跨学科合作能力在医护人员安宁疗护实践水平与困难程度间的中介作用

The mediating effect of interdisciplinary cooperation ability on the level of hospice care practice and the degree of difficulty of medical staff

目的:探讨医护人员安宁疗护的跨学科合作能力在实践水平与困难程度间的中介作用,为提高医护人员安宁疗护服务质量,以期为相关管理者制订减少实施安宁疗护困难的有效措施提供依据。方法:本研究为横断面调查,2022年7—8月采用便利抽样方法,对十堰市全部安宁疗护机构的362名医护人员应用一般资料调查表、安宁疗护困难量表、安宁疗护自评实践量表、跨学科合作修正指数进行调查。结果:本次调查的362名医护人员安宁疗护困难量表总分为(40.58±13.44)分,安宁疗护自评实践量表总分为(67.47±12.50)分,跨学科修正指数为(108.36±21.46)分。医护人员安宁疗护跨学科合作修正指数总分与安宁疗护困难量表总分呈正相关(r=0.500,P<0.01);安宁疗护自评实践量表总分与跨学科合作修正指数总分呈负相关(r=-0.337,P<0.01),与安宁疗护困难量表总分呈负相关(r=-0.189,P<0.01)。医护人员安宁疗护的跨学科合作能力在安宁疗护实践水平与安宁疗护实施困难程度间起完全中介作用(效应值为-0.190,95%CI-0.274~-0.126),中介效应占总效应值的98.5%。结论:医护人员安宁疗护实践水平无法直接影响实施的困难程度,但是可通过采取积极的措施来提高跨学科合作能力,从而增强实践水平,进而降低安宁疗护实施的困难程度。

Objective To explore the mediating role of interdisciplinary cooperation ability between the level of hospice care practice and difficulty degree of hospice care for medical staff,in order to improve the quality of hospice care services for medical staff,and to provide evidence for relevant managers to formulate effective measures to reduce the implementation of hospice care difficulties.MethodsThis study was a cross-sectional survey.Using convenience sampling method,the general data questionnaire,Palliative Care Difficulties Scale(PCDS),Palliative Care Self-Report Practice Scale(PCPS)and Modified Index of Interdisciplinary Collaboration(MIIC)were used to investigate 362 medical staff in all hospice care institutions of Shiyan City from July to August 2022.ResultsThe total score of PCDS in 362 medical staff was(40.58±13.44)points,(67.47±12.50)points for PCPS and(108.36±21.46)points for MIIC.There was a positive correlation between the total score of MIIC and PCDS(r=0.500,P<0.01).The total score of PCPS was negatively correlated with the total score of MIIC(r=-0.337,P<0.01)and the total score of PCDS(r=-0.189,P<0.01).The interdisciplinary cooperation ability of medical staff in hospice care had a complete mediating effect between the level of practice and the degree of difficulty(Effect value=-0.190,95%CI-0.274 to-0.126),and the mediating effect accounted for 98.5%of the total effect value.ConclusionsThe practice level of hospice care can not directly affect the implementation of the difficulty degree,but by taking active measures to improve the interdisciplinary cooperation ability,so as to enhance the practice level,and then reduce the implementation of hospice care difficulty degree.