Current Status Of Clinical Decision-making Ability And Its Correlation With Self-efficacy And Coping Style In Undergraduate Nursing Students

Objective:1.To understand the status of clinical decision-making ability,self-efficacy and coping style of undergraduate nursing students at the end of the year.2.Analyze the factors that affecting the clinical decision-making ability of undergraduate nursing students.3.To explore the correlation between clinical decision-making ability and self-efficacy and coping styles of undergraduate nursing students,and provide a scientific theoretical basis for undergraduate nursing students to improve their clinical decision-making ability from the perspective of clinical and educational combination.Methods:This study mainly includes two parts.The first part: qualitative interview.Through the purposeful sampling method,10 undergraduate nursing students in two top three hospitals in Shandong Province were selected for internship for more than 8 months,and the factors related to clinical decision-making ability of nursing students were extracted by phenomenological analysis.The second part: quantitative research.To practice more than 8 months of the undergraduate nursing students as the research object,in March 2017-2017 year in July,take random cluster sampling method,from a general hospital in Shandong province were randomly selected from two tertiary internship 400 nursing students conducted a questionnaire survey.The research tools included general information questionnaire,general self efficacy scale(GSES),Simplified Coping Style Scale(SCSS)and clinical decision making assessment tool(CDMNS).After the data were reviewed,the Excel spreadsheet database was established.The data were analyzed by SPSS19.0 software.Count data with frequency and percentage to describe quantitative data with mean and standard deviation to describe the difference;with the independent sample t test,single factor variance analysis to compare self-efficacy,coping style and clinical decision-making ability;using Pearson verification and analysis of Undergraduate Practice relationship between self-efficacy and coping styles of nursing students and clinical decision-making ability;analysis of factors affecting the clinical decision-making ability of nursing undergraduate students with multiple regression.Results:1.Undergraduate nursing students at the end of the clinical decision making ability in the middle level,School of graduation,professional attitude,open courses,professional choices,clinical decision making problems is preferred to encourage independent degree of solving,teachers have influence on clinical decision-making ability,the difference was statistically significant(P<0.05).2.The scores of coping styles of undergraduate nursing students were significantly influenced by four factors,including student origin,professional attitude,professional choice and the encouragement level of teachers.The difference was statistically significant(P<0.05).3.The scores of self-efficacy of undergraduate nursing students with different demographic data had significant difference in the two aspects of whether the only child and the teacher encouraged.The difference was statistically significant(P < 0.05).4.Correlation analysis:(1)the positive coping styles of undergraduate nursing students were positively correlated with the clinical decision-making ability and all dimensions.Negative coping styles were negatively correlated with the total score and the dimensions of clinical decision-making ability.(2)self-efficacy was positively correlated with the total score and the dimensions of clinical decision-making ability.(3)There was a significant positive correlation between self-efficacy and positive coping styles(r=0.681,P<0.01),and negatively correlated with the negative coping style(r=-0.242,P<0.05).5.Multiple stepwise regression analysis showed that the magnitude of the influence on the dependent variable was self-efficacy,positive coping,negative coping,teachers' encouragement,professional attitude and whether they met the problem independently.The adjustment R2 is 0.802,indicating that 6 variables co-explained 80.2% of the total variation.Conclusion:1.The decision-making ability of undergraduate clinical practice is at the middle level,and the scores from high to low are: evaluation or multiple evaluation,clear objectives and values,finding information or new information,and looking for alternatives.2.It is suggested that hospital administrators and educators should make proper intervention according to the differences of personal data of nursing students,make up for gaps in teaching and training,increase communication among colleges,enhance the clinical decision-making ability of nursing students,and improve the quality of nursing students' practice.