我国循证护理实践中证据应用概念模式的构建
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摘要
目的构建我国循证护理实践中证据应用概念模式。方法采用建构扎根理论的方法对参与我国大陆24项以证据应用为目的的循证护理实践项目的 56名人员进行了非结构式个人深入访谈,首先通过初始编码分析转录资料,然后进行聚焦编码同时收集项目相关文本资料。结果构建了以生根为核心的我国循证护理实践中证据应用过程的概念模式,包括证据应用的过程、影响因素和一线护理管理者推动证据应用的领导力三部分。结论证据应用是一个具有四个阶段的持续循环,证据应用的影响因素需持续评估,并重视护理管理者在证据应用中的作用。来自卫生保健系统中的各个层面的人士需要积极参与循证护理实践,在系统层面营造支持性的氛围,采用有针对性的应用策略,有效并可持续地使循证护理理念和证据内容在系统流程、日常护理实践和护士专业能力发展中生根。
Objective To develop a conceptual model of evidence implementation in nursing practice in China. Methods A grounded theory study using unstructured in-depth individual interviews was conducted with 56 participants involved in 24 evidence-based nursing implementation projects in Mainland China. Projects related documents were also collected. Transcribed data were analyzed first by initial coding,and then focal coding with constant comparison was processed. Results A model with the core " taking root" was developed to describe evidence implementation in nursing practice in China. This model included three components,including the evidence implementation process,influencing factors and Chinese nursing managers' leadership practice to promote evidence implementation. Conclusion evidence implementation is a sustaining cycle of 4 stages. The influencing factors requires persistent evaluation,and the role of nursing managers should be prized. Involvement of various levels of the healthcare workers in evidence implementation process should be encouraged. With the help of a supportive system,and targeted strategies,the concept of evidence-based nursing and evidence itself will be able to effectively and sustainably " take root" in the system,in daily caring work,as well as in nurses' professional development.
Objective To develop a conceptual model of evidence implementation in nursing practice in China. Methods A grounded theory study using unstructured in-depth individual interviews was conducted with 56 participants involved in 24 evidence-based nursing implementation projects in Mainland China. Projects related documents were also collected. Transcribed data were analyzed first by initial coding,and then focal coding with constant comparison was processed. Results A model with the core " taking root" was developed to describe evidence implementation in nursing practice in China. This model included three components,including the evidence implementation process,influencing factors and Chinese nursing managers' leadership practice to promote evidence implementation. Conclusion evidence implementation is a sustaining cycle of 4 stages. The influencing factors requires persistent evaluation,and the role of nursing managers should be prized. Involvement of various levels of the healthcare workers in evidence implementation process should be encouraged. With the help of a supportive system,and targeted strategies,the concept of evidence-based nursing and evidence itself will be able to effectively and sustainably " take root" in the system,in daily caring work,as well as in nurses' professional development.
引文
[1]Cheng L,Feng S,Hu Y.Evidence-based nursing implementation in Mainland China:a scoping review[J].Nurs Outlook,2017,65(1):27-35.
[2]Charmaz K.Constructing grounded theory[M].London:Thousand Oaks,Calif:Sage,2014:109-161.
[3]Graham I D,Logan J,Harrison M B,et al.Lost in knowledge translation:time for a map?[J].J Contin Educ Health Prof,2006,26(1):13-24.
[4]Titler M G,Kleiber C,Steelman V J,et al.The Iowa Model of Evidence-Based Practice to Promote Quality Care[J].Crit Care Nurs Clin North Am,2001,13(4):497-509.
[5]Kristensen N,Nymann C,Konradsen H.Implementing research results in clinical practice-the experiences of healthcare professionals[J].BMC Health Serv Res,2016,16:48.
[6]Stetler C B,Ritchie J A,Rycroft-Malone J,et al.Leadership for evidence-based practice:strategic and functional behaviors for institutionalizing EBP[J].Worl-dviews Evid Based Nurs,2014,11(4):219-226.
[7]Taylor M V,Priefer B A,Alt-White A C.Evidence-based practice:embracing integration[J].Nurs Outlook,2016,64(6):575-582.
[8]韩柳,晏利姣,姜雨婷,等.PARIHS循证概念框架的演变及其应用思考[J].护理学杂志,2017,32(9):84-86.
[9]Solomons N M,Spross J A.Evidence-based practice barriers and facilitators from a continuous quality improvement perspective:an integrative review[J].J Nurs Ma-nag,2011,19(1):109-120.
[10]Kath L M,Stichler J F,Ehrhart M G,et al.Predictors of nurse manager stress:a dominance analysis of potential work environment stressors[J].Int J Nurs Stud,2013,50(11):1474-1480.
[11]Delury J."Harmonious"In China[J].Policy Review,2008(148):35-44.
[12]Farh J,Cheng B.A Cultural analysis of paternalistic leadership in chinese organizations[M]//Li J T,Tsui A S,Weldon E.Management and organizations in the Chinese context.London:Palgrave Macmillan,2000:84-127.
[13]Holroyd E,Cheung Y K,Cheung S W,et al.A Chinese cultural perspective of nursing care behaviours in an acute setting[J].J Adv Nurs,1998,28(6):1289-1294.
[2]Charmaz K.Constructing grounded theory[M].London:Thousand Oaks,Calif:Sage,2014:109-161.
[3]Graham I D,Logan J,Harrison M B,et al.Lost in knowledge translation:time for a map?[J].J Contin Educ Health Prof,2006,26(1):13-24.
[4]Titler M G,Kleiber C,Steelman V J,et al.The Iowa Model of Evidence-Based Practice to Promote Quality Care[J].Crit Care Nurs Clin North Am,2001,13(4):497-509.
[5]Kristensen N,Nymann C,Konradsen H.Implementing research results in clinical practice-the experiences of healthcare professionals[J].BMC Health Serv Res,2016,16:48.
[6]Stetler C B,Ritchie J A,Rycroft-Malone J,et al.Leadership for evidence-based practice:strategic and functional behaviors for institutionalizing EBP[J].Worl-dviews Evid Based Nurs,2014,11(4):219-226.
[7]Taylor M V,Priefer B A,Alt-White A C.Evidence-based practice:embracing integration[J].Nurs Outlook,2016,64(6):575-582.
[8]韩柳,晏利姣,姜雨婷,等.PARIHS循证概念框架的演变及其应用思考[J].护理学杂志,2017,32(9):84-86.
[9]Solomons N M,Spross J A.Evidence-based practice barriers and facilitators from a continuous quality improvement perspective:an integrative review[J].J Nurs Ma-nag,2011,19(1):109-120.
[10]Kath L M,Stichler J F,Ehrhart M G,et al.Predictors of nurse manager stress:a dominance analysis of potential work environment stressors[J].Int J Nurs Stud,2013,50(11):1474-1480.
[11]Delury J."Harmonious"In China[J].Policy Review,2008(148):35-44.
[12]Farh J,Cheng B.A Cultural analysis of paternalistic leadership in chinese organizations[M]//Li J T,Tsui A S,Weldon E.Management and organizations in the Chinese context.London:Palgrave Macmillan,2000:84-127.
[13]Holroyd E,Cheung Y K,Cheung S W,et al.A Chinese cultural perspective of nursing care behaviours in an acute setting[J].J Adv Nurs,1998,28(6):1289-1294.