目的 探讨无法忍受不确定性在本科护生批判性思维与临床推理间的中介效应,为提升本科护生的临床推理能力提供理论依据。方法 采用便利抽样法,于2023年10—12月选取山东省某所三级甲等医院的363名本科护生作为研究对象,采用一般资料调查表、批判性思维量表、无法忍受不确定性量表、临床推理能力量表对其进行调查。运用AMOS 26.0构建结构方程模型,并采用Bootstrap法对中介效应模型进行检验。结果 本组本科护生批判性思维能力、无法忍受不确定性、临床推理能力总分依次为（130.94±20.94）分、（32.40±6.51）分、（55.15±14.23）分;无法忍受不确定性与批判性思维、临床推理能力均呈负相关（均 P<0.01）,批判性思维与临床推理能力呈正相关（P<0.01）;无法忍受不确定性在临床推理能力与批判性思维间起部分中介作用,中介效应值为0.133,中介效应占总效应的34.10%。结论 临床推理能力、无法忍受不确定性与批判性思维关系密切,批判性思维可以通过无法忍受不确定性来间接影响临床推理能力。护理教育者应采取策略培养本科护生的批判性思维能力,改善不确定性容忍度,进而提高临床推理能力。
Abstract
Objective To explore the mediating effect of intolerance of uncertainty between critical thinking and clinical reasoning among nursing undergraduates, and to provide theoretical basis for enhancing their clinical reasoning abilities. Methods Using convenience sampling, 363 nursing undergraduates from a tertiary grade-A hospital in Shandong Province from October to December 2023 were selected as subjects. Data were collected using the General Information Questionnaires, the Critical Thinking Disposition Inventory, the Intolerance of Uncertainty Scale, and the Nurses Clinical Reasoning Scale. Structural equation modeling was conducted using AMOS 26.0, and the Bootstrap method was applied to examine the mediating effect model. Results The scores for critical thinking, intolerance of uncertainty, and clinical reasoning among nursing undergraduates were 130.94±20.94, 32.40±6.51, and 55.15±14.23, respectively. Intolerance of uncertainty was negatively correlated with both critical thinking and clinical reasoning (both P<0.01), while critical thinking was positively correlated with clinical reasoning (P<0.01). Intolerance of uncertainty played a partial mediating role between clinical reasoning and critical thinking, with a mediating effect value of 0.133, accounting for 34.10% of the total effect. Conclusion Clinical reasoning ability, intolerance of uncertainty, and critical thinking are closely related. Critical thinking can indirectly influence clinical reasoning ability through intolerance of uncertainty. Nursing educators should adopt strategies to foster critical thinking and improve tolerance of uncertainty in nursing undergraduates to enhance their clinical reasoning abilities.
关键词
本科护生 /
无法忍受不确定性 /
临床推理 /
批判性思维 /
中介效应
Key words
nursing undergraduate /
intolerance of uncertainty /
clinical reasoning /
critical thinking /
mediating effect
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基金
山东省重点研发计划-软科学项目（2020RKB14106）; 山东省教育厅本科教学改革研究项目（XM2022134）
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