and ability to implement personalized care were the factors influencing the level of knowledge, belief, and practice of evidence-based nursing practice among clinical nurses in Grade 3A general hospitals in Bengbu City (P<0.05). Conclusion Evidence-based practice competencies of clinical nurses in Grade 3A general hospital need to be further improved. Management leadership should develop and implement targeted training programs that take into account all relevant factors in order to enhance the level of medical care services.
- Evidence-based nursing /
- Knowledge-attitude-practice /
- Influencing factors

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表 1 251名三甲医院临床护士EBPQ总分及各维度得分情况(x±s, 分)

Table 1. Total scores and various dimensions of the EBPQ for 251 clinical nurses in grade 3A hospitals (x±s, points)

项目	总分	条目均分
行为	26.82±7.05	4.47±1.17
态度	22.80±5.15	4.56±1.03
知识技能	55.61±11.22	4.27±0.86
总分	105.24±20.98	4.38±0.87

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表 2 不同特征三甲医院临床护士EBPQ得分比较(x±s, 分)

Table 2. Comparison of EBPQ scores of clinical nurses with different characteristics in grade 3A hospitals (x±s, points)

项目	例数	量表得分	统计量	P值	项目	例数	量表得分	统计量	P值
性别			2.252^a	0.135	每日工作时间(h)			0.613^a	0.354
男性	15	4.46±1.15			6~8	156	4.34±0.84
女性	236	4.38±0.86			＞8	95	4.45±0.93
年龄(岁)			3.863^b	0.005	专科技术水平(专科护士资质)			2.017^a	0.045
18~25	37	4.20±0.83			有	34	4.66±0.94
26~30	71	4.19±0.94			无	217	4.34±0.86
31~40	93	4.50±0.86			护理职业态度			10.204^b	＜0.001
41~50	37	4.75±0.70			不喜欢	4	4.42±0.68
51~60	13	4.09±0.78			一般	127	4.15±0.88
职称			4.122^b	0.007	喜欢	120	4.63±0.81
护士	54	4.04±0.87			循证护理知晓程度			17.737^b	＜0.001
护师	84	4.40±0.81			从未听过	14	3.57±0.75
主管护师	97	4.52±0.90			听说过	88	4.09±0.87
副主任护师及以上	16	4.63±0.76			基本了解	105	4.45±0.70
第一学历			2.597^b	0.770	比较熟悉	38	4.99±0.70
中专	51	4.61±0.84			非常熟悉	6	5.75±1.05
大专	150	4.29±0.86			是否参加过循证相关培训			3.790^a	＜0.001
本科	50	4.23±0.94			是	72	4.71±0.91
最高学历			6.808^a	0.870	否	179	4.26±0.83
大专及以下	51	4.41±1.04			是否开展过循证实践			16.452^b	＜0.001
本科及以上	200	4.38±0.83			从未实践	67	3.91±0.81
工作年限			3.565^b	0.015	有过想法	152	4.45±0.80
5年及以下	84	4.15±0.90			实践了但未成功	10	4.70±0.37
6~10年	47	4.38±0.95			实践了并成功了	22	5.21±0.93
11~20年	73	4.55±0.77			是否能够实施个性化护理方案			7.507^b	＜0.001
21年及以上	47	4.54±0.82			无法实施	7	3.73±0.90
英语水平			2.458^b	0.088	偶尔可以	43	4.02±0.81
无	184	4.34±0.88			基本可以	104	4.33±0.76
大学英语四级	58	4.43±0.83			总是可以	97	4.65±0.93
大学英语六级	9	4.99±0.99			循证护理是否具有临床实用性			17.125^b	＜0.001
计算机技能			4.374^b	0.005	不清楚	71	3.93±0.91
无	70	4.21±0.88			实用性一般	47	4.27±0.52
一级	77	4.23±0.89			有时有	111	4.57±0.80
二级	95	4.61±0.81			总是有	22	5.18±0.93
三级及以上	9	4.67±0.80
注：^a为t值，^b为F值。

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表 3 自变量赋值情况

Table 3. Assignment of independent variables

自变量	赋值方法
计算机技能	无=1，一级=2，二级=3，三级及以上=4
护理职业态度	不喜欢=1，一般=2，喜欢=3
循证护理知晓程度	从未听过=1，听说过=2，基本了解=3，比较熟悉=4，非常熟悉=5
是否开展过循证实践	从未实践=(0，0，0)，有过想法=(1，0，0)，实践了但未成功=(0，1，0)，实践了并成功了=(0，0，1)
是否能够实施个性化护理方案	无法实施=1，偶尔可以=2，基本可以=3，总是可以=4

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表 4 三甲医院临床护士循证护理实践知信行影响因素的多元线性逐步回归分析

Table 4. Multiple linear stepwise regression analysis on the factors influencing the knowledge, attitude, and practice of evidence-based nursing among clinical nurses in grade 3A hospitals

变量	B	SE	β	t值	P值
循证护理知晓程度	0.314	0.067	0.312	4.725	＜0.001
是否能够实施个性化护理方案	0.238	0.056	0.222	4.222	＜0.001
护理职业态度	0.291	0.087	0.176	3.337	＜0.001
是否开展过循证实践	0.154	0.072	0.143	2.148	0.033
计算机技能	0.113	0.053	0.114	2.123	0.035

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