目的 探讨临床护士专业自我概念在护理工作环境和护理缺失间的中介效应。 方法 便利抽样法选取北京市3所三级甲等医院的420名临床护士为研究对象，采用护士专业自我概念量表、护理工作环境量表和护理缺失量表对其进行调查，并进行中介效应分析。 结果 临床护士专业自我概念得分为（6.37±0.87）分，护理工作环境得分为（3.13±0.38）分，护理缺失得分为（4.63±0.35）分；三者均呈正相关（均P＜0.001）；结果显示，总效应值为0.431，工作环境对护理缺失的直接效应显著（β=0.280，95% CI:0.185~0.375，P＜0.001），专业自我概念在护理工作环境与护理缺失间起部分中介（β=0.151，95% CI:0.092～0.214，P＜0.001），中介效应占总效应的35.03%。 结论 护理工作环境和护士专业自我概念以及护理缺失三者具有相关性，专业自我概念可部分中介护理工作环境对护理缺失的影响，通过引导护士增加专业自我概念，有利于减少护理缺失的发生。

Objective To explore the mediating effect of clinical nurses’ professional self-concept between their work environment and missed nursing care.Methods 420 clinical nurses from 3 tertiary A hospitals in Beijing were selected by convenience sampling.Nurses’ professional self-concept scale,nursing work environment scale,and the MISSCARE survey were adopted,with a mediation effect analysis conducted.Results The score of clinical nurses’ professional self-concept was (6.37±0.87),and that of nursing work environment was(3.13±0.38),and that of the MISSCARE survey was(4.63±0.35).All 3 variables were positively correlated (all P<0.001).The total effect value was 0.431,with a significant direct effect of the work environment on missed nursing care (β=0.280,95%CI:0.185 to 0.375,P<0.001).Professional self-concept partially mediated the relationship between work environment and missed nursing care (β=0.151,95% CI:0.092 to 0.214,P<0.001),making up 35.03% of the total effect.Conclusions Nurses’ professional self-concept,work environment,and missed nursing care are all correlated,with the first partially mediating the effect of the second on the last.Enhancement of nurses’ professional self-concept can reduce the occurrence of missed nursing care.

R47

北京市医管局“培育计划”管理项目（PG2023015）