自我效能在临床护士压力性损伤知识与预防态度间的中介效应 [中文引用][英文引用]

目的  探讨临床护士压力性损伤知识、预防态度与自我效能 3 者间的相互关系，并检验自我效能在压力性损伤知识与预防态度间的中介作用。方法  采用便利抽样法，于 2024 年 9 月— 10 月，选取厦门市某 3 所三级甲等综合医院 402 名临床护士作为研究对象。采用一般资料调查表、中文版压力性损伤预防态度量表（Chinese version of attitude towards pressure ulcerprevention，C-APUP）、中文版压力性损伤知识评估工具（Chinese version of pressure ulcer knowledge assessment tool，C-PUKAT）和护士管理压力性损伤自我效能量表（pressure injury management self-efficacy scale for nurses，PIMSES）进行调查。采用 Pearson相关分析临床护士压力性损伤预防态度、知识及自我效能的相关性；采用分层回归分析临床护士压力性损伤预防态度的影响因素；采用 AMOS29.0 软件构建以压力性损伤知识为自变量、自我效能为中介变量、压力性损伤预防态度为因变量的中介效应模型，并通过 Bootstrap 法进行中介效应检验。结果  402 名护士完成研究。临床护士压力性损伤预防态度总分（41.69±5.21）分，得分率为 80.17%；知识总分（8.40±2.69）分，正确率为 42.00%；自我效能总分（122.69±22.42）分。临床护士压力性损伤预防态度与压力性损伤知识呈正相关（r=0.298，P<0.01），与自我效能呈正相关（r=0.474，P<0.01），自我效能与压力性损伤知识呈正相关（r=0.254，P<0.01）。压力性损伤知识和自我效能是压力性损伤态度的影响因素（β=0.259，P<0.001；β=0.378，P<0.001）。自我效能在临床护士压力性损伤知识与预防态度间存在中介效应，效应值为 0.096，占总效应的 27.04%。结论  临床护士对压力性损伤预防持积极态度，自我效能良好，但压力性损伤知识不足。自我效能在压力性损伤知识与预防态度间存在中介效应。

Objective To identify the relationships among clinical nurses’knowledge and attitudes and self-efficacy regarding prevention of pressure injury（PI），and to examine the mediating effect of self-efficacy on the relationship between the knowledge of and attitudes toward PI prevention. Methods A convenience sample of 402 clinical nurses was recruited from three tertiary hospitals in Xiamen City between September and October 2024. Data were collected using a general information questionnaire，the attitude towards pressure ulcer prevention scale（Chinese version，C-APUP），Chinese version pressure ulcer knowledge assessment tool（C-PUKAT）， and the pressure injury management self-efficacy scale for nurses（PIMSES）. Pearson correlation analysis was used to examine the relationships among nurses’attitudes toward PI prevention，knowledge，and self-efficacy. Hierarchical regression analysis was conducted to identify the factors influencing nurses’attitudes toward PI prevention. Amos 29.0 software was applied to establish a structured model with knowledge as the independent variable，self-efficacy as the mediator，and attitude as the dependent variable. The mediating effect of self-efficacy was then tested using the Bootstrap method. Results Totally 402 nurseds finished the study. The total score of attitudes to PI prevention among clinical nurses was 41.69±5.21，with a score rate of 80.17%；the total score of knowledge was 8.40±2.69， with a correct rate of 42.00%；and the total score of self-efficacy was 122.69±22.42. Attitudes toward PI prevention were positively correlated with PI knowledge（r=0.298，P<0.01），and with self-efficacy（r=0.474，P<0.01）；self-efficacy was positively correlated with PI knowledge（r=0.254，P<0.01）. Both PI knowledge and self-efficacy were the factors influencing the attitudes toward PI（β=0.259， P<0.001；β=0.378，P<0.001）. Self-efficacy mediated the relationship between PI knowledge and PI prevention attitudes among clinical nurses，with a mediation effect of 0.096，accounting for 27.04% of the total effect. Conclusion Clinical nurses demonstrate positive attitudes toward PI prevention with high self-efficacy，but exhibit insufficient knowledge about PI. Self-efficacy mediates the relationship between the knowledge and attitudes towards PI prevention.