Investigation On The Quality Of Humanistic Care Of Nurses And Mixed Teaching Intervention In Women And Children’s Hospital

Objective:1.To explore the current situation and influencing factors of humanistic caring quality of nurses in women and children’s hospital.2.To explore the application effect of mixed teaching in humanistic care quality training of nurses in women and children’s hospital.Methods:1.From March to may 2019,537 nurses in a women’s and children’s hospital in Fujian province were investigated and 12 nurses were interviewed in-depth by using the method of quantitative and qualitative research,the quality scale of nurses’humanistic care products,the self-efficacy scale and the general situation questionnaire.A survey of 230 inpatients in a women’s and children’s hospital in Fujian province was conducted by using the nurse care behavior scale and the general situation questionnaire.2.70 nurses of women and children’s hospital were randomly divided into two groups,35 in intervention group and 35 in control group.Routine training measures were used in the control group.The intervention group carried out mixed teaching and training based on the research framework of action research method steps,based on the problems found and analyzed in the first stage of the investigation;combined with literature research and expert meeting,an online and offline mixed teaching and training program was formed to set training objectives,training contents,training hours,teaching experts and training forms from three aspects:humanistic knowledge （cognitive field）,humanistic skills（action skill field）and humanistic attitude（emotional field）;used the method of online learning of“nursing assistant”app and offline theory and skill teaching to implement the empirical research of the preliminary training program;applied the qualitative method to reflect and analyze the interviews of research group members and research objects,and form and implement the final training program of hybrid teaching mode.Koch’s training evaluation model was used to evaluate the teaching effect.In the reaction layer,the training satisfaction was used as the evaluation index.In the learning layer,the theory evaluation and skill evaluation were used as the evaluation index.In the behavior layer,the Mini-CEX evaluation,the humanistic care quality and self-efficacy of nurses were used as the evaluation indexes.In the result layer,the humanistic output of departments and the incidence of nursing service complaints were used as the evaluation indexes.3.SPSS22.0 software was used for reliability analysis,factor analysis,two independent samples t-test,one way ANOVA,χ² test,pearson correlation analysis,multiple linear regression analysis and logistic regression analysis.AMOS25 software was used for confirmatory factor analysis and model modification.Results:1.Cronbach’sαcoefficient of nurses’humanistic care product quality table was 0.966.The fitting degree of the modified model of confirmatory factor analysis reaches the acceptable range,and the fitting degree index wasχ²/df=3.405,RMSEA=0.067.The total score of humanistic care quality was（116.21±16.04）.The independent variables were used for multiple collinearity diagnosis,Variance expansion factor was less than 2,tolerance was more than 0.6,and there was no collinearity.Multiple linear regression analysis showed that the main factors influencing the quality of humanistic care of nurses were self-efficacy（X₁）,concern of colleagues（X₂）and attitude towards nursing work（X₃）.The regression equation was Y^=104.664+0.818X₁-3.331X₂-2.275X₃.The equation was statistically significant（F=11.165,P<0.001）,R=0.587,R²=0.345.Through qualitative research,the paper abstracts five themes that hinder the implementation of humanistic care by nurses in women and children’s hospital:lack of professional knowledge,heavy workload,distrust of patients or family members,job burnout and lack of humanistic care training.2.The total score of nursing care behavior of inpatients was（122.93±19.62）.Multiple linear regression analysis showed that the main factors influencing the total score of care behavior of inpatients was departments（Pediatrics）.The regression equation was Y^=127.405-12.525X.The equation was statistically significant（F=10.210,P=0.000）,R=0.487,R²=0.237.3.There was no significant difference between the intervention group and the control group in the scores of theoretical knowledge,the scores of skill,the total score of humanistic care quality,the concept of humanistic care quality,the knowledge of humanistic care quality,the perception of humanistic care quality and the ability of humanistic care quality and self-efficacy（P>0.05）.There was no significant difference in the total score of humanistic care quality,the concept of humanistic care quality,the knowledge of humanistic care quality,the perception of humanistic care quality and the ability of humanistic care quality in the control group before and after training （P>0.05）.The overall satisfaction of nurses in women and children’s hospital was97.14%.After training,the scores of theoretical knowledge assessment and skill assessment in the intervention group were higher than those in the intervention group and the control group（P<0.05）,and the scores of quality,concept,knowledge,perception,ability and self-efficacy in the intervention group were higher than those in the control group（P<0.05）.There were significant differences in the scores before training and after training in the control group（P<0.05）.After the training,85.71%of the nurses in the intervention group got the excellent score in Mini-CEX evaluation.After the training,10 nurses in the intervention group received the patient’s name recognition,and 2 nurses published the humanities research papers.After the intervention,no one in the control group wrote and published research papers on humanities.Conclusion:1.The nurses’self-evaluation of the quality of humanistic care is good,the better self-efficacy,the more concerned by colleagues,the more like nurses’working attitude,the better the quality of humanistic care.The evaluation of nursing care behavior of inpatients is good,but the scores of respect and connection dimensions are low,and that of paediatric inpatients（guardians）is lower than that of gynecological and obstetric.2.Mixed teaching can effectively improve the quality and self-efficacy of humanistic care of women and children nurses,improve the theoretical knowledge and skill operation level of humanistic care of nurses,and improve the satisfaction of patients with medical treatment,which can provide evidence-based basis for future nursing managers and college nursing teachers to improve the humanistic training of clinical nurses.But its long-term effect needs further study.