安宁疗护病房护士关怀行为的现状及潜在剖面分析

doi:10.3761/j.issn.0254-1769.2025.01.013

摘要/Abstract

摘要：

目的探究安宁疗护病房护士的关怀行为现状，分析其潜在剖面特征及影响因素，为制订针对性干预措施提供依据。方法采用便利抽样法，于2023年8月—11月选取江苏省、浙江省、上海市、山东省、安徽省、北京市、广东省、四川省22所二级及以上医院安宁疗护病房的护士作为调查对象，采用一般资料调查表、护士关怀行为量表、安宁疗护护士共情能力量表、护理工作环境量表进行调查。将护士关怀行为量表的24个条目作为外显指标进行潜在剖面分析，并通过Logistic回归分析探究不同潜在剖面的影响因素。结果共回收420份问卷，其中有效问卷393份，有效问卷回收率为93.57%。安宁疗护病房护士的关怀行为分为3个潜在剖面，分别为高关怀水平-低尊重与联系组（49.62%）、高偏下关怀水平-整体波动组（30.79%）、中关怀水平-高知识与技能组（19.59%）。Logistic回归分析结果显示，年龄、认知和情感共情能力、高质量护理所需的工作环境是护士关怀行为潜在剖面的影响因素（P<0.05）。结论安宁疗护病房护士的关怀行为存在明显异质性，护理管理者应根据不同潜在剖面的影响因素制订个性化干预措施，以改善护士的关怀行为。

关键词: 安宁疗护, 关怀行为, 共情能力, 工作环境, 潜在剖面分析, 护理

Abstract:

Objective To explore the current situation of caring behavior among hospice nurses，and to analyze its latent profiles and population characteristics，so as to provide ideas for targeted interventions. Methods From August to November 2023，convenience sampling was used to select hospice nurses from 22 secondary and above hospitals in Jiangsu Province，Zhejiang Province，Shanghai City，Shandong Province，Anhui Province，Beijing City，Guangdong Province，and Sichuan Province. The demographic characteristics questionnaire，the Caring Behaviors Inventory，the Empathy Ability Scale for Hospice Nurses，and the Practice Environment Scale were used for investigation. Latent profile analysis was conducted based on 24 items of the Caring Behaviors Inventory as explicit indicators，and the influencing factors of different profiles were analyzed through multivariate logistic regression model. Results A total of 420 questionnaires were collected，of which 393 were valid，with a valid questionnaire response rate of 93.57%. The caring behavior of hospice nurses could be divided into 3 latent profiles，namely high level of care-low respect and connection group（49.62%），high to low caring behavior-overall fluctuation group（30.79%），and medium level of care-high knowledge and skills group（19.59%）. The results of multivariate logistic regression showed that age，the dimensions of cognitive and emotional empathy in the Empathy Ability Scale for Hospice Nurses and the dimension of nursing foundations for quality of care in the Practice Environment Scale were the influencing factors of the latent profile of hospice nurses’ caring behavior（P<0.05）. Conclusion There is significant heterogeneity in the caring behavior of hospice nurses. Nursing managers should develop individualized interventions for hospice nurses according to the influencing factors of different latent profiles to improve their level of caring behavior.

Key words: Hospice Care, Caring Behavior, Empathy, Work Environment, Latent Profile Analysis, Nursing Care

王甜甜, 陈洁, 任南晓, 李云容, 张柳柳, 吴冰, 赵云. 安宁疗护病房护士关怀行为的现状及潜在剖面分析[J]. 中华护理杂志, 2025, 60(1): 90-98.

WANG Tiantian, CHEN Jie, REN Nanxiao, LI Yunrong, ZHANG Liuliu, WU Bing, ZHAO Yun. Current status and latent profile analysis of nurses’ caring behaviors in hospice care[J]. Chinese Journal of Nursing, 2025, 60(1): 90-98.

图/表 4

表1 调查对象的一般资料及其关怀行为3个潜在剖面影响因素的单因素分析结果

Table 1 Demographic characteristics of hospice nurses and their single-factor analysis on the 3 latent profiles of caring behavior

图1 安宁疗护病房护士关怀行为的潜在剖面特征

Figure 1 Characteristics of latent profile in caring behavior of hospice nurses

表2 安宁疗护病房护士关怀行为潜在剖面模型的拟合结果

Table 2 Model fitting information for the latent profile of caring behavior of hospice nurses

表3 安宁疗护病房护士关怀行为3个潜在剖面影响因素的Logistic回归分析结果（n=393）

Table 3 Multiple logistic regression of 3 latent profiles in caring behavior of hospice nurses（n=393）

参考文献 29

[1]	王心茹, 朱信雨, 贾玉玲, 等. 文化因素对安宁疗护实践影响的质性研究[J]. 中华护理杂志, 2023, 58(13):1552-1558. DOI URL
	Wang XR, Zhu XY, Jia YL, et al. A qualitative study on the specificity of cultural factors in palliative care practice[J]. Chin J Nurs, 2023, 58(13):1552-1558. DOI URL
[2]	白静. 医院伦理氛围对护士关怀行为的影响:有调节的中介效应[D]. 承德: 承德医学院, 2023.
	Bai J. Influence of hospital ethical atmosphere on nurses’ caring behavior:moderating mediating effect[D]. Chengde: Che-ngde Medical College, 2023.
[3]	Labrague LJ, de los Santos JAA, Tsaras K, et al. The associa-tion of nurse caring behaviours on missed nursing care,adverse patient events and perceived quality of care:a cross-sectional study[J]. J Nurs Manag, 2020, 28(8):2257-2265.
[4]	马玉蓉, 杨素云. 山西省安宁疗护护士关怀及共情能力调查研究[J]. 护理研究, 2020, 34(4):601-604.
	Ma YR, Yang SY. Investigation and study on caring and empa-thy ability of hospice nurses in Shanxi Province[J]. Chin Nurs Res, 2020, 34(4):601-604.
[5]	Arsat N, Chua BS, Wider W, et al. The impact of working environment on nurses’ caring behavior in Sabah,Malaysia[J]. Front Public Health, 2022,10:858144.
[6]	李进俊. 护士医学叙事能力、共情能力与人文关怀能力的相关研究[D]. 广州: 南方医科大学, 2023.
	Li JJ. Study on the correlation between nurses’ medical narra-tive ability,empathy ability and humanistic care ability[D]. Guang-zhou: Southern Medical University, 2023.
[7]	尹奎, 彭坚, 张君. 潜在剖面分析在组织行为领域中的应用[J]. 心理科学进展, 2020, 28(7):1056-1070. DOI
	Yin K, Peng J, Zhang J. The application of latent profile analysis in organizational behavior research[J]. Adv Psychol Sci, 2020, 28(7):1056-1070. DOI
[8]	倪平, 陈京立, 刘娜. 护理研究中量性研究的样本量估计[J]. 中华护理杂志, 2010, 45(4):378-380.
	Ni P, Chen JL, Liu N. The sample size estimation hi quanti-tative nursing research[J]. Chin J Nurs, 2010, 45(4):378-380.
[9]	Wolf ZR. The concept of caring:beginning exploration[D]. Phi-ladelphia: University of Pennsylvania School of Nursing,1981.
[10]	Wu Y, Larrabee JH, Putman HP. Caring behaviors inventory:a reduction of the 42-item instrument[J]. Nurs Res, 2006, 55(1):18-25.
[11]	达朝锦, 曹枫林, 张选奋, 等. 护士关怀行为量表的汉化及信效度分析[J]. 护理学杂志, 2017, 32(21):72-75.
	Da CJ, Cao FL, Zhang XF, et al. Translation and validation of Caring Behaviour Inventory[J]. J Nurs Sci, 2017, 32(21):72-75.
[12]	王亚玲, 李惠玲. 安宁疗护护士共情能力量表的编制及信效度检验[J]. 中华护理杂志, 2023, 58(13):1565-1571. DOI URL
	Wang YL, Li HL. Development of Empathy Ability Scale for Hospice Nurses and the test of its reliability and validity[J]. Chin J Nurs, 2023, 58(13):1565-1571. DOI URL
[13]	郭晓栋, 郑泓, 阮盾, 等. 认知和情感共情与负性情绪:情绪调节的作用机制[J]. 心理学报, 2023, 55(6):892-904. DOI
	Guo XD, Zheng H, Ruan D, et al. Associations between empa-thy and negative affect:effect of emotion regulation[J]. Acta Psychol Sin, 2023, 55(6):892-904.
[14]	Lake ET. Development of the Practice Environment Scale of the Nursing Work Index[J]. Res Nurs Health, 2002, 25(3):176-188. DOI PMID
[15]	王丽, 李乐之. 中文版护理工作环境量表的信效度研究[J]. 中华护理杂志, 2011, 46(2):121-123.
	Wang L, Li LZ. Reliability and validity of Chinese version of the Practice Environment Scale[J]. Chin J Nurs, 2011, 46(2):121-123.
[16]	李梦琦, 郑晶, 刘佳丽, 等. 不同性别护士对护理工作环境评价的对比研究[J]. 中华护理杂志, 2017, 52(9):1098-1103.
	Li MQ, Zheng J, Liu JL, et al. Nurses’ perception on nursing work environment:gender difference analysis[J]. Chin J Nurs, 2017, 52(9):1098-1103.
[17]	官春燕, 潘绍山, 胡德英, 等. 103所医院护理人文关怀开展现况的调查研究[J]. 护理学杂志, 2023, 38(21):82-86.
	Guan CY, Pan SS, Hu DY, et al. Survey on the current status of nursing humanistic care in 103 hospitals[J]. J Nurs Sci, 2023, 38(21):82-86.
[18]	周洁, 邓泽英, 曾庆燕, 等. 精神病院精神科护士人文关怀能力现状及影响因素[J]. 心理月刊, 2023, 18(19):218-220. DOI
	Zhou J, Deng ZY, Zeng QY, et al. The current situation and influencing factors of humanistic care ability of psychiatric nurses in a psychiatric hospital[J]. Psy Monthly, 2023, 18(19):218-220.
[19]	许玉玲, 宋瑰琦, 王茜, 等. 护士自身关怀行为与其对护士长真实型领导风格感知的相关性研究[J]. 上海护理, 2023, 23(11):40-44.
	Xu YL, Song GQ, Wang Q, et al. Study on correlation between nurses’ self-compassion behavior and their perception of head nurses’ authentic leadership style[J]. Shanghai Nurs, 2023, 23(11):40-44.
[20]	李亚敏, 李栩亭, 余强, 等. 护士健康队列研究的大样本文献计量学分析[J]. 中华护理杂志, 2024, 59(3):330-337. DOI URL
	Li YM, Li XT, Yu Q, et al. Bibliometric analysis of large-scale nurse health cohort studies[J]. Chin J Nurs, 2024, 59(3):330-337. DOI URL
[21]	吴红艳, 谢红珍, 刘义兰, 等. 27个省份护士人文关怀知信行的多中心调查研究[J]. 中华护理杂志, 2023, 58(19):2387-2394. DOI URL
	Wu HY, Xie HZ, Liu YL, et al. Current status of knowledge,attitude and practice of humanistic care on nurses in 27 provinces and autonomous regions of China:a multicenter investigation[J]. Chin J Nurs, 2023, 58(19):2387-2394.
[22]	蔡丽梅, 翟惠敏, 徐宁君. 心内科护士人文关怀能力现状及影响因素分析[J]. 广州医科大学学报, 2022, 50(2):98-103.
	Cai LM, Zhai HM, Xu NJ. Analysis on the present situation and influencing factors of humanistic care ability of nurses in cardiology department[J]. Acad J Guangzhou Med Univ, 2022, 50(2):98-103.
[23]	常红娟, 解梦瑶, 陈静, 等. 临床护士自我关怀现状及潜在剖面分析[J]. 中华护理杂志, 2023, 58(13):1615-1622. DOI URL
	Chang HJ, Xie MY, Chen J, et al. Current situation and potential profile analysis of self-compassion behavior of clinical nurses[J]. Chin J Nurs, 2023, 58(13):1615-1622. DOI URL
[24]	王亚玲, 李惠玲. 护士在安宁疗护情境中共情体验的质性研究[J]. 解放军护理杂志, 2021, 38(7):45-48.
	Wang YL, Li HL. Nurses’ empathy experience in hospice care:a qualitative study[J]. Nurs J Chin PLA, 2021, 38(7):45-48.
[25]	Coetzee SK, Laschinger HKS. Toward a comprehensive,theore-tical model of compassion fatigue:an integrative literature review[J]. Nurs Health Sci, 2018, 20(1):4-15.
[26]	陈朝德. 认知重评训练对重症监护室护士情绪劳动能力和同情心疲乏水平的影响[J]. 中国当代医药, 2022, 29(33):46-49.
	Chen CD. Influence of cognitive reappraisal training on emo-tional labor ability and level of compassion fatigue in inten-sive care unit nurses[J]. China Mod Med, 2022, 29(33):46-49.
[27]	Ahmad R, Nawaz MR, Ishaq MI, et al. Social exchange theory:systematic review and future directions[J]. Front Psychol, 2022,13:1015921.
[28]	Pahlevan Sharif S, Ahadzadeh AS, Sharif Nia H. Mediating role of psychological well-being in the relationship between organizational support and nurses’ outcomes:a cross-sectional study[J]. J Adv Nurs, 2018, 74(4):887-899. DOI PMID
[29]	薛朝华, 刘义兰, 许娟, 等. 医联体基层医院护士人文关怀能力现状调查分析[J]. 护理学杂志, 2019, 34(14):43-46.
	Xue CH, Liu YL, Xu J, et al. Caring ability of nurses in secondary and primary hospitals participating in the hospital alliance program[J]. J Nurs Sci, 2019, 34(14):43-46.

编辑推荐 0

Metrics

阅读次数

全文

HTML			PDF

最新录用	在线预览	正式出版	最新录用	在线预览	正式出版
0	0	0	0	0	9

	来源	本网站

	次数	9
	比例	100%

摘要

450

最新录用	在线预览	正式出版

0	0	450

	来源	本网站

	次数	450
	比例	100%