郭闯　李艳秋　李芳

[摘要] 目的 探讨本科护生毕业实习前3个月临床实践行为的动态变化及其影响因素分析。 方法 采取便利抽样法选择2017年7～9月在黑龙江中医药大学附属第一医院实习的75名本科护生作为研究对象，采用自行设计的本科护生一般资料问卷和邓仁丽修订的临床实践行为量表分别于实习第1、2、3个月对其进行调查。 结果 本科护生临床实践行为总分均在2.5以上，总均分由高到低依次为实习第1个月、实习第2个月及第3个月。实习第3个月的四个维度中运用理论知识、自我导向的学习行为、明确患者的权利和义务、临床技能维度得分均高于实习第1个月，临床实践行为实习第1个月总分高于实习第2个月和第3个月，差异均有统计学意义（P < 0.05）。热爱护理事业护生临床实践行为得分高于不热爱护理事业护生，第一志愿是护理专业的护生临床实践行为得分高于第一志愿非护理专业的护生，差异均有统计学意义（P < 0.05）。 结论 本科护生对实习初期临床实践行为满意，影响本科护生临床实践行为的因素为第一志愿是否护理专业和是否热爱护理事业。

[关键词] 本科护生；实习；临床实践行为；动态变化，影响因素

[中图分类号] R473.55 [文献标识码] A [文章编号] 1673-7210（2018）07（b）-0148-04

[Abstract] Objective The purpose of this study was to explore dynamic change of clinical practice behavior and its influencing factors in nursing students three months of intership. Methods From July to September 2017， 75 undergraduate nursing students in First Affiliated Hospital， Heilongjiang University of Traditional Chinese Medicine were selected as the research objects by convenient sampling method. Self-designed nursing undergraduate general information questionnaire and Deng Renli′s revised clinical practice behavior were applied to investigate in 1， 2 months and 3 months of internship. Results The total scores of clinical practice behaviors in nursing undergraduates were all above 2.5， and the total average scores from high to low were 1， 2 months and 3 months of the internship respectively. The scores of the four dimensions in the third month of practice （including using theoretical knowledge， self-directed learning behavior， defining the rights and obligations of patients， and clinical skills dimensions） were higher than that of first month of the internship； the total score of 1 month of clinical practice behavior practice was higher than those of 2 months and 3 months of internship， with statistically significant differences （P < 0.05）. The score of clinical practice behavior in the students of loving nursing career was higher than that of non-loving， the score in students whose first volunteer was nursing was higher than that of the first volunteer non-nursing students （P < 0.05）. Conclusion Nursing undergraduates are satisfied with the clinical practice. The influencing factors of the clinical practice behavior in undergraduate nursing students are whether the first volunteer is nursing specialty or whether loving nursing career.

[Key words] Nursing undergraduate； Internship； Clinical practice behavior； Dynamic changes， Influencing factors

临床实习是从学生转变为临床护士的必要学习阶段，是护生进入临床护理工作的第一步，是实现护生到护士身份转变的重要时期。临床实习是把书本理论转化为临床实践的过程，也是护生巩固學习理论知识、提高临床护理工作能力和职业综合素质形成的关键阶段[1]。实习初期（≤3个月）是护生临床实践的重要时期，这一时期是护生形成正确理念及职业素养的重要阶段，并且此阶段的实习经历将会影响护生后期的实习[2-3]。临床实习质量的高低是评价学生临床实践行为表现的客观指标。实习质量不仅关系到护理教育教学质量，而且关系到医院培养的护理人才是否合格。……