隐私保护高认知水平手术室护士的患者隐私保护行为及影响因素分析

应小叶; 俞英; 毛呈璟; 林雅琴; 高小民; 任盈

doi:10.16766/j.cnki.issn.1674-4152.004150

隐私保护高认知水平手术室护士的患者隐私保护行为及影响因素分析

doi: 10.16766/j.cnki.issn.1674-4152.004150

温州医科大学附属第一医院手术室，浙江温州 325000

基金项目:

浙江省温州市科技局项目 Y20220516

浙江省医药卫生科技计划项目 2024KY143

详细信息

通讯作者:
任盈, E-mail: reny1536969@163.com

中图分类号: R473.6
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- 文章访问数: 13
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- 被引次数: 0
出版历程
- 收稿日期: 2024-08-07
- 网络出版日期: 2025-10-31

Analysis of patient privacy protection behavior and its influencing factors among operating room nurses with high privacy protection cognitive level

Operating Room Department, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China

摘要

摘要: 目的探讨隐私保护高认知水平手术室护士的患者隐私保护行为现状及影响因素，为手术室护士的临床管理提供一定的参考。方法使用方便抽样法于2024年4—5月选取近1年内参加过患者隐私保护培训的306名三甲医院手术室护士作为研究对象。使用基本资料调查表、患者隐私保护量表、Jefferson同理心量表和伦理敏感性量表进行问卷调查。使用聚类分析对护士的患者隐私保护行为进行分类，使用logistic回归分析进行患者隐私保护行为影响因素分析。结果患者隐私保护行为得分为(108.53±15.67)分。以104分为界，将手术室护士分为行为高水平组207人(67.6%)和行为中等水平组99人(32.4%)。Logistic回归分析结果显示，曾发生过与患者隐私相关医疗纠纷/护患不和、伦理敏感性、同理心、手术室工作负荷的承受程度和手术室隐私保护相关配套设施均是高认知水平手术室护士对患者隐私保护行为的影响因素(P < 0.05)。结论管理者应正视手术室护士对患者隐私保护认知与行为间的差距，并可通过提高手术室护士的伦理敏感性和同理心，定期评估手术室护士的工作负荷程度，确保隐私保护设施的完善性和适用性等方式积极促进患者隐私保护行为。
- 隐私保护高认知水平 /
- 手术室护士 /
- 患者隐私保护认知 /
- 患者隐私保护行为
Abstract: Objective To explore the current situation and influencing factors of patient privacy protection behavior of operating room nurses with high privacy protection cognitive level, and provide some references for the clinical management of operating room nurses. Methods A total of 306 operating room nurses who had participated in patient privacy protection training in nearly one year were selected between April and May 2024 by convenient sampling. The basic data questionnaire, patient privacy protection scale, Jefferson empathy scale and ethical sensitivity scale were used in the investigation. The cluster analysis was used to classified nurses' patient privacy protection behavior, and the logistic regression was used to analyze the influencing factors of privacy protection behavior. Results The score of patient privacy protection behavior was 108.53±15.67. The operating room nurses were divided into high-level group of 207 nurses (67.6%) and median group of 99 nurses (32.4%) by 104 boundaries. The results of the logistic regression showed that there had been patient privacy-related medical disputes / nurse-patient discord, ethical sensitivity, empathy, operating room workload tolerance and operating room supporting facilities related to privacy protection were the factors affecting the patient privacy protection behavior of operating room nurses with high cognitive level (P < 0.05). Conclusion Managers should face up to the gap between cognition and behavior, and can actively explore methods to promote the patient privacy protection behavior through improving the ethical sensitivity and empathy, regularly assessing the operating room nurse' s workload, ensuring the perfection of privacy and applicability of privacy facilities.
- High privacy protection cognitive level /
- Operating room nurses /
- Patient privacy protection cognition /
- Patient privacy protection behavior

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表 1 高认知水平手术室护士患者隐私保护行为现状(x±s，分)

Table 1. The current status of patient privacy protection behavior in operating room nurses with high privacy protection cognitive level(x±s, points)

维度	认知		行为
维度	总分	条目均分	总分	条目均分
身体隐私	18.42±1.72	4.59±0.45	16.74±2.41	4.21±0.60
个人资讯和生活隐私	45.29±4.38	4.51±0.43	40.64±5.13	4.15±0.59
性别隐私	22.48±2.31	4.44±0.41	19.75±2.78	3.99±0.54
环境隐私	17.42±1.88	4.33±0.43	15.83±2.47	3.98±0.58
不能自行保护患者的隐私	17.65±1.86	4.31±0.44	15.57±2.16	3.92±0.57
量表总分	121.26±12.24	4.47±0.46	108.53±15.67	4.03±0.61

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表 2 2组护士患者隐私保护认知与行为比较(x±s，分)

Table 2. Comparative analysis of patient privacy protection cognition and behavior in two groups of nurses(x±s, points)

组别	人数	患者隐私保护认知	患者隐私保护行为
行为高水平组	207	122.04±12.22	110.71±15.34
行为中等水平组	99	119.63±12.18	103.97±14.97
t值		1.618	3.655
P值		0.107	＜0.001

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表 3 高认知水平手术室护士患者隐私保护行为的单因素分析

Table 3. Univariate analysis of patient privacy protection behavior of operating room nurses with high cognitive level

项目	人数	行为高水平组(n=207)	行为中等水平组(n=99)	统计量	P值
年龄[人(%)]				0.999^a	0.607
≤30岁	104	72(34.8)	32(32.3)
31~40岁	130	84(40.6)	46(46.5)
≥40岁	72	51(24.6)	21(21.2)
性别[人(%)]				0.483^a	0.487
男性	11	9(4.3)	2(2.0)
女性	295	198(95.7)	97(98.0)
工作年限[人(%)]
≤10年	137	84(40.6)	53(53.5)	4.546^a	0.033
>10年	169	123(59.4)	46(46.5)
手术室工作年限[人(%)]
≤5年	93	59(28.5)	34(34.3)	1.080^a	0.299
>5年	213	148(71.5)	65(65.7)
文化程度[人(%)]
大专及以下	72	45(21.7)	27(27.3)	1.140^a	0.286
本科及以上	234	162(78.3)	72(72.7)
平均月收入[人(%)]
≤5 000元	54	33(16.0)	21(21.2)	2.267^a	0.322
5 001~10 000元	140	93(44.9)	47(47.5)
≥10 001元	112	81(39.1)	31(31.3)
职称[人(%)]
初级	98	60(29.0)	38(38.4)	18.426^a	< 0.001
中级	169	109(52.7)	60(60.6)
高级	39	38(18.3)	1(1.0)
民族[人(%)]
汉族	285	191(92.3)	94(94.9)	0.752^a	0.386
其他	21	16(7.7)	5(5.1)
宗教信仰[人(%)]
有	29	22(10.6)	7(7.1)	0.988^a	0.320
无	277	185(89.4)	92(92.9)
对手术室工作满意程度[人(%)]
满意	101	69(33.3)	32(32.3)	2.109^a	0.348
一般	149	96(46.4)	53(53.5)
不满意	56	42(20.3)	14(14.2)
对患者隐私保护规章制度的了解程度[人(%)]
很了解	132	92(44.4)	40(40.4)	0.569^a	0.752
一般了解	139	91(44.0)	48(48.5)
不太了解	35	24(11.6)	11(11.1)
手术室对隐私保护规章制度执行程度[人(%)]
很好	101	82(39.6)	19(19.2)	14.782^a	0.001
一般	130	84(40.6)	46(46.5)
不好	75	41(19.8)	34(34.3)
手术室隐私保护相关配套设施[人(%)]
完善	135	101(48.8)	34(34.3)	7.007^a	0.030
一般	114	74(35.7)	40(40.4)
不完善	57	32(15.5)	25(25.3)
患者隐私相关医疗纠纷/护患不和[人(%)]
有	37	34(16.4)	3(3.0)	11.304^a	0.001
无	269	173(83.6)	96(97.0)
手术室工作负荷的承受程度[人(%)]
能承受	157	116(56.0)	41(41.4)	6.192^a	0.045
勉强能承受	122	76(36.7)	46(46.5)
承受不了	27	15(7.3)	12(12.1)
同理心(x±s，分)		105.64±16.73	101.12±16.17	2.262^b	0.024
伦理敏感性(x±s，分)		40.33±5.12	38.61±5.02	2.786^b	0.005
注：^a为χ²值，^b为t值。

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表 4 自变量赋值情况

Table 4. Assignment of independent variable

变量	赋值方法
工作年限(年)	≤10=0，>10=1
职称	初级=0，中级=1，高级=2
手术室对隐私保护规章制度执行程度	不好=0，一般=1，很好=2
手术室隐私保护相关配套设施	不完善=0，一般=1，完善=2
患者隐私相关医疗纠纷/护患不合	无=0，有=1
手术室工作负荷的承受程度	承受不了=0，勉强承受=1，能承受=2
注：其余连续性变量均以实际值赋值。

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表 5 高认知水平手术室护士患者隐私保护行为影响因素的logistic回归分析

Table 5. Logistic regression analysis of factors influencing patient privacy protection behavior among operating room nurses with high cognitive level

变量	B	SE	Waldχ²	P值	OR值	95% CI
患者隐私相关医疗纠纷/护患不和	1.783	0.714	6.236	0.013	5.948	4.364~7.402
伦理敏感性	0.581	0.223	6.788	0.009	1.788	1.225~2.349
同理心	0.476	0.195	5.959	0.015	1.610	1.210~2.113
手术室工作负荷的承受程度	1.372	0.483	8.069	0.005	3.943	2.869~5.004
手术室隐私保护相关配套设施	1.913	0.597	10.268	0.001	6.773	5.217~8.140

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参考文献(21)

[1]	郭进京, 张雪, 林鑫, 等. 国内患者隐私泄露情形及隐私保护现状分析[J]. 医学信息学杂志, 2020, 41(2): 21-28. GUO J J, ZHANG X, LIN X, et al. Analysis of domestic patients' privacy disclosure situation and privacy protection status[J]. Journal of Medical Intelligence, 2020, 41(2): 21-28.
[2]	刘霞, 廖春丽, 何悦, 等. 临床护士的患者隐私保护行为现状及影响因素分析[J]. 中华现代护理杂志, 2021, 27(22): 3021-3024. LIU X, LIAO C L, HE Y, et al. Current status and influencing factors of patient privacy protection behavior of clinical nurses[J]. Chin J Mod Nurs, 2021, 27(22): 3021-3024.
[3]	李真, 杨英, 高兴莲, 等. 手术室护士对患者隐私保护认知现状调查及影响因素分析[J]. 循证护理, 2022, 8(20): 2813-2816. LI Z, YANG Y, GAO X L, et al. Investigation on the status quo of nurses' cognition of patients' privacy protection in operating room and analysis of influencing factors[J]. Chinese Evidence-based Nursing, 2022, 8(20): 2813-2816.
[4]	王晓础, 李娉婷, 钱黄静, 等. 基于计划行为理论干预手术室护士对手术患者隐私保护的探讨[J]. 浙江临床医学, 2022, 24(8): 1223-1224. WANG X C, LI P T, QIAN H J, et al. Exploration of patient privacy protection based on the planned behavior theory in operating room nurses[J]. Zhejiang Clinical Medical Journal, 2022, 24(8): 1223-1224.
[5]	刘春晓, 李紫红, 何丹玉, 等. 保护患者隐私在提高手术患者满意度中的应用[J]. 基层医学论坛, 2022, 26(18): 109-111. LIU C X, LI Z H, HE D Y, et al. The application of patient privacy protection in improving patient satisfaction with surgery[J]. The Medical Forum, 2022, 26(18): 109-111.
[6]	闫江楠, 王鑫, 张海霞. 护士的患者隐私保护知信行研究进展[J]. 当代护士(中旬刊), 2024, 31(6): 1-4. YAN J N, WANG X, ZHANG H X. Progress in knowledge-attitude-behavior of patient privacy protection among nurses[J]. Modern Nurse, 2024, 31(6): 1-4.
[7]	黄静雅. 基于患者隐私保护的血透患者需求与护士认知状况的调查研究[D]. 广州: 南方医科大学, 2019. HUANG J Y. A study on nurses' and patients' perception of privacy protection[D]. Guangzhou: Southern Medical University, 2019.
[8]	倪平, 陈京立, 刘娜. 护理研究中量性研究的样本量估计[J]. 中华护理杂志, 2010, 45(4): 378-380. NI P, CHEN J L, LIU N. The sample size estimation hi quantitative nursing research[J]. Chinese Journal of Nursing, 2010, 45(4): 378-380.
[9]	OZTURK H, BAHÇECIK N, OZÇELIK K S. The development of the patient privacy scale in nursing[J]. Nurs Ethics, 2014, 21(7): 812-828. doi: 10.1177/0969733013515489
[10]	陈丽, 冯先琼, 李罗红, 等. 护士对患者的隐私保护行为现状及其影响因素分析[J]. 中国护理管理, 2018, 18(1): 38-43. CHEN L, FENG X Q, LI L L, et al. Nurses' behaviors of patients' privacy protection and influencing factors[J]. Chinese Nursing Management, 2018, 18(1): 38-43.
[11]	马莉. 中文版Jefferson同理心量表编制及护理人员同理心现状的调查研究[D]. 沈阳: 中国医科大学, 2009. MA L. The development of the Chinese version of the Jefferson Scale of Empathy and investigation for empathy of nurses[D]. Shenyang: China Medical University, 2009.
[12]	HUANG F F. Cross-cultural validation of the moral sensitivity questionnaire-revised Chinese version[J]. Nurs Ethics, 2016, 23(7): 784-793. doi: 10.1177/0969733015583183
[13]	潘婷. 医务人员对患者隐私保护的行为机理研究[D]. 大连: 大连理工大学, 2020. PAN T. Understanding medical personnel' s protection of patient privacy[D]. Dalian: Dalian University of Technology, 2020.
[14]	黄美华. 肛肠科护士对肛肠术后病人的隐私保护行为现状与影响因素研究[J]. 全科护理, 2023, 21(32): 4603-4606. HUANG M H. Study on the status and influencing factors of patients after anorectal surgery[J]. Chinese General Practice Nursing, 2023, 21(32): 4603-4606.
[15]	潘少波, 王秋香, 王莺, 等. 手术室护士对患者隐私保护行为现状及其影响因素研究[J]. 护理与康复, 2023, 22(12): 28-31, 36. PAN S B, WANG Q X, WANG Y, et al. Study on the current situation of patients' privacy protection behavior and its influencing factors in operating room nurses[J]. Nursing and Rehabilitation Journal, 2023, 22(12): 28-31, 36.
[16]	岳鑫彦, 王小平, 田金莲, 等. 三级医院护士伦理敏感性现状及影响因素分析[J]. 护理学杂志, 2021, 36(13): 51-55. YUE X Y, WANG X P, TIAN J L, et al. Analysis on status quo and influencing factors of ethical sensitivity among nurses in tertiary hospitals[J]. Journal of Nursing Science, 2021, 36(13): 51-55.
[17]	黄斌, 陈偶英, 张茜, 等. 神经外科护士伦理敏感性现状及影响因素研究[J]. 护理管理杂志, 2024, 24(1): 6-10. HUANG B, CHEN O Y, ZHANG X, et al. Study on the ethical sensitivity status and influencing factors of neurosurgical nurses[J]. J Nurs Admin, 2024, 24(1): 6-10.
[18]	陈乐, 刘婕, 高喆, 等. 实习护士职业认同对人文素养的影响: 同理心的中介作用[J]. 湖南师范大学学报(医学版), 2023, 20(3): 169-173, 180. CHEN L, LIU J, GAO Z, et al. Mediating effect of empathy between professional identity and humanistic literacy among nursing students[J]. Journal of Hunan Normal University(Medical Science), 2023, 20(3): 169-173, 180.
[19]	赵瀛, 史家兴, 朱霞, 等. 军队医院护士职业延迟满足在同理心与职业获益感中的中介效应[J]. 职业与健康, 2023, 39(1): 59-62, 68. ZHAO Y, SHI J X, ZHU X, et al. Mediating effect of occupational delayed gratification on empathy and occupational benefits of nurses in military hospitals[J]. Occupation and Health, 2023, 39(1): 59-62, 68.
[20]	汤小丽, 陈利敏, 董芬, 等. 职业韧性在工作负荷与护士情绪衰竭间的调节作用[J]. 中华全科医学, 2022, 20(5): 890-893. doi: 10.16766/j.cnki.issn.1674-4152.002480 TANG X L, CHEN L M, DONG F, et al. The moderating role of career resilience on the relationship between workload and emotional exhaustion[J]. Chinese Journal of General Practice, 2022, 20(5): 890-893. doi: 10.16766/j.cnki.issn.1674-4152.002480
[21]	黄雪玉, 陈钦, 刘兰玉. 手术室护士对患者隐私保护的认知水平现状调查及相关影响因素研究[J]. 中西医结合护理(中英文), 2024, 10(1): 130-132. HUANG X Y, CHEN Q, LIU L Y. Investigation of the cognitive status of patient privacy protection and related influencing factors in operating room nurses[J]. Journal of Clinical Nursing in Practice, 2024, 10(1): 130-132.