基于行为事件访谈法和专家咨询法的肿瘤科护士自杀守门人胜任力模型研究

Competency model of suicide gatekeeper for oncology nurses based on behavioral event interview and expert consultation

目的构建肿瘤科护士自杀守门人的胜任力模型,为住院肿瘤患者自杀守门人的培训和管理提供参考依据。方法某综合三级甲等医院肿瘤中心近10年发生24起肿瘤患者自杀安全事件,2023年7-12月,采用典型抽样法选取优秀自杀守门人组和普通自杀守门人组各9名护理人员,进行行为事件访谈,通过专家咨询法确定肿瘤科护士自杀守门人的胜任力,提取鉴别优秀肿瘤科护士自杀守门人的胜任力要素,构建出肿瘤科护士自杀守门人胜任力模型。结果访谈文本中,2组访谈文本长度差异均无统计学意义(P>0.05);25项胜任力在平均等级分数、总频次、最高等级分数与访谈长度的比较分别有1项、3项、8项胜任力有显著相关性(P<0.05),2组平均等级分数的比较有7项胜任力有统计学意义(P<0.05)。最终肿瘤科护士自杀守门人的胜任力模型包括:专业知识、专业技能、专业能力、职业素养、个人特质、价值观6个维度的7项鉴别性胜任特征和18项基准性胜任特征,总的归类一致性为0.789;总的编码信度系数为0.891。结论基于行为事件咨询法和专家访谈法构建的肿瘤科护士自杀守门人模型具有稳定性和科学性,18项基准性胜任特征培养肿瘤科护士自杀守门人拥有肿瘤患者自杀风险管理意识,7项鉴别性胜任特征选拔优秀肿瘤科护士自杀守门人对肿瘤患者进行有效的自杀危机干预,为建立基于胜任力的肿瘤科自杀守门人培训模式指引方向。

Objective To construct a competency model of suicide gatekeeper for oncology nurses,and to provide reference for the training and management of suicide gatekeeper for cancer inpatients.Methods There were 24 suicides in tumor center of a tertiary grade-A general hospital in recent ten years.From July to December 2023,a typical sampling method was used to select 9 nursing staff on duty from excellent suicide gatekeeper group and 9 from ordinary suicide gatekeeper group for behavioral event interviews.Through expert consultation method,competency elements of suicide gatekeepers for oncology nurses were determined.Then,competency elements of suicide gatekeepers for excellent oncology nurses were extracted,and a competency model for suicide gatekeepers for oncology nurses was constructed.Results There was no significant difference in the length of interview texts between the two groups(P>0.05).Among the 25 competency elements,there were 1 element,3 and 8 ones with significant correlation in terms of average grade score,total frequency,top grade score and interview length(P<0.05),respectively,and 7 competency elements with statistical significance in terms of average grade score of the two groups(P<0.05).Finally,the competency model for suicide gatekeepers for oncology nurses consisted of 7 discriminative competency characteristics and 18 benchmark competency characteristics from 6 dimensions of professional knowledge,professional skills,professional ability,professional quality,personal traits and values.The overall consistency of classification was 0.789,and the overall coding reliability coefficient 0.891.Conclusion The suicide gatekeeper model for oncology nurses based on behavioral event interview method and expert consultation is stable and scientific.Eighteen benchmark competency characteristics are beneficial for cultivating the awareness of suicide risk management in cancer patients for oncology nurse suicide gatekeepers,and seven discriminative competency characteristics for selecting excellent oncology nurse suicide gatekeepers for effective suicide crisis intervention for cancer patients.The model provides guidance for establishing a training model of suicide gatekeeper in oncology based on competency.