Latent Class Analysis and Influencing Factors of Cognitive Ability Level of Hospice Care Nursing Students
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摘要:
目的 基于个体为中心的视角探讨本科护生安宁疗护认知能力水平的不同潜在类别及特点,并分析其影响因素,为制定针对性的护理教育提供参考。 方法 便利选取云南省某医科大学在校护生,于2023年3月至2023年6月,采用一般资料调查表、安宁疗护知识问卷进行横断面调查,应用SPSS、Mplus进行数据分析。 结果 护生安宁疗护认知能力水平被识别出3个潜在类别,分别命名为安宁疗护高认知能力水平组、一般认知能力水平组、低认知能力水平组,占比分别为28.74%、57.29%、13.97%;护生的性别、民族、居住地、安宁疗护学习和实践经历(有无接触过癌症终末期患者、有无接受过安宁疗护相关的培训)、是否愿意从事安宁疗护相关工作是护生安宁疗护认知能力水平不同潜在类别的影响因素(P < 0.05)。 结论 护生安宁疗护认知能力水平存在3个潜在类别,未接触过癌症终末期患者、未接受过安宁疗护相关的培训、不愿意从事安宁疗护相关工作、居住于农村的男性少数民族护生安宁疗护认知水平较弱。未来学者可根据护生安宁疗护认知能力水平的不同潜在类别的特征制定针对性的培训策略,以提高护生的安宁疗护认知能力水平,为安宁疗护队伍储备人才。 Abstract:Objective To explore the different latent class and characteristics of the cognitive ability level of undergraduate nursing students in hospice care based on the individual-centered perspective, and analyze its influencing factors to provide the reference for the formulation of targeted nursing education. Methods Nursing students in a medical university in Yunnan Province were selected from March 2023 to June 2023. The general data questionnaire and hospice care knowledge questionnaire were used to conduct a cross-sectional survey. SPSS and Mplus were used for the data analysis. Results Three latent class of hospice care cognitive ability were identified, which were named as hospice care high cognitive ability group, general cognitive ability group, and low cognitive ability group, accounting for 28.74%, 57.29%, and 13.97%, respectively; Nursing students’ gender, nationality, place of residence, earning and practice experience of hospice care(whether they had the contact with end-stage cancer patients, whether they had received the hospice care related training), and whether they were willing to engage in the hospice care related work were the influencing factors of different potential categories of cognitive ability of hospice care among nursing students(P < 0.05). Conclusion There are three latent class of hospice care cognitive ability of nursing students. Male minority nursing students who have not been exposed to end-stage cancer patients and have not received the hospice care-related training, are unwilling to engage in the hospice care-related work. Male ethnic minority nursing students residing in rural areas have the weaker cognitive levels of hospice care. Scholars in the future can formulate targeted training strategies according to different latent class of hospice care cognitive ability to improve nursing students’ hospice care cognitive ability and reserve talents for hospice care teams. -
Key words:
- Nursing students /
- Hospice care /
- Cognitive ability level /
- Latent class analysis /
- Influencing factors
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表 1 安宁疗护知识问卷得分[( $\bar x \pm s $), $ { \text{分} }$]
Table 1. Scores on the palliative care quiz for nursing[( $\bar x \pm s $),points]
维度 条目数 平均正确率(%) 得分 条目均分 平均正确率排序 心理支持和精神支持 3 63.70 1.91±0.96 0.64±0.32 1 疼痛与症状控制 14 52.84 8.56±3.44 0.61±0.25 2 姑息护理哲理和原则 3 31.72 1.82±1.12 0.61±0.38 3 PCQN总分 20 50.62 11.9±4.72 0.60±0.24 − 注:PCQN:安宁疗护知识问卷;−:空白项。 表 2 安宁知识认知能力水平潜在类别分析拟合指标
Table 2. Model fit index of LCA for the cognitive ability level ofpalliative care
模型 AIC BIC aBIC Entropy LMR BLRT 潜类别概率 M1 11844.970 11929.021 11865.540 M2 10601.569 10773.873 10643.739 0.902 <0.001 <0.001 0.777/0.0.223 M3 10212.516 10473.073 10276.284 0.860 <0.001 <0.001 0.140/0.573/0.287 M4 10093.657 10442.468 10179.025 0.846 <0.013 <0.001 0.052/0.190/0.269/0.488 M5 10047.857 10484.921 10154.824 0.858 0.457 <0.001 0.257/0.488/0.046/0.160/0.051 表 3 安宁疗护认知能力水平不同潜在类别分析的单因素分析[n(%)]
Table 3. Univariate analysis of the analysis of different latent classes for the level of cognitive competence in palliative care[n(%)]
项目 分类 低认知能力水平组
(n=69)一般认知能力
水平组
(n=283)高认知能力水平组
(n=142)χ2 P 性别 男 19(27.5) 41(14.5) 11(7.7) 14.784 0.001* 女 50(72.5) 242(86.5) 131(92.3) 年级 大一 19(27.5) 38(13.4) 15(10.6) 17.210 0.009* 大二 24(31.9) 83(29.3) 41(28.9) 大三 13(18.8) 68(24.0) 30(21.1) 大四 13(18.8) 94(33.3) 56(39.4) 居住地 农村 25(29.1) 133(47.0) 80(56.3) 7.889 0.019* 城镇 44(70.9) 150(53.0) 62(43.7) 民族 汉族 38(44.1) 204(72.1) 92(64.8) 8.057 0.018* 少数民族 31(55.9) 79(27.9) 50(35.4) 否为独生子女 是 20(23.3) 110(38.9) 62(43.7) 4.210 0.122 否 49(76.7) 173(61.1) 80(56.3) 有无宗教信仰 有 9(10.5) 38(13.4) 14(9.9) 1.148 0.563 无 60(89.5) 245(86.6) 128(90.1) 有无接触过癌症终末期患者 有 4(5.8) 75(26.5) 24(16.9) 16.293 <0.001* 没有 65(94.2) 208(73.5) 118(83.1) 有无接受过安宁疗护相关的培训 有 4(5.8) 57(20.1) 42(29.6) 16.114 <0.001* 没有 65(94.2) 226(79.9) 100(70.4) 是否愿意从事安宁疗护相关工作 愿意 9(10.5) 98(34.6) 41(28.9) 12.430 0.002* 不愿意或不确定 60(89.5) 185(65.4) 101(71.1) 疾病告知态度:如果一个患者得了癌症,您觉得应该告诉他/她真实病情吗 应该告诉 31(44.9) 142(50.2) 94(66.2) 12.458 0.002* 不应该告诉 38(55.1) 141(49.8) 48(33.8) 您认为谁应该是第一个知道患者真实病情的人 患者 15(21.7) 76(26.9) 39(27.5) 2.445 0.655 患者和家属一起 25(36.2) 98(34.6) 56(39.4) 家属 29(42.1) 109(38.5) 47(33.1) *P<0.05。 表 4 安宁疗护认知能力水平潜在类别的无序多分类Logistic回归分析(n=494)
Table 4. Disordered multinomial Logistic regression analysis of latent classes of palliative care cognitive ability level(n=494)
项目 高认知能力水平组 低认知能力水平组 b OR 95%CI P b OR 95%CI P 下限 上限 下限 上限 性别 −0.608 4.609 2.159 9.840 <0.001* −0.561 0.570 0.275 1.183 0.131 民族 1.528 0.521 0.293 0.925 0.026* −0.298 0.742 0.476 1.159 0.190 居住地 −0.652 0.782 0.436 1.403 0.410 0.459 1.583 1.038 2.415 0.033* 有无接触过癌症终末期患者 0.246 0.108 0.034 0.346 <0.001* −0.340 0.712 0.409 1.239 0.229 有无接受过安宁疗护相关的培训 −2.228 0.373 0.120 1.155 0.087 −0.757 2.132 1.238 3.670 0.006* 有无意愿从事安宁疗护相关工作 0.987 0.406 0.170 0.968 0.042* −0.565 0.568 0.332 0.974 0.040* 注:以一般认知能力水平组为参照;性别以女作为参考;民族以少数民族为参考;居住地以城镇作为参考,有无接触过癌症终末期患者以无作为参考;有无接受过安宁疗护相关的培训以无作为参考;有无意愿从事安宁疗护相关工作以无作为参考。*P<0.05。 -
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