我国本科护士临床护理实践中的问题调查

　　摘要

　　目的：

　　在对本科护士临床护理实践中常见问题相关文献分析的基础上，通过调查分析国内医院本科护士在临床护理实践中存在的问题，系统地了解我国护理本科教育 10 年来的成果与不足，探讨解决问题的方法和对策，为加快护理教育改革，调整护理本科教育课程设置，优化在校生人才培训，加强人文素质教育提供参考依据，为培养适合临床需要和人民群众健康需求的合格护理人才探明方向。

　　方法：

　　本研究主要采用文献分析法和问卷调查法，在分析国内外有关本科护士临床护理实践中常见问题及对策方面文献的基础上，自编调查问卷，并选取省内外 5家三级甲等医院的本科护士本人、护理管理者和护理同行分别进行调查研究，应用统计软件 SPSS17.0 进行数据分析。

　　结果：

　　1．在临床护理实践中，护理管理者和护理同行一致认为本科护士职业道德、诚信意识和护理伦理意识较强，专业理论知识扎实；本科护士本人认为其在职业道德、诚信意识、敬业精神和团队意识方面表现突出。与此同时，护理管理者认为本科护士在科研能力、动手能力、团队意识和心理素质方面较薄弱，护理同行对本科护士科研能力、动手能力、团队意识和敬业精神的评价较低，本科护士本人认为其在科研能力、创新意识、外语水平和管理水平方面有待提高。2．不同调查对象对本科护士临床护理工作评价之间的差异性研究发现，职业道德、护理伦理意识、诚信意识、敬业精神、解决问题能力、法制观念、工作适应能力、团队意识、外语水平、计算机水平、创新意识和动手能力上的差异有统计学意义（P<0.05）；专业知识、语言表达能力、自学能力、与患者沟通能力、应急能力、心理素质、教学能力、管理水平和科研能力上的差异无统计学意义（P>0.05）。3．采用主成分分析法，通过 KMO 检验，得出 KMO 统计量为 0.904，偏相关性很弱，非常适于因子分析。通过 Bartlett 球型检验，P<0.001，亦说明适于因子分析。因子旋转后，特征值大于 1 的主成分有 5 个，其对总方差的累积贡献率为 63.349%。提取的 5 个主成分分别为，F1：团队意识、敬业精神、诚信意识、法制观念、动手能力；F2：心理素质、与患者沟通能力、解决问题能力、工作适应能力、应急能力、创新意识；F3：护理伦理意识、职业道德；F4：科研能力、管理水平、教学能力；F5：计算机水平、外语水平、语言表达能力、自学能力、专业知识。一般来说，第 1 主成分贡献率最大，即 F1 是评价者最为看重的因素。

　　结论：

　　本科护士在团队意识、敬业精神和心理素质方面有待加强，在动手能力、科研能力、创新意识、外语水平和管理水平等方面仍较为薄弱。

　　针对本科护士在临床护理实践中的常见问题，提出三个方面的对策：本科护士自身应加强自我修养，提升综合素质；医院和管理者应制订培养方案，合理规划使用；护理高等院校应结合临床需要，优化课程设置。

　　关键词：护理；本科；实践；问题；对策

　　Abstract

　　Objective:

　　On the basis of the analysis of literature on common problems in clinical nursingpractice of the undergraduate nurses, through investigating and analyzing the problemsof the domestic undergraduate nurses in clinical nursing practice, knowing theachievements and deficiency of nursing undergraduate education in China in the past 10years, exploring the methods and countermeasures to solve the problems, providing areference basis ,in order to speed up the reform of nursing education, adjust the nursingundergraduate education curriculum, optimize personnel training students, andstrengthen humanistic quality education, find ing out the direction for training qualifiednursing talents who are suitable for clinical needs and people's health demand.

　　Methods:

　　This research mainly adopts literature analysis and questionnaire survey, based onthe analysis of relevant undergraduate nurses clinical nursing practice at home andabroad on the basis of the common problems and countermeasures in the aspects ofliterature, the self-made questionnaire, and both five third rate of undergraduate nurses,nursing managers and hospital care peer study respectively, application SPSS17.0statistical software for data analysis.

　　Results:

　　1. In clinical nursing practice, nursing managers and peers agree thatundergraduate nurses consciousness of professional ethics, integrity and nursing ethicsconsciousness is stronger, solid professional theoretical knowledge;Undergraduate nurseI think in the consciousness of professional ethics, integrity, professionalism and teamconsciousness.At the same time, the nursing managers think undergraduate nurses in thescientific research ability, practical ability, team consciousness and the psychologicalquality is relatively weak, nursing colleagues for undergraduate nurse scientific researchability, practical ability, team consciousness and the professional spirit of evaluation islow, undergraduate nurse I think in the scientific research ability, innovationconsciousness, to improve foreign language level and management level.2. Differentsubjects of undergraduate nurses clinical nursing evaluation between the study foundthat the difference of the professional ethics, nursing ethics, integrity, dedication,problem solving skills, legal idea, the ability to adapt work, team consciousness, foreignlanguage level, computer level, innovation consciousness and practice ability in thedifference was statistically significant (P < 0.05);Professional knowledge, languageexpression ability, self-learning ability, ability to communicate with patients, emergencyability, psychological quality, teaching ability, management level and the differences ofscientific research ability has no statistical significance (P > 0.05).3. Using principalcomponent analysis (pca), through the KMO test, get KMO statistic is 0.904, the partialcorrelation is very weak, very suitable for factor analysis. By Bartlett ball type test, P <0.001, also suitable for factor analysis. The rotation factor, characteristic value greaterthan 1 main component has 5, its cumulative contribution rate of 63.349% of totalvariance. Extraction of five principal components, respectively, F1, team consciousness,professional dedication, integrity awareness, legal idea, the beginning ability;F2:

　　psychological quality, and patient communication skills, problem solving skills, abilityto adapt work, emergency ability, innovation consciousness;F3: nursing ethicsawareness and professional ethics;F4: scientific research ability, management level andteaching ability;F5: computer skills, foreign language level, language expression ability,self-learning ability, professional knowledge. In general, the first principal componentcontribution rate, the biggest one is the most value factors of evaluators.

　　Conclusion:

　　Undergraduate nurses in terms of team consciousness, spirit and psychologicalquality needs to be strengthened, the beginning ability, scientific research ability andinnovation consciousness, foreign language level and management level is stillrelatively weak. For undergraduate nurses is a common problem in clinical nursingpractice, put forward the strategy of three aspects: the undergraduate nurses themselvesshould strengthen self-cultivation, improve the overall quality; Hospital and themanagement shall formulate training plan, reasonable planning use; Nursing institutionsof higher learning should be combined with clinical needs, optimizing the curriculum.

　　Key words:Nursing; Undergraduate; Practical; Problems; Countermeasures
 

　　目录

　　摘要

　　Abstract

　　前言

　　1研究背景

　　2相关概念

　　3文献回顾

　　4研究目的

　　研究内容及方法

　　1研究内容

　　2研究方法

　　结果

　　1问卷回收及被调查对象的一般情况

　　2调查对象对本科护士临床护理工作评价的单因素分析

　　3调查对象对本科护士临床护理工作评价的多因素分析

　　讨论

　　1本科护士临床护理实践中存在的问题和对策研究的现实意义

　　2研究对象评价的科学性分析

　　3本科护士临床护理实践中常见问题的分析

　　4本科护士在临床护理实践中常见问题的对策和建议

　　结论

　　1研究结论

　　2主要创新点

　　3研究局限

　　参考文献

　　致谢