外科手术病人安全感及其影响因素的研究
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摘要
目的
1.描述外科手术病人的总体安全感水平。
2.探讨影响外科手术病人安全感的因素,以便帮助医务人员更加关注病人的安全感,提供更为人性化、整体化、安全有效的护理,为临床实践提供理论依据。
方法
应用自编的外科手术病人安全感问卷,采用便利抽样的方法,于2009年10月至2009年12月对山东省6家综合医院的243名外科手术病人进行调查。
结果
1.外科手术病人安全感问卷具有较好的内部一致性,总体Cronbach's a系数为0.905,5个因子的Cronbach's a系数为0.6-0.9之间。因子分析产生5个公因子累积解释总方差68.98%,并在相应项目上具有较强的因子载荷,表明量表的结构效度较好。
2.外科手术病人安全感得分为89.07±15.08,介于一般-比较安全之间(73-96分)。
3.外科手术病人安全感5个维度得分由低到高依次为：人际关系(2.92±0.60)、疾病病情(3.43士1.07)、医院环境(3.56±0.99)、医护行为(4.45±0.59)和医院管理(4.54±0.59)
4.通过多元线性回归分析,家庭收入、择院理由(诊疗技术高,名声好)、患病时间以及子女情况进入安全感的回归方程。
结论
1.外科手术病人安全感问卷具有良好的信度和效度,适用于外科手术病人安全感的调查。
2.外科手术病人的安全感介于一般与比较安全之间的水平。人际关系方面的安全感最低,其次为疾病病情、医院环境、医护行为和医院管理。
3.影响病人安全感的因素是家庭收入、子女情况、择院原因(诊疗技术高,名声好)及患病时间。家庭收入越高,病人的安全感越高；有子女的病人安全感高；医院诊疗技术高,名声好,病人的安全感高；患病时间短,病人的安全感高。未发现性别、年龄、职业、教育程度等与安全感相关。
Objectives
①to describe the general security level of the perioperative patients;②to explore the factors that affect their sense of security so as to provide basic information for further study and theoretical basis for clinical practice.Thus the medical staff will pay more attention to the security of patients, provding more humane, more comprehensive and more effective earring.
Methods
243 cases of six comprehensive hospitals in Shandong province were corresponded from Oct.2009 to Dec.2009, using the questionaire designed by myself on the security level of the patients and the method of convenient sampling.
Results
1.This questionaire on the security level of the patients is well internally consistent with the Cronbach's coefficient alpha being 0.905. The Cronbach's coefficient alpha of five factors is between 0.6-0.9. The factor analysis brought about five common factors with the general variance of 68.98 percent. And each has a comparatively strong factor load on correspond-ing item. This indicates that the scale construction has a good effect.
2. The patients got a security level of 89.07±15.08, which comes between the general and the comparatively security(73～96 points).
3. The five demensions of the security level are (order based on marks) Interpersonal relationship (2.92±0.60), Disease state (3.43±1.07), Hospital environment (3.56±0.99).Caring behaviour(4.45±0.59), and Hospital administ-ration (4.54±0.59)
4. By multiple linear regression analysis, the family income, reasons for choosing hospital, illness time and information of the children will go into the security level linear regression analysis.
Conclusions
1. The questionaire has a good reliability and validity, and it can be applied to the survey of the security level of perioperative patients.
2. The perioperative patients'sense of security is between the ordinary level and the comparatively security. perioperative patients have a high security level generally.
3. The lowest security level of the five demensions is the interpersonal relationship.
4. The security level of the patients can be affected by the family income, reasons for choosing hospital, illness time and information of the children. The higher the family income is, the higher the patients'sense of security is; patients with children have a higher sense of security; patients have a higher sense of security for hospitals with high technology and good reputation and they have a higher sense of security for illness with a short time. This research also found that there is no relationship between patients'sense of security and gender, age occupation and education level.
1.描述外科手术病人的总体安全感水平。
2.探讨影响外科手术病人安全感的因素,以便帮助医务人员更加关注病人的安全感,提供更为人性化、整体化、安全有效的护理,为临床实践提供理论依据。
方法
应用自编的外科手术病人安全感问卷,采用便利抽样的方法,于2009年10月至2009年12月对山东省6家综合医院的243名外科手术病人进行调查。
结果
1.外科手术病人安全感问卷具有较好的内部一致性,总体Cronbach's a系数为0.905,5个因子的Cronbach's a系数为0.6-0.9之间。因子分析产生5个公因子累积解释总方差68.98%,并在相应项目上具有较强的因子载荷,表明量表的结构效度较好。
2.外科手术病人安全感得分为89.07±15.08,介于一般-比较安全之间(73-96分)。
3.外科手术病人安全感5个维度得分由低到高依次为：人际关系(2.92±0.60)、疾病病情(3.43士1.07)、医院环境(3.56±0.99)、医护行为(4.45±0.59)和医院管理(4.54±0.59)
4.通过多元线性回归分析,家庭收入、择院理由(诊疗技术高,名声好)、患病时间以及子女情况进入安全感的回归方程。
结论
1.外科手术病人安全感问卷具有良好的信度和效度,适用于外科手术病人安全感的调查。
2.外科手术病人的安全感介于一般与比较安全之间的水平。人际关系方面的安全感最低,其次为疾病病情、医院环境、医护行为和医院管理。
3.影响病人安全感的因素是家庭收入、子女情况、择院原因(诊疗技术高,名声好)及患病时间。家庭收入越高,病人的安全感越高；有子女的病人安全感高；医院诊疗技术高,名声好,病人的安全感高；患病时间短,病人的安全感高。未发现性别、年龄、职业、教育程度等与安全感相关。
Objectives
①to describe the general security level of the perioperative patients;②to explore the factors that affect their sense of security so as to provide basic information for further study and theoretical basis for clinical practice.Thus the medical staff will pay more attention to the security of patients, provding more humane, more comprehensive and more effective earring.
Methods
243 cases of six comprehensive hospitals in Shandong province were corresponded from Oct.2009 to Dec.2009, using the questionaire designed by myself on the security level of the patients and the method of convenient sampling.
Results
1.This questionaire on the security level of the patients is well internally consistent with the Cronbach's coefficient alpha being 0.905. The Cronbach's coefficient alpha of five factors is between 0.6-0.9. The factor analysis brought about five common factors with the general variance of 68.98 percent. And each has a comparatively strong factor load on correspond-ing item. This indicates that the scale construction has a good effect.
2. The patients got a security level of 89.07±15.08, which comes between the general and the comparatively security(73～96 points).
3. The five demensions of the security level are (order based on marks) Interpersonal relationship (2.92±0.60), Disease state (3.43±1.07), Hospital environment (3.56±0.99).Caring behaviour(4.45±0.59), and Hospital administ-ration (4.54±0.59)
4. By multiple linear regression analysis, the family income, reasons for choosing hospital, illness time and information of the children will go into the security level linear regression analysis.
Conclusions
1. The questionaire has a good reliability and validity, and it can be applied to the survey of the security level of perioperative patients.
2. The perioperative patients'sense of security is between the ordinary level and the comparatively security. perioperative patients have a high security level generally.
3. The lowest security level of the five demensions is the interpersonal relationship.
4. The security level of the patients can be affected by the family income, reasons for choosing hospital, illness time and information of the children. The higher the family income is, the higher the patients'sense of security is; patients with children have a higher sense of security; patients have a higher sense of security for hospitals with high technology and good reputation and they have a higher sense of security for illness with a short time. This research also found that there is no relationship between patients'sense of security and gender, age occupation and education level.
引文
[1]殷磊,于艳秋.护理学基础[M].北京：人民卫生出版社,2000.26
[2]阿瑟.S.雷伯.心理学词典[M].李伯黍,译.上海：上海译文出版社,1996.765.
[3]王登峰,张伯源.大学生心理卫生与心理咨询[M].北京：北京大学出版社,2000,2-3.
[4]安莉娟,丛中.安全感研究评述[J].中国行为医学科学,2003,12(6)：699.
[5]江绍伦.安全感的建造[M].李伯黍,译.上海：上海译文出版社,1996.765.
[6]杨堂英.北京市流动儿童安全感及其相关因素研究：[硕士学位论文].北京.北京林业大学,2008.
[7]罗文进,王小锋.安全感概念界定、形成过程和改善途径[J].江苏警官学院学报,2004,19(5)：5-9.
[8]康中琴.浅谈手术病人的心理反应及护理措施[J].现代医药卫生,2006,22(2)：294.
[9]毛群燕.手术患者心理护理[J].齐鲁护理杂志,2005,11(7)：891.
[10]Maslow,AHA.Clinically derived test for measuring psychological security-insecurity[J].Journal of General Psychology,1945,31:21.
[11]杨元花.初中生安全感发展的家庭动因研究：[硕士学位论文].湖南.湖南师范大学,2006.
[12]李骊.农村留守儿童安全感发展的学校动因研究：[硕士学位论文].湖南.湖南师范大学,2008.
[13]安莉娟,丛中,王欣.高中生的安全感及其相关因素[J].中国心理卫生杂志,2004,18(10)：717-720.
[14]何雨.城市居民的社区安全感及其多元影响因子—基于南京市玄武区的调查数据[J].特别策划,2004,18(10)：23-26.
[15]王艳芝.河北省幼儿园工作人员的安全感及相关因素[J].中国心理卫生杂志.2007,21(6)：411-414.
[16]丛中,安莉娟.安全感量表.见中国行为医学科学编辑委员会,编.行为医学量表手册.北京：中华医学电子出版社,2005,199-200.
[17]刘玲爽,汤永隆,张静秋,等.5.12地震灾民安全感与PTSD的关系[J].心理科学进展,2009,17(3)：547-550.
[18]陈顺森,叶桂青,陈伟静,等.大学生安全感量表的初步编制[J].中国行为医学科学,2006,15(12)：1142-1143.
[19]沈学武,耿德勤,李梅,等.不安全感自评量表的编制与信度、效度研究[J].中国行为医学科学,2005,14：856-857.
[20]Portney LG, Watkins MP.Foundation of clinical research:application to practice.2nd ed.New Jersey: Prentice-Hall,2002:142-145.
[21]Stevens J. Applied multivariate statistics for the social science.3rd ed. Mahwah, NJ: Lawrence Erlbaum,1996:245.
[22]孙德娟,万学英,张玉璞.老年病房护士关怀照护行为的调查研究[J].护理学杂志,2009,9(3)：36-38.
[23]姜乾金.医学心理学[M].北京：北京科学技术出版社,1993,3-11.
[24]冯雪梅.手术前针对性心理护理的应用[J].中外健康文摘.临床医师,2008(5)138-139.
[25]Jenkins V,Fallowfield L,Saul J.Information needs of patients with cancer results from a large study in UK Cancer Centres[J].Br J cancer,2001,84 (1):48-51.
[26]Qlan YX.Whether should cancer patients know their diagnose or not in Japan[J].Chinese J Nurs,2000,35(3):190-191.
[27]李斌,张莉.3022例住院患者满意度分析[J].新疆医科大学学报,2009,32(9)：1359-1060.
[28]彭卫平,梁立武,彭碧波.医院开展满意度测评的做法与体会[J].中国医报,2008,12(3)：68.
[29]蔡文智.医务人员职业伤害是重要的全球性公共卫生问题[J].中华护理杂志,2009,44(10),881.
[30]杨筱多,姜亚芳,李春等.综合医院护士遭受工作场所暴力现状及影响因素的研究[J].中华护理杂志,2009,44(10)：877-881.
[31]何雪莹,朱海萍,工作场所暴力事件的自我防护[J].国外医学·护理学分册,2003,(06)
[32]王业钊,孙荣国,周亮.建立与完善医院病人满意度测评管理体系[J].现代预防医学,2008,35(13)：2452-2453.
[33]孙国武,谈慧芳,吴海华.探索出院病人回访调查在医院管理中的作用[J]. 中国医院,2008,12(9)：87-89.
[34]李锋.收入对安全感的影响考证[J].统计观察,2007(6)88-90.
[35]王艳芝,王欣,孟海英.收入状况对幼儿教师安全感、社会支持生存质量及幸福感的影响[J].中国行为医学科学,2006,15(2)151-152.
[36]洪善娟.精神科开设家庭化病房试行个性化护理的探讨[J].护士杂志,2002,17(10)：773-774.
[37]沈爱新,钱敏丽.亲人陪护对住院精神病患者康复干预的调查分析[J]解放军护理杂志,2007,24(6)37-38.
[38]黎贵湘,向代群,陈美,等.住院患者对陪护需求的调查分析[J].护士进修杂志,2001,16(2)：76-72.
[39]高明瑞,杨东震.民众就医行为重要影响因素与医院营销之研究—以高雄都会区为例[J].中山管理评论,1995,3(3)：55-73.
[40]毛羽,李春霞.“以病人为中心”对医院实施细节管理[J].医院院长论坛,2008,11(6)：20-22.
[41]陈雄.健康医院环境设计的思考[J].茂名学院学报,2009,19(3)：81-83.
[42]刘阳.健康医院环境初探[J].合肥工业大学学报,2008,31(8)：1237-1240.
[2]阿瑟.S.雷伯.心理学词典[M].李伯黍,译.上海：上海译文出版社,1996.765.
[3]王登峰,张伯源.大学生心理卫生与心理咨询[M].北京：北京大学出版社,2000,2-3.
[4]安莉娟,丛中.安全感研究评述[J].中国行为医学科学,2003,12(6)：699.
[5]江绍伦.安全感的建造[M].李伯黍,译.上海：上海译文出版社,1996.765.
[6]杨堂英.北京市流动儿童安全感及其相关因素研究：[硕士学位论文].北京.北京林业大学,2008.
[7]罗文进,王小锋.安全感概念界定、形成过程和改善途径[J].江苏警官学院学报,2004,19(5)：5-9.
[8]康中琴.浅谈手术病人的心理反应及护理措施[J].现代医药卫生,2006,22(2)：294.
[9]毛群燕.手术患者心理护理[J].齐鲁护理杂志,2005,11(7)：891.
[10]Maslow,AHA.Clinically derived test for measuring psychological security-insecurity[J].Journal of General Psychology,1945,31:21.
[11]杨元花.初中生安全感发展的家庭动因研究：[硕士学位论文].湖南.湖南师范大学,2006.
[12]李骊.农村留守儿童安全感发展的学校动因研究：[硕士学位论文].湖南.湖南师范大学,2008.
[13]安莉娟,丛中,王欣.高中生的安全感及其相关因素[J].中国心理卫生杂志,2004,18(10)：717-720.
[14]何雨.城市居民的社区安全感及其多元影响因子—基于南京市玄武区的调查数据[J].特别策划,2004,18(10)：23-26.
[15]王艳芝.河北省幼儿园工作人员的安全感及相关因素[J].中国心理卫生杂志.2007,21(6)：411-414.
[16]丛中,安莉娟.安全感量表.见中国行为医学科学编辑委员会,编.行为医学量表手册.北京：中华医学电子出版社,2005,199-200.
[17]刘玲爽,汤永隆,张静秋,等.5.12地震灾民安全感与PTSD的关系[J].心理科学进展,2009,17(3)：547-550.
[18]陈顺森,叶桂青,陈伟静,等.大学生安全感量表的初步编制[J].中国行为医学科学,2006,15(12)：1142-1143.
[19]沈学武,耿德勤,李梅,等.不安全感自评量表的编制与信度、效度研究[J].中国行为医学科学,2005,14：856-857.
[20]Portney LG, Watkins MP.Foundation of clinical research:application to practice.2nd ed.New Jersey: Prentice-Hall,2002:142-145.
[21]Stevens J. Applied multivariate statistics for the social science.3rd ed. Mahwah, NJ: Lawrence Erlbaum,1996:245.
[22]孙德娟,万学英,张玉璞.老年病房护士关怀照护行为的调查研究[J].护理学杂志,2009,9(3)：36-38.
[23]姜乾金.医学心理学[M].北京：北京科学技术出版社,1993,3-11.
[24]冯雪梅.手术前针对性心理护理的应用[J].中外健康文摘.临床医师,2008(5)138-139.
[25]Jenkins V,Fallowfield L,Saul J.Information needs of patients with cancer results from a large study in UK Cancer Centres[J].Br J cancer,2001,84 (1):48-51.
[26]Qlan YX.Whether should cancer patients know their diagnose or not in Japan[J].Chinese J Nurs,2000,35(3):190-191.
[27]李斌,张莉.3022例住院患者满意度分析[J].新疆医科大学学报,2009,32(9)：1359-1060.
[28]彭卫平,梁立武,彭碧波.医院开展满意度测评的做法与体会[J].中国医报,2008,12(3)：68.
[29]蔡文智.医务人员职业伤害是重要的全球性公共卫生问题[J].中华护理杂志,2009,44(10),881.
[30]杨筱多,姜亚芳,李春等.综合医院护士遭受工作场所暴力现状及影响因素的研究[J].中华护理杂志,2009,44(10)：877-881.
[31]何雪莹,朱海萍,工作场所暴力事件的自我防护[J].国外医学·护理学分册,2003,(06)
[32]王业钊,孙荣国,周亮.建立与完善医院病人满意度测评管理体系[J].现代预防医学,2008,35(13)：2452-2453.
[33]孙国武,谈慧芳,吴海华.探索出院病人回访调查在医院管理中的作用[J]. 中国医院,2008,12(9)：87-89.
[34]李锋.收入对安全感的影响考证[J].统计观察,2007(6)88-90.
[35]王艳芝,王欣,孟海英.收入状况对幼儿教师安全感、社会支持生存质量及幸福感的影响[J].中国行为医学科学,2006,15(2)151-152.
[36]洪善娟.精神科开设家庭化病房试行个性化护理的探讨[J].护士杂志,2002,17(10)：773-774.
[37]沈爱新,钱敏丽.亲人陪护对住院精神病患者康复干预的调查分析[J]解放军护理杂志,2007,24(6)37-38.
[38]黎贵湘,向代群,陈美,等.住院患者对陪护需求的调查分析[J].护士进修杂志,2001,16(2)：76-72.
[39]高明瑞,杨东震.民众就医行为重要影响因素与医院营销之研究—以高雄都会区为例[J].中山管理评论,1995,3(3)：55-73.
[40]毛羽,李春霞.“以病人为中心”对医院实施细节管理[J].医院院长论坛,2008,11(6)：20-22.
[41]陈雄.健康医院环境设计的思考[J].茂名学院学报,2009,19(3)：81-83.
[42]刘阳.健康医院环境初探[J].合肥工业大学学报,2008,31(8)：1237-1240.