A Study On Investigation And Intervention Of Humanistic Care Ability Of Operating Room Nurses

ObjectivesTo understand the status of humanistic care ability of operating room nurses,and to analyze the influence factors of humanistic care ability of operating room nurses.To explore the effectiveness of narrative pedagogy in improving humanistic care ability of operating room nurses,and provide a reference for clinical managers to implement relevant training.Methods1.Investigation research:(1)Qualitative research: Using the purposive sampling method,15 operating room nurses were selected for in-depth interviews to explore the real experience and feelings of the operating room nurses implementing humanistic care.Use the phenomenological approach to collect and analyze data,and summarize themes and topics at all levels.(2)Quantitative research: Basing on the domestic literature,the questionnaire of the “Questionnaire on Humanistic Care Competence Level and Impact Factors for Operating Room Nurses” was revised and applied to investigate 255 operating room nurses who worked in three provincial general hospitals and two municipal hospitals from May 2018 to June 2018 by using the convenience sampling method.197 surgical patients from three provincial general hospitals and two municipal hospitals in Fuzhou were selected as survey subjects from August 2018 to September 2018 by using the convenient sampling method.The Chinese version of the “Caring Behaviors Inventory’’ was used.The survey data was entered using SPSS25.0 by two persons.The normal data was analyzed using t-test and analysis of variance.Use multiple stepwise regression analysis to analyze the influencing factors of the humanistic care ability of nurses in the operating room.2.Intervention researchFrom June 2020 to July 2020,70 operating room nurses from a tertiary general hospital were included in the study.The study subjects were randomly divided into two groups to carry out humanistic care training in surgical specialty,the intervention group(n=33)was trained by narrative teaching method,and the control group(n=29)was trained by conventional lecture teaching method.The training lasted 8 weeks in total,1 time per week,1 hour each time.Before and after the training,the two groups filled out the “Questionnaire on Humanistic Care Ability of Operating Room Nurses”,the “Questionnaire on Humanistic Care Ability of Nurses”,the “Evaluation Form of Nurses’ Caring Behavior”,and the “Evaluation Form of Empathy”.After the eighth week of the training,both groups filled out the "Satisfaction Evaluation Questionnaire for Teaching Activities".In addition,the intervention group wrote a reflection diary after the training..The collected data were processed by spss25.0 statistical software.The normal data was analyzed by independent samples t test,paired t test and χ~2 test.While Mann-Whitney U test and Wilcoxon test were employed to analyze non-normal data.Result1.Results of qualitative researchThree themes can be extracted from the humanistic care experience of nurses in operating room,which can be listed as follow: the perception of humane care,the practical elements of humanistic care nursing,and the influencing factors of humanistic care nursing.The connotation has three sub-themes: providing comprehensive care at the psychological,social and disease levels,expanding to the patients’ families as the target of care services and providing continuous care during perioperative period.The practical elements have three sub-themes: communicative care,personalized care and emotional care.The influencing factors have three sub-themes: clinical objective factors,nurses’ own factors,training and education factors.2.Results of quantitative research(1)Nurses:1)Humanistic care ability of operating room nurses was at a medium level,with a total score of 128.35±15.57 and a score rate of 71.3%.The three dimensions with a higher score rate can be listed as humane altruism values(20.06 ±2.77,the scoring rate was 83.6%),promotion of emotional communication(16.44± 2.57,the scoring rate was 82.2%)and health education(22.41±3.61,the scoring rate was 80.0%).The three dimensions with a lower score rate can be listed as providing a good environment(6.50±3.95,the scoring rate was 32.5%),helping to relieve difficulties(10.32±3.56,the scoring rate was 51.6%)and assistance in meeting basic needs(12.09±1.76,the scoring rate was 75.6%).2)Different birthplaces,ages,working seniorities,political outlooks,religious beliefs,marital statues and other social demographic factors,as well as receiving the education of humanistic care knowledge or not,were the factors that influent humanistic care ability of operating room nurses.The differences were statistically significant(P<0.05).(2)Patients:The total average score of items evaluated by surgical patients on operating room nurses’ caring behavior was 5.23±0.74,and the score rate was 87.1%.Meanwhile,The knowledge and skill dimensions have an average score of 5.39±0.77 and the scoring rate was 89.8%.The support and guarantee dimensions have an average score of5.25±0.86 and The respect and connection dimensions have an average score of5.14±0.76 and the scoring rate was 87.1%.2.Results of intervention research(1)The baseline results before interventionA total of 70 nurses were included and 62 nurses finished the training.33 in the intervention group and 29 in the control group.There was no significant differences in the baseline characteristics,humanistic care ability,nursing care behavior and empathy ability between intervention group and control group before intervention(P>0.05).(2)The results after intervention1)There was no significant difference in the total scores of humanistic care ability between the intervention group and control group(P> 0.05).While the score of humanistic care ability was significantly improved after narrative training.There are statistically significant differences in scores in the three dimensions of "assisting to meet basic needs","helping to solve difficulties" and "providing a good environment"(P<0.05).The score of "cognition" dimension of Caring Ability Inventory in the intervention group after training was higher than that before the training(P< 0.05).2)There was no statistically significant difference in the care behavior score between the intervention group and the control group(P>0.05).However the sore of care behavior score was significantly improved after the training(P< 0.05)."knowledge and skills" dimension in the intervention group was significantly higher than that before the training(P< 0.05).3)After the training,the empathy score of the intervention group was higher than that of the control group,the difference was statistically significant(P< 0.05).The scores of the three dimensions of "opinion taking","emotional care" and "empathy" in the intervention group were higher than those before the training,the difference was statistically significant(P<0.05).There was a positive correlation between humanistic care ability and humanistic care empathy ability(r=0.421,P<0.001).4)The teaching satisfaction score of the intervention group was higher than that of the control group,and the difference was statistically significant(P<0.05).In the intervention group,the scores of "class content meets demand","active participation in class","classroom learning atmosphere" and "teaching method" were higher than those of the control group,and the differences were statistically significant(P<0.05).(2)Refining results of reflective diaryAfter the training,the intervention group wrote a reflection diary with the theme of "humanistic care",and reviewed and self-reflection on the clinical practice of humanistic care.1)Humanistic care in the operating room was embodied in the warm attitude of receiving patients,providing verbal care,paying attention to patient privacy protection,and caring for patients’ family members.2)Use empathy skills and empathy in humanistic care nursing.3)The nurses have insufficient knowledge of humanistic care.4)Managers should pay attention to the professional care of nurses.Conclusion(1)Operating room nurses had certain experience and recognition of the perception,clinical practice elements and influencing factors of humanistic care.However,the humanistic care ability of operating room nurses was only at a moderate level and needed to be improved.Different birthplaces,ages,working seniorities,political outlooks,religious beliefs,marital statues and other social demographic factors,as well as receiving the education of humanistic care knowledge or not,working hours,working pressure and human resources in operating room were influencing factors of the humanistic care ability and the implementation of care behavior of the operating room nurses.(2)Surgical patients have a high evaluation of the care of the operating room nurses’ operational behaviors(injection,skills,etc.);while they have a low evaluation of the care of the operating room nurses’ expressive behaviors(emotional talk,companionship,etc.).(3)Narrative pedagogy is feasible in the training teaching of operating room nurses,which can effectively improve the level of humanistic care ability and empathy ability of operating room nurses.