Innovative motivation as a pathway from evidence-based nursing competence and nurse-physician collaboration to knowledge sharing behavior among surgical nurses : A structural equation modeling study based on the COM-B model

创新动机作为从循证护理能力和护士-医生协作到外科护士知识共享行为的途径:基于COM-B模型的结构方程模型研究

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Abstract

BACKGROUND: With the development of evidence-based medicine, a large amount of high-quality evidence is constantly generated, but surgical nurses are still weak in terms of the knowledge sharing behavior. Organizational and individual factors will determine how surgical nurses share knowledge. However, few cross-sectional studies had based on the Capabilities, Opportunities, Motivations, Behavior (COM-B) model to explore the influence paths of individual internal and external factors on the knowledge sharing behavior of surgical nurses. OBJECTIVE: This paper aims to evaluate (1) the current status and factors influencing on knowledge sharing behavior and (2) the pathways to knowledge sharing behavior of surgical nurses based on COM-B model. DESIGN: Cross-sectional study. SETTINGS: 174 public hospitals in 31 provinces and municipalities of China. METHODS: A cross-sectional study was conducted in the surgery department in China from May to June 2023. Convenience sampling and questionnaires were used to facilitate sampling and data collection. A total of 1388 surgical nurses were included in the study. The data was processed using univariate analysis and correlation analysis, the central hypotheses were tested using a structural equation model (SEM). RESULTS: Of the participants, the knowledge sharing behavior score was 54.98 ± 13.33, and compared with the average score, it was at a moderately low level. There was a positive correlation between the level of knowledge sharing behavior and each variable (p < 0.001). The knowledge sharing behavior was significantly positively correlated with evidence-based nursing competence (r = 0.399), creative self-efficacy (r = 0.496), nurse-physician collaboration (r = 0.288). Both evidence-based nursing competence and nurse-physician collaboration can have a direct effect on knowledge sharing behavior. The results confirmed that creative self-efficacy partially mediates the relationships between evidence-based nursing competence and knowledge sharing behavior (β = 0.038, 95 % confidence interval [0.029, 0.049]). Meanwhile, creative self-efficacy also plays a partial mediating role between the nurse-physician collaboration and knowledge sharing behavior (β = 0.083, 95 % confidence interval [0.065, 0.104]). CONCLUSIONS: According to the COM-B model, the multiple effective paths of evidence-based nursing competence, innovative motivation, and organizational collaboration for knowledge sharing behavior were verified. Surgical nurses have extensive experience in the care of perioperative patients and critically ill patients. If they can actively share knowledge by themselves or with the support of the team, it is crucial for improving the quality of care and ensuring patient safety.

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