NICU护士新生儿安宁疗护态度现状及影响因素分析

A study on the status quo and influencing factors of neonatal palliative care attitude among NICU nurses

目的了解NICU护士新生儿安宁疗护态度现状并分析其影响因素,以期为医院管理层改善NICU护士新生儿安宁疗护态度提供参考和方向。方法采用整群抽样法,于2021年11—12月选取河北省石家庄市9所医院的237名NICU护士作为研究对象,采用一般资料调查表、新生儿安宁疗护态度量表、共情能力量表及死亡应对能力量表对研究对象进行问卷调查,并对结果进行分析。结果NICU护士新生儿安宁疗护态度总分为(89.35±18.86)分,各维度条目均分由高到低依次为信念、工作经历、资源、组织、障碍;新生儿安宁疗护态度总分与共情能力总分(r=0.653,P<0.01)和死亡应对能力总分(r=0.597,P<0.01)均呈正相关,其中"障碍"与共情能力、死亡应对能力呈负相关(r=-0.602、-0.526,均P<0.01);多元线性回归分析显示学历、是否护理过濒死婴儿、在医院参加安宁疗护教育的频次、共情能力总分、死亡应对能力总分是新生儿安宁疗护态度的影响因素,可解释总变异的47.3%。结论NICU护士新生儿安宁疗护态度总体处于中等水平,且受学历等5个方面因素的影响。医院管理层应提供以提高共情能力及死亡应对能力为前提的个性化、多样化教育培训支持,多途径、多层次提高其共情能力及死亡应对能力,改善NICU护士新生儿安宁疗护态度,进而提升护理服务质量。

Objective To understand the status quo of neonatal palliative care attitude of nurses in neonatal intensive care unit(NICU)and analyze the influencing factors,in order to provide reference and direction for hospital management to improve the neonatal palliative care attitude of NICU nurses.Methods A total of 237 NICU nurses in 9 hospitals in Shijiazhuang,Hebei Province were selected by cluster sampling method from November to December 2021,and the questionnaire was conducted using General Data Survey,Neonatal Palliative Care Attitude Scale(NiPCAS),the Jefferson Scale of Empathy(JSE)and Coping with Death Scale(CDS).And analyze the results.Results The total score of the NICU nurses′neonatal palliative care attitude was 89.35±18.86.The average score of each dimension from high to low was belief,work experience,resources,organization,and obstacle;and the total score of neonatal palliative care attitude was positively correlated with empathy ability(r=0.653,P<0.01)and death coping ability(r=0.597,P<0.01),in addition the factor of barrier was negatively correlated with empathy and death coping ability(r=-0.602,-0.526,both P<0.01)Multiple linear regression analysis showed that educational background,whether nursing dying infants,frequency of attending hospice nursing education in hospitals,empathy ability and death coping ability were the influencing factors of neonatal palliative care attitude,which could explain 47.3%of the total variation.Conclusions NICU nurses′neonatal palliative care attitude was generally at a moderate level,and affected by five factors such as education.It is suggested that hospital management should provide to improve empathy ability and death response ability as the premise of personalized,diversified education training support,multiple ways,multi-level improve its empathy ability and death coping ability,improve neonatal palliative care attitude,and then improve the quality of nursing service.