产科循证护理实践变革对护士临床护理工作益处与挑战的质性研究  

Benefits and challenges of reform in evidence-based obstetric nursing practice in clinical nursing:a qualitative study

作　　者：陈鹏[1] 林琳 张纹 万婷 谢桂香 王培红 Chen Peng;Lin Lin;Zhang Wen;Wan Ting;Xie Guixiang;Wang Peihong(Department of Obstetrics and Gynaecology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,Hubei Province,China)

机构地区：[1]华中科技大学同济医学院附属协和医院妇产科,湖北武汉430022

出　　处：《现代临床护理》2025年第1期52-58,共7页Modern Clinical Nursing

基　　金：华中科技大学同济医学院第一临床学院教学改革院级专项,项目编号为202140。

摘　　要：目的 探讨产科循证护理实践变革对护士临床护理工作的益处与挑战,为循证实践变革的启动和维持提供参考依据。方法 采用描述现象学研究方法,2024年1月—2月通过目的抽样选取本院10名临床护士作为受访者,根据文献回顾和专家访谈制定访谈提纲,进行半结构式访谈。运用Colaizzi提出的7步分析法提炼核心主题。结果 归纳出3个主题,12个副主题:护士对循证护理实践变革的接纳性(知识层面、决策层面、行动层面);护士对循证护理实践变革益处感知(提升临床护理工作的专业性和科学性、改善就医体验和护理效果、提升护理质量与安全、促使在职培训教育创新、促进护理团队协助);护士对循证护理实践变革挑战感知(压力与挑战、存在疑虑和抵触情绪、医护配合欠佳、临床决策存在风险)。结论 产科护士对循证护理实践接纳程度不同,应促进其对变革的接纳程度,对益处与挑战因素针对性引导与干预,以便促进循证护理实践变革顺利实施。Objective To investigate the benefits and challenges of the reform in evidence-based obstetric nursing practice in clinical nursing,therefore to provide a reference for initiating and keeping the reform in evidence-based nursing practices.Methods A method of descriptive phenomenological research was conducted between January and February 2024 in our hospital on 10 selected clinical nurses by purposive sampling.An outline for interviews was developed based on literature review and expert interviews,followed by semi-structured interviews with the nurses.Core themes were extracted with Colaizzi’s seven-step analysis.Results Three themes and 12 sub-themes were summarised in this study.The 3 core themes that were identified among the nurses included:acceptance of evidence-based nursing practice reform(with 3 domains regarding knowledge,decision-making and action),perception of the benefits of the reform in evidence-based nursing practice(with 5 domains regarding the professionalism and scientific nature of clinical nursing,improvement of patient experience and nursing outcomes,enhancement of nursing quality and safety,promotion of innovation in on-the-job training and education,and facilitation of collaboration within the nursing team),and perception in the challenges of reform in evidence-based nursing practice(with 4 domains regarding the stress and challenges,doubts and resistance,poor cooperation between doctors and nurses,and risks in clinical decision-making).Conclusion The acceptance regarding reform in evidence-based nursing practice varies among the nurses.It is necessary to promote the acceptance,provide the targeted guidance and intervene in the factors of benefits and challenges among the nurses,hence to facilitate a smooth implementation of the reform in evidence-based nursing practice.

关 键 词：产科 循证护理实践 变革 描述现象学研究 

分 类 号：R47[医药卫生—护理学]