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中华胃肠内镜电子杂志 ›› 2024, Vol. 11 ›› Issue (04) : 276 -281. doi: 10.3877/cma.j.issn.2095-7157.2024.04.012

护理园地

解释消化内镜在职护士培训的现实主义整合
周微薇1, 罗宇1, 何朝晖1,()   
  1. 1.519000 珠海,遵义医科大学第五附属(珠海)医院消化内科
  • 收稿日期:2024-08-05 出版日期:2024-11-15
  • 通信作者: 何朝晖

Explaining the training of digestive endoscopy nurses-A realist synthesis

Weiwei Zhou1, Yu Luo1, Zhaohui He1,()   

  1. 1.Department of Gastroenterology, The Fifth Affiliated (Zhuhai) Hospital of Zunyi Medical University, Zhuhai 519000, China
  • Received:2024-08-05 Published:2024-11-15
  • Corresponding author: Zhaohui He
引用本文:

周微薇, 罗宇, 何朝晖. 解释消化内镜在职护士培训的现实主义整合[J]. 中华胃肠内镜电子杂志, 2024, 11(04): 276-281.

Weiwei Zhou, Yu Luo, Zhaohui He. Explaining the training of digestive endoscopy nurses-A realist synthesis[J]. Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition), 2024, 11(04): 276-281.

目的

对有关消化内镜在职护士培训的证据进行现实主义整合,以发展消化内镜护士培训相关方案理论,旨在说明两个问题:哪种培训方式对消化内镜护士进行培训是有用的? 在什么环境下起作用以及为什么起作用?

方法

通过文献回顾确定理论框架。 系统检索并整理国内外消化内镜护士培训的相关文献。 根据现实主义整合的方法,依据“情景-机制-结局”及选定的理论框架对文献证据进行归纳分析,以充分解释消化内镜护士培训的适用情景、促进因素、阻碍因素。

结果

共纳入20 篇文献,分析得出两大方面消化内镜护士培训相关“情景-机制-结局”解释路径。 (1)在构建消化内镜护士培训统一标准化培训体系、不同内镜护士基础的背景下,护士的外在表现促进培训效果与质量;(2)在消化内镜护士工作繁忙、领导重视度、消化内镜工作特殊性、科室氛围、薪资待遇的背景下,护士内在表现促进或阻碍培训效果。

结论

依据理论框架对消化内镜护士的培训进行解释,以冰面以上及冰面以下的两条培训路径为切入点有利于消化内镜护士的培训。

Objective

To conduct a realist synthesis of evidence on the training of digestive endoscopy nurses to develop a theory for digestive endoscopy nurse training programs. The aim is to address two questions:Which training methods are useful for training digestive endoscopy nurses? Under what circumstances do they work and why?

Methods

Determine the theoretical framework through literature review. Systematically search and collate relevant literature on the training of digestive endoscopy nurses at home and abroad. According to the realist synthesis method, summarize and analyze the literature evidence based on the “context-mechanism-outcome” and the selected theoretical framework to fully explain the applicable scenarios, facilitating factors, and hindering factors of digestive endoscopy nurse training.

Results

A total of 20 articles were included, and two major aspects of the “context-mechanism-outcome” explanatory paths related to digestive endoscopy nurse training were analyzed. (1) Under the background of constructing a unified and standardized training system for digestive endoscopy nurses and different baselines of endoscopy nurses, the external performance of nurses promotes the training effect and quality; (2) Under the background of the busy work of digestive endoscopy nurses, leadership attention, the particularity of digestive endoscopy work, department atmosphere, and salary and treatment, the internal performance of nurses promotes or hinders the training effect.

Conclusion

According to the theoretical framework, the training of digestive endoscopy nurses is explained. Taking the two training paths above and below the ice surface as the starting point is beneficial to the training of digestive endoscopy nurses.

图1 文献检索结果及筛选流程图
图2 胜任力冰山模型
表1 消化内镜护士培训相关环境、机制及相应解释
C(环境) 对C的解释 M(机制) 对M的解释
1.标准化培训体系(培训内容、建立统一认证机构、培训方式) 标准化培训体系规范了对消化内镜护士的培训内容、培训方式及考核方式,促进培训效果的同时确保培训质量[1] 理论知识[23] 消化内镜护士在接受培训期间所获取理论知识的多少与质量
2.学员内镜基础 内镜护理基础知识掌握更多的护士培训效果更好[14] 操作技能[20] 如诊疗配合能力、消化内镜的洗消技能、内镜器械的管理维护能力等
3.消化内镜护士的受重视程度 当地政府、医院管理层对消化内镜护士的重视度增强护士自信心及工作积极性[1,31] 工作的积极性与动力[1,20,28,29,31] 消化内镜护士的意识和积极态度
4.消化内镜护理工作的特殊性 消化内镜护士工作的专科性强,有利于增强其职业成就感、自我效能感[25],促进消化内镜护士对培训的需求 职业成就感[20,25,28]
自我效能感[21]
个体在工作中获得的积极心理体验和成就感
成功的表现提高了感知自我效能感
5.消化内镜护士之间的相处氛围 包容开放、增长导向的工作环境可以减轻护士压力,有利于提高护士对工作的满意度[1,28] 消化内镜护士对工作的满意度[28] 护士对工作的满意度影响工作行为的规范化程度
6.消化内镜护士工作繁忙度 护理人力资源不足导致护理工作繁忙,影响消化内镜护士对继续教育及培训的重视程度及积极性[20] 职业倦怠感[25] 因不能有效应对工作中的压力而产生的情感衰竭、去人格化、个人成就感降低。
7.护士薪资与劳动程度的适配度 与劳动度相匹配的薪资能够促进护士的积极性[29] 沟通协调能力[1,14,20-23] 包括与患者及家属的沟通、与内镜医生的沟通、团队成员之间的沟通
职业道德素养[20,23,28] 热爱工作岗位、奉献精神、工作责任心、具备团队协作精神
职业韧性[23,25] 个体在逆境中成长和恢复的能力
教学与科研创新能力[20,22,23,32] 对护士的教学及患者的健康宣教;在工作中发现临床问题,通过科研创新优化临床实践
管理与统筹能力[32] 协助护士长管理好科室的各项事务,保证科室的正常运行
临床实践能力[20,23] 对突发事件的处理能力;对患者病情观察的准确性
图3 消化内镜护士培训路径
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