ICU护士安宁疗护核心能力现状及影响因素分析

The status quo and influencing factors of core competencies of ICU nurses in palliative care

目的探讨ICU护士安宁疗护核心能力现状,并分析其影响因素。方法本研究为横断面研究。采用便利抽样法,于2022年1—3月选取张家口市2所三甲医院的148名ICU护士为研究对象,采用一般资料调查问卷、安宁疗护护士核心能力问卷及中文版死亡态度描绘量表(修订版)对其进行调查。采用Pearson相关分析、多重线性回归分析探讨ICU护士安宁疗护核心能力的影响因素。本研究共发放问卷148份,回收有效问卷为143份,有效回收率为96.62%(143/148)。结果143名ICU护士的安宁疗护核心能力总分为(77.28±16.95)分,中文版死亡态度描绘量表(修订版)得分较高的前2个维度分别是自然接受[(4.40±0.34)分]、逃离接受[(3.34±0.49)分]。Pearson相关性分析结果显示,ICU护士安宁疗护核心能力与死亡恐惧呈负相关(r=-0.214,P<0.05),与自然接受死亡、逃离接受死亡均呈正相关(r值分别为0.171、0.221;P<0.05)。多重线性回归分析结果显示,性别、年龄、职称、是否参加过安宁疗护相关培训、自然接受死亡、逃离接受死亡是ICU护士安宁疗护核心能力的主要影响因素(P<0.05)。结论ICU护士安宁疗护核心能力水平较高,其持有正向死亡态度。护理管理者应重视ICU护士安宁疗护能力的培养,开展针对性的安宁疗护实践培训,并积极组织死亡继续教育,引导ICU护士树立积极的死亡观,提高其安宁疗护核心能力。

Objective To explore the status quo of ICU nurses'core competence in palliative care and analyze its influencing factors.Methods This is a cross-sectional study.From January to March 2022,totally 148 ICU nurses from two ClassⅢGrade A hospitals in Zhangjiakou were selected by convenience sampling and investigated with the General Information Questionnaire,Core Competence Questionnaire for Hospice Nurses and Chinese version of Death Attitude Profile-Revised.Pearson correlation analysis and multiple linear regression analysis were used to explore the influencing factors of ICU nurses'core competence in palliative care.A total of 148 questionnaires were distributed in this study,and 143 valid questionnaires were recovered,with an effective recovery rate of 96.62%(143/148).Results The total score of palliative care core competence of 143 ICU nurses was(77.28±16.95),and the top 2 dimensions with higher scores on the Chinese version of Death Attitude Profile-Revised were natural acceptance[(4.40±0.34)points]and escape acceptance[(3.34±0.49)points].Pearson correlation analysis showed that palliative care core competency for ICU nurses was negatively correlated with fear of death(r=-0.214;P<0.05),and positively correlated with both natural acceptance of death and escape from acceptance of death(r=0.171,0.221;P<0.05).Multiple linear regression analysis revealed that gender,age,professional title,whether they had participated in palliative care-related training,natural acceptance of death,and escape from acceptance of death were the main influencing factors of the core competence of ICU nurses in palliative care(P<0.05).Conclusions ICU nurses have a high level of core competence in palliative care,and they hold a positive attitude towards death.Nursing managers should pay attention to cultivating ICU nurses'palliative care ability,carry out targeted palliative care training,and vigorously organize death continuing education,guide ICU nurses to establish a positive view of death,and improve their core competence in palliative care.