实习护生临床归属感的潜在类别及影响因素分析

袁妞; 吕张红; 何玲英

doi:10.16766/j.cnki.issn.1674-4152.003731

实习护生临床归属感的潜在类别及影响因素分析

doi: 10.16766/j.cnki.issn.1674-4152.003731

袁妞^{1, 2, 3},
吕张红⁴,
何玲英^2, ,

1.
浙江中医药大学护理学院，浙江杭州 310053
2.
浙江大学医学院附属第一医院护理部，浙江杭州 310003
3.
浙江大学医学院附属第一医院全科医学科，浙江杭州 310003
4.
浙江大学医学院附属第一医院全科医学科，浙江杭州 310003

基金项目:

浙江省教育厅抗疫专项项目 Y202043495

浙江大学医学院附属第一医院护理学科建设科研专项基金 2023ZYHL30

详细信息

通讯作者:
何玲英，E-mail：he0y@163.com

中图分类号: R192.6
计量
- 文章访问数: 35
- HTML全文浏览量: 14
- PDF下载量: 2
- 被引次数: 0
出版历程
- 收稿日期: 2024-05-06
- 网络出版日期: 2024-12-28

Latent profile analysis and influencing factors of clinical belongingness among nursing interns

YUAN Niu^{1, 2, 3},
LYU Zhanghong⁴,
HE Lingying^{2
, ,}

1.
College of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310053, China

摘要

摘要: 目的探索实习护生临床归属感的潜在类别及其特征差异，分析不同类别的影响因素，为制订精准干预策略提供参考。方法 2023年3月22日—12月7日，便利选取浙江、江西、安徽、河南11所医院实习的836名护生作为调查对象，应用一般资料调查问卷、临床归属感量表(护生版)、杰弗逊共情量表(护生版)、感知压力量表调查，以潜在剖面分析识别实习护生临床归属感的类别及其特征，并通过无序多分类logistic回归模型分析不同类别的影响因素。结果实习护生临床归属感分为3个类别，分别为低(46.89%)、中(44.74%)、高归属型(8.37%)。相较于低归属型，男护生归入高归属型的概率更高(OR=2.504, P=0.011)；父亲职业为创业人员的实习护生归到中归属型的概率更高(OR=1.923, P=0.037)；共情能力越强归到中归属型、高归属型的概率越高(OR=1.054, P < 0.001；OR=1.052, P < 0.001)；而感知压力越小归入中归属型、高归属型的概率越高(OR=0.898, P < 0.001；OR=0.816, P < 0.001)。结论实习护生临床归属感普遍不高且存在异质性，可分为3个类别。院校护理教育管理者可根据不同类别特征差异进行精准干预，以提高实习护生的临床归属感。
- 实习护生 /
- 临床归属感 /
- 潜在剖面 /
- 影响因素
Abstract: Objective To explore the latent categories and characteristics of clinical belongingness among nursing interns, and to analyze the influencing factors of various categories, so as to provide references for formulating precision intervention strategies. Methods From March 22 to December 7, 2023, a total of 836 nursing students from 11 hospitals in Zhejiang, Jiangxi, Anhui, and Henan were conveniently selected as survey participants. General demographic information questionnaires, belongingness scale-clinical placement experience, Jefferson scale of physician empathy for nursing students, and perceived stress scale were utilized for investigation. Latent profile analysis was employed to identify categories and characteristics of clinical sense of belonging among internship nursing students. An unordered multinomial logistic regression model was utilized to analyze the factors associated with latent categories of clinical belongingness. Results The clinical sense of belonging among nursing interns can be classified into three categories: low (46.89%), moderate (44.74%), and high belonging (8.37%). Compared to those in the low belonging category, male nursing interns had a higher likelihood of belonging to the high belonging category (OR=2.504, P=0.011). Nursing interns whose fathers work as entrepreneurs are more likely to belong to the moderate belonging category (OR=1.923, P=0.037). The probability of belonging to the moderate and high belonging categories increases with stronger empathy (OR=1.054, P < 0.001; OR=1.052, P < 0.001), and the likelihood of belonging to the moderate and high belonging categories increases with lower perceived stress (OR=0.898, P < 0.001; OR=0.816, P < 0.001). Conclusion The clinical sense of belonging among nursing interns is generally moderate and exhibits heterogeneity, categorized into three distinct groups. Nursing education administrators can implement precise interventions based on the characteristic differences among these groups to enhance the clinical sense of belonging among nursing interns.
- Nursing interns /
- Clinical belongingness /
- Latent profile /
- Influencing factors

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表 1 实习护生临床归属感的潜在剖面拟合信息

Table 1. Potential profile fitting information for clinical belonging of nursing students

模型	AIC	BIC	aBIC	Entropy	LMR	BLRT	类别概率
1	71 645.781	71 967.328	71 751.383
2	64 054.444	64 541.492	64 541.492	0.957	< 0.001	< 0.001	0.569 4/0.430 6
3	61 864.156	62 516.707	62 078.465	0.967	< 0.001	< 0.001	0.468 9/0.447 4/0.083 7
4	60 720.383	61 538.436	60 989.046	0.973	0.550	< 0.001	0.014 4/0.470 1/0.431 8/0.083 7
5	59 874.642	60 858.196	60 197.658	0.944	0.782	< 0.001	0.010 8/0.340 9/0.253 6/0.318 2/0.076 5

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表 2 不同临床归属感潜在剖面类别实习护生一般资料比较

Table 2. Comparison of general data of nursing students in different potential profile categories of clinical belonging

项目	总体(n=836)	低归属型(n=392)	中归属型(n=374)	高归属型(n=70)	统计量	P值
性别[例(%)]					14.702^a	< 0.001
男性	104(12.4)	51(13.0)	35(9.4)	18(25.7)
女性	732(87.6)	341(87.0)	339(90.6)	52(74.3)
年龄(x±s, 岁)	20.73±1.54	20.79±1.54	20.68±1.48	20.67±1.78	0.540^b	0.583
家庭居住地址[例(%)]					2.908^a	0.234
农村	490(58.6)	238(60.7)	217(58.0)	35(50.0)
城镇	346(41.4)	154(39.3)	157(42.0)	35(50.0)
宗教信仰[例(%)]					3.747^a	0.156
有	48(5.7)	28(7.1)	15(4.0)	5(7.1)
无	788(94.3)	364(92.9)	359(96.0)	65(92.9)
独生子女[例(%)]					0.858^a	0.660
是	206(24.6)	98(25.0)	88(23.5)	20(28.6)
否	630(75.4)	294(75.0)	286(76.5)	50(71.4)
父亲文化程度[例(%)]					5.019^c	0.543
小学及以下	131(15.7)	65(16.6)	54(14.1)	12(17.1)
初中	409(48.9)	192(49.0)	190(50.8)	27(38.6)
高中/中专	198(23.7)	94(24.0)	84(22.5)	20(28.6)
大专及以上	98(11.7)	41(10.5)	46(12.3)	11(15.7)
母亲文化程度[例(%)]					3.764^c	0.711
小学及以下	222(26.6)	106(27.0)	101(27.0)	15(21.4)
初中	383(45.8)	179(45.7)	173(46.3)	31(44.3)
高中/中专	163(19.5)	80(20.4)	67(17.9)	16(22.9)
大专及以上	68(8.1)	27(6.9)	33(8.8)	8(11.4)
父亲职业[例(%)]					27.852^a	< 0.001
工人/农民	300(35.9)	140(35.7)	146(39.0)	14(20.0)
创业人员	185(22.1)	62(15.8)	99(26.5)	24(34.3)
企业职员	87(10.4)	45(11.5)	34(9.1)	8(11.4)
体制员工	64(7.7)	37(9.4)	23(6.1)	4(5.7)
其他	200(23.9)	108(27.6)	82(19.3)	20(28.6)
母亲职业[例(%)]					18.651^a	0.017
工人/农民	246(29.4)	115(29.3)	119(31.8)	12(17.1)
创业人员	157(18.8)	56(14.3)	83(22.2)	18(25.7)
企业职员	129(15.4)	70(17.9)	50(13.4)	9(12.9)
体制员工	42(5.0)	21(5.4)	17(4.5)	4(5.7)
其他	262(31.3)	130(33.2)	105(28.1)	27(38.6)
月均生活费用[例(%)]					10.151^c	0.116
≤1 500元	405(48.4)	192(49.0)	185(49.5)	28(40.0)
>1 500~3 000元	363(43.4)	160(40.8)	168(44.9)	35(50.0)
>3 000~6 000元	51(6.1)	32(8.2)	15(4.0)	4(5.7)
>6 000元	17(2.0)	8(2.0)	6(1.6)	3(4.3)
专业选择原因[例(%)]					10.779^a	0.095
自愿	315(37.7)	133(33.9)	146(39.0)	36(51.4)
父母或他人建议	413(49.4)	200(51.0)	187(50.0)	26(37.1)
调剂	54(6.5)	30(7.7)	19(5.1)	5(7.1)
其他	54(6.5)	29(7.4)	22(5.9)	3(4.3)
实习时间[例(%)]					7.617^c	0.106
3~6个月	359(43.0)	168(42.9)	162(43.3)	29(41.4)
6~9个月	358(42.8)	157(40.0)	172(46.0)	29(41.4)
≥9个月	119(14.2)	67(17.1)	40(10.7)	12(17.2)
共情能力(x±s, 分)	100.59±12.77	94.47±13.67	105.88±14.51	106.66±19.49	66.629^b	< 0.001
感知压力(x±s, 分)	40.96±5.83	42.81±4.76	39.86±5.78	36.47±7.42	45.746^b	< 0.001
注：^a为χ²值，^b为F值, ^c为Z值。

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表 3 实习护生临床归属感潜在剖面类别影响因素的多因素分析

Table 3. Multi-factor analysis of influencing factors of potential profile categories of clinical belonging among nursing interns

变量	中归属型vs. 低归属型					高归属型vs. 低归属型
变量	B	SE	Waldχ²	P值	OR(95% CI)	B	SE	Waldχ²	P值	OR(95% CI)
男性	-0.320	0.264	1.470	0.225	0.726 (0.433~1.218)	0.918	0.360	6.496	0.011	2.504 (1.236~5.071)
父亲职业
工人/农民	0.355	0.284	1.563	0.211		-0.375	0.524	0.513	0.474
创业人员	0.654	0.313	4.362	0.037	1.923 (1.041~3.551)	0.567	0.488	1.350	0.245	1.764 (0.677~4.593)
企业职员	0.240	0.343	0.490	0.484		0.406	0.572	0.503	0.478
体制员工	-0.106	0.404	0.068	0.794		-1.036	0.756	1.876	0.171
母亲职业
工人/农民	0.011	0.279	0.002	0.968		-0.560	0.530	1.118	0.290
创业人员	0.015	0.306	0.002	0.962		-0.387	0.487	0.631	0.427
企业职员	-0.250	0.295	0.719	0.397		-0.647	0.521	1.540	0.215
体制员工	0.544	0.463	1.383	0.240		0.524	0.763	0.471	0.493
共情能力	0.052	0.006	82.580	< 0.001	1.054 (1.042~1.066)	0.051	0.009	29.092	< 0.001	1.052 (1.033~1.072)
感知压力	-0.108	0.017	40.961	< 0.001	0.898 (0.869~0.928)	-0.204	0.026	61.741	< 0.001	0.816 (0.775~0.858)
注：性别以女性为参照，父亲/母亲职业以其他为参照。

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