肿瘤科护士一般自我效能感及人文关怀能力在共情能力和医学叙事能力中的链式中介作用  

Chain mediation of oncology nurses'general self-efficacy and humanistic care competence in empathy and medical narrative competence

作　　者：董勇 蔡帅中 李瑞娥 周文僮 蒋蕾[1] 杨海银 杨诗瑶 朱悦熙 苗金虎 关琼瑶[1] Dong Yong;Cai Shuaizhong;Li Ruie;Zhou Wentong;Jiang Lei;Yang Haiyin;Yang Shiyao;Zhu Yuexi;Miao Jinhu;Guan Qiongyao(Nursing Department,the Third Affiliated Hospital of Kunming Medical University,Kunming 650118,China;Department of Orthopedics,Yan'an Hospital of Kunming City,Kunming 650051,China;Department of Hematology Oncology,Qujing Second People's Hospital,Qujing 655000,China;Outpatient Department,People's Hospital of Yuxi City,Yuxi 653110,China)

机构地区：[1]昆明医科大学第三附属医院护理部,昆明650118 [2]昆明市延安医院骨科,昆明650051 [3]曲靖市第二人民医院血液肿瘤科,曲靖655000 [4]玉溪市人民医院门诊部,玉溪653110

出　　处：《中华现代护理杂志》2025年第8期1072-1077,共6页Chinese Journal of Modern Nursing

基　　金：云南省科技厅-昆明医科大学应用基础研究联合(202101AY070001-178);昆明医科大学教育教学研究课题(2023-JY-Y-062)。

摘　　要：目的探讨一般自我效能感和人文关怀能力在肿瘤科护士共情能力与医学叙事能力间的链式中介作用,以期为制订针对性的医学叙事能力提升策略提供参考。方法采用便利抽样法,于2023年5—8月选取云南省17家三甲医院的1104名肿瘤科护士为研究对象,采用一般资料调查表、医学叙事能力量表、中文版杰弗逊共情能力量表、人文关怀能力量表、一般自我效能感量表对肿瘤科护士进行调查。采用Pearson相关分析对肿瘤科护士一般自我效能感、共情能力、人文关怀能力、医学叙事能力间的相关性进行分析。采用SPSS宏程序PROCESS 4.0插件中的Model 6进行中介效应分析。采用Bootstrap法重复抽样5000次进行链式中介效应检验。结果本研究共发放问卷1104份,回收有效问卷为931份,问卷有效回收率为84.33%(931/1104)。931名肿瘤科护士医学叙事能力量表得分为(151.52±17.61)分、人文关怀能力量表得分为(191.68±18.80)分、中文版杰弗逊共情能力量表得分为(95.31±13.96)分、一般自我效能感量表得分为(27.59±6.02)分。肿瘤科护士医学叙事能力、共情能力、人文关怀能力、一般自我效能感之间两两呈正相关(P<0.01);一般自我效能感和人文关怀能力在肿瘤科护士共情能力与医学叙事能力间起到链式中介作用,中介效应占总效应的43.13%。结论一般自我效能感和人文关怀能力是肿瘤科护士共情能力与医学叙事能力的中介变量,护理管理者应当注重护士的共情能力的培养,激发护士的自我效能,推进护理人文关怀实践,进而提升肿瘤科护士的医学叙事能力,提高护理服务质量。ObjectiveTo explore the chain mediating role of general self-efficacy and humanistic care competence between oncology nurses'empathy and medical narrative competence,with a view to informing the development of targeted medical narrative competence enhancement strategies.MethodsConvenience sampling was used to select 1104 oncology nurses from 17 ClassⅢGrade A hospitals in Yunnan Province from May to August 2023 for the study.The General Information Questionnaire,Narrative Competence Scale,Chinese version of the Jefferson Scale of Empathy,Caring Ability Inventory,and General Self-Efficacy Scale were used to survey oncology nurses.Pearson correlation was used to analyze the correlation among oncology nurses'general self-efficacy,empathy,humanistic care competence,and medical narrative competence.Mediating effects were analyzed using Model 6 in the SPSS macro program PROCESS 4.0 plug-in.Bootstrap method was used to repeat the sampling 5000 times for the chained mediating effect test.ResultsA total of 1104 questionnaires were distributed and the number of valid questionnaires recovered was 931,with a valid recovery rate of 84.33%(931/1104).Among 931 oncology nurses,the scores of Narrative Competence Scale,Caring Ability Inventory,Chinese version of Jefferson Scale of Empathy,and General Self-Efficacy Scale were(151.52±17.61),(191.68±18.80),(95.31±13.96),and(27.59±6.02),respectively.There was a positive two-by-two correlation among oncology nurses'medical narrative competence,empathy,humanistic care competence,and general self-efficacy(P<0.01).General self-efficacy and humanistic care competence acted as chain mediators between oncology nurses'empathy and medical narrative competence,with the mediating effect accounting for 43.13%of the total effect.ConclusionsGeneral self-efficacy and humanistic care are mediating variables between oncology nurses'empathy and medical narrative competence.Nursing managers should focus on the cultivation of nurses'empathy,stimulate nurses'self-efficacy,and promote the practice of

关 键 词：护士 肿瘤科护士 医学叙事能力 共情能力 人文关怀能力 一般自我效能感 链式中介 

分 类 号：R47[医药卫生—护理学]