The Construction Of Psychological Care Training Knowledge System For Nurses-Based On The Demand

Objective:As the most direct and main participant in medical activities,clinical nurses were an important force to maintain the mental health of patients.However,the current situation of patients' psychological care was not fully satisfied,and nurse-led psychological care played a minor role in maintaining patients' mental health.The main reason was that nurses lack of sufficient knowledge and skills related to psychological care.Although some hospitals had recognized the importance of psychological care and had conducted some on-the-job training of psychological care for hospital nurses,there are still some shortcomings.Such as the lack of systematic training content,the over-theoretical training form,and the difficulty of practical training,which had restricted the development of clinical nurses' psychological care and failed to fully meet the psychological needs of patients.Therefore,based on the psychological care needs of patients and their families,as well as the psychological care training needs of clinical nurses,this study analyzed domestic and foreign psychological care related work guidelines/practice standards/training frameworks and related research literatures,and develop a"psychological care training knowledge system for clinical nurses" after a questionnaire surveys and expert comments,which will provide a basis for the development of systematic and professional psychological care training.Methods:1.Qualitative research on the psychological care experience and needs of both nurses and patients:According to the principles of phenomenological methodology,we used the purpose sampling method to select 22 nurses,16 patients and their families for semi-structured interviews to clarify the needs of nurses in psychological nursing training and patients'needs in psychological care.2.Literature analysis of clinical nurses' psychological care work content:The content analysis method was used to analyze domestic and foreign psychological care related guidelines,practice standards,and training frameworks,and the main work content of psychological care was identified;3.Preliminary construction of psychological care training knowledge system for clinical nurses:based on the needs of learners(nurses)and the needs of society(patients/patients' families)obtained from qualitative research,and combined with the results of literature,we preliminarily established a draft training knowledge system including training modules,sub-modules and learning units.After discussion at the expert group meeting,a preliminary draft of the "psychological care training knowledge system for clinical nurses" was revised.4.Revision and improvement of the psychological care training knowledge system for clinical nurses:on the basis the first draft of "psychological care training knowledge system for clinical nurses",we developed the demand questionnaire of psychological care training for clinical nurses,which included 113 learning units involved in the first draft.A convenience sample of 1017 clinical nurses from 8 general hospitals of 6 provinces were recruited to complete demand questionnaire through www.wjx.cn.Combined with the results of this survey,18 experts were invited to conduct 2 rounds of Delphi expert consultations on the first draft of the "psychological care training knowledge system for clinical nurses",the training knowledge system was further revised and improved,and the"psychological care training knowledge system for clinical nurses" was finally established.Results:Through in-depth interviews with both nurses and patients,two themes from patients'perspective were summarized:"Patients can benefit from psychological care but there were still unmet psychological needs","Patients have multiple psychological needs";Three themes from nurses' perspective were summarized:"Nurses recognize the importance of psychological care but lack associated ability","Nurses urgently need professional training in psychological care",and "Nurses expect systematic and practical training content."Through the integration of the needs of nurses and patients,we have identified 18 specific training contents in 7 categories that require training:(1)Promoting effective nurse-patient communication;(2)Establishing a good nurse-patient relationship;(3)Psychological evaluation and abnormalities recognition;(4)Common clinical psychological nursing techniques;(5)Professional methods of psychological treatment;(6)Psychological support of patients in crisis;(7)Psychological support of end-of-life patients and their families.2.Based on the analysis of the literatures,we summarized the psychological care related work content for nurses to maintain patients' mental health,including four topics of nurse-patient communication and nurse-patient relationship,clinical psychological assessment,clinical psychological nursing intervention,and psychological support for patients and their families in crisis.3.Combining the results of qualitative research and literature analysis,a draft training knowledge system including 5 training modules,26 sub-modules,and 118 learning units(divided into basic level and advanced level)was constructed.After an expert group meeting,a preliminary draft of a psychological care training knowledge system suitable for clinical nurses was initially established,including 5 training modules,25 sub-modules,and 113 learning units,and the content of the training modules and sub-modules was described.The training and learning unit is divided into three levels:entry level,intermediate level and advanced level.4.The survey results of 1017 clinical nurses in 8 general hospitals of 6 provinces showed that the clinical nurses' demand scores for psychological care training content were all higher than 4 points,and the overall demand score was(4.369±0.577)points.Through 2 rounds of Delphi expert consultations,the training knowledge system was further revised.The final version of "psychological care training knowledge system for clinical nurses"included 5 training modules,25 training sub-modules,and 107 learning units which involved 59 entry-level training content,35 intermediate-level training content and 13 advanced-level training content.Conclusion:This study clarified the psychological care needs of patients and the psychological care training needs of clinical nurses through qualitative research,and on this basis,combined with the work content of psychological care and expert consultancy,5 training modules and 25 training sub-modules and their connotation,107 learning units and their grading were determined,and a systematic knowledge system of psychological care training for clinical nurses was established.This training knowledge system focused on the clinical practicality of the training content,improved the proportion of practical skills,and strived to achieve training migration.The modular and hierarchical training setting was conducive to targeted and flexible training,and provided theoretical and practical guidance for the systematic and step-by-step implementation of clinical nurses' psychological care training.This research not only explored the content setting of psychological care training,but also provided directional guidance for future training materials and the improvement of psychological care capabilities,which enriched the theoretical system of clinical nurses'on-the-job training.