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Article(id=1322630897065636478, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322630794611380728, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.18.008, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1762704000000, receivedDateStr=2025-11-10, revisedDate=1781625600000, revisedDateStr=2026-06-17, acceptedDate=null, acceptedDateStr=null, onlineDate=1793269379154, onlineDateStr=2026-10-29, pubDate=1790265600000, pubDateStr=2026-09-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793269379154, onlineIssueDateStr=2026-10-29, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793269379154, creator=13701087609, updateTime=1793269379154, updator=13701087609, issue=Issue{id=1322630794611380728, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='18', pageStart='3153', pageEnd='3344', issueExtLink='null', onlineDate='null', pubDate='1790265600000', pubDateStr='2026-09-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=1, specialIssue=null, createTime=1793269354727, creator='13701087609', updateTime=1793343080645, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322940023645011984, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322630794611380728, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322940023645011985, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322630794611380728, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=3206, endPage=3212, ext={EN=ArticleExt(id=1322630897279545983, articleId=1322630897065636478, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Status quo and influencing factors of clinical evidence-based nursing practice competence among master of nursing specialist students： a mixed-method study, columnId=1220689484526572183, journalTitle=Chinese Nursing Research, columnName=Original Articles, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the clinical evidence-based nursing practice competence among master of nursing specialist students and analyze its influencing factors.

Methods

A mixed-methods study with an explanatory sequential design was adopted.For the quantitative phase,convenience sampling was used to select 130 master of nursing specialist students from four tertiary grade A hospitals in Shanxi province from March to May 2023.The participants were surveyed using a general information questionnaire and the Chinese version of the Evidence-Based Practice Questionnaire.For the qualitative phase,a total of 19 master of nursing specialist students were selected to participate in semi-structured interviews from the quantitative study sample.

Results

The total score on the Chinese version of the Evidence-based Practice Questionnaire among the 130 master of nursing specialist students was 115.95±21.04,with an average item score of 4.64±0.84.Regression analysis showed that research experience(participating in academic conferences and research projects and so on),awareness of the importance of clinical evidence-based nursing practice,and knowledge of clinical evidence-based nursing practice were influencing factors for the score on the Chinese version of the Evidence-Based Practice Questionnaire(all P<0.05).The qualitative analysis extracted four themes,namely high recognition and internalization of values,identifying clinical evidence-based nursing practice as a professional development direction;weak practical competence and lack of systematic support,leading to a knowing-doing gap;multidimensional facilitating factors stimulating the implementation of clinical evidence-based nursing practice;and multiple barriers constraining the clinical application of evidence-based nursing practice.

Conclusions

The clinical evidence-based nursing practice competence among master of nursing specialist students was at a moderate level.Hospitals and schools should improve teaching methods based on students' learning needs and experiences, provide more support,and enhance their clinical evidence-based nursing practice competence.

, authors=Xiaohong MENG1, Zhaojie CHANG1, Jing LI1, Meixia REN2, Yuan ZHAO1, Jiaqi LI3, Yuling LI1, authorsList=Xiaohong MENG, Zhaojie CHANG, Jing LI, Meixia REN, Yuan ZHAO, Jiaqi LI, Yuling LI, authorCompany=null, correspAuthors=Yuling LI, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322630898021937794, articleId=1322630897065636478, tenantId=1146029695717560320, journalId=1220038315760373764, language=CN, title=护理硕士专业学位研究生临床循证护理实践能力现状及影响因素的混合研究, columnId=1220689484681761433, journalTitle=护理研究, columnName=科研论著, runingTitle=null, highlight=null, articleAbstract=
目的

了解护理硕士专业学位研究生的临床循证护理实践能力，分析其影响因素。

方法

采用解释性序列设计的混合研究法，量性研究采用便利抽样法，于2023年3月—5月选取山西省4所三级甲等医院的130名护理硕士专业学位研究生作为研究对象，采用一般资料调查表和中文版循证实践知识、态度、行为问卷进行调查。质性研究从量性研究中选取同意参与质性访谈的19名护理硕士专业学位研究生进行半结构式访谈。

结果

130名护理硕士专业学位研究生中文版循证实践知识、态度、行为问卷总分为（115.95±21.04）分，条目均分为（4.64±0.84）分。回归分析结果显示，科研经历（如参与学术会议、课题研究等）、开展临床循证护理实践的重要性认知、临床循证护理实践知晓度是护理硕士专业学位研究生中文版循证实践知识、态度、行为问卷得分的影响因素（均P<0.05）。质性研究共提炼出4个主题，即高认同度与价值内化，将临床循证护理实践作为专业发展方向；实践能力薄弱与系统支持缺失，导致知行脱节困境；多维促进因素，激发临床循证护理实践实施；多重阻碍因素，制约临床循证护理实践的临床应用。

结论

护理硕士专业学位研究生临床循证护理实践能力处于中等水平，医院及学校可从学生学习需求、体验着手改进教学方式为护理硕士专业学位研究生提供更多支持，提升其临床循证护理实践能力。

, authors=孟效红1, 常兆洁1, 李婧1, 任美霞2, 赵媛1, 李嘉琪3, 李育玲1, *, *, authorsList=孟效红, 常兆洁, 李婧, 任美霞, 赵媛, 李嘉琪, 李育玲, authorCompany=null, correspAuthors=李育玲, authorNote=

孟效红，副主任护师，硕士研究生

, correspAuthorsNote=
李育玲，E-mail:
LI Yuling, E-mail:
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articleId=1322630897065636478, language=EN, label=Table 1, caption=

Five items with the lowest scores on the Chinese version of the EBPQ among MNS degree students（n=130）

, figureFileSmall=null, figureFileBig=null, tableContent=
条目所属维度得分（x±s）
将您获得的最佳研究证据（或信息）与您的临床经验进行有效整合知识4.48±1.04
将实践中发现的问题转化为研究问题行为4.44±1.11
科研能力行为4.38±1.09
评价您的循证实践效果知识4.24±1.26
与科室老师或同学分享您循证的成果知识4.15±1.42
), ArticleFig(id=1322630906737701564, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322630897065636478, language=CN, label=表1, caption=

MNS研究生中文版EBPQ得分较低的5个条目（n=130）

, figureFileSmall=null, figureFileBig=null, tableContent=
条目所属维度得分（x±s）
将您获得的最佳研究证据（或信息）与您的临床经验进行有效整合知识4.48±1.04
将实践中发现的问题转化为研究问题行为4.44±1.11
科研能力行为4.38±1.09
评价您的循证实践效果知识4.24±1.26
与科室老师或同学分享您循证的成果知识4.15±1.42
), ArticleFig(id=1322630906829976253, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322630897065636478, language=EN, label=Table 2, caption=

Univariate analysis of factors influencing scores on the Chinese version of the EBPQ among MNS degree students

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分类人数得分（x±s）P
性别男9128.78±21.370.058
女121114.99±20.79
年龄<25岁93117.04±21.210.348
≥25岁37113.19±20.62
年级研究生一年级68111.91±19.660.010
研究生二年级43116.88±19.16
研究生三年级19128.26±25.55
英语等级大学英语四级3113.330.829
大学英语六级127116.01±21.21
培养方式非定向120114.94±19.910.214
定向10128.00±30.51
婚姻状况已婚6113.33±21.360.757
未婚124116.07±21.10
学习过文献检索课程是127115.71±21.180.404
否3126.00
临床实习（工作）经历<6个月12118.92±23.420.706
6~12个月83114.81±19.78
>12个月35117.63±23.43
临床EBNP知晓度较少了解65110.00±21.530.001
比较了解62120.77±18.61
非常熟悉3145.00
参加循证护理相关讲座或培训次数0次49110.49±21.310.021
1次或2次65117.49±20.10
≥3次16126.38±20.15
开展临床EBNP的重要性认知不重要395.000.028
有一定重要性54112.09±19.41
非常重要73119.66±21.73
科研经历（如参与学术会议、课题研究等）有96120.41±20.23<0.001
无34103.35±18.18
), ArticleFig(id=1322630907085828799, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322630897065636478, language=CN, label=表2, caption=

MNS研究生中文版EBPQ得分影响因素的单因素分析

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分类人数得分（x±s）P
性别男9128.78±21.370.058
女121114.99±20.79
年龄<25岁93117.04±21.210.348
≥25岁37113.19±20.62
年级研究生一年级68111.91±19.660.010
研究生二年级43116.88±19.16
研究生三年级19128.26±25.55
英语等级大学英语四级3113.330.829
大学英语六级127116.01±21.21
培养方式非定向120114.94±19.910.214
定向10128.00±30.51
婚姻状况已婚6113.33±21.360.757
未婚124116.07±21.10
学习过文献检索课程是127115.71±21.180.404
否3126.00
临床实习（工作）经历<6个月12118.92±23.420.706
6~12个月83114.81±19.78
>12个月35117.63±23.43
临床EBNP知晓度较少了解65110.00±21.530.001
比较了解62120.77±18.61
非常熟悉3145.00
参加循证护理相关讲座或培训次数0次49110.49±21.310.021
1次或2次65117.49±20.10
≥3次16126.38±20.15
开展临床EBNP的重要性认知不重要395.000.028
有一定重要性54112.09±19.41
非常重要73119.66±21.73
科研经历（如参与学术会议、课题研究等）有96120.41±20.23<0.001
无34103.35±18.18
), ArticleFig(id=1322630907178103489, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322630897065636478, language=EN, label=Table 3, caption=

Linear regression analysis of factors influencing scores on the Chinese version of EBNP among MNS degree students

, figureFileSmall=null, figureFileBig=null, tableContent=
变量回归系数标准误标准化回归系数t值P
常量104.11311.1189.364<0.001
科研经历（如参与学术会议、课题研究等）-13.3774.108-0.281-3.2570.001
开展临床EBNP的重要性认知7.0823.1200.1832.2700.025
临床EBNP知晓度7.0473.3640.1832.0950.038
), ArticleFig(id=1322630907241018050, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322630897065636478, language=CN, label=表3, caption=

MNS研究生中文版EBNP得分影响因素的线性回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量回归系数标准误标准化回归系数t值P
常量104.11311.1189.364<0.001
科研经历（如参与学术会议、课题研究等）-13.3774.108-0.281-3.2570.001
开展临床EBNP的重要性认知7.0823.1200.1832.2700.025
临床EBNP知晓度7.0473.3640.1832.0950.038
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护理硕士专业学位研究生临床循证护理实践能力现状及影响因素的混合研究
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孟效红 1 , 常兆洁 1 , 李婧 1 , 任美霞 2 , 赵媛 1 , 李嘉琪 3 , 李育玲 1, *, *
护理研究 | 科研论著 2026,40(18): 3206-3212
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护理研究 |科研论著 2026 , 40 (18) : 3206 -3212
护理硕士专业学位研究生临床循证护理实践能力现状及影响因素的混合研究
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孟效红，副主任护师，硕士研究生

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孟效红1, 常兆洁1, 李婧1, 任美霞2, 赵媛1, 李嘉琪3, 李育玲1, *, *
作者信息
  • 1山西医科大学第一医院，山西 030001
  • 2平遥计生妇幼服务中心
  • 3山西医科大学护理学院
通讯作者:
李育玲，E-mail:
LI Yuling, E-mail:
作者简介:

孟效红，副主任护师，硕士研究生

Status quo and influencing factors of clinical evidence-based nursing practice competence among master of nursing specialist students： a mixed-method study
Xiaohong MENG1, Zhaojie CHANG1, Jing LI1, Meixia REN2, Yuan ZHAO1, Jiaqi LI3, Yuling LI1
Affiliations
  • 1First Hospital of Shanxi Medical University, Shanxi 030001 China
  • 2Pingyao Maternal and Child Health Service Center
  • 3Nursing College of Shanxi Medical University
出版时间: 2026-09-25 doi: 10.12102/j.issn.1009-6493.2026.18.008
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摘要
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目的

了解护理硕士专业学位研究生的临床循证护理实践能力，分析其影响因素。

方法

采用解释性序列设计的混合研究法，量性研究采用便利抽样法，于2023年3月—5月选取山西省4所三级甲等医院的130名护理硕士专业学位研究生作为研究对象，采用一般资料调查表和中文版循证实践知识、态度、行为问卷进行调查。质性研究从量性研究中选取同意参与质性访谈的19名护理硕士专业学位研究生进行半结构式访谈。

结果

130名护理硕士专业学位研究生中文版循证实践知识、态度、行为问卷总分为（115.95±21.04）分，条目均分为（4.64±0.84）分。回归分析结果显示，科研经历（如参与学术会议、课题研究等）、开展临床循证护理实践的重要性认知、临床循证护理实践知晓度是护理硕士专业学位研究生中文版循证实践知识、态度、行为问卷得分的影响因素（均P<0.05）。质性研究共提炼出4个主题，即高认同度与价值内化，将临床循证护理实践作为专业发展方向；实践能力薄弱与系统支持缺失，导致知行脱节困境；多维促进因素，激发临床循证护理实践实施；多重阻碍因素，制约临床循证护理实践的临床应用。

结论

护理硕士专业学位研究生临床循证护理实践能力处于中等水平，医院及学校可从学生学习需求、体验着手改进教学方式为护理硕士专业学位研究生提供更多支持，提升其临床循证护理实践能力。

护理硕士专业学位  /  循证护理实践  /  影响因素  /  混合研究
Objective

To investigate the clinical evidence-based nursing practice competence among master of nursing specialist students and analyze its influencing factors.

Methods

A mixed-methods study with an explanatory sequential design was adopted.For the quantitative phase,convenience sampling was used to select 130 master of nursing specialist students from four tertiary grade A hospitals in Shanxi province from March to May 2023.The participants were surveyed using a general information questionnaire and the Chinese version of the Evidence-Based Practice Questionnaire.For the qualitative phase,a total of 19 master of nursing specialist students were selected to participate in semi-structured interviews from the quantitative study sample.

Results

The total score on the Chinese version of the Evidence-based Practice Questionnaire among the 130 master of nursing specialist students was 115.95±21.04,with an average item score of 4.64±0.84.Regression analysis showed that research experience(participating in academic conferences and research projects and so on),awareness of the importance of clinical evidence-based nursing practice,and knowledge of clinical evidence-based nursing practice were influencing factors for the score on the Chinese version of the Evidence-Based Practice Questionnaire(all P<0.05).The qualitative analysis extracted four themes,namely high recognition and internalization of values,identifying clinical evidence-based nursing practice as a professional development direction;weak practical competence and lack of systematic support,leading to a knowing-doing gap;multidimensional facilitating factors stimulating the implementation of clinical evidence-based nursing practice;and multiple barriers constraining the clinical application of evidence-based nursing practice.

Conclusions

The clinical evidence-based nursing practice competence among master of nursing specialist students was at a moderate level.Hospitals and schools should improve teaching methods based on students' learning needs and experiences, provide more support,and enhance their clinical evidence-based nursing practice competence.

master of nursing specialist  /  evidence-based nursing practice  /  influencing factors  /  mixed-methods study
孟效红, 常兆洁, 李婧, 任美霞, 赵媛, 李嘉琪, 李育玲. 护理硕士专业学位研究生临床循证护理实践能力现状及影响因素的混合研究. 护理研究, 2026 , 40 (18) : 3206 -3212 . DOI: 10.12102/j.issn.1009-6493.2026.18.008
Xiaohong MENG, Zhaojie CHANG, Jing LI, Meixia REN, Yuan ZHAO, Jiaqi LI, Yuling LI. Status quo and influencing factors of clinical evidence-based nursing practice competence among master of nursing specialist students： a mixed-method study[J]. Chinese Nursing Research, 2026 , 40 (18) : 3206 -3212 . DOI: 10.12102/j.issn.1009-6493.2026.18.008
正文
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随着全球医疗健康事业的持续进步，循证护理（evidence-based nursing，EBN）已成为推动护理专业化、提升病人结局和优化医疗资源分配的核心驱动力[1]。循证护理实践（evidence-based nursing practice，EBNP）强调护理决策应基于最佳科研证据、临床专家专业判断以及病人价值观与意愿的有机结合[2]，而在真实、复杂临床情境中强调应用循证思维以解决实际问题的综合素养即为临床EBNP。护理硕士专业学位（master of nursing specialist，MNS）研究生是我国高级护理实践人才的后备力量，临床EBNP能力不仅是衡量其培养质量的关键指标，更直接影响其未来在临床一线引领护理革新、解决复杂护理问题以及推动证据转化的能力[3]。如何有效提升MNS研究生的临床EBNP能力是当前护理教育领域面临的重要问题。故本研究采用解释性序列设计的混合研究方法，通过量性先行、质性补充的策略，揭示影响MNS研究生临床EBNP能力的关键因素，从个体经验层面探索潜在的影响机制与需求，为构建以临床需求为导向的EBNP培养路径提供科学依据。
1　对象与方法
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1.1　研究对象
1.1.1　量性研究
采用便利抽样法，于2023年3月—5月选取山西省4所三级甲等医院的MNS研究生作为研究对象。纳入标准：全日制硕士研究生；研究生在读；已完成循证护理学课程；知情同意并自愿参与本研究。排除标准：研究生期间休学。本研究共涉及12个观测变量，依据Kendall粗略估计方法，样本量应设定为变量数的5~10倍[4]，考虑10%的无效问卷，经计算确定最小样本量为67人。本研究已通过山西医科大学第一医院伦理委员会审核批准（审批号：No.KYYJ-2023-168）。
1.1.2　质性研究
采用嵌套样本法，采用差异最大化目的抽样法，以不同年级、临床实习（工作）经历、临床EBNP知晓度、开展临床EBNP的重要性认知、科研经历（如参与学术会议、课题研究等）为筛选指标，从量性调查中选取同意参与质性访谈的研究生为研究对象。纳入和排除标准同量性研究。按序循环进行招募、访谈和数据分析，直至新数据不带来新见解，达到信息饱和，从而确定最终样本量。最终纳入19名MNS研究生（编号为S1~S19）。
1.2　研究方法
采用混合方法研究中的解释性序列设计。首先，对MNS研究生的临床EBNP能力现状及其影响因素进行全面调查；随后，选取研究对象进行半结构式访谈。通过质性研究深入剖析MNS研究生临床BNEP能力的影响因素，进一步补充和阐释量性研究结果。研究开始前向研究对象详细阐释研究目的、具体内容及实施方法，获得其知情同意后开展研究工作。所有收集的问卷和录音资料均采用匿名编号的方式保存。本研究严格遵循混合方法研究报告标准（Good Reporting of a Mixed Method Study，GRAMMS）[5]。
1.2.1　量性研究
1.2.1.1　调查工具
1）一般资料调查表：由研究者查阅文献后自行设计，包括性别、年龄、年级、英语等级、培养方式、婚姻状况、是否学习过文献检索课程、临床实习（工作）经历、临床EBNP知晓度、参加循证护理相关讲座或培训次数、开展临床EBNP的重要性认知、科研经历（如参与学术会议、课题研究等）等。2）中文版循证实践知识、态度、行为问卷（Evidence-Based Practice Questionnaire，EBPQ）：EBPQ由Dominic Upton等于2006年编制[6]，杨如美[7]对其翻译及修订形成中文版EBPQ，问卷由3个维度、25个条目组成，其中，行为维度包括6个条目，“从不”计1分，“经常”计7分；态度维度包括5个条目，“反对”计1分，“赞成”计7分；知识维度包括14个条目，“最差”计1分，“最好”计7分，总分25~175分。本研究中问卷的Cronbach's α系数为0.963，各维度的Cronbach's α系数为0.891~0.960。
1.2.1.2　资料收集及质量控制
采用问卷星生成调查问卷，在正式调查前对课题组成员进行针对性培训。选取5%的研究生进行预调查，确认问卷内容、收集项目无误后进行正式调查。由课题组负责人发放问卷，说明研究目的及要求，研究生自愿匿名填写后提交问卷。利用问卷星后台进行质量控制，同一账号仅可填写1次问卷，并设置所有问卷题目为必答题，以保证问卷填写的有效性。问卷回收后由2名研究者核对数据，剔除不符合要求的问卷。共发放问卷147份，剔除有重复作答选项、作答时间<3 min的问卷，回收有效问卷130份，问卷有效回收率为88.44%。
1.2.2　质性研究
1.2.2.1　资料收集方法
采用描述性现象学方法，对MNS研究生进行半结构式访谈。经文献回顾[7-10]和研究小组反复论证后确定访谈提纲如下：1）您如何理解临床EBNP？2）您认为现有课程设置是否足够支持临床EBNP的实施？3）在检索、评价证据过程中哪些环节让您感到困难？4）您在护理病人过程中是如何实施EBNP的？是否达到预期目标？如果没有，原因是什么？5）您认为哪些因素对提升您的临床EBNP能力至关重要？6）您认为医院/学校需要进一步重视哪些方面？访谈前研究者向受访者解释研究目的，在不受打扰的房间进行访谈，每次访谈时间为30~60 min，其间根据具体情况调整提问方式，充分使受访者表达自己的想法。访谈全程录音，访谈结束后将其逐字转录为文字资料，确保数据的完整性和准确性。研究者将部分访谈结果反馈给受访者，确认其真实性和准确性。
1.2.2.2　资料分析方法
采用Colaizzi 7步分析法分类、归纳、提炼主题：1）导入并熟悉资料；2）提取有意义的陈述；3）编码和初步生成主题；4）主题整合与调整；5）详细描述现象；6）构建现象结构；7）验证与反馈。
1.3　统计学方法
采用SPSS 26.0软件和Nvivo 14.0软件进行数据分析。符合正态分布的定量资料以均数±标准差（x±s）表示，组间比较采用t检验或方差分析；采用线性回归分析探讨MNS研究生临床EBNP能力的影响因素。以P<0.05为差异有统计学意义。
2　结果
收起
2.1　量性研究
2.1.1　MNS研究生中文版EBPQ得分
130名MNS研究生中文版EBPQ总分为（115.95±21.04）分，条目均分为（4.64±0.84）分，其中，行为维度得分为（26.62±6.39）分，条目均分为（4.45±1.08）分；态度维度得分为（29.52±5.51）分，条目均分为（5.88±1.10）分；知识维度得分为（63.54±12.51）分，条目均分为（4.56±0.94）分。中文版EBPQ得分较低的5个条目见表1。
2.1.2　MNS研究生中文版EBPQ得分影响因素的单因素分析（见表2）
2.1.3　MNS研究生中文版EBPQ得分影响因素的多因素分析
以中文版EBPQ总分为因变量，以单因素分析中差异有统计学意义（P<0.05）的变量为自变量，进行线性回归分析（α入=0.05，α出=0.10），结果显示，科研经历（如参与学术会议、课题研究等）、开展临床EBNP的重要性认知、临床EBNP知晓度是MNS研究生中文版EBPQ得分的影响因素（均P<0.05）。见表3。
2.2　质性研究
2.2.1　主题1：高认同度与价值内化，将临床EBNP作为专业发展方向
受访者均对临床EBNP表示认同，认为临床EBNP可以使护理从传统经验式的实践转化为科学决策和专业化实践，缩小研究证据与临床实践间的差距，促进护理人员对医疗干预的参与，提高临床护理质量，提升其职业价值感，对科研和临床工作具有重要意义。S1：“通过查询得到一些证据支持，就会节省一些临床医疗资源，提高医疗效率”。S11：“之前我的带教老师恰好在参加某项竞赛，我们根据最新的循证指南调整了病人术后约束管理方案，病人满意度得到显著提升”。S13：“这种方法能帮助我们减少护理实践中的主观性，更科学一点”。S15：“我觉得临床EBNP要求我们要不断学习以更新知识，这样才能保证病人得到最佳护理”。
2.2.2　主题2：实践能力薄弱与系统支持缺失，导致知行脱节困境
2.2.2.1　技能转化困难：从“知道”到“做到”的断层
部分受访者表示虽然对EBNP有所了解，但对如何获得高质量成果仍不熟悉，相关技能掌握薄弱。研究生一年级受访者表示，研究生阶段首次接触相关课程后逐步建立了循证护理思维模式，但这些受访者未能将所学理论有效转化为操作实践。研究生二年级及研究生三年级受访者表示，尽管对临床EBNP的整体框架有了较为清晰的认识，但在实际操作过程中仍然面临诸多挑战。S5：“当遇到一个问题的时候，首先需要进行检索，虽然大家都懂怎样检索，但实践起来还是停在理论层面，不知道从何下手”。S8：“学习相关课程的时候感觉可以理解，可自己去做的话就比较困难”。S10：“之前有位艾灸病人表示，每次艾灸结束后总会便秘，我检索到了多种便秘病人管理方案，但由于缺乏对证据质量的判断能力，最终未能选择最合适的方案，这让我感到非常挫败”。S18：“在病人护理实践中，如何根据证据制定具体的护理措施，我感觉自己还是没有那么清楚”。S19：“临床工作节奏很快，我们很难有足够的时间深入检索和评价证据，往往流于形式”。
2.2.2.2　现有教育支持不足：课程与实践脱节
受访者认为单纯理论课程学习较为枯燥，应采取多元化教学方式将理论与实践结合，并加强实践教学。S7：“我们之前讲课的老师就是边讲边让我们操作，我觉得这种授课方式更有效率”。S8：“学校虽然开设了循证护理课程，但是听完之后感觉无法连贯起来，不够系统化”。S9：“之前听过线上培训，听完有不懂的地方还可以回看，感觉这一点很好”。S16：“我觉得老师和学生之间应该有一个类似学习通的反馈平台，及时让老师解答学生在实际操作中遇到的困难”。S17：“我希望医院可以给我们更多的实践机会，比如以小组床旁实践的形式让临床老师指导我们将检索到的证据应用到病人身上”。
2.2.3　主题3：多维促进因素，激发临床EBNP实施
受访者表示自我学习需求、善于发现问题等主观因素以及经验丰富的老师、科技发展、科室科研氛围浓厚、制定奖励机制等客观条件是临床EBNP的促进因素。S2：“对于1个案例，自己去循证实践过1次之后感到确实很有用，我觉得这会成为良性循环，有利于促进再次实践”。S3：“科室的学习环境也很重要，在遇到相关临床问题时，要有意识地动员大家去循证”。S4：“平时会跟着导师去申报一些项目，自己也会参加一些竞赛，促进了我这方面技能提升”。S10：“学校经常组织同学参加创新大赛，会有相应的奖项和学分奖励，如果临床EBNP也采取这种方式应该也会有很多人参与”。S19：“之前实习的时候参加疑难病例讨论，我发现当和医生一起讨论治疗方案时，能够更全面地考虑病人的情况，我觉得这可以帮助我们更好地应用证据”。
2.2.4　主题4：多重阻碍因素，制约EBNP的临床应用
受访者表示缺乏临床实践经验、个性化护理挑战、无法全面检索证据、无法评价证据等级、缺乏循证思维、科研能力不足等主观因素以及建设水平不高、重理论轻实践、病人不理解等客观条件是阻碍循证实践的因素。S1：“我在读研究生后才有了遇到问题检索文献的想法”。S6：“病人理解和支持也很重要。我们需要通过健康教育让病人明白，EBNP是为了提供更科学、有效的护理服务，而不是将他们当作试验对象”。 S7：“我在临床实践过程中发现，临床中的很多护理决策或者方法是比较模糊的，在这种情况下，很少有人去求证最新的指南和专家共识”。S12：“我在理解病人情感、文化背景和独特需求方面能力比较差，这可能使我提出的建议在进行个性化护理时不如经验丰富的临床护士灵活、有效”。S14：“我会依据病人病情查阅一些证据总结、指南，主要是在饮食和日常活动方面。虽然我可以给出基于证据的建议，但因为临床经验不够丰富，我无法直接观察和分析病人的具体情况。我也无法像经验丰富的护士那样，根据病人的实际状况做出个性化的判断和干预”。
2.3　混合研究结果整合
将量性研究结果和质性研究结果进行整合，结果见图1。
3　讨论
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3.1　MNS研究生临床EBNP能力处于中等水平
本研究结果显示，MNS研究生有较好的态度，但实践技能较差，与赵静等[11]研究结果相似。中文版EBPQ条目均分为（4.64±0.84）分，处于中等水平，仍有提升空间。在得分较低的5个条目中，2个条目属于行为维度，说明MNS研究生执行临床EBNP的能力不足，原因可能是我国各院校对EBNP的实践教育关注较少，导致部分学生无法全面掌握相关技能，在进行实践时会面临诸多障碍[12]。3个条目属于知识维度，可能与教学方式以及在临床实践中带教老师对循证知识教学关注度不高有关，导致学生在临床环境中无法运用所学知识。态度维度条目均分在3个维度中最高，表明学生已逐渐认识到临床EBNP的优势及重要性。良好态度是促进行为动机的基础，故需充分发挥态度的潜在作用，鼓励学生将理论知识转化为实践能力。Moore等[6]研究表明，通过系统培训，MNS研究生的临床EBNP能力与创新能力均能得到提升。但本研究中仅有16名（12.3%）MNS研究生参与过3次及以上的培训，可能与医院及学校开设讲座不足、学生对临床EBNP缺乏兴趣等相关。为提高MNS研究生的临床EBNP能力，医院及学校应提高培训频率，并通过设置学分奖励或举办竞赛等方式提高学生的参与兴趣，逐渐提高其对临床EBNP的认识和理解，加强其应用证据的能力，弥合循证资料与证据转化间的鸿沟。
3.2　科研训练、认知深度与价值认同是提升MNS研究生临床EBNP能力的关键内在动力
量性研究结果显示，有科研活动经历是MNS研究生临床EBNP能力的正向预测因素。参与课题申报、学术研讨、论文撰写等科研活动可有效锻炼学生的文献评判、问题凝练和严谨逻辑思维，这些能力可直接迁移至EBNP的证据检索、评价与整合环节。同时，对临床EBNP的知晓度和认同其开展的重要性也可影响MNS研究生临床EBNP能力水平。质性研究结果显示，对EBNP价值有深刻认知的学生会表现出更强的学习内驱力，会主动查阅指南，寻求导师指导，而认知不足的学生则多处于被动状态。提示激发学生内在的价值认同是促使其克服障碍、主动实践的重要心理基础。已有研究结果显示，医院管理人员的支持是促进临床EBNP的重要因素[13]，提示不仅需在管理层面加强科研思维的系统培养，更应有意识地在教学与管理中凸显EBNP的临床效益，通过展示成功案例等方式深化学生的价值认同，从而将积极态度转化为实践动能。
3.3　改进教学方式，从理论传授转向以临床问题为导向的能力建构
当前教学模式与学生需求间的错位是导致其能力提升受限的重要原因。质性研究显示，“课程内容与临床脱节”“实践机会太少”反馈频率较高，与崔雅玲等[14]研究结果相似。提示以理论讲授和简单案例分析为主的传统教学法已难以满足培养学生复杂实践能力的需求，为弥合这一差距，教学改革需以“实践能力产出”为核心进行设计，可系统引入Melnyk等[15]的七步模型作为课程主线，使教学结构紧密围绕提出临床问题、检索与评价证据、应用与评价这一完整过程。目前MNS研究生的EBNP课程以理论讲授、案例教学为主[16]，该类教学方式不利于培养学生独立思考及创新能力。应在相应步骤采用多元化教学法，如在证据检索环节，采用演示教学与工作坊解决不会系统检索的问题；在证据应用环节，采用高仿真情景模拟或基于真实临床病例的专题项目解决理论与临床脱节的问题；在证据转化评价环节，通过证据系统评价、设计证据应用方案等形式考核，解决实践效果不会评价的问题。同时，线上资源与线下实践相结合的混合式教学，可为学生提供更灵活、个性化的学习路径，有利于巩固知识，锻炼批判性思维[17]。
3.4　建立专业临床EBNP师资团队，提升MNS研究生临床EBNP能力
优质的师资是连接理论与实践的关键桥梁。本研究中质性研究结果显示，学生普遍期望由既有丰富理论知识，又有熟练临床EBNP经验的教师带教，与窦蓓等[18]研究结果相似，反映了当前优质师资匮乏。临床EBNP涉及多学科知识，要求教师不仅懂护理、懂科研，还需精通证据转化。然而，本研究也在研究过程中发现，临床带教老师自身常因科研压力、临床负荷或知识更新不足等原因，在开展临床EBNP教学时存在精力不足的问题，与胡明钰等[19]研究结果相似。因此，提升学生能力的同时也需重视提升师资水平。医院与高校应协同建立专业化的EBNP教学团队，并通过同辈支持、工作坊[20]、短期集中培训、提供科研与实践融合的基金项目等方式，重点提升师资的实操技能与教学信心，真正发挥教师在学生临床EBNP过程中的指导、示范与监督作用[21]。此外，本研究也显示，高校护理教师临床EBNP能力也需加强，建议加强高校与临床医疗机构联动，鼓励高校教师定期下临床实践，临床骨干参与教学培训，共同开发基于真实情境的教学案例，从而有效破解临床EBNP教学瓶颈。
4　小结
收起
本研究通过混合研究发现，MNS研究生对临床EBNP态度积极，但知识与实践技能仍有提升空间。线性回归分析进一步显示，科研经历（如参与学术会议、课题研究等）、开展临床EBNP的重要性认知、临床EBNP知晓度是MNS研究生中文版EBPQ得分的影响因素，然而模型整体解释力有限，且常量项偏大，提示可能遗漏了如学生基础学术能力、院校教学资源及学习动机等重要变量。因此，该模型更适用于识别影响因素的作用，若用于个体水平的精确预测则需谨慎。为有效提升学生临床EBNP能力，建议从课程改革、师资建设及院校与医院协同等方面系统完善培养体系。未来可扩大调查范围，并从教育者视角进一步深入探究，以构建更为全面、精准的能力培养与预测模型。

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2026年第40卷第18期
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doi: 10.12102/j.issn.1009-6493.2026.18.008
  • 接收时间：2025-11-10
  • 首发时间：2026-10-29
  • 出版时间：2026-09-25
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  • 收稿日期：2025-11-10
  • 修回日期：2026-06-17
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    1山西医科大学第一医院，山西 030001
    2平遥计生妇幼服务中心
    3山西医科大学护理学院

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2种不同金属材料的力学参数
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Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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