护士反思性实践的概念分析

doi:10.3761/j.issn.0254-1769.2024.01.017

摘要/Abstract

摘要：

目的分析护士反思性实践概念的定义及其内涵。方法系统检索中国知网、万方数据库、中国生物医学文献数据库、PubMed、Embase、Scopus、CIHNAL数据库中与护士反思性实践相关的文献，检索时限为建库至2022年12月。应用Walker和Avant概念分析法进行分析。结果共纳入43篇文献。护士反思性实践的定义属性包括积极主动、批判性思维、开放与接纳、建立与既往知识或经验的关联、外界支持和动态持续6个方面；其前因包括内部和外部驱动力，最终产生了对自身、患者和组织的影响。反思性实践问卷是近年来国外较为常用的测量护士反思性实践能力的评估工具。结论通过概念分析明确了护士反思性实践的概念属性，为护理教育者培养护士的反思性实践能力提供了参考依据。在今后的研究中，研究者可结合护士反思性实践的内涵，研制针对国内护士反思性实践水平的特异性评估工具，构建出本土化的护士反思性实践干预方案，从而推动国内护理领域反思性实践的发展。

关键词: 护士, 反思性实践, 概念分析, 护理管理研究

Abstract:

Objective To clarify and analyze the concept and connotation of the reflective practice in nurses. Methods CNKI，Wanfang，CBM，PubMed，Embase，Scopus，CIHNAL database were searched in relation to reflective practice in nurses. The retrieval period was from the inception to Dec.2022. Walker and Avant’s concept analysis method was used to analyze the connotation. Results A total of 43 articles were retrieved. 6 attributes of reflective practice in nurses were identified，including active engagement，critical thinking，openness and acceptance，making connections with previous knowledge or experiences，external support，dynamic and continuity. Antecedents included internal and external drivers. The reflective practice in nurses ultimately had a vital impact on themselves，patients and organizations. In recent years Reflective Practice Questionnaire has been one of the most commonly used data collection tools to measure the reflective practice in nurses. Conclusion The concept attributes of reflective practice in nurses were identified by concept analysis method，which provides references for nursing educators to cultivate reflective practice ability of nurses. In future research，researchers can combine the connotations of reflective practice for nurses to develop specific assessment tools for testing the level of reflective practice of nurses and construct the local reflective practice intervention scheme for nurses，so as to promote the development of reflective practice in nursing field in China.

Key words: Nurses, Reflective Practice, Concept Analysis, Nursing Administration Research

董燕燕, 潘靖达, 何家欣, 林穗仪, 于红静, 凌冬兰. 护士反思性实践的概念分析[J]. 中华护理杂志, 2024, 59(1): 124-129.

DONG Yanyan, PAN Jingda, HE Jiaxin, LIN Suiyi, YU Hongjing, LING Donglan. A concept analysis of reflective practice in nurses[J]. Chinese Journal of Nursing, 2024, 59(1): 124-129.

参考文献 33

[1]	Goulet MH, Larue C, Alderson M. Reflective practice:a compa-rative dimensional analysis of the concept in nursing and education studies[J]. Nurs Forum, 2016, 51(2):139-150. DOI URL
[2]	王芝, 许燕, 施银, 等. 反思性学习在急诊护士业务学习培训中的应用[J]. 中华护理杂志, 2013, 48(12):1119-1120.
	Wang Z, Xu Y, Shi Y, et al. Application of reflective learning in professional learning and training of emergency nurses[J]. Chin J Nurs, 2013, 48(12):1119-1120.
[3]	de Vries J, Timmins F. Care erosion in hospitals:problems in reflective nursing practice and the role of cognitive dissonance[J]. Nurse Educ Today, 2016, 38:5-8. DOI URL
[4]	Lucy O’Neill, Johnson J, Mandela R. Reflective practice groups:are they useful for liaison psychiatry nurses working within the emergency department?[J]. Arch Psychiatr Nurs, 2019, 33(1):85-92. DOI URL
[5]	Yu HJ, Ling DL, Hu JL. Advancing the quality of care and nursing practice through emancipatory reflection[J]. Front Nurs, 2019, 6(1):1-4.
[6]	张业芳, 曾铁英. 护理教育反思性教学研究进展[J]. 护理研究, 2015, 29(13):1548-1550.
	Zhang YF, Zeng TY. Research progress on reflective teaching in nursing education[J]. Chin Nurs Res, 2015, 29(13):1548-1550.
[7]	李加敏, 李学靖, 杨丹, 等. 低价值护理的概念分析及研究现状[J]. 中华护理杂志, 2022, 57(17):2171-2176. DOI URL
	Li JM, Li XJ, Yang D, et al. Concept analysis and research progress of low-value care[J]. Chin J Nurs, 2022, 57(17):2171-2176. DOI URL
[8]	Bogumil RJ. The reflective practitioner:how professionals think in action[J]. Proc IEEE, 1985, 73(4):845-846.
[9]	李爱华. 反思性学习法在护理本科生临床实践中的应用研究[D]. 太原: 山西医科大学, 2009.
	Li AH. Application of reflective learning method in clinical practice of nursing undergraduates[D]. Taiyuan: Shanxi Medical University, 2009.
[10]	Bolg JR, Dwyer PA, Doherty DP, et al. The impact of critical reflective inquiry education on experienced nurses’ insights into practice[J]. J Nurses Prof Dev, 2020, 36(2):68-73. DOI URL
[11]	Thompson N, Pascal J. Developing critically reflective practice[J]. Reflective Pract, 2012, 13(2):311-325. DOI URL
[12]	Rolfe G. Rethinking reflective education:what would Dewey have done?[J]. Nurse Educ Today, 2014, 34(8):1179-1183. DOI URL
[13]	Richard A, Gagnon M, Careau E. Using reflective practice in interprofessional education and practice:a realist review of its characteristics and effectiveness[J]. J Interprofessional Care, 2019, 33(5):424-436. DOI URL
[14]	O’ Brien B, Graham MM. BSc nursing & midwifery students experiences of guided group reflection in fostering personal and professional development. Part 2[J]. Nurse Educ Pract, 2020, 48:102884. DOI URL
[15]	Lawrence LA. Work engagement,moral distress,education level,and critical reflective practice in intensive care nurses[J]. Nurs Forum, 2011, 46(4):256-268. DOI PMID
[16]	Tsingos-Lucas C, Bosnic-Anticevich S, Schneider CR, et al. The effect of reflective activities on reflective thinking ability in an undergraduate pharmacy curriculum[J]. Am J Pharm Educ, 2016, 80(4):65. DOI PMID
[17]	Schwind JK, Manankil-Rankin L. Using narrative reflective pro-cess to augment personal and aesthetic ways of knowing to support holistic person-centred relational practice[J]. Reflec-tive Pract, 2020, 21(4):473-483.
[18]	Bijani M, Mohammadi F, Haghani F, et al. Development and psychometric evaluation of a reflection on Clinical Practice Questionnaire for Nursing Students[J]. BMC Nurs, 2021, 20(1):185. DOI PMID
[19]	Mann K, Gordon J, MacLeod A. Reflection and reflective prac-tice in health professions education:a systematic review[J]. Adv in Health Sci Educ, 2009, 14(4):595-621. DOI URL
[20]	来小彬, 梁燕, 吴明, 等. 应用反思法提升护生专业素养的实践教学:以基础护理学课程思政建设为例[J]. 护士进修杂志, 2021, 36(14):1335-1338.
	Lai XB, Liang Y, Wu M, et al. Practical teaching of improving nursing students’ professional quality by reflective method:taking the ideological and political construction of basic nursing course as an example[J]. J Nurses Train, 2021, 36(14):1335-1338.
[21]	Alsalamah Y, Albagawi B, Babkair L, et al. Perspectives of nurs-ing students on promoting reflection in the clinical setting:a qualitative study[J]. Nurs Rep, 2022, 12(3):545-555. DOI URL
[22]	吴雪, 李燕, 李静, 等. 反思性实践问卷的汉化与修订及其在专科护士中的信度效度检验[J]. 中国护理管理, 2022, 22(6):898-903.
	Wu X, Li Y, Li J, et al. Reliability and validity of Reflective Practice Questionnaire of Chinese version and its application in specialist nurses[J]. Chin Nurs Manag, 2022, 22(6):898-903.
[23]	Sherwood G, McNeill J. Reflective practice:providing safe qua-lity patient-centered pain management[J]. Pain Manag, 2017, 7(3):197-205. DOI PMID
[24]	段功香, 沈宁, 伍冰. 反思性学习对本科实习护生临床沟通能力影响的研究[J]. 中华护理杂志, 2007, 42(9):773-775.
	Duan GX, Shen N, Wu B. Effects of reflective learning on clinical communication skills for undergraduate nursing students in clinical practice period[J]. Chin J Nurs, 2007, 42(9):773-775.
[25]	侯梦晓, 王飞杰, 越丽霞, 等. 临床护士临床实践中专业反思体验的质性研究[J]. 中华护理教育, 2019, 16(12):937-941.
	Hou MX, Wang FJ, Yue LX, et al. A qualitative research on how clinical nurses conduct reflective practice[J]. Chin J Nurs Educ, 2019, 16(12):937-941.
[26]	Bagheri M, Taleghani F, Abazari P, et al. Triggers for reflec-tion in undergraduate clinical nursing education:a qualitative descriptive study[J]. Nurse Educ Today, 2019, 75:35-40. DOI URL
[27]	李松, 李红玉, 张艳丽, 等. 护生临床实践反思问卷的汉化及信效度检验[J]. 护理学杂志, 2022, 37(23):8-11.
	Li S, Li HY, Zhang YL, et al. Translation and validation of the Reflection on Clinical Practice Questionnaire for Nursing Students[J]. J Nurs Sci, 2022, 37(23):8-11.
[28]	Aukes LC, Geertsma J, Cohen-Schotanus J, et al. The develop-ment of a scale to measure personal reflection in medical practice and education[J]. Med Teach, 2007, 29(2/3):177-182. DOI URL
[29]	Kember D, Leung DYP, Jones A, et al. Development of a ques-tionnaire to measure the level of reflective thinking[J]. Assess Eval High Educ, 2000, 25(4):381-395. DOI URL
[30]	Priddis L, Rogers SL. Development of the Reflective Practice Questionnaire:preliminary findings[J]. Reflective Pract, 2018, 19(1):89-104. DOI URL
[31]	Gustafsson S, Engström Å, Lindgren BM, et al. Reflective capa-city in nurses in specialist education:Swedish translation and psychometric evaluation of the Reflective Capacity Scale of the Reflective Practice Questionnaire[J]. Nurs Open, 2021, 8(2):546-552. DOI URL
[32]	陆悦, 李明子, 孙玉梅, 等. 反思日志在护理临床教学中的应用进展[J]. 中华护理教育, 2015, 12(9):704-707.
	Lu Y, Li MZ, Sun YM, et al. Review on the application of reflective journal in nursing clinical teaching[J]. Chin Nurs Edu, 2015, 12(9):704-707.
[33]	张美娟, 沈建新, 陈卫军, 等. 应用学生见习反思日记开发教学案例的做法与评价[J]. 中华护理杂志, 2011, 46(2):153-154.
	Zhang MJ, Shen JX, Chen WJ, et al. Practice and evaluation of developing teaching cases with students’ reflection diary[J]. Chin J Nurs, 2011, 46(2):153-154.