神经重症监护室护士床头抬高行为启动和维持意向调查

Initiation and sustenance intention investigation on the head-of-bed elevation behavior among nurses in neurological intensive care unit

目的调查神经重症监护室护士床头抬高行为启动和维持意向,旨在为临床制订行为干预路径提供参考。方法便利选取重庆市11所三级甲等综合医院NICU护士716人为调查对象,采用自制的床头抬高行为启动和维持意向问卷及一般资料调查表进行调查。结果在过去6个月中,14.11%护士能够遵守床头抬高指南要求,41.76%护士未参加过神经重症患者体位管理相关教育或培训。护士床头抬高行为启动意向得分为31.00±9.26,参与性谈话、行为自信、物质环境改变维度得分率分别为43.05%、68.20%、72.75%。床头抬高行为维持意向得分为26.19±6.54,情感转换、行为改变实践、社会环境改变维度得分率分别为72.83%、72.58%、72.92%。结论神经重症监护室护士对床头抬高护理的认知及自评依从性不佳。护理管理者需加强对其床头抬高行为改变过程的认知,积极识别影响护士床头抬高行为启动和维持过程的因素,并构建针对性的行为干预路径,以提高神经重症监护室护士体位管理水平。

Objective To investigate the initiation and sustenance intention of the head-of-bed elevation behavior among nurses in neurological intensive care unit(NICU),so as to provide reference for developing clinical behavioral intervention path.Methods A total of 716 NICU nurses from 113A general hospitals in Chongqing were recruited by convenient sampling method,then they were investigated using a self-made questionnaire of the initiation and sustenance intention on the head-of-bed elevation behavior and the general information questionnaire.Results In the past six months,14.11%NICU nurses could comply with the guidelines for head-of-bed elevation,41.76%NICU nurses didn′t participate in postural management related education or training for neurological critical patients.The score of initiation intention on the head-of-bed elevation behavior among NICU nurses was 31.00±9.26,and the subscale score rate of participatory dialogue,behavioral confidence and changes in the physical environment was 43.05%,68.20%and 72.75%.The score of sustenance intention on the head-of-bed elevation behavior among NICU nurses was 26.19±6.54,and the subscale score rate of emotional transformation,practice for change and changes in the social environment was 72.83%,72.58%and 72.92%respectively.Conclusion The cognition and self-assessed compliance with the head-of-bed elevation behavior among NICU nurses are not good,so nursing managers should strengthen their cognition of the behavior change process,identify the factors influencing the nurses′head-of-bed elevation behavior initiation and sustenance process,and establish targeted behavior intervention path,so as to improve NICU nurses′postural management level.