临床专科护士培训迁移影响因素的研究

A longitudinal assessment of factors affecting training transfer among new clinical nurse specialists

目的探讨临床专科护士培训后培训迁移的影响因素,以及这些因素如何随时间变化,为提高临床专科护士培训迁移水平提供理论依据。方法采用量性纵向研究方法。于2018年6月-2019年12月,选取参加云南省专科护士培训的46名护士为研究对象,其中参加静脉治疗专科护士培训的护士30名,参加伤口、造口专科护士培训护士16名。采用培训迁移影响因素问卷分别在专科护士培训后1个月、3个月、6个月及1年对护士进行调查,问卷包括管理支持(20个条目),组织障碍因素(6个条目),培训项目有效性(10个条目),组织和个人的促进因素(11个条目),个人对培训迁移的态度(6个条目),共5个维度,53个条目。结果专科护士培训迁移影响因素随时间推移而下降,其中管理支持、组织障碍因素、培训项目有效性、个人对培训迁移的态度随时间变化有统计学意义(P<0.05),组织和个人的促进因素随时间变化无统计学差异(P=0.229)。在培训后初期(培训后1个月和3个月),组织障碍是培训迁移最大的阻碍因素。培训后期(培训后6个月和1年),管理层支持是培训迁移最大的影响因素。整体培训迁移水平,静疗护士于培训后3个月显著下降(P<0.001),伤口、造口护士于培训后1年显著下降(P<0.001)。结论培训迁移影响因素随时间的推移而下降。了解培训迁移的状态及其影响因素,有助于护理管理者开展护士专科培训,同时提高培训效果。

Objective:This study aimed to explore the determinants influencing training transfer and evaluate how those factors change over time among nurses who graduated from clinical nurse specialist training to provide a theoretical basis for improving the training transfer of clinical nurse specialists(CNSs).Methods:A quantitative longitudinal survey with four rounds of data collection was utilized to measure the influencing aspects of training transfer from June 2018 to December 2019.A total of 46 new CNSs participated in this study,including 30 and 16 nurses receiving training programs for CNSs in Infusion,Wound and Ostomy.The factor influencing training transfer(FITT)questionnaire was used to collect data for the first month(time 1),the third month(time 2),the sixth month(time 3),and the first year(time 4)after training.This questionnaire contains 53 items divided into five dimensions,including managerial support(20 items);hindrance in the organization(6 items);the validity of the training program(10 items);organizational and personal facilitators(11 items);and personal attitudes towards training transfer(6 items).Results:The influencing factors of cNSs transfer decreased over time,with managerial support,hindrance in the organization,the validity of the training program,and personal attitudes towards training transfer changing statistically over time(P<0.05),and no statistical difference in organizational and personal facilitators over time(P=0.229).During early after training(the first month and the third month after training),hindrance in the organization is the biggest obstacle to training transfer.During the later of training(the sixth month and first year after the training),managerial support is the biggest obstacle to training transfer.Overall level of influencing factors of training transfer decreased in three months after training among Infusion nurses(P<0.o01),and Wound and Ostomy nurses decreased in the first year after training(P<0.001).Conclusions:The trend and level of training transfer predictors decreased depending on time.Clarifying the factors influencing transfer and its patterns may help nursing managers enhance the implementation and impact of nurse specialist training.