本科学历护士对低价值护理去实施体验和感受的质性研究

Experience and feelings of undergraduate nurses in low-value care de-implementation:a qualitative study

目的了解本科学历护士对低价值护理去实施的体验和感受,为制订低价值护理去实施的具体策略提供参考。方法采用目的抽样法,选取2023年7—10月郑州大学第一附属医院14名全日制本科学历护士作为研究对象,采用现象学研究方法进行半结构式深入访谈,应用Colaizzi 7步分析法对资料进行分析。结果提炼出3个主题:对低价值护理去实施高度认可:减轻护士工作负担、改善患者就医体验、促进和谐护患关系;对低价值护理去实施认知不一:低效型认知、保持观望态度;低价值护理去实施受多重阻碍:缺乏批判性思维、担心医疗护理风险、缺乏循证护理能力、缺乏组织环境的支持、患者医学认知缺如。结论本科学历护士对低价值护理去实施的意义高度认可,但在其临床实践中仍面临诸多困境,应多措并举,推动低价值护理去实施的临床实践。

Objective To explore the experience and feelings of undergraduate nurses in low-value care de-implementation,so as to provide reference for formulating specific strategies for low-value care de-implementation.Methods From July to October 2023,purposive sampling was used to select 14 full-time undergraduate nurses from the First Affiliated Hospital of Zhengzhou University as research subjects.The phenomenological research method was used to conduct semi-structured in-depth interviews,and Colaizzi 7-step analysis method was used to analyze the data.Results Three themes were extracted in total.Highly recognizing the low-value care de-implementation included reducing nurses'workload,improving patients'medical experience,and promoting harmonious nurse-patient relationships.Cognitive dissonance for low-value care de-implementation involved low efficiency cognition and maintaining a wait-and-see attitude.Low-value care de-implementation was hindered by multiple factors,including a lack of critical thinking,concerns about medical nursing risks,a lack of evidence-based nursing skills,a lack of organizational support,and a lack of medical knowledge among patients.Conclusions Undergraduate nurses highly recognize the significance of low-value care de-implementation,but still face many challenges in their clinical practice.Multiple measures should be taken to promote the low-value care de-implementation in clinical practice.