摘要
目的系统评价急危重症护士道德困境的影响因素。方法采用计算机检索方式,检索The Cochrane Library、PubMed、Embase、Web of Science、中国生物医学文献数据库、中国知网、万方数据知识服务平台、维普中文科技期刊数据库等关于急危重症护士道德困境影响因素的文献,检索时限为建库至2025年10月31日,两名研究者独立进行文献筛选、质量评价及资料提取和汇总工作。结果最终纳入23篇文献,共6278名护士。定性分析结果显示,道德困境的影响因素包括个人因素及组织因素,与职业倦怠、离职倾向呈正相关,与工作满意度呈负相关。结论急危重症护士频繁遭受道德困境,且受诸多因素的影响,护理管理者应依据影响因素聚焦易发生道德困境的护士,从可控因素入手,制订相应的干预措施以减少道德困境的发生。
Objective To systematically evaluate the factors influencing moral distress among emergency and critical care nurses.Methods A comprehensive search was conducted in The Cochrane Library,PubMed,Embase,Web of Science,CBM,CNKI,Wanfang and VIP for literature on factors associated with moral distress in emergency and critical care nurses.The search period was from database inception to October 31,2025.Two researchers independently screened the literature,evaluated the quality,and extracted and summarized the data.Results A total of 23 studies involving 6278 nurses were included.Qualitative synthesis results indicated that the influencing factors of moral distress can be categorized into personal factors and organizational factors.Moral distress were positively correlated with job burnout and turnover propensity,and negatively correlated with job satisfaction.Conclusion Moral distress is prevalent among emergency and critical care nurses and is influenced by multiple factors.Nursing managers should identify nurses at risk based on these influencing factors and develop targeted interventions to mitigate the occurrence of moral distress.
作者
陈晨
管艳
张驰
金花
王岩
王哲芸
CHEN Chen;GUAN Yan;ZHANG Chi;JIN Hua;WANG Yan;WANG Zheyun(ICU of Department of Cardiac Surgery,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China)
出处
《护理管理杂志》
2026年第2期162-168,共7页
Journal of Nursing Administration
基金
2023年度南京大学中国医院改革发展研究院课题(NDYGN2023020)
2022年度南京大学中国医院改革发展研究院课题(NDYG2022073)
南京鼓楼医院护理科研课题(2023-B2264)。
关键词
急危重症护士
道德困境
影响因素
护理
系统评价
emergency and critical care nurse
moral distress
influencing factors
nursing
systematic review
