目的 调查三级甲等医院临床护士共享决策能力现状并分析其影响因素,以期为护理管理者制定针对性的干预措施提高护士共享决策能力提供参考。方法 选取便利抽样法,以山东省5所三级甲等医院的608名护士作为研究对象,采用一般资料调查表、护理人员共享决策能力量表及护理工作环境量表进行问卷调查。结果 临床护士共享决策能力总分为（209.40±27.04）分,共享决策能力总分与护理工作环境总分呈正相关（r=0.763,P<0.01）;多元线性回归分析显示,职称、工作年限、目前所在科室、是否接受过共享决策的教育培训、护理工作环境总分进入回归方程（P<0.05）,可解释临床护士共享决策能力总变异的62.9%。结论 608名临床护士的共享决策能力处于中等偏上水平,职称、工作年限、目前所在科室、是否接受过共享决策的教育培训、护理工作环境总分是其主要影响因素。护理管理者需构建以护士为主导的共享决策胜任力培训体系,构建跨专业共享决策模式,从组织层面营造良好的护理工作环境和共享决策氛围,以提高护士共享决策能力,进而改善医患关系、提升患者治疗依从性和就医获得感。
Abstract
Objective To investigate the current status of shared decision making competence among clinical nurses in tertiary grade-A hospitals and analyze its influencing factors, and to provide reference for nursing managers to develop targeted interventions. Methods Convenience sampling was used to select 608 nurses from 5 tertiary grade-A hospitals in Shandong Province as the research subjects. The General Information Questionnaire, Competency of Shared Decision Making in Nursing Staff, and Nursing Work Environment Scale were used to conduct the survey. Results The total score of nurses’ shared decision making competence was 209.40±27.04. Shared decision making competence was positively correlated with the total score of nursing work environment (r=0.763, P<0.01). Multiple linear regression analysis showed that professional title, years of experience, current department, whether having education and training on shared decision making or not, and total score of nursing work environment entered the regression equation (P<0.05), which could explain 62.9% of the total variation. Conclusion The shared decision making competence of 608 clinical nurses is above the average. Professional title, years of experience, current department, whether receiving education and training on shared decision-making or not, and the total score of nursing work environment are the main influencing factors of nurse’s shared decision making competence. A nurse-led shared decision-making competency training system and interdisciplinary shared-decision making models are conducive to creating positive nursing work environment and shared decision making atmosphere from the organizational level, so as to improve nurses’ shared decision making competency, doctor-patient relationships, patient treatment compliance and sense of medical access.
关键词
临床护士 /
共享决策能力 /
护理工作环境 /
影响因素
Key words
clinical nurses /
shared decision making competence /
nursing work environment /
influencing factor
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基金
中华医学会杂志社2022-2023年护理学科研究课题（CMAPH-NRI2022057）
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