国内护士对死亡的态度现状及影响因素的系统评价  

Meta-analysis of attitudes towards death and influencing factors among nurses in China

作　　者：黄玉婷 张慧琳[1] 朱婧 邹颖 覃祖明 张晓可 HUANG Yuting;ZHANG Huilin;ZHU Jing;ZOU Ying;QIN Zuming;ZHANG Xiaoke

机构地区：[1]中南大学湘雅二医院护理部,长沙市410011 [2]湖南中医药大学护理学院

出　　处：《中华护理教育》2024年第6期718-725,共8页Chinese Journal of Nursing Education

基　　金：湖南省哲学社会科学基金(22YBA016)。

摘　　要：目的了解国内临床护士死亡态度现状及相关因素,为护理管理者对其进行针对性干预提供参考。方法检索中国知网、中国生物医学文献数据库、维普、万方、Pubmed、Web of Science、EMbase、CINHAL、the Cochrane Library数据库,纳入使用修订版死亡态度描绘量表评估国内护士死亡态度横断面研究的文献,检索时限为建库至2023年5月10日,采用RevMan 5.4及Stata 17.0进行Meta分析。结果共纳入38篇文献,总样本量为17284。我国护士死亡态度维度均分最高为自然接受维度3.79(95%CI:3.59,3.98)。女护士自然接受维度得分更高(Z=2.14,P=0.03,I^(2)=9%);与工作10年以上的护士相比,工作6~10年的护士死亡恐惧维度得分更高(Z=2.90,P=0.004,I^(2)=46%);与工作≤5年的护士相比,工作6~10年(Z=2.20,P=0.03,I^(2)=68%)和10年以上(Z=3.60,P<0.001,I^(2)=0%)的护士死亡逃避维度得分更高,工作10年以上护士趋近接受维度得分(Z=2.08,P=0.04,I^(2)=0%)和逃离接受维度得分(Z=4.71,P<0.001,I^(2)=0%)更高;有进行患者临终处置经历的护士死亡恐惧维度得分更低(Z=2.05,P=0.04,I^(2)=0%),趋近接受维度得分更低(Z=2.57,P=0.01,I^(2)=0%)。结论国内临床护士的死亡态度得分以自然接受维度得分最高,死亡逃避维度得分次之。护士的性别、工作年限、患者临终处置经历是影响其死亡态度的因素,护理管理者应了解临床护士死亡态度,针对性开展死亡教育。Objective To understand the state of attitudes towards death among nurses,and then provide references for targeted intervention.Methods The cross-sectional studies on attitude towards death among nurses using the Death Attitude Profiled-Revised(DAP-R)were searched in CNKI,CBM,VIP,Wanfang Data,PubMed,Web of Science,Embase,CINHAL,and the Cochrane Library from inception to May 10,2023.Meta-analysis was performed using RevMan 5.4 and Stata 17.0.Results Totally 38 articles were included with a total sample size of 17284.The highest score of death attitudes among Chinese nurses was 3.79(95%CI:3.59,3.98)for neutral acceptance.Female nurses were more likely to neutral acceptance(Z=2.14,P=0.03,I^(2)=9%);Nurses with 6 to 10 years of service had higher scores on the fear of death dimension compared to nurses with more than 10 years of service(Z=2.90,P=0.004,I^(2)=46%),and compared to nurses with≤5 years of service,nurses with 6 to 10 years of service(Z=2.20,P=0.03,I^(2)=68%)and more than 10 years of service(Z=3.60,P<0.001,I^(2)=0%)death avoidance dimension scores were higher,and nurses with more than 10 years of employment had higher convergent acceptance dimension scores(Z=2.08,P=0.04,I^(2)=0%)and escape acceptance dimension scores(Z=4.71,P<0.001,I^(2)=0%);nurses who had experience of end-of-life management of patients had lower fear of death scores(Z=2.05,P=0.04,I^(2)=0%)and lower approach acceptance scores(Z=2.57,P=0.01,I^(2)=0%).Conclusion Clinical nurses'attitudes toward death are complex,with neutral acceptance being predominant and death avoidance secondary.Nurses'gender,working experience,and the exprience of managing patients at the end of life are the influencing factors of death attitude.The attitudes towards death of clinical nurses should be identified as soon as possible to carry out targeted death education.

关 键 词：护士 死亡态度 影响因素 系统评价 

分 类 号：R192.6[医药卫生—卫生事业管理]