本科实习护生转型冲击现状及其影响因素分析

潘倩文; 许栋; 王茜

doi:10.16766/j.cnki.issn.1674-4152.003350

本科实习护生转型冲击现状及其影响因素分析

doi: 10.16766/j.cnki.issn.1674-4152.003350

蚌埠医学院护理学院，安徽蚌埠 233000

基金项目:

安徽省教学研究项目 2018jyxm0856

详细信息

通讯作者:
王茜，E-mail：847202583@qq.com

中图分类号: R192
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- 文章访问数: 96
- HTML全文浏览量: 27
- PDF下载量: 7
- 被引次数: 0
出版历程
- 收稿日期: 2023-01-05
- 网络出版日期: 2024-03-09

Analysis of the impact level and influencing factors on the transition of undergraduate nursing students

School of Nursing, Bengbu Medical College, Bengbu, Anhui 233000, China

摘要

摘要: 目的调查本科实习护生的转型冲击现状，探讨其影响因素，分析本科实习护生在转型过程中存在的问题，为制定有针对性的干预方案提供依据。方法采用便利抽样方法, 于2021年7月—2022年3月选取安徽省3所高校256名全日制本科实习护生为研究对象，以Meleis过渡理论为理论框架，使用一般资料问卷、护理本科实习生转型冲击评价量表及护理专业自我概念量表对其进行调查。采用t检验对不同性别、生源地、是不是独生子女等进行分析，采用方差分析对不同填报志愿原因、在校学习成绩等的转型冲击得分差异进行比较，采用多元逐步回归法分析本科实习护生转型冲击的影响因素。结果 256名本科实习护生转型冲击得分为(48.51±1.71)分；专业自我概念得分为(82.56±9.77)分；不同的填报志愿原因、专业满意程度、岗前培训时长、学校关心程度、毕业后职业规划的转型冲击得分差异均有统计学意义(P < 0.05)；Pearson相关分析结果显示，本科实习护生转型冲击总分与专业自我概念总分呈负相关关系(r=-0.405，P < 0.01)。多元线性回归分析结果表明，本科实习护生专业满意度、岗前培训时长、实习期间学校的关心程度及实习护生的专业自我概念水平均是影响本科实习护生转型冲击水平的因素(P < 0.05)。结论本科实习护生转型冲击处于中高水平，在实习护生管理中可通过提高实习护生的专业概念水平、学校的关心程度、专业满意度，适当安排岗前培训等措施降低实习护生的冲击水平。
- 转型冲击 /
- 本科实习护生 /
- 问卷调查 /
- 专业自我概念
Abstract: Objective To investigate the current situation of transition shock of undergraduate nursing students and explore influencing factors: an analyze of challenges in the transformation process to inform targeted intervention programs. Methods A total of 256 full-time undergraduate nursing interns from 3 colleges and universities in Anhui Province were selected as research objects by convenient sampling method. The study was conducted from July 2021 to March 2022. The research utilized the theoretical framework of Meleis transition theory and employed a general data questionnaire, transition impact assessment scale for undergraduate nursing interns, and nursing self-concept scale to collect data. The independent sample t-test was used to analyze gender differences, differences based on place of origin, and whether the student was the only child. Variance analysis was used to compare the transformation impact scores, such as reasons for filling out voluntary applications and academic performance in school. The multiple step-up regression method was utilized to analyze the influencing factors of the transformation impact experienced by undergraduate nursing students. Results The mean transition impact score for undergraduate nursing students was found to be 48.51±1.71. Additionally, the professional self-concept score was determined to be 82.56±9.77. Statistical analysis showed significant differences in the transformation impact scores based on various factors, including reasons for volunteering, professional satisfaction, pre-job training duration, school concern, and post-graduation career planning (P < 0.05). Furthermore, Pearson correlation analysis demonstrated a negative correlation between the total transformation impact score of undergraduate nursing interns and the total professional self-concept score (r=-0.405, P < 0.01). Multiple stepwise regression analysis identified professional satisfaction, pre-job training duration, the level of school support during the internship, and the professional self-concept of nursing students as significant factors influencing the level of transition impact experienced by undergraduate nursing students (P < 0.05). Conclusion The impact level of transition experienced by undergraduate nursing students is moderately high. To effectively manage nursing students and mitigate the impact level of their transition, several measures can be implemented. These include enhancing their professional concept, increasing the level of school support and concern, improving professional satisfaction, and appropriately arranging pre-job training.
- Transition shock /
- Practice nursing students /
- Questionnaire survey /
- Professional self-concept

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表 1 本科实习护生转型冲击各维度得分

Table 1. Scores of undergraduate nursing students in various dimensions of transformation impact

维度	得分(x±s，分)	得分率(%)
理论与实践冲突	7.84±1.50	65.33
工作量大	9.14±1.63	76.17
社会支持缺失	5.15±1.27	64.38
人际关系	7.97±1.67	66.42
护理价值观困惑	13.64±2.73	68.20
实习与个人生活不协调	4.76±1.18	59.50
总分	48.51±1.71	66.88

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表 2 本科实习护生专业自我概念各维度得分

Table 2. Professional self-concept scores of undergraduate nursing students

维度	得分(x±s，分)	得分率(%)
领导	11.03±1.88	68.94
技能	14.94±2.32	74.70
灵活性	20.42±3.29	72.93
满意度	22.85±3.87	63.47
沟通交流	13.32±1.71	66.60
总分	82.56±9.77	68.80

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表 3 不同特征的本科实习护生转型冲击水平得分比较(n=256)

Table 3. Comparison of transformation impact scores of undergraduate nursing interns with different characteristics (n=256)

项目	人数(%)	得分(x±s，分)	统计量	P值
性别			0.276^a	0.783
男性	40(15.6)	48.23±6.60
女性	216(84.4)	48.56±7.26
独生子女			0.046^a	0.963
是	45(17.6)	48.47±6.73
否	211(82.4)	48.52±7.25
生源地			1.277^a	0.203
农村	187(73.0)	48.17±6.99
城镇	69(27.0)	49.45±7.53
填报志愿原因			3.556^b	0.015
自愿选择	107(41.8)	46.86±7.11
父母选择	36(14.1)	49.19±7.11
就业影响	43(16.8)	50.33±6.72
高考调剂	70(27.3)	49.57±7.09
专业满意程度			18.354^b	< 0.001
满意	31(12.1)	44.52±8.75
一般	192(75.0)	48.15±5.96
不满意	33(12.9)	54.36±8.44
在校学习成绩			0.432^b	0.650
优秀	72(28.1)	47.86±7.11
良好	142(55.5)	48.71±7.35
一般	42(16.4)	48.95±6.58
岗前培训时长(d)			6.061^b	0.003
0	55(21.5)	49.02±6.75
1~3	144(56.3)	47.29±6.91
≥4	57(22.3)	51.03±7.47
学校关心程度			8.059^b	< 0.001
很多	147(57.4)	47.14±6.63
一般	88(34.4)	49.82±6.73
较少	21(8.2)	52.62±9.70
毕业后职业规划			7.977^b	< 0.001
考研	70(27.3)	50.09±6.80
从事护理工作	162(63.3)	47.10±6.92
转行	13(5.1)	54.85±6.43
其他	11(4.3)	51.73±7.03
注：^a为t值，^b为F值。

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表 4 本科实习护生转型冲击各维度及总分与专业自我概念的相关性分析结果(r值)

Table 4. Correlation analysis results between the dimensions, total score of transformation impact and professional self-concept in undergraduate nursing students (r value)

项目	转型冲击总分	理论与实践冲突	工作量大	社会支持缺失	人际关系	护理价值观困惑	实习与个人生活不协调
专业自我概念总分	-0.405^a	-0.165^a	-0.221^a	-0.146^b	-0.343^a	-0.449^a	-0.257^a
领导	-0.172^a	-0.231^a	-0.160	-0.033	-0.222^a	-0.108	-0.124^b
技能	-0.188^a	-0.102	-0.075	0.260	-0.186^a	-0.243^a	-0.104
灵活性	-0.247^a	-0.105	-0.124^b	-0.056	-0.259^a	-0.276^a	-0.136^b
满意度	-0.508^a	-0.101	-0.378^a	-0.234^a	-0.346^a	-0.610^a	-0.275^a
沟通交流	-0.284^a	-0.135^b	-0.074	-0.197^a	-0.224^a	-0.260^a	-0.318^a
注：^aP < 0.01，^bP < 0.05。

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表 5 自变量赋值情况

Table 5. Assignment methods of argument variables

变量	赋值方法
填报志愿原因	自愿选择=(0，0，0)，父母选择=(1，0，0)，就业影响(0，1，0)，高考调剂(0，0，1)；以自愿选择为对照。
专业满意度	满意=1，一般=2，不满意=3
岗前培训时长	没有培训=1, 1~3 d=2, ≥4 d=3
学校关心程度	较多=1，一般=2，很少=3
职业规划	从事护理工作=(0，0，0)，考研=(1，0，0)，转行=(0，1，0)，其他=(0，0，1)；以从事护理工作为对照

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表 6 本科实习护生转型冲击影响因素的多元线性回归分析结果

Table 6. Multiple linear regression analysis of the influencing factors of transition impact in undergraduate nursing students

变量	B	SE	β	t值	P值
专业满意度	2.776	0.882	0.195	3.149	0.002
实习期间学校关心	1.641	0.640	0.148	2.565	0.011
岗前培训时长	1.201	0.596	0.596	2.017	0.045
护理专业自我概念	-0.220	0.044	-0.300	-4.987	< 0.001

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参考文献(16)

[1]	BIJANI M, MOHAMMADI F, HAGHANI F, et al. Development and psychometric evaluation of a reflection on clinical practice questionnaire for nursing students[J]. BMC nursing, 2021, 20(1): 201-211. doi: 10.1186/s12912-021-00719-8
[2]	AL-GAMAL E, ALHOSAIN A, ALSUNAYE K. Stress and coping strategies among Saudi nursing students during clinical education[J]. Perspect Psychiatr C, 2018, 54(2): 198-205. doi: 10.1111/ppc.12223
[3]	DUCHSCHER J E. Transition shock: the initial stage of role adaptation for newly graduated registered nurses[J]. J Adv Nurs, 2009, 65(5): 1103-1113. doi: 10.1111/j.1365-2648.2008.04898.x
[4]	REZAPOUR-MIRSALEH Y, AGHABAGHERI M. The relationship between personality dimensions, spirituality, coping strategies and clinical clerkship satisfaction among intern nursing students: a cross-sectional study[J]. BMC Nursing, 2020, 19(1): 191-199.
[5]	林敏, 朱佳楠, 陈京立. 过渡理论在出院护理实践领域的应用及研究进展[J]. 护士进修杂志, 2020, 35(23): 2141-2145. https://www.cnki.com.cn/Article/CJFDTOTAL-FSJX202023007.htm LIN M, ZHU J N, CHEN J L. Application and research progress of transition theory in discharge nursing practice[J]. Journal of Nurses Training, 2020, 35(23): 2141-2145. https://www.cnki.com.cn/Article/CJFDTOTAL-FSJX202023007.htm
[6]	KIM S Y, SHIN Y S. Validity and reliability of the transition shock scale for undergraduate nursing students[J]. J Korean Acad Soc Nurs Educ, 2019, 25(1): 17-26. doi: 10.5977/jkasne.2019.25.1.17
[7]	黄雨萱, 牟绍玉, 朱佳露, 等. 护理本科实习生转型冲击评价量表的汉化及信效度检验[J]. 中华护理教育, 2021, 18(8): 727-732. doi: 10.3761/j.issn.1672-9234.2021.08.012 HUANG Y X, MOU S Y, ZHU J L, et al. The Sinicization and reliability and validity test of the transition Impact Assessment Scale for nursing undergraduate interns[J]. Chinese Journal of Nursing Education, 2021, 18(8): 727-732. doi: 10.3761/j.issn.1672-9234.2021.08.012
[8]	张悦, 戴艺, 田莹, 等. 多民族高原地区低年资护士专业自我概念现状及影响因素分析[J]. 护理学报, 2022, 29(20): 50-54. https://www.cnki.com.cn/Article/CJFDTOTAL-NFHL202220008.htm ZHANG Y, DAI Y, TIAN Y, et al. Analysis on the Status quo and Influencing Factors of Professional Self-concept of junior nurses in Multi-ethnic Plateau area[J]. Journal of Nursing, 2022, 29(20): 50-54. https://www.cnki.com.cn/Article/CJFDTOTAL-NFHL202220008.htm
[9]	THOMAS D, MERRILL K. Meeting theory-to-practice gaps? Evaluation of new graduates[J]. J Nurses Prof Dev, 2022, 14(5): 20-24.
[10]	张媛媛, 章雅青, 钱萍, 等. 新护士一年内工作压力的纵向研究[J]. 中国护理管理, 2017, 17(11): 1517-1521. doi: 10.3969/j.issn.1672-1756.2017.11.017 ZHANG Y Y, ZHANG Y Q, QIAN P, et al. Longitudinal study on job stress of new nurses in one year[J]. China Nursing Management, 2017, 17(11): 1517-1521. doi: 10.3969/j.issn.1672-1756.2017.11.017
[11]	滑婧夷. 某校护理本科生创新行为现状及其影响因素分析[D]. 长春: 长春中医药大学, 2022. HUA J Y. Analysis of Innovative Behavior of Nursing Undergraduates in a school and its Influencing Factors[D]. Changchun: Changchun University of Traditional Chinese Medicine, 2022.
[12]	杨从艳, 李静, 周小梅, 等. 实习护生临床实习适应能力的影响因素分析及教学提升策略[J]. 中华全科医学, 2022, 20(11): 1950-1953. doi: 10.16766/j.cnki.issn.1674-4152.002744 YANG C Y, LI J, ZHOU X M, et al. Analysis on Influencing Factors of Clinical Practice Adaptability of nursing students and teaching improvement strategies[J]. Chinese Journal of General Practice, 2022, 20(11): 1950-1953. doi: 10.16766/j.cnki.issn.1674-4152.002744
[13]	SALIFU D A, GROSS J, SALIFU M A, et al. Experiences and perceptions of the theory-practice gap in nursing in a resource-constrained setting: a qualitative description study[J]. Nurs Open, 2019, 6(1): 72-83. doi: 10.1002/nop2.188
[14]	WANG M, GUAN H, LI Y, et al. Academic burnout and professional self-concept of nursing students: a cross-sectional study[J]. Nurse Educ Today, 2019, 77(11): 27-31.
[15]	毕亚平, 牟绍玉. 护理硕士专业学位研究生专业自我概念对患者安全态度和职业素养的影响[J]. 解放军护理杂志, 2021, 38(1): 5-8, 12. https://www.cnki.com.cn/Article/CJFDTOTAL-JFHL202101002.htm BI Y P, MOU S Y. Effect of Professional Self-concept on patient safety attitude and professional quality of nursing master degree students[J]. PLA Nursing Journal, 2021, 38(1): 5-8, 12. https://www.cnki.com.cn/Article/CJFDTOTAL-JFHL202101002.htm
[16]	何亚林, 杜娟, 周莉, 等. 本科实习护生的社会支持和成就动机在其自主学习准备度与问题解决能力间的中介作用[J]. 护理学报, 2021, 28(8): 50-55. https://www.cnki.com.cn/Article/CJFDTOTAL-NFHL202108015.htm HE Y L, DU J, ZHOU L, et al. The Mediating Role of Social Support and Achievement Motivation in the Relationship between independent Learning Readiness and problem solving ability of undergraduate nursing students[J]. Journal of Nursing, 2021, 28(8): 50-55. https://www.cnki.com.cn/Article/CJFDTOTAL-NFHL202108015.htm