精神科中医护理的“知信行”研究：现状、影响因素与干预策略综述

A Review on the “Knowledge-Attitude-Practice” Research in Psychiatric Traditional Chinese Medicine Nursing: Current Status, Influencing Factors, and Intervention Strategies

摘要: 目的：系统梳理精神科中医护理领域中“知信行”(知识、信念、行为)的研究现状，分析影响护士“知信行”水平的关键因素，并总结有效的干预策略，为提升精神科中医护理服务质量提供理论依据与实践参考。方法：通过系统性回顾与分析近五年内公开发表的31篇文献，采用内容分析法，对精神科护士中医护理“知信行”的现状水平、影响因素及干预措施进行归纳与评述。结果：现有研究表明，精神科护士普遍认识到中医护理的重要性(“信”)，但其“知”(中医基础理论、辨证施护知识)与“行”(临床实践能力)水平相对薄弱，且“知”与“行”之间存在显著鸿沟。影响其“知信行”水平的因素是多层次的：个人层面包括学历、护龄、科室和中医知识来源；组织层面则涉及系统化培训的缺失、管理模式的不完善以及跨学科合作的障碍。为提升“知信行”水平，研究者们探索了分类分层培训、PBL联合情境模拟、BOPPPS混合式学习等多种创新培训模式，并通过构建专业小组、优化岗位职责、融入中医药文化等管理手段，有效提升了护士的中医素养和临床实践能力。结论：当前精神科中医护理“知信行”研究已取得一定成果，但在客观评价“行”的转化效果和探究深层行为障碍方面仍有不足。未来应致力于开发更科学的评价工具，深入探究从“知”到“行”的转化机制，并构建集精准培训、系统管理和文化培育于一体的综合干预体系，以实现精神科中医护理的规范化与可持续发展。

Abstract: Objective: To systematically review the research on the “Knowledge-Attitude-Practice” (KAP) framework in psychiatric traditional Chinese medicine (TCM) nursing, analyze the key factors influencing nurses’ KAP levels, and summarize effective intervention strategies, thereby providing theoretical basis and practical references for improving the quality of psychiatric TCM nursing services. Methods: A systematic review and analysis of 31 recently published core articles were conducted. Content analysis was employed to summarize and evaluate the current status of nurses’ KAP levels, influencing factors, and intervention measures in psychiatric TCM nursing. Results: Existing research indicates that psychiatric nurses generally recognize the importance of TCM nursing (“Attitude”). However, their “Knowledge” (TCM foundational theories, syndrome differentiation for nursing) and “Practice” (clinical application skills) levels are relatively weak, with a significant gap between “Knowledge” and “Practice”. The factors influencing KAP levels are multi-layered: at the individual level, they include educational background, years of nursing experience, department, and sources of TCM knowledge; at the organizational level, they involve the lack of systematic training, inadequate management models, and barriers to interdisciplinary collaboration. To enhance KAP levels, researchers have explored various innovative training models, such as categorized and stratified training, PBL combined with scenario simulation, and BOPPPS blended learning. Additionally, management strategies like establishing specialized teams, optimizing job responsibilities, and integrating TCM culture have effectively improved nurses’ TCM competence and clinical practice abilities. Conclusion: While significant progress has been made in the KAP research of psychiatric TCM nursing, there remains a lack of objective evaluation on the translation of “Knowledge” into “Practice” and an insufficient exploration of deep-seated behavioral barriers. Future efforts should focus on developing more scientific assessment tools, delving into the mechanisms of translating “Knowledge” into “Practice”, and constructing a comprehensive intervention system that integrates precise training, systematic management, and cultural cultivation. This will promote the standardization and sustainable development of psychiatric TCM nursing.