目的 了解社区护士预立医疗照护计划(advance care planning,ACP)推行意愿的现状及其影响因素。方法 2024年3-5月,采用便利抽样法选取成都市15个社区卫生服务中心的317名护士为研究对象,采用一般资料调查表、ACP推行意愿量表、死亡态度描绘量表-修订版(death attitude profile-revised,DAP-R)对其进行调查。结果 社区护士ACP推行意愿总分为(56.87±9.73)分,死亡态度中自然接受维度得分最高[(3.76±0.63)分]。社区护士ACP推行意愿与死亡恐惧、死亡逃避呈负相关(r=-0.358、-0.414,均P＜0.01),与自然接受、趋近接受、逃离接受呈正相关(r=0.494、0.169、0.151,均P＜0.01)。多元线性回归显示,年龄、学历、是否接受过死亡教育培训、是否了解或接触过ACP、死亡态度(死亡逃避和自然接受)为社区护士ACP推行意愿的主要影响因素(均P＜0.05)。结论 社区护士ACP推行意愿处于中等偏上水平,但认知不足;死亡态度以自然接受为主,但负向死亡态度仍然存在。应加强对社区护士的死亡教育培训,帮助其树立正确的死亡观。

Objective To understand the current status of community nurses' willingness to implement advance care planning (ACP) and its influencing factors.Methods From March to May 2024,317 nurses from 15 community health service centers in Chengdu were selected by convenience sampling and surveyed using a general information questionnaire, the willingness to implement ACP scale,and the Death Attitude Profile-Revised (DAP-R).Results The total score for community nurses' willingness to implement ACP was (56.87±9.73) points.Among attitudes toward death,the score for the natural acceptance dimension was the highest (3.76±0.63 points).Community nurses' willingness to implement ACP was negatively correlated with fear of death and death avoidance (r=-0.358,-0.414,both P<0.01),and positively correlated with natural acceptance,approach acceptance,and escape acceptance (r=0.494,0.169,0.151,all P<0.01).Multiple linear regression analysis showed that age,educational level,whether they had received death education/training,whether they were familiar with or had exposure to ACP,and attitudes toward death(death avoidance and natural acceptance) were the main influencing factors for community nurses' willingness to implement ACP.Conclusions Community nurses' willingness to implement ACP is at a moderate to high level,but awareness is insufficient.Their attitude toward death is primarily natural acceptance,yet negative attitudes towards death still exist.It is necessary to strengthen death education and training for community nurses,helping them establish correct views on death.

R47-05

四川大学华西护理学科发展专项基金(HXHLG20027)