华人生死学
基层医疗机构护士心理资本与死亡素养的相关性研究
DOI: 10.12209/j.hrssx.2026060206
1.澳门镜湖护理学院
2.昆明理工大学附属安宁市第一人民医院
3.四川天府新区太平中心卫生院
基金项目:
A Study on the Correlation between Psychological Capital and Death Literacy of Nurses in Primary Health Care
摘要
目的 调查基层医疗机构护士心理资本与死亡素养的现状,探讨两者关系及影响因素。方法 采用分层抽样的方法,选取成都市22个县(市、区)的1700名护士作为调查对象,使用一般资料调查表、死亡素养指数量表及护士心理资本量表进行横断面调查。采用SPSS26.0进行数据的统计分析,采用Pearson相关分析及多重线性回归分析。结果 回收有效问卷1524份,有效回收率为89.6%。基层医疗机构护士的心理资本总分均分为144.61±17.08,条目均分为4.83±0.57;死亡素养总分均分为203.94±33.05分,条目均分为7.04±1.13分;心理资本与死亡素养呈正相关(r=0.602,P\textless0.01);多重线性回归分析显示:年龄、生育子女、疗护终末期患者经历、疗护已故亲属经历、接受生死教育培训,以及心理资本中希望、协作、责任和自信维度是PHC护士死亡素养的独立影响因素(P\textless0.05)。结论 基层医疗机构护士的心理资本处于较高水平,死亡素养处于中等偏上水平,建议基层医疗机构加强对护士心理资本的训练,缓解死亡压力,开展分层递进的死亡教育课程,将死亡素养培训纳入继续教育必修学分,更好地应对死亡问题。
Abstract
Objective To investigate the current status of psychological capital and death literacy among nurses in primary health care, and to explore the relationship between the two and the factors influencing them. Methods A stratified sampling method was employed to select 1,700 nurses from 22 counties (cities and districts) in Chengdu as the study subjects. A cross-sectional survey was conducted using a demographic questionnaire, the Death Literacy Index Scale, and the Nurses’ Psychological Capital Scale. Statistical analysis was performed using SPSS 26.0, employing Pearson’s correlation analysis and multiple linear regression analysis. Results A total of 1,524 valid questionnaires were returned, yielding a response rate of 89.6%. The mean total score for psychological capital among nurses in primary health care was 144.61 ± 17.08, with a mean item score of 4.83 ± 0.57; the mean total score for death literacy was 203.94 ± 33.05, with a mean item score of 7.04 ± 1.13; psychological capital was positively correlated with death literacy (r = 0.602, P < 0.01),and positive correlations were also observed between their respective dimensions. The multiple linear regression analysis revealed that age, number of children, experience of caring for patients at the end of life, experience of caring for deceased relatives, receipt of life-and-death education training, and the dimensions of hope, collaboration, responsibility and self-confidence within psychological capital were independent predictors of death literacy among nurses (P < 0.05). Conclusion Nurses in primary health care exhibit high levels of psychological capital and above-average levels of death literacy. It is recommended that primary health care strengthen training in psychological capital for nurses to alleviate death-related stress, implement tiered and progressive death education programmes, and incorporate death literacy training into compulsory continuing education credits to better address issues surrounding death.

邱林萍,宋国强,刘梦,等. 我国省间基层医疗卫生机构医护资源分布特征研究[J]. 中国全科医学,2024,27(31): 3911$-$3918

闫旭,安然,万巧琴. 社区开展安宁疗护的SWOT分析与建议[J]. 医学与哲学, 2025(6): 54$-$58

Zhang S,Wang J,Song S,et al. Disparities in hospice and palliative care services: evidence of healthcare provider practice in various regions of China[J]. BMC Public Health,2025,25(1).

李雪莹,荆丽梅,许艺帆,等. 上海市社区安宁疗护试点自主服务项目开展现况研究[J]. 中国全科医学,2022,25(13): 1624$-$1628

Youssef$-$Morgan C M,Luthans F. Psychological Capital and Well$-$being[J]. Stress and health : journal of the International Society for the Investigation of Stress,2015,31(3): 180$-$188.

李艳萍,黄丹丹. 心理资本在ICU护士道德勇气与死亡应对能力间的中介效应分析[J]. 护士进修杂志,2023,38(03): 204$-$208

Noonan K. Death literacy$-$developing a tool to measure the social impact of public health initiatives[J]. Annals of palliative medicine,2018,7(Suppl 1): AB007.

Folkman S. Personal control and stress and coping processes: a theoretical analysis[J]. Journal of personality and social psychology,1984,46(4): 839$-$852.

Sallnow L,Richardson H,Murray S A,et al. The impact of a new public health approach to end$-$of$-$life care: A systematic review[J]. Palliative medicine,2016,30(3): 200$-$211.

陈燕子. 江苏省安宁疗护服务现况调研及对策研究[D]. 苏州大学,2024.

龙庆珍,马允亮,刘帅. 城市社区安宁疗护病房服务困境及对策分析——以H社区卫生服务中心安宁疗护病房为例[J]. 医学与哲学,2024,45(19): 36$-$40

陈小莉,杨士来. 基层医院护士死亡焦虑现状及其影响因素[J]. 护理实践与研究,2020, 17(18): 27$-$29

张志军,刘朝杰. 北京市社区护士职业倦怠现状调查及其影响因素分析[J]. 中国全科医学,2018,21(02): 232$-$238

刘诗逸,刘毅. 分级诊疗背景下成都市不同圈层医疗资源分布与利用分析[J]. 中国卫生事业管理,2020,37(05): 364$-$367

Beale E M,Kendall M G,Mann D W. The discarding of variables in multivariate analysis[J]. Biometrika,1967,54(3): 357$-$366.

倪平,陈京立,刘娜. 护理研究中量性研究的样本量估计[J]. 中华护理杂志,2010,45(4): 378$-$380

袁中清,王佳琳,金曼,等. 护士心理资本量表的编制及信效度检验[J]. 中华护理杂志,2023,58(1): 74$-$80

Leonard R,Noonan K,Horsfall D,et al. Developing a death literacy index[J]. Death studies,2022,46(9): 2110$-$2122.

Che S L,Li X,Zhu M,et al. The Death Literacy Index: translation, cultural adaptation, and validation of the Chinese version[J]. Frontiers in public health,2023,11: 1140475.

Beck C T. Statistical power analysis in pediatric nursing research[J]. Issues in comprehensive pediatric nursing,1994,17(2): 73$-$80.

Teng M,Wang J,Jin M,et al. Psychological capital among clinical nurses: A latent profile analysis[J]. International nursing review,2024,71(4): 786$-$793.

Vitorino J V,Duarte B V,Ali A M,et al. Compassionate engagement of communities in support of palliative and end$-$of$-$life care: challenges in post$-$pandemic era[J]. Frontiers in medicine,2024,11: 1489299.

谢伟琼,郭红英,朱培玲,等. 社区护士逆境商现状及影响因素研究[J]. 护理管理杂志,2025,25(09): 741$-$745

朱明霞,谢淑玲,黎想,等. 粤港澳大湾区华人居民死亡素养现状及当代生死教育初探[J]. 中国医学伦理学,2024,37(4): 491$-$498

Graham$-$Wisener L,Toner P,Leonard R,et al. Psychometric validation of the death literacy index and benchmarking of death literacy level in a representative uk population sample[J]. BMC palliative care,2022,21(1): 145.

' data-baidu-text='百度学术' data-index='26'>

Li X,Che S L,Zhu M,et al. What we learnt from parents' death experience: A cross$-$sectional study of death literacy and parent's death quality among adult children in China[J]. Palliative & supportive care,2024,22(5): 1217$-$1225.

Johansson T,Olsson Å,Tishelman C,et al. Validation of a culturally adapted Swedish$-$language version of the Death Literacy Index[J]. PloS one,2023,18(11): e0295141.

Noonan K,Grindrod A,Shrestha S,et al. Progressing the Death Literacy Index: the development of a revised version (DLI$-$R) and a short format (DLI$-$9)[J]. Palliative care and social practice,2024,18: 26323524241274806.

Ng W I,Che S L,Li X,et al. Association of filial attitude, filial behavior and death literacy: implications for development of death system in Guangdong$-$Hong Kong$-$Macao Greater Bay Area of China[J]. BMC public health,2024,24(1): 721.

罗正鹏,高一虹. 走向死亡话语素养[J]. 医学与哲学,2023,44(8): 19$-$23

陈松友. 中国传统文化中的生死观[J]. 人民论坛,2024(8): 98$-$100

黄婷娟,朱迪,贺舒悦,等. 新医科背景下医护生生死教育的必要性与实施进路[J]. 护理研究,2024,38(16): 2958$-$2962

' data-baidu-text='百度学术' data-index='33'>

Li X,Che S L,Zhu M,et al. What we learnt from parents' death experience: A cross$-$sectional study of death literacy and parent's death quality among adult children in China[J]. Palliative & supportive care,2024,22(5): 1217$-$1225.

Tang M L,Goh H S,Zhang H,et al. An Exploratory Study on Death Anxiety and Its Impact on Community Palliative Nurses in Singapore[J]. Journal of hospice and palliative nursing : JHPN : the official journal of the Hospice and Palliative Nurses Association,2021,23(5): 469$-$477.

龙庆珍,马允亮,刘帅. 城市社区安宁疗护病房服务困境及对策分析——以H社区卫生服务中心安宁疗护病房为例[J]. 医学与哲学,2024,45(19): 36$-$40

Choi J,Gu M,Oh S,et al. Relationship between End$-$of$-$Life Care Stress, Death Anxiety, and Self$-$Efficacy of Clinical Nurses in South Korea[J]. International journal of environmental research and public health,2022,19(3): 1082.

王芹,王琳. 海岛地区军队医院护士组织支持感、心理资本特点及其与留职意愿的关系[J].解放军护理杂志,2021,38(05): 21$-$24

Wang A,Nan F,Jin L S,et al. A SWOT Analysis of Death Literacy Education in Nursing: Implications for Hospice and Palliative Care in China[J]. Journal of multidisciplinary healthcare,2025 18: 7749$-$7756.

岳鹏,许丽杰,高丽,等. 医学生“生命关怀与死亡教育”课程的设计与实施[J]. 中国护理管理,2024,24(02): 161$-$16

Johansson T,Olsson Å,Tishelman C,et al. Validation of a culturally adapted Swedish$-$language version of the Death Literacy Index[J]. PloS one,2023,18(11): e0295141.

黄晓燕,裘佳佳,张明迪. 抚养未成年子女的乳腺癌患者养育体验的质性研究[J]. 护理学杂志,2020,35(15): 27$-$30

古茹,赵丽燕,王倩茹,等. 前馈控制模式对改善手术室护士职业倦怠状况的临床研究[J]. 中国医学伦理学,2025(10): 1373$-$1378

赵浩梅,汪张毅,朴京京,等. 新入职护士死亡教育需求状况及影响因素分析[J]. 护理学杂志,2022,37(2): 41$-$45

林美欣,朱明霞,王思琛. 澳门医院护士死亡应对能力照顾临终病人经验现状调查[J]. 华人生死学,2022(1): 126$-$143

熊凌. 成都平原经济圈的圈层结构及经济辐射作用研究[D]. 四川师范大学,2015.

Noonan K,Grindrod A,Shrestha S,et al. Progressing the Death Literacy Index: the development of a revised version (DLI$-$R) and a short format (DLI$-$9)[J]. Palliative care and social practice,2024,18: 26323524241274806.

Kunkel C,Kopp W,Hanson M. A Matter of Life and Death: End$-$of$-$Life Simulation to Develop Confidence in Nursing Students[J]. Nursing education perspectives,2016,37(5): 285$-$286.

Gbd C O D C. Global burden of 292 causes of death in 204 countries and territories and 660 subnational locations, 1990$-$2023: a systematic analysis for the Global Burden of Disease Study 2023[J]. Lancet (London, England),2025,406(10513): 1811$-$1872.

Semerci çakmak V,Sönmez Sarı E,Seven A. Death Literacy Index Short Form: Cultural Adaptation and Psychometric Evaluation of the Turkish Version[J]. Omega,2025: 302228251366736.

' data-baidu-text='百度学术' data-index='50'>

Midlöv E M,Lindberg T,Skär L. Relative's suggestions for improvements in support from health professionals before and after a patient's death in general palliative care at home: A qualitative register study[J]. Scandinavian journal of caring sciences,2024,38(2): 358$-$367.

周雨欣,周明飞,纪光伟. 死亡素养:安宁缓和医疗的新公共卫生视角[J]. 医学与哲学,2024,45(4): 1$-$5

sss
ddd
1主要系统原理图1
Fig.1Main system schematic diagram