Analysis of influencing factors of clinical practice adaptability of nursing students and teaching promotion strategies
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摘要:
目的 了解安徽省实习护生临床实习适应能力现状，探讨临床实习适应能力的影响因素，从护理教学角度讨论提升临床实习适应能力的策略。 方法 采用便利抽样的方法，于2021年7—9月选择安徽省8家三甲医院1 210名实习护生作为调查对象，应用实习护生压力源量表、心理韧性量表和临床实习适应量表进行调查。临床实习适应能力的单因素分析应用成组t检验和方差分析，实习压力、心理韧性和临床实习适应能力相关分析采用Pearson相关分析，采用多元线性回归分析研究临床实习适应能力的影响因素。 结果 是否自愿选择护理专业、是否毕业后愿意从事护理工作和不同喜欢护理专业的程度、就业态度、性格特征、身体健康状态和人际交往的护生临床实习适应能力得分比较，差异均有统计学意义(均P < 0.01)；压力总分与临床实习适应能力各维度及总分之间均呈负相关关系(r=-0.592~-0.456，均P < 0.01)；心理韧性总分与临床实习适应能力各维度及总分之间均呈正相关关系(r=0.415~0.592，均P < 0.01)；就业态度、性格特征、喜欢护理专业程度、压力和心理韧性是护生临床实习适应能力的影响因素。 结论 实习压力、心理韧性和临床实习适应能力存在关联，学校及实习医院应意识到临床实习适应能力的重要性，实施针对性的临床教学方法提升适应能力，从而稳定护理队伍。 Abstract:Objective To know about the status quo of clinical practice adaptability of nursing students in Anhui, explore the factors influencing the adaptability of clinical practice, so discuss the strategies to improve the adaptability of clinical practice from the angle of nursing teaching. Methods A total of 1 210 nursing students from 8 tertiary hospitals in Anhui Province were selected by convenience sampling from July to September 2021. The stress scale, psychological resilience scale and clinical practice adaptation scale were used to investigate. Two sample t-test and ANOVA were used for univariate analysis of clinical practice adaptability. Pearson correlation analysis was used for correlation analysis of stressors, psychological resilience and clinical practice adaptability. Multiple linear regression was used for influencing factors of clinical practice adaptability. Results There were statistically significant difference in the clinical practice adaptation among liking the degree of nursing, employment attitude, personality traits, physical health state, interpersonal communication, whether voluntary choice of nursing profession and willing to work in nursing after graduation of nursing students (all P < 0.01). The total score of stress was negatively correlated with the dimensions and total scores of clinical practice adaptability (r: -0.592 to -0.456, all P < 0.01), while the mental toughness was positively correlated with the dimensions and total scores of clinical practice adaptability (r: 0.415 to 0.592, all P < 0.01). The employment attitude, personality traits, liking the degree of nursing, stress and mental toughness were the influence factors of the clinical practice adaptability. Conclusion Internship stress, mental toughness and clinical practice adaptability are related. Schools and practice hospitals should realize the importance of clinical practice adaptability and implement targeted clinical teaching methods to improve the adaptability, so as to stabilize the nursing team. -
Key words:
- Nursing students /
- Stress /
- Mental toughness /
- Clinical practice /
- Adaptability /
- Influence factors
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表 1 实习护生临床实习适应能力的单因素分析
Table 1. Univariate analysis of clinical practice adaptability of nursing students
项目 人数 得分(x±s，分) 统计量 P值 自愿选择护理 是 935 96.32±18.02 7.488f < 0.001 否 275 88.18±15.14 毕业是否愿意从事护理 是 1 080 95.79±17.44 8.031f < 0.001 否 130 83.50±16.36 喜欢护理专业的程度 非常喜欢 125 108.94±19.25a 58.698g < 0.001 喜欢 501 98.29±17.33 一般 559 88.68±14.44 不太喜欢 19 76.00±14.57 非常不喜欢 6 71.00±19.67 就业态度 乐观 554 101.31±18.38b 91.374g < 0.001 不确定 537 89.58±14.38 悲观 119 84.79±16.59 性格特征 外向 112 104.44±19.91c 20.148g < 0.001 偏外向 212 98.28±16.79 中性 489 94.43±17.47 偏内向 291 90.31±15.16 内向 106 87.89±18.97 健康状态 很好 507 100.25±19.25d 39.697g < 0.001 良好 577 91.49±14.75 一般 114 85.47±16.81 较差 12 78.92±11.26 人际关系 融洽 292 103.74±20.17e 42.997g < 0.001 较好 764 93.22±15.50 一般 147 82.71±14.27 较差 5 83.80±13.86 糟糕 2 77.50±16.23 注：与对应其他程度比较，aP < 0.05；与不确定、悲观比较，bP < 0.05；与对应偏外向、中性、偏内向、内向比较，cP < 0.05；与对应良好、一般、较差比较，dP < 0.05；与对应较好、一般、较差、糟糕比较，eP < 0.05。f为t值，g为F值。 
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表 2 护生实习压力、心理韧性和临床实习适应能力的相关分析(r值)
Table 2. Correlation analysis of internship pressure, mental toughness and adaptability of nursing students in clinical practice (r-value)
变量 压力总分 心理韧性总分 职业认知 情绪 人际交往 行为表现 适应能力总分 压力总分 1 心理韧性总分 -0.431 1 职业认知 -0.542 0.547 1 情绪 -0.456 0.415 0.630 1 人际交往 -0.515 0.576 0.695 0.614 1 行为表现 -0.530 0.491 0.660 0.838 0.709 1 适应能力总分 -0.592 0.592 0.841 0.806 0.897 0.893 1 注：均P < 0.01。
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表 3 护生临床实习适应能力影响因素自变量赋值
Table 3. Independent variable assignment of influencing factors of nursing students' clinical practice adaptability
变量 赋值方法 自愿选择护理 是=1，否=2 毕业是否愿意从事护理 是=1，否=2 喜欢护理专业的程度 非常喜欢=1，喜欢=2，一般=3，不太喜欢=4，非常不喜欢=5 就业态度 乐观=0, 0，悲观=1, 0，不确定=0, 1 性格特征 外向=0，0，0，0，偏外向=1，0，0，0，中性=0，1，0，0，偏内向=0，0，1，0，内向=0，0，0，1 健康状态 很好=1，良好=2，一般=3，较差=4 人际关系 融洽=1，较好=2，一般=3，较差=4，糟糕=5 实习压力 以实际值赋值 心理韧性 以实际值赋值
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表 4 护生临床实习适应能力影响因素的多元线性回归分析
Table 4. Multiple linear regression analysis of influencing factors of nursing students' clinical practice adaptability
变量 B SE β t值 P值 喜欢护理专业程度 -2.859 0.619 -0.115 4.617 < 0.001 就业态度 -1.243 0.411 -0.067 3.027 0.003 性格特征 1.105 0.353 0.066 3.130 0.002 实习压力 -0.283 0.019 -0.353 15.050 < 0.001 心理韧性 0.459 0.031 0.349 14.911 < 0.001
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[1] SHDAIFAT E, JAMAMA A, ALMER M. Stress and coping strategies among nursing students[J]. Glob J Health Sci, 2018, 10(5): 33. doi: 10.5539/gjhs.v10n5p33 [2] HELMINEN K, JOHNSON M, ISOAHO H, et al. Final assessment of nursing students in clinical practice: Perspectives of nursing teachers, students and mentors[J]. J Clin Nurs, 2017, 26(23-24): 4795-4803. doi: 10.1111/jocn.13835 [3] 艾婷, 肖泽梅, 曹莹, 等. 医学生适应的现状及干预研究进展[J]. 护理学报, 2016, 23(2): 26-30. https://www.cnki.com.cn/Article/CJFDTOTAL-NFHL201602009.htmAI T, XIAO Z M, CAO Y, et al. Current situation and intervention research progress of medical students' adaptation[J]. Journal of Nursing, 2016, 23(2): 26-30. https://www.cnki.com.cn/Article/CJFDTOTAL-NFHL201602009.htm [4] 田凌云, 方正清, 肖洪玲. 实习护生心理复原力现状及影响因素研究[J]. 当代护士(上旬刊), 2017, 24(5): 14-17. doi: 10.3969/j.issn.1006-6411.2017.05.006TIAN L Y, FANG Z Q, XIAO H L. Study on the status quo and influencing factors of mental resilience of nursing students[J]. Today Nurse, 2017, 24(5): 14-17. doi: 10.3969/j.issn.1006-6411.2017.05.006 [5] COLLIER A D. Characteristics of an effective nursing clinical instructor: The state of the science[J]. J Clin Nurs, 2018, 27(1-2): 363-374. doi: 10.1111/jocn.13931 [6] 吴华, 余结根, 姚应水. 关于医学临床实习生思想政治教育的思考[J]. 西部素质教育, 2017, 3(17): 19-22. https://www.cnki.com.cn/Article/CJFDTOTAL-XBSJ201717010.htmWU H, YU J G, YAO Y S. Thoughts on ideological and political education of medical clinical interns[J]. Western China Quality Education, 2017, 3(17): 19-22. https://www.cnki.com.cn/Article/CJFDTOTAL-XBSJ201717010.htm [7] 张桂霞, 高姗, 黄海燕. 实习护生压力源问卷的编制及结构分析[J]. 护理学杂志, 2014, 29(12): 60-62. doi: 10.3870/hlxzz.2014.12.060ZHANG G X, GAO S, HUANG H Y. Preparation and structure analysis of stressors questionnaire for nursing students in practice[J]. Magazine Introduction, 2014, 29(12): 60-62. doi: 10.3870/hlxzz.2014.12.060 [8] 胡月琴, 甘怡群. 青少年心理韧性量表的编制和效度验证[J]. 心理学报, 2008, 40(8): 902-912. https://www.cnki.com.cn/Article/CJFDTOTAL-XLXB200808005.htmHU Y Q, GAN Y Q. Development and psychometric validity of the resilience scale for chinese adolescents[J]. Acta Psychologica Sinica, 2008, 40(8): 902-912. https://www.cnki.com.cn/Article/CJFDTOTAL-XLXB200808005.htm [9] 雷洁, 沈思媚, 李稚玲, 等. 护生实习适应不良量表的初步编制[J]. 卫生职业教育, 2011, 29(8): 99-102. doi: 10.3969/j.issn.1671-1246.2011.08.058LEI J, SHEN S M, LI Z L, et al. The preliminary preparation of nursing students practice maladjustment scale[J]. Health Vocational Education, 2011, 29(8): 99-102. doi: 10.3969/j.issn.1671-1246.2011.08.058 [10] 刘亚萍, 陈飞宇, 王静静, 等. 实习本科护生心理弹性对护理核心能力的影响: 临床实习适应能力的中介作用[J]. 卫生职业教育, 2020, 38(5): 120-124. https://www.cnki.com.cn/Article/CJFDTOTAL-ZDYX202005057.htmLIU Y P, CHEN F Y, WANG J J, et al. The influence of mental resilience on nursing core competence of undergraduate nursing students: the mediating role of clinical practice adaptability[J]. Health Vocational Education, 2020, 38(5): 120-124. https://www.cnki.com.cn/Article/CJFDTOTAL-ZDYX202005057.htm [11] 陶蕾, 李伦兰, 张凤英, 等. 护生实习初期临床适应能力分析及提升策略[J]. 临床护理杂志, 2021, 20(3): 69-72. https://www.cnki.com.cn/Article/CJFDTOTAL-LCHL202103023.htmTAO L, LI L L, ZHANG F Y, et al. Clinical adaptability analysis and improvement strategy of nursing students in the early stage of practice[J]. Journal of Clinical Nursing, 2021, 20(3): 69-72. https://www.cnki.com.cn/Article/CJFDTOTAL-LCHL202103023.htm [12] GUO Y J, YANG L, JI H X, et al. Caring characters and professional identity among graduate nursing students in China: A cross sectional study[J]. Nurse Educ Today, 2018, 65: 150-155. [13] 凡秀娟, 蒋露苗, 郎自娜, 等. 本科护生实习前情绪管理能力现状及影响因素分析[J]. 全科护理, 2019, 17(3): 260-262. https://www.cnki.com.cn/Article/CJFDTOTAL-JTHS201903004.htmFAN X J, JIANG L M, LANG Z N, et al. The status of emotional management ability and its influential factors among before the practice of undergraduate nursing students[J]. Chinese General Practice Nursing, 2019, 17(3): 260-262. https://www.cnki.com.cn/Article/CJFDTOTAL-JTHS201903004.htm [14] 陈燕, 李根娣. 情景模拟教学对手术室实习护生心理状态和工作适应情况的影响[J]. 中国医药导报, 2021, 18(22): 88-91. https://www.cnki.com.cn/Article/CJFDTOTAL-YYCY202122020.htmCHEN Y, LI G D. Influences of scenario simulation education on psychological status and work adaptation of nursing students in internship in operating room[J]. China Medical Herald, 2021, 18(22): 88-91. https://www.cnki.com.cn/Article/CJFDTOTAL-YYCY202122020.htm [15] 丁丽宏, 王星, 高尚. 护理本科生感知压力、心理韧性对其生涯适应力的评估研究[J]. 内蒙古医科大学学报, 2020, 42(S2): 83-85. https://www.cnki.com.cn/Article/CJFDTOTAL-NMYX2020S2032.htmDING L H, WANG X, GAO S. A study on the assessment of perceived stress and mental toughness on career adaptability of nursing undergraduates[J]. Journal of Inner Mongolia Medical University, 2020, 42(S2): 83-85. https://www.cnki.com.cn/Article/CJFDTOTAL-NMYX2020S2032.htm [16] 郭亚男, 陈馨, 张美琳. 实习护生择业焦虑与自尊对心理韧性的影响研究[J]. 护理管理杂志, 2021, 21(3): 207-211. https://www.cnki.com.cn/Article/CJFDTOTAL-HLGL202103016.htmGUO Y N, CHEN X, ZHANG M L. Study on the influence of career anxiety and self-esteem on mental toughness of intern nursing students[J]. Journal of Nursing Administration, 2021, 21(3): 207-211. https://www.cnki.com.cn/Article/CJFDTOTAL-HLGL202103016.htm [17] 吴珏, 梁晓燕. 认知行为团体辅导对某中职护校学生心理韧性的干预研究[J]. 卫生职业教育, 2017, 35(14): 137-138. https://www.cnki.com.cn/Article/CJFDTOTAL-ZDYX201714075.htmWU J, LIANG X Y. Study on the intervention of cognitive behavioral group counseling on mental toughness of students in a secondary vocational nursing school[J]. Health Vocational Education, 2017, 35(14): 137-138. https://www.cnki.com.cn/Article/CJFDTOTAL-ZDYX201714075.htm [18] 赵秀荷, 孙金海, 贾守梅, 等. 三线放松法对护生心理压力的团体干预研究[J]. 中国学校卫生, 2019, 40(7): 1040-1042. https://www.cnki.com.cn/Article/CJFDTOTAL-XIWS201907025.htmZHAO X H, SUN J H, JIA S M, et al. Effectiveness of the three-line relaxation-based group intervention on mental stress management among nursing students[J]. Chinese Journal of School Health, 2019, 40(7): 1040-1042. https://www.cnki.com.cn/Article/CJFDTOTAL-XIWS201907025.htm [19] 李青文. 护理专业大学生共情能力现状及影响因素分析[J]. 中华全科医学, 2017, 15(10): 1744-1747. doi: 10.16766/j.cnki.issn.1674-4152.2017.10.032LI Q W. Analysis of current situation and influencing factors of the empathy ability of nursing students[J]. Chinese Journal of General Practice, 2017, 15(10): 1744-1747. doi: 10.16766/j.cnki.issn.1674-4152.2017.10.032 [20] 郭秋月. 情景模拟教学提高手术室实习护生软实力的应用效果[J]. 医学理论与实践, 2021(19): 3487-3488. https://www.cnki.com.cn/Article/CJFDTOTAL-YXLL202119086.htmGUO Q Y. The application effect of situational simulation teaching to improve the soft power of nursing students in operating room[J]. The Journal of Medical Theory and Practice, 2021(19): 3487-3488. https://www.cnki.com.cn/Article/CJFDTOTAL-YXLL202119086.htm [21] 刘思维, 骆璐. 萨提亚模式对本科实习护生临床实习适应能力的影响研究[J]. 当代护士(上旬刊), 2020, 27(5): 156-159. https://www.cnki.com.cn/Article/CJFDTOTAL-DDZT202005073.htmLIU S W, LUO L. Study on the influence of Satia model on the adaptability of undergraduate nursing students in clinical practice[J]. Today Nurse, 2020, 27(5): 156-159. https://www.cnki.com.cn/Article/CJFDTOTAL-DDZT202005073.htm -
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