Aim: to identify: (1) nursing competencies for FCC in a hospital setting; and (2) to explore perspectives on these competencies among Dutch and Australian professionals including lecturers, researchers, Registered Nurses and policy makers.
Design: A multinational cross-sectional study using Q-methodology.
Methods: First, an integrative review was carried out to identify known competencies regarding FCC and to develop the Q-set (search up to July 2018). Second, purposive sampling was used to ensure stakeholder involvement. Third, participants sorted the Q-set using a web-based system between May and August 2019. Lastly, the data were analysed using a by-person factor analysis. The commentaries on the five highest and lowest ranked competencies were thematically analysed.
Results: The integrative review identified 43 articles from which 72 competencies were identified. In total 69 participants completed the Q-sorting. We extracted two factors with an explained variance of 24%. The low explained variance hampered labelling. Based on a post-hoc qualitative analysis, four themes emerged from the competencies that were considered most important, namely: (a) believed preconditions for FCC; (b) promote a partnership between nurses, patients and families; (c) be a basic element of nursing; and (d) represent a necessary positive attitude and strong beliefs of the added value of FCC. Three themes appeared from the competencies that were considered least important because they: (a) were not considered a specific nursing competency; (b) demand a multidisciplinary approach; or (c) require that patients and families take own responsibility.
Conclusions: Among healthcare professionals, there is substantial disagreement on which nursing competencies are deemed most important for FCC.
Impact: Our set of competencies can be used to guide education and evaluate practicing nurses in hospitals. These findings are valuable to consider different views on FCC before implementation of new FCC interventions into nursing practice.
目的: 确定: (1) 医院环境中FCC的护理能力; (2) 探讨荷兰和澳大利亚专业人员 (包括讲师、研究者、注册护士和决策者) 对这些能力的看法。 设计: 采用Q方法的跨国横断面研究。 方法: 首先进行综合评估, 以确定与FCC有关的已知能力, 并制定Q集 (检索截至2018年7月) 。第二, 采用目的性抽样来确保利益相关者参与度。第三, 参与者在2019年5月至8月期间使用基于网络 (web)的系统对Q集进行排序。最后, 采用个人因素分析法对数据进行分析。对排名最高和最低的5项能力的评注进行了专题分析。 结果: 在综合评估中, 研究了43篇文章, 从中确定了72项能力。共有69名参与者完成了Q分类。我们提取了两个因素, 解释方差为24%。低解释方差阻碍了标签化。基于事后定性分析, 从被视为是最重要的能力中衍生出四个主题, 即: (a) 所信的FCC先决条件; (b) 促进护士、患者和家属之间的合作关系; (c) 成为护理工作的基本要素; (d) 代表一种必要的积极态度和对FCC附加价值的强烈信念。从被视为是最不重要的能力中衍生出三个主题, 因为它们: (a) 没有被视为是一种特定的护理能力; (b) 需要采用多学科方法; 或 (c) 要求患者和家属自行承担责任。 结论: 在医疗保健专业人员中, 对于哪些护理能力被视为对FCC而言最重要, 存在很大的分歧。 影响: 我们的一系列能力可以用来指导教育和评估医院的执业护士。在护理实践中实施新的FCC干预措施之前, 在考虑不同的FCC观点方面, 这些研究结果很有价值。.
Keywords: clinical competence; education; factor analysis; family nursing; nurses; nursing; qualitative research; stakeholder participation; statistical.
© 2020 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.