【原】亚急性医院环境中久坐行为的护理观点：一项混合研究

AUTUMN

2021

混合研究设计之解释性研究设计：

研究者先收集量化数据来建构研究主题的整体框架,然后收集质性数据以帮助解释量化数据的结果。

例如,对于研究生新生人学适应的问题,可以先用测验法了解适应程度,然后再选取适应得很好和很差的极端被试进行访谈,探寻背后的影响因素。

Hills, D., Ekegren, C., Plummer, V., Freene, N., Kunstler, B., Robinson, T., Healy, E., Vo, J., Gasevic, D., & Crabtree, A. (2021). Nursing perspectives on reducing sedentary behaviour in sub-acute hospital settings: A mixed methods study. Journal of Clinical Nursing, 00, 1– 14. 

https:///10.1111/jocn.15994

亚急性医院环境中久坐行为的护理观点：一项混合研究

Aim and objectives To determine the factors influencing nurses’ decisions and capacity to reduce sedentary behaviour in hospital inpatients in sub-acute hospital settings.

研究目的：确定亚急性医院环境中影响护士减少住院病人久坐行为的决策和能力的因素。

Background Sedentary behaviour in hospital inpatients is a complex issue that can be resistant to resolution. There is little research investigating factors influencing nurses’ promotion of reduced levels of sedentary behaviour in sub-acute hospital settings.

研究背景：住院病人的久坐行为是一个复杂的问题，可能难以解决。在亚急性医院环境中，很少有研究调查影响护士促进减少久坐行为水平的因素。

Design An explanatory sequential design was employed, comprising quantitative and qualitative phases.

研究设计：采用解释性顺序设计，包括定量和定性阶段。

Methods An online survey was conducted with a convenience sample of 138 nurses from five Australian states. Logistic regression modelling identified demographic and behavioural characteristics of nurses who often encouraged patients to reduce their sedentary behaviour. In-depth interviews were conducted with 11 ward nurses and nurse managers, with the content subjected to thematic analysis. STROBE and GRAMMS checklists were employed.

研究方法：（1）采用线性调查，收集澳大利亚5个州的138名护士，关于久坐行为的决策和能力的因素。（2）对11名病房护士和护士长进行了深入访谈，并对访谈内容进行了主题分析。

Results Nurses recognised their role in promoting reduced sedentary behaviour but faced a range of personal and organisational barriers in achieving this outcome for patients. Few nurses were aware of national physical activity and sedentary behaviour guidelines. Five themes emerged from interviews (nursing role, care challenges, expectations of advocates, teamwork and improving the experience). Overall, many nurses experienced a lack of agency in promoting reduced sedentary behaviour and cognitive dissonance in feeling unable to undertake this role.

研究结果：（1）护士意识到自身在促进减少护士久坐行为方面的角色作用；但面临一些列的个人和组织等阻碍因素。（2）很少有护士知晓国家体育活动和就做行为等指南。（3）提炼五个主题：护士角色、护理挑战、倡导者期望、团队合作和改善体验。

总的来说，许多护士在促进减少久坐行为和感觉无法承担这一角色的认知失调方面缺乏能动性。

Conclusions The results of this study are significant in confirming that reducing sedentary behaviour in hospital inpatients is influenced by a range of complex and multi-level factors. There is a fundamental need for organisational and clinical leadership in building a culture and climate in which staff feel empowered to promote reduced sedentary behaviour in their patients.

研究结论：这项研究的结果对证实减少住院病人久坐行为受到一系列复杂和多层次因素的影响具有重要意义。建立一种文化和氛围，使医务人员感到有能力促进减少患者久坐行为，这是组织和临床领导的根本需要。

Relevance to clinical practice The results of this study highlight the importance of taking action to reduce sedentary behaviour in sub-acute hospital settings. A co-design approach to developing interventions in local health services is warranted.

对临床实践的意义：这项研究的结果强调了在亚急性医院环境中采取行动减少久坐行为的重要性。有必要在地方医疗服务中采取共同设计的方法来制定干预措施。