护士对患者安全文化感知的潜在剖面分析及其影响因素

Latent profile analysis of nurses'perception of patient safety culture and its influencing factors

目的了解、分析临床护士对患者安全文化感知的现状、潜在剖面及其与护士职业应对自我效能的关系,探讨不同剖面的影响因素。方法2023年3—4月,采用电子问卷方式,对湖南省某三级甲等医院261名护士发放一般资料调查表、患者安全文化感知量表、护士职业应对自我效能量表进行调查,以患者安全文化感知量表5个维度作为外显指标进行潜在剖面分析,以潜在类别作为因变量,一般资料、职业负担及关系相处困难2个维度得分作为自变量进行多元Logistic回归分析,筛选不同类别护士对患者安全文化感知的影响因素。结果261名护士的患者安全文化感知存在异质性,可分为“低感知组、中感知组、高感知组”3个潜在类别。年龄、关系相处困难是预测因子(P<0.05)。结论患者安全文化感知可分为3个类别,护理管理者可根据不同类别的护士特征采取相应措施,针对“低感知组”护士,应注重适当增加人力、优化工作流程、减少不必要的工作等方式来保证护士有足够的休息时间,恢复精力,减轻疲惫,保持最佳的工作状态。针对“中感知组”护士,护理管理者应该鼓励其参与安全管理,对提出合理建议的人员给予适当的奖励或者将其纳入评优评先考核指标,进一步提高其对患者安全文化的重视程度。同时应立足于其工作诉求,在工作、生活中给予一定的支持,提高其工作满意度,减轻职业倦怠感。针对“高感知组”护士,护理管理者可以合理分工,做到一人一专长,一科一特色,根据不同护士的能力特长,安排任务,提高护士工作效率及职业成就感。

Objective To understand and analyze the current status and latent profiles of clinical nurses'perception of patient safety culture,and their relationship with nurses'occupational coping self-efficacy,as well as to explore the influencing factors of different profiles.Methods From March to April 2023,the electronic questionnaire method was used to survey 261 nurses from a tertiary grade A hospital in Hunan Province.The survey included the General Information Questionnaire,the Patient Safety Culture Perception Scale,and the Occupational Coping Self-efficacy for Nurses Scale.The five dimensions of the Patient Safety Culture Perception Scale were used as manifest indicators for latent profile analysis.Multivariate Logistic regression analysis was performed with latent categories as the dependent variable and general information,along with the scores for occupational burden and relationship difficulties,as independent variables to identify the influencing factors of nurses'perceptions of patient safety culture across different categories.Results The perception of patient safety culture among the 261 nurses was heterogeneous and could be categorized into three latent groups:"low perception group,medium perception group,and high perception group".Age and relationship difficulties were predictors(P<0.05).Conclusion Patient safety culture perception can be categorized into three types.Nursing managers can take corresponding measures based on the characteristics of nurses in different categories.For nurses in the"low perception group",it is important to increase staffing levels appropriately,optimize workfl ows,and reduce unnecessary tasks to ensure that nurses have enough rest time,recover their energy,alleviate fatigue,and maintain the best working state.For nurses in the"medium perception group",nursing managers should encourage their participation in safety management and provide appropriate rewards for those who offer reasonable suggestions,or include them in evaluation criteria for awards,to further improve their focus on patient safety culture.Additionally,managers should address their work-related needs and provide certain support in both work and daily life to improve their job satisfaction and reduce occupational burnout.For nurses in the"high perception group",nursing managers can make a reasonable division of labor,with one person having a specialty and each department having a distinct feature.They can arrange tasks based on the abilities and specialties of different nurses to improve the nurses'work efficiency and sense of professional achievement.