文献分享 | Experiences of Nurses Speaking Up in Healthcare Settings: A Qualitative Metasynthesis
来源： Journal of Advanced Nursing
DOI： 10.1111/jan.16592
IF：3.8
Abstract
Aims: To systematically review and synthesise qualitative research on nurses' experiences of speaking up in various contexts and to identify factors facilitating or impeding such a behaviour.
目的：系统回顾和综合有关护士在各种情况下畅所欲言的经历的定性研究，并确定促进或阻碍这种行为的因素。
Design: Online survey.This review was conducted as a qualitative metasynthesis, utilising the qualitative meta-ethnography approach.
设计：本综述采用定性元民族志方法进行定性元综合。
Methods:A total of 6250 articles were screened. Two reviewers screened titles, abstracts and full texts. A total of 15 studies were included in this review. Researchers conducted a quality appraisal using the JBI critical appraisal checklist for qualitative research. An a priori protocol was created and registered on the Open Science Framework.
调查方法：共筛选了 6250 篇文章。两名审稿人对标题、摘要和全文进行了筛选。本综述共纳入 15 项研究。研究人员使用 JBI 定性研究批判性评估清单进行了质量评估。创建了先验协议，并在开放科学框架上进行了注册。
Data sources: Literature searches were conducted in five international bibliographic databases (MEDLINE, Embase, PsycINFO, CINAHL and ProQuest Dissertations and Theses Global) and five Korean databases (RISS, KISS, DBpia, KCI and NDSL).
数据来源：在五个国际文献数据库（MEDLINE、Embase、PsycINFO、CINAHL 和 ProQuest Dissertations and Theses Global）和五个韩国数据库（RISS、KISS、DBpia、KCI 和 NDSL）中进行了文献检索。
Results: Three main themes were identified from the 15 studies used in the metasynthesis: (1) decisional complexity of speaking up, (2) motivators for speaking up and (3) barriers to speaking up. Nurses experienced challenges in speaking up. They were, and continue to be, concerned about negative responses. Hierarchy structure and poor work environment were identified as barriers to speaking up; professional responsibility and a supportive atmosphere were identified as facilitators for speaking up.
结果：元综合中使用的 15 项研究确定了三大主题：（1）直言不讳的决策复杂性；（2）直言不讳的动机；（3）直言不讳的障碍。护士在直言不讳方面遇到了挑战。她们曾经并将继续担心负面反应。等级结构和恶劣的工作环境被认为是畅所欲言的障碍；专业责任和支持性氛围被认为是畅所欲言的动力。
Conclusion: This review synthesised nurses' experiences of speaking up and influencing factors. Speaking up is crucial for nurses to improve patient safety, as frontline nurses are ideally positioned to observe early indicators of unsafe conditions in healthcare delivery.
结论：本综述总结了护士畅所欲言的经验和影响因素。直言不讳对于护士改善患者安全至关重要，因为一线护士处于观察医疗服务中不安全状况早期指标的理想位置。
Impact: Identified motivators and barriers of nurses' speaking-up behaviour offer considerations and opportunities for healthcare leaders and managers. This could lead to improvement in patient safety through the establishment of a safety culture that facilitates nurses' speaking-up behaviour.
影响：已确定的护士畅所欲言行为的动机和障碍为医疗保健领导者和管理者提供了考虑因素和机会。这可以通过建立促进护士畅所欲言行为的安全文化来改善患者安全。
Reporting method: The review adhered to the ENTREQ guideline.
报告方法： 审查遵循 ENTREQ 指南。
Patient or public contribution: No patient or public contribution has been made in this review.
患者或公众的贡献：本次审查没有病人或公众的贡献。
Keywords: nurses; patient safety; qualitative research; speaking up.
关键词：护士；病人安全；定性研究；畅所欲言。
（译文仅供参考）
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