666名军队医院护士医学叙事能力现状及影响因素分析

doi:10.16460/j.issn1008-9969.2024.05.073

摘要/Abstract

摘要： 目的调查军队医院护士医学叙事能力现状,并分析其影响因素。方法采用便利抽样法,选取2023年9-10月在西安市3所军队综合医院的临床护士为研究对象。采用一般资料调查表、医学叙事能力量表、一般自我效能感量表、家庭关怀度指数量表及工作相关生活质量量表对其进行调查。采用多元线性回归分析军队医院护士医学叙事能力的影响因素。结果军队医院护士医学叙事能力总分为（155.06±18.30）分。医学叙事能力与一般自我效能感（r=0.576）、家庭关怀度（r=0.252）、工作相关生活质量（r=0.443）呈正相关（P<0.01）。单因素结果分析显示：婚育状况、工作年限、住院或陪护经历、叙事护理知识储备、叙事护理培训经历在医学叙事能力上差异有统计学意义（P<0.05）。多元线性回归分析结果显示：叙事护理知识储备（B=0.161）、一般自我效能感（B=0.458）、家庭关怀度（B=0.101）及工作相关生活质量（B=0.259）进入回归方程（P<0.01）,共解释总变异的40.4%。结论军队医院护士的医学叙事能力总体处于中等水平。叙事护理知识储备、一般自我效能感、家庭关怀度及工作相关生活质量均对医学叙事能力有显著影响。护理管理者需重视这些因素,提供针对性培训和支持,进一步提升护士的医学叙事能力。

关键词: 医学叙事能力, 军队医院护士, 一般自我效能感, 家庭关怀度, 工作相关生活质量

Abstract: Objective To investigate the current status of medical narrative competence of nurses in military hospitals and analyze its influencing factors. Methods Convenience sampling was used to select clinical nurses from three military general hospitals in Xi'an from September to October 2023. The nurses were surveyed using a general information questionnaire, Medical Narrative Competence Scale, General Self-Efficacy Scale, Family APGAR Index Scale and Work-related Quality of Life Scale. Multiple linear regression was used to analyze the influencing factors of medical narrative competence of nurses in military hospitals. Results The total score of medical narrative competence of nurses was 155.06±18.30. Medical narrative competence was positively correlated with general self-efficacy（r=0.576）, family care（r=0.252） and work-related quality of life (r=0.443) (P<0.01). Single factor analysis showed that marital status and childbearing, working length, experience as a caregiver, narrative nursing knowledge reserve, and narrative nursing training experience were statistically significant in terms of medical narrative competence (P<0.05). Multiple linear regression showed that narrative nursing knowledge reserve (B=0.161), general self-efficacy (B=0.458), family function（B=0.101）and work-related quality of life(B=0.259) entered the regression equation (P<0.01), accounting for 40.4% of the total variation. Conclusion The level of medical narrative competence of nurses in military hospitals is at a medium level. Narrative nursing knowledge reserve, general self-efficacy, family functions and work-related quality of life have a significant impact on medical narrative competence. Nursing managers should pay attention to these influencing factors, and perform targeted nursing training to improve the level of medical narrative competence.

Key words: narrative medical competence, military hospitals nurse, general self-efficacy, family care, work-related quality of life

中图分类号:

曾辉, 史艳茹, 李琦, 董艳, 徐远平, 梁苗苗. 666名军队医院护士医学叙事能力现状及影响因素分析[J]. 护理学报, 2024, 31(5): 73-78.

ZENG Hui, SHI Yan-ru, LI Qi, DONG Yan, XU Yuan-ping, LIANG Miao-miao. Current status of medical narrative competence and its influencing factors: a case study of 666 nurses in military hospitals[J]. Journal of Nursing, 2024, 31(5): 73-78.

参考文献

[1] Nash W,Erondu M,Childress A.Expanding narrative medicine through the collaborative construction and compelling performance of stories[J].J Med Humanit,2023,44(2):207-225.DOI:10.1007/s10912-022-09779-6.
[2] 王国位,窦鸿伟,李梦琦,等.心内科门诊军队伤病员焦虑抑郁状况横断面调查及影响因素[J]. 西北国防医学杂志,2019,40(3):159-163.DOI:10.16021/j.cnki.1007-8622.2019.03.006.
[3] 朱思悦,赵婷,王晓媛.军队干部平战时期心理健康状况及影响因素研究[J].联勤军事医学,2023,37(6):506-510.DOI:10.13730/j.issn.2097-2148.2023.06.011.
[4] 黄黎烜,周晨枫,张程程,等.叙事护理中文文献研究[J].医学与哲学,2023,44(12):63-67.DOI:10.12014/j.issn.1002-0772.2023.12.14.
[5] 李铮,刘宁.护理学研究方法[M].2 版.北京:人民卫生出版社,2018:58.
[6] 马婉贞,顾平,张晶晶,等.医护人员医学叙事能力量表的编制及信效度检验[J].中华护理杂志,2020,55(4):578-583.DOI:10.3761/j.issn.0254-1769.2019.04.019.
[7] 王才康,胡中锋,刘勇.一般自我效能感量表的信度和效度研究[J].应用心理学,2001,7(1):37-40.DOI:10.3969/j.issn.1006-6020.2001.01.007.
[8] 吕繁,顾溪.家庭APGAR问卷及其临床应用[J].国外医学医院管理分册,1995(2):56-59.
[9] 邵亚,廖少玲,钟慧琴,等.护士工作相关生活质量量表的信效度研究[J].护理学杂志,2014,29(13):1-3.DOI:10.3870/hlxzz.2014.13.001.
[10] 田丽,李梦媛,肖抒情,等.三级医院护士医学叙事能力现状及影响因素分析[J].护理学杂志,2021,36(7):72-75.DOI:10.3870/j.issn.1001-4152.2021.07.072.
[11] 梁慧,王建宁,张艺,等.422名新入职护士医学叙事能力现状及影响因素分析[J].护理学报,2022,29(19):1-5.DOI:10.16460/j.issn1008-9969.2022.19.001.
[12] 王丽梅,李露,喻鹏,等.237名护理硕士研究生医学叙事能力现状及影响因素分析[J].护理学报,2023,30(17):1-4.DOI:10.16460/j.issn1008-9969.2023.17.001.
[13] 侯佳坤,周宏珍,胡瑞丹,等.临床护士医学叙事能力现状及影响因素分析[J].护理学杂志,2021,36(1):63-65.DOI:10.3870/j.issn.1001-4152.2021.01.063.
[14] 于翠香,王建英,周松,等.临床护士叙事护理的知信行现状及其影响因素[J].护理学杂志,2019,34(23):50-53.DOI:10.3870/j.issn.1001-4152.2019.23.050.
[15] 梁鑫悦,王秋静,李燕,等.医护人员医学叙事能力的研究进展与思考[J].中国护理管理,2021,21(7):1107-1111.DOI:10.3969/j.issn.1672-1756.2021.07.029.
[16] 石婷婷,韩悦,张竞,等.肿瘤科护士医学叙事能力现状及其影响因素分析[J].护理管理杂志, 2021,21(9):650-654.DOI:10.3969/j.issn.1671-315x.2021.09.009.
[17] 翟艳萍,徐红梅,李润,等.叙事护理在中青年脑卒中伴急性应激障碍病人中的应用[J].护理研究,2023,37(17):3211-3216.DOI:10.12102/j.issn.1009-6493.2023.17.032.
[18] 周雅婷,易敏,张先红,等.儿科无陪护病房护理人员医学叙事能力与一般自我效能感的相关性分析[J]. 全科护理,2022, 20(30):4268-4271.DOI:10.12104/j.issn.1674-4748.2022.30.024.
[19] 刘文文,史晓红,谢正,等.同理心培训对住院医师知觉压力及情绪的影响[J].临床心身疾病杂志,2021,27(5):59-62.DOI:10.3969/j.issn.1672-187X.2021.05.015.
[20] 黄丽萍,陈安丽,赵素凡,等.浙江省部分三级甲等医院临床护士家庭功能与共情能力水平的相关性研究[J].中华现代护理杂志, 2020, 26(19):2569-2573.DOI:10.3760/cma.j.cn115682-20190904-03196.
[21] 田洁,田丽,张莉,等.肿瘤专科护士医学叙事能力的现状调查及影响因素分析[J].天津护理,2021, 29(4):383-386.DOI:10.3969/j.issn.1006-9143.2021.04.002.
[22] Biagioli V, Prandi C, Nyatanga B, et al.The role of professional competency in influencing job satisfaction and organizational citizenship behavior among palliative care nurses[J].J Hosp Palliat Nurs,2018, 20(4):377-384.DOI:10.1097/NJH.0000000000000454.
[23] 李进俊,李牧玲,刘月,等.护士共情能力在医学叙事能力与人文关怀能力的中介效应分析[J].护理学报,2022,29(24):1-5.DOI:10.16460/j.issn1008-9969.2022.24.001.

Metrics

Viewed

Full text

Abstract

Cited

Shared