实习护生压力与应对策略质性研究的meta整合分析

A qualitative meta-synthesis of qualitative research on stress and coping strategies of intern nursing students

目的系统评价实习护生压力与应对策略的质性研究,为护理教育和护理管理提供参考依据。方法以中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、Web of Science、The Cochrane Library、CINAHL、Embase为文献来源,全面检索有关实习护生压力与应对策略的质性研究文献,检索时限为建库至2022年7月。根据澳大利亚Joanna Briggs Institute(JBI)循证卫生保健中心质性研究质量评价标准(2016)评价文献质量,采用meta整合方法对结果进行整合分析。结果共纳入13项研究,提炼31个研究结果,归纳成11个新的类别,综合成3个整合结果:(1)压力来源,包括缺乏专业知识和技能、患者和家属、学习和就业、陌生环境以及临床教师和团队;(2)身心体验,包括身心的应激、对压力的认知、内心的需求;(3)应对策略,包括以问题为中心的应对、以情绪为中心的应对、以逃避为中心的应对。结论护理管理者和教育者了解护生在实习期间的真实体验,深入开发有效的教学环境,多途径、全方位帮助护生适应压力,增强其留职意愿,稳定护理队伍。

Objective Systematically review the qualitative research on stress and coping strategies of practice nursing students,provide a reference for nursing education and nursing management.Methods From inception to July 2022,qualitative studies on practice nursing students'stress and coping strategies were retrieved from CNKI,Wan Fang Database,VIP Database,Chinese Biomedical Literature Database,PubMed,Web of Science,The Cochrane Library,CINAHL,and Embase.Used the Joanna Briggs Institute Critical Appraisal Tool(2016)to evaluate the quality of the included studies,and the results were interpreted and integrated using meta-synthesis.Results Totally 13 studies were included.This study extracted 31 clear findings,11 new categories,and3 integrated results:(1)sources of stress,including lack of professional knowledge and skills,patients and their family members,studies and employment,unfamiliar environments,and clinical faculty and teams.(2)Physical and psychological experiences,including physical and psychological stress,perceptions of stress,and internal demands.(3)Coping strategies,including problem-focused coping,emotion-focused coping,and avoidance-focused coping.Conclusions Nursing managers and educators should pay attation to understand the real experiences of practice nursing students,and develop effective teaching environments.Moreover,multiple and comprehensive measures should be taken to help nursing students deal with stress,enhance their willingness to stay in the profession,and stabilize the nursing team.