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Article(id=1322168399254369199, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322168262247432815, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.05.023, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1747929600000, receivedDateStr=2025-05-23, revisedDate=1768406400000, revisedDateStr=2026-01-15, acceptedDate=null, acceptedDateStr=null, onlineDate=1793159111082, onlineDateStr=2026-10-28, pubDate=1773072000000, pubDateStr=2026-03-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793159111082, onlineIssueDateStr=2026-10-28, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793159111082, creator=13701087609, updateTime=1793159111082, updator=13701087609, issue=Issue{id=1322168262247432815, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='5', pageStart='705', pageEnd='880', issueExtLink='null', onlineDate='null', pubDate='1773072000000', pubDateStr='2026-03-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793159078418, creator='13701087609', updateTime=1793159078418, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=863, endPage=867, ext={EN=ArticleExt(id=1322168399589913520, articleId=1322168399254369199, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Application progress on fuzzy-set qualitative comparative analysis in nursing management, columnId=1220689485315101342, journalTitle=Chinese Nursing Research, columnName=Review Articles, runingTitle=null, highlight=null, articleAbstract=

This article reviewed the advantages and specific operational steps of fuzzy-set qualitative comparative analysis(fsQCA) and its application status in the field of nursing staff management.It also explored future development directions,aiming to provide references for the diversified development of research methods in nursing management.

, authors=Yuanyuan LI1, Meimei ZHANG2, Juanjuan ZHOU1, Tianyan WANG2, Aixian LI2, 3, authorsList=Yuanyuan LI, Meimei ZHANG, Juanjuan ZHOU, Tianyan WANG, Aixian LI, authorCompany=null, correspAuthors=Aixian LI, authorNote=null, correspAuthorsNote=
LI Aixian, E-mail:
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对模糊集定性比较分析的优势、具体操作步骤以及在护理人员管理领域中的应用现状进行综述，并对其未来发展方向进行展望，以期为护理管理领域研究方法的多元化发展提供参考。

, authors=黎媛媛1, 张美美2, 周娟娟1, 王田燕2, 李爱仙2, 3, *, *, authorsList=黎媛媛, 张美美, 周娟娟, 王田燕, 李爱仙, authorCompany=null, correspAuthors=李爱仙, authorNote=

黎媛媛，护士，硕士研究生在读

, correspAuthorsNote=
李爱仙，E-mail:
LI Aixian, E-mail:
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黎媛媛，护士，硕士研究生在读

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黎媛媛，护士，硕士研究生在读

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模糊集定性比较分析在护理管理中的应用进展
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黎媛媛 1 , 张美美 2 , 周娟娟 1 , 王田燕 2 , 李爱仙 2, 3, *, *
护理研究 | 科研综述 2026,40(5): 863-867
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护理研究 |科研综述 2026 , 40 (5) : 863 -867
模糊集定性比较分析在护理管理中的应用进展
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黎媛媛，护士，硕士研究生在读

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黎媛媛1, 张美美2, 周娟娟1, 王田燕2, 李爱仙2, 3, *, *
作者信息
  • 1江苏大学医学院，江苏 212013
  • 2昆山市第一人民医院（江苏大学附属昆山医院）
  • 3昆山市妇幼保健院
通讯作者:
李爱仙，E-mail:
LI Aixian, E-mail:
作者简介:

黎媛媛，护士，硕士研究生在读

Application progress on fuzzy-set qualitative comparative analysis in nursing management
Yuanyuan LI1, Meimei ZHANG2, Juanjuan ZHOU1, Tianyan WANG2, Aixian LI2, 3
Affiliations
  • 1School of Medicine, Jiangsu University, Jiangsu 212013 China
  • 2The First People's Hospital of Kunshan City(Jiangsu University Affiliated Kunshan Hospital)
  • 3Kunshan Maternal and Child Health Care Hospital
    • Corresponding Author:
    LI Aixian, E-mail:
出版时间: 2026-03-10 doi: 10.12102/j.issn.1009-6493.2026.05.023
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摘要
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对模糊集定性比较分析的优势、具体操作步骤以及在护理人员管理领域中的应用现状进行综述，并对其未来发展方向进行展望，以期为护理管理领域研究方法的多元化发展提供参考。

模糊集定性比较分析  /  护理管理  /  多元化  /  综述

This article reviewed the advantages and specific operational steps of fuzzy-set qualitative comparative analysis(fsQCA) and its application status in the field of nursing staff management.It also explored future development directions,aiming to provide references for the diversified development of research methods in nursing management.

fuzzy-set qualitative comparative analysis  /  nursing management  /  diversification  /  review
黎媛媛, 张美美, 周娟娟, 王田燕, 李爱仙. 模糊集定性比较分析在护理管理中的应用进展. 护理研究, 2026 , 40 (5) : 863 -867 . DOI: 10.12102/j.issn.1009-6493.2026.05.023
Yuanyuan LI, Meimei ZHANG, Juanjuan ZHOU, Tianyan WANG, Aixian LI. Application progress on fuzzy-set qualitative comparative analysis in nursing management[J]. Chinese Nursing Research, 2026 , 40 (5) : 863 -867 . DOI: 10.12102/j.issn.1009-6493.2026.05.023
正文
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护理人员是医疗卫生服务体系的核心力量，密切关系着医疗服务质量、病人生命安全以及“健康中国”建设。国家统计局2024年公布的数据显示，截至2024年，我国的注册护士达到584万人，占卫生技术从业人员的45.1%[1]，较2021年增长了16.38%[2]，超过《全国护理事业发展规划（2021—2025年）》[3]中提出的“我国的注册护士预计到2025年将达到的550万人”。随着护理队伍规模的逐年扩大，提升了医疗服务的可及性，但同时也对护理人员的管理提出了更高要求。研究显示，护理人员管理是一个复杂的系统工程，涉及个体、组织及环境等多个层面的因素，这些因素之间不是简单的线性关系，而是呈现出复杂的交互作用[4]。现有护理研究大多依赖传统的回归分析方法来分析数据。然而，这些方法难挖掘多重因素间的协同效应，在揭示复杂交互效应方面存在一定的局限性。鉴于此，可以使用模糊集定性比较分析（fuzzy-set qualitative comparative analysis,fsQCA）来识别不同因素组合对护理管理产生的影响路径，进一步探讨护理管理中存在的复杂因果关系，其契合护理人员管理研究的复杂性需求，可以更好地完善护理管理体系。本研究概述fsQCA的相关内容，以及在护理人员管理各维度的应用现状及效果，为护理管理者提供新的研究视角和管理方法，推动护理管理研究与实践的创新发展，进一步提升护理管理的科学性和有效性，促进护理事业的高质量发展。
1　fsQCA概述
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1987年，Ragin[5]首次提出定性比较分析（QCA）的概念，同时提出了二元变量清晰集定性比较分析（crisp-set qualitative comparative analysis,csQCA）作为QCA的基本形式。随着QCA方法论的不断完善，Ragin[6]于2000年提出三元变量多值集定性比较分析（multi-value qualitative comparative analysis,mvQCA）和fsQCA，fsQCA作为定性比较分析中的一种类型，是一种以案例为导向的研究方法，其基于集合理论思想与组态思维，将定量与定性有效联结，借助架构理论和布尔代数运算，从集合的角度考察前因条件及条件组合与结果之间的关系，从而解释现象背后复杂的因果关系[7]。
1.1　fsQCA的优势
fsQCA与csQCA相比，能够捕捉到案例中存在的程度差异[8]，与mvQCA相比则更加灵活，因为fsQCA通过等距刻度将数据转化为模糊隶属分数，使用0和1之间的任何数值（0表示完全不属于，1表示完全属于）来表示不同程度的隶属关系；因此，具有多定距变量优点，特别是精确区分的能力[9]。除此之外，fsQCA还具有其他优势：1）数据包容性强，适用于大样本量的同时也适用于中小样本量[10]；2）揭示多因素组合的组态效应，而非单一因素影响；3）承认结果的非对称性，即导致结果出现与不出现的前因条件组合并非镜像对称，需要分别分析正向和反向结果的成因[11]，从而更精准地揭示复杂现象背后的多元路径；4）fsQCA同时具备定性和定量研究方法的优势，可整合定量数据和定性信息，既保留了案例研究的深度，又具备系统性分析的严谨性；5）研究具有可重复性，fsQCA是从案例角度出发揭示理论背后因果关系，分析过程和结果呈现是定量式的；6）能够处理不同条件的交互作用和非线性关系[11]。故既往研究更倾向于使用模糊集而非清晰集和多值集定性比较分析[4]。
1.2　fsQCA的操作步骤
1）确定研究问题：研究问题首先要具有研究意义，可以是探索性研究或验证性研究，但需要同时包含正面结果和负面结果，能够展现条件组合的多样性[12]，更全面地理解因果机制；2）案例选择：案例的选择必须考虑案例的清晰界定，所选择的案例应具有足够的相似性和在特定维度上的可比性以及案例间最大异质性[9]，避免过度一致；3）条件选择：根据已有的理论和经验选择合适的条件变量[12]，条件数量的选择要考虑样本数量和模型简约性，n个条件理论上存在2n个条件组合，过多的条件会使条件组合数量超过案例数量[9]；4）条件与结果校准：一共存在2种校准方法，一种是间接校准法[13]，研究人员根据主观判断，为每个条件分配多个0和1之间的值，然后使用软件对数据进行校准，主观性强但灵活性高，适用于小规模数据、分类变量或缺乏明确定量指标的情况；另一种是最常用的直接校准法[12]，基于理论和实践提出3个定性锚点，完全隶属为1，完全不隶属为0，交叉点为0.5，再用fsQCA软件将原始数据转换为隶属分数，客观性强，适合处理大规模连续变量数据[11]；5）必要性条件分析：使用fsQCA软件生成的一致性和覆盖度对条件变量进行必要性检验，若某一条件变量的一致性≥0.9，并且有足够的覆盖度，则说明该条件变量是结果变量的强必要条件[11]；6）组态分析：构建完善真值表后进行标准分析生成解集；fsQCA解集包括复杂解、中间解和简单解，杜运周等[11]推荐组态分析采用中间解，并利用中间解和简约解分析组合路径的核心条件和边缘条件；7）稳健性检验：通过改变校准锚点、改变一致性阈值、增删案例或使用不同的解等方式进行稳健性检验，确保研究结果的可靠性[14]。
2　应用现状
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2.1　护理人员满意度研究
护理人员的满意度通常会有多种影响因素，在满意度不同的类型中呈现不同的影响效果，因此，fsQCA在探究护理人员满意度这一程度上拥有独特优势，可以研究影响护理人员工作满意度的相互作用因素。如蔡媛青等[15]通过对22所公立医院进行了1 738份问卷调查，探讨某市公立医院医务人员工作满意度影响机制，发现7种会导致高工作满意度的条件组合；其中，工作情境主导模式强调工作环境、工作负担和福利薪酬的协同作用，对护士群体的影响尤为显著。王晨等[16]运用fsQCA分析黑龙江省和河北省公立医院医务人员的薪酬满意度影响因素，发现薪酬满意度是由工作环境导向型、社会环境导向型和额外收入补偿型3种条件组合产生。其中，工作环境导向型突出了工作和岗位环境等要素对薪酬满意度的重要性，这些都与护理人员的工作满意度密切相关。研究表明，fsQCA能够有效地揭示影响护理人员满意度的多重因素及其相互作用，为提升护理人员满意度提供理论依据和决策支持。通过fsQCA分析，管理者可以更加全面地了解影响护理人员满意度的因素组合，然后采取针对性的措施，例如优化工作环境、减轻工作负担、提高福利薪酬、完善职业发展制度等，最终提升护理人员的工作满意度和工作绩效。
2.2　护理人员行为研究
护理人员行为具有复杂性，通过单一条件变量难以充分解释护理人员行为的影响因素。fsQCA从总体的角度出发，通过系统化跨案例比较，识别出多个影响护理人员行为的条件变量组合，为研究护理人员行为提供了新的视角。Asante等[17]以计划行为理论为基础，同时结合了感知组织支持和行动线索两个外源变量，运用fsQCA识别出了预测护士安全合规行为的心理因素组合以及必要条件；此外，利用fsQCA非对称性的特点，研究发现护士对不遵守安全协议可能引发的不良后果的意识，能够诱导安全合规行为。吕森森[18]在研究影响基层医疗机构糖尿病管理指南实施的因素时，发现个体对组织的认同感为核心条件，除此之外，还需要结合资源、工作压力等多因素的综合作用才能完整地解释指南执行率机制，为医院管理者和政策制定者提供了宝贵的启示，有助于改善护士的安全状况，并最终提升医疗质量[19]。
2.3　护理人员决策研究
fsQCA可以分析影响护士决策准确性的因素组合。影响分诊决策准确性是由个体因素和组织因素的复杂组合决定，而非单因素净效应。Ponsiglione等[20]通过fsQCA得到了出现错误分诊的5种组态路径，强调了将个体因素与决策背景相结合的重要性。通过fsQCA分析方法可以更好地理解各因素间的互动关系，设计出更有效的培训和管理方法，可以帮助护士做出更准确的分诊决策，让病人得到更及时、更有效的治疗。《新一代人工智能发展规划》[21]指出，人工智能（AI）在护理决策领域得到了广泛的应用，在未来的研究中应紧跟时代发展，进一步将AI技术（如机器学习）纳入护理人员决策的影响因素中。
2.4　离职意愿研究
护士的高离职意愿会对临床护理质量和病人安全产生严重影响[22]，所以降低护士离职率对提高护理队伍的稳定性至关重要。在以往的研究中，关于护士的职业发展大多只关注不同因素的独立作用[23]，忽略了变量间的交互作用和组合效应，而护士的离职意愿往往是由多种因素以不同的方式组合起来共同导致，例如在一项针对男护士留职意愿影响因素的组态分析中发现，男护士留职意愿的形成依赖于多种因素的共同作用和相互配合[24]。薪酬待遇是必要前提，而研究发现的5种因素组态则反映了导致男护士留职意愿的5条不同路径，为理解护理人员离职的因果机制发展了新的理论视角。另一项研究中提到，年轻的护理人员会因为自身技能水平低但是工作要求高而产生离职心理，但是随着年龄增长技能水平不断提高，工作时长的延长和较低的组织支持也同样会导致离职的发生，说明离职意愿因素不仅受到不同因素组合的影响，而且随着年龄的增长影响因素组合也会发生改变[25]，且利用fsQCA非对称性这一性质得到，即使导致高离职意愿的那些条件变量不存在，也不必然导致离职这一结果不发生，说明离职意愿是一个复杂的动态变化的过程，传统的单一因素分析方法难以对离职意愿进行深入挖掘。在未来的研究中，可以使用队列研究或是重复横断面研究，深入了解离职意愿的时间变化趋势以及发展过程。
2.5　护理实习生管理研究
在临床护理管理中，护理实习生作为护理事业的新生力量，在对护理实习生进行管理时常面临诸多挑战，通过fsQCA识别出影响护理实习生管理的不同条件组合，从而更好地促进护理实习生管理的发展。David等[26]对私立大学的574名护生进行实习满意度的路径分析，发现了影响护理实习生对临床实习满意度的7种因素，以及导致高总体满意度的13条组态路径。这与Sundler等[27]的调查结果相同，这些结果可用于制定与改善临床实习相关的干预措施和实践方案，帮助护生从校园学习逐渐过渡到临床实践。但是对护理实习生满意度的影响因素考虑得还不够全面，O'Brien等[28]的研究指出，良好的实习体验还应该包括带教老师所给予的适当指导与支持、明确的学习目标和学习计划、有效的沟通以及实习生自身积极的态度等。实习生是未来护理事业发展的储备力量，除了关注护理实习生实习期间学习生活的满意度，也应对职业理想做到有效引导，壮大护理队伍的同时也增加了稳定性。在使用fsQCA对影响实习生的职业理想发展的路径进行研究时发现了导致护理实习生高职业理想的8个条件组合[29]，虽然并没有构成高职业理想的必要因素，但在所有因素中积极职业态度的影响最大，为护理实习生管理机制的改进提供了参考。
2.6　其他维度研究
fsQCA作为一种新的研究工具和方法，还被应用于护理人员自我管理的维度，例如探究针对急诊护士职业重塑的因素[30]，结果显示心理授权是核心条件，并揭示了影响职业重塑的多种组态；或者将fsQCA与传统的回归分析方法相结合，探究高压力下护士疲劳的形成因素[31]，揭示护士疲劳机制的同时，也为如何进行合理的护士排班提供了实证依据。除此之外，fsQCA在护理人力资源配置[32]、护士心理弹性[33]、护士沟通态度管理[34]等多个方面都有应用。
3　展望
收起
3.1　扩展应用领域
目前，fsQCA在护理管理领域已得到了广泛应用，主要聚焦于护理人员满意度、护理实习生管理、心理弹性等议题，可以进一步拓展其应用领域。1）探究护士职业倦怠的影响路径，现有的研究中多采用单一视角[35-36]，fsQCA能够将单一因素关联起来形成条件链，挖掘多因素叠加效应对护士职业倦怠的影响，从而更全面地阐释职业倦怠出现的内在机制。2）护理质量管理是一个复杂系统工程，不仅包含护理的规范化流程制定与实施，还包括护理人员的培训与教育、护理质量的监督机制等多个方面[37-38]，可以使用fsQCA来探究护理质量各方面的多因素耦合机制。
3.2　方法学创新
fsQCA是一种分析某个时间点数据的方法，主要用来处理横截面数据，而不擅长处理时间序列数据或面板数据，因此，其难以捕捉现象随时间变化的动态过程。在未来的研究中，可以尝试使用QCA面板数据[39]，研究者通过分时段分析，揭示不同阶段的驱动因素，以此来弥补fsQCA在时间以及空间维度上的缺陷，从而为护理管理人员在不同时间点、不同场景下制定有针对性的管理策略提供科学依据。除此之外，随着人工智能等发展，机器学习逐渐走入大众视野，将fsQCA与机器学习结合，使用机器学习进行数据预处理和特征选择，使分析过程科学严谨，减少主观偏差，提高结果的可靠性[40]。此外，机器学习算法还可以基于fsQCA的结果构建预测模型，护理人员管理者可以根据预测结果，针对关键组态中的薄弱环节制定针对性干预措施，从而更好地提高预测精确度。
3.3　完善fsQCA的规范与标准
目前，尽管现有资源对fsQCA的应用提供了指导[9,41]，涵盖了从数据准备到结果分析的全流程，但尚未建立统一、正式的使用规范，研究者可以根据自身研究需求选择不同的操作步骤或参数设置，保证结果的稳健性和可比性。为推动fsQCA的应用，可以鼓励跨学科研究者共同制定标准化操作流程和参数设置指南，组织领域专家编写fsQCA的教材和操作手册，提供在线学习资源，为研究者提供全面的指导。此外，通过定期组织fsQCA专题研讨会，分享应用案例和研究经验，使fsQCA方法得到进一步推广。
4　小结
收起
fsQCA作为一种新型的研究方法，近年来在护理管理领域逐渐得到应用并取得了一定的进展，其弥补了线性回归等分析方法的局限性，帮助研究人员更好地理解复杂管理现象背后的多因素协同效应。但是fsQCA在护理管理领域的研究仍需要进一步拓展与完善，使用过程中仍缺乏足够的严谨性和科学性，且存在无法进行跨时间比较的缺陷。因此，未来研究应积极探索使用fsQCA的统一标准和指南，并结合其他研究方法来弥补其不足，更好地促进fsQCA在护理管理领域的应用和发展。

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doi: 10.12102/j.issn.1009-6493.2026.05.023
  • 接收时间：2025-05-23
  • 首发时间：2026-10-28
  • 出版时间：2026-03-10
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  • 收稿日期：2025-05-23
  • 修回日期：2026-01-15
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    1江苏大学医学院，江苏 212013
    2昆山市第一人民医院（江苏大学附属昆山医院）
    3昆山市妇幼保健院

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