主管:国家卫生健康委员会
主办:国家卫生健康委医院管理研究所
中国科技核心期刊(中国科技论文统计源期刊)
中国科学引文数据库(CSCD)核心库期刊
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中国护理管理 ›› 2026, Vol. 26 ›› Issue (4): 587-593.doi: 10.3969/j.issn.1672-1756.2026.04.020

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临床护士共享决策知信行现状及影响因素的混合研究

马静 毕敏 贾微 徐敏 李嫣然 姚丽   

  1. 宁夏医科大学总医院产科,750004 银川市(马静);宁夏医科大学总医院心血管内科(毕敏,姚丽);宁夏医科大学护理学院(马静,贾微,徐敏,李嫣然)
  • 出版日期:2026-04-15 发布日期:2026-04-15
  • 通讯作者: 姚丽,硕士,副主任护师,护士长,E-mail:13995088029@163.com
  • 作者简介:马静,硕士在读,护师
  • 基金资助:
    宁夏医科大学科学研究资助项目(XY2024012)

Knowledge, Attitudes, and Practices toward Shared Decision-Making among clinical nurses and their influencing factors: a mixed methods study

MA Jing, BI Min, JIA Wei, XU Min, LI Yanran, YAO Li   

  1. Obstetrical Department, General Hospital of Ningxia Medical University, Yinchuan, 750004, China
  • Online:2026-04-15 Published:2026-04-15
  • Contact: E-mail:13995088029@163.com

摘要: 目的:调查临床护士共享决策知信行的现状及影响因素,为制定共享决策方案提供依据。方法:基于聚敛式混合研究设计,使用分阶段多层抽样法,于2024年7月对宁夏回族自治区13家医院898名护士使用一般资料调查表及共享决策问卷展开调查;同期,采用描述性质性研究方法,使用目的抽样法,选取10名护士进行半结构式访谈。结果:临床护士共享决策问卷总分为97.00(96.00,117.00)分,得分率为80.8%。广义线性模型分析结果显示,临床护士年龄、职务、所在医院等级、医院所在市及是否了解患者决策辅助工具是共享决策知信行水平的影响因素(均P<0.05)。质性研究共提炼出临床护士对共享决策的认知及实施态度呈现差异化及护士参与共享决策的制约因素2个主题(临床护士对共享决策的认知及实施态度呈现差异化、护士参与共享决策的制约因素)及6个亚主题。结论:临床护士共享决策知信行整体处于中等偏上水平,其表现受到个体特征、环境条件及工具支持等多维因素的综合影响。

关键词: 共享决策;知信行;临床护士;影响因素

Abstract: Objective: To investigate the current status and influencing factors of clinical nurses' Knowledge, Attitude, and Practice (KAP) regarding Shared Decision-Making (SDM) and to provide a basis for the development of SDM implementation strategies. Methods: A convergent mixed-methods design was adopted. Using convenience sampling, a total of 898 nurses from 13 hospitals in Ningxia Hui Autonomous Region were surveyed in July 2024 with a general information questionnaire and the SDM Questionnaire. Simultaneously, a descriptive qualitative study was conducted, in which 10 nurses were selected through purposive sampling for semi-structured interviews. Results: The score of nurses' SDM-KAP was 97.00 (96.00, 117.00), with a scoring rate of 80.8%. Generalized linear model analysis showed that nurses' age, professional position, hospital level, city of hospital location, and awareness of patient decision aids were significant factors influencing SDM-KAP levels (all P<0.05). Qualitative analysis yielded two themes and six subthemes regarding the cognitive and implementation attitudes of clinical nurses towards shared decision-making, as well as the constraints on nurses' participation in shared decision-making. Conclusion: The overall level of SDM-KAP among clinical nurses in this region was moderately high, and was influenced by multiple factors, including individual characteristics, environmental conditions, and tool support.

Key words: Shared Decision-Making; Knowledge, Attitude and Practice; clinical nurse; influencing factor

中图分类号:  R47;R197