目的 对护士临终沟通自我效能相关研究进行范围综述,总结护士临终沟通自我效能的评估工具、现状、影响因素及干预策略。方法 系统检索PubMed、Embase、CINAHL、Medline、PsycINFO、Web of Science、Cochrane Library、ProQuest、中国知网、中国生物医学文献数据库等中英文数据库。检索时限为建库至2024年9月。对纳入文献进行分析。结果 共纳入20篇文献,包括11篇横断面研究、4篇类实验研究,2篇随机对照研究,3篇混合研究。护士临终沟通自我效能的评估工具如下：安宁疗护自我效能量表中的沟通子量表、自编问卷、改编自其他调查类或干预性研究中使用的工具、照顾无意义感患者态度量表中关于沟通自我效能的1个条目等。38.00%~54.53%的护士临终沟通自我效能处于较低水平。人口学因素、工作经历、工作环境、心理特征和安宁疗护相关经历会影响护士临终沟通自我效能。护士临终沟通自我效能的干预策略注重多学科及多种形式结合。结论 护士临终沟通自我效能有待进一步提升,影响因素复杂多元,评估工具缺乏特异性,干预策略有待进一步完善。
Abstract
Objective To provide a scoping review of studies on nurses’ self-efficacy regarding end-of-life communication, and to summarize its assessment tools, current status, influencing factors, and intervention strategies. Methods We retrieved literature from Chinese and English databases including PubMed, Embase, CINAHL, Medline, PsycINFO, Web of Science, Cochrane Library, ProQuest, CNKI, and CBM, with a retrieval time spanning from the inception of the databases to September 2024. The included literature was analyzed and discussed. Results Twenty studies were included, including 11 cross-sectional studies, 4 class-experimental studies, 2 randomized controlled trials, and 3 mixed studies. Nurses' self-efficacy regarding end-of-life communication was assessed by the following instruments: The Communication Subscale of the Hospice Self-Efficacy Scale, a self-designed questionnaire, instruments adapted from those used in other survey-type or intervention studies, an item in the Attitudes to Caring for Patients with a Sense of Meaninglessness Scale on communication self-efficacy, etc. Totally, 38.00% to 54.53% of nurses reported low self-efficacy regarding end-of-life communication. Demographic factors, work experience, work environment, psychological characteristics, and hospice-related experiences affected nurses' self-efficacy regarding end-of-life communication. Intervention strategies for nurses' self-efficacy regarding end-of-life communication were multidisciplinary and with diverse forms. Conclusion Nurses' self-efficacy regarding end-of-life communication needs further improvement, with complex and multidimensional influencing factors, a lack of specific assessment tools and intervention strategies requiring further improvement.
关键词
护士 /
临终沟通 /
自我效能 /
安宁疗护 /
范围综述
Key words
nurse /
end-of-life communication /
self-efficacy /
hospice care /
scoping review
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基金
中国生命关怀协会第二届人文护理科研项目（RW2024YB19）
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