基于模糊集定性比较分析血液透析护士超声接受度的提升路径OA

Objective:Arteriovenous fistula(AVF)is the preferred vascular access for patients undergoing hemodialysis.Ultrasound technology plays an important role in vascular access assessment,puncture guidance,and complication detection.The acceptance of ultrasound among hemodialysis nurses is influenced by multiple factors.However,previous studies have mainly focused on individual factors,making it difficult to comprehensively elucidate the combined effects of multiple influencing factors.This study applied fuzzy-set qualitative comparative analysis(fsQCA)to explore multiple configurational pathways influencing hemodialysis nurses'acceptance of AVF ultrasound technology and to reveal the complex interactions among these factors,thereby providing evidence for nursing managers to develop targeted intervention strategies. Methods:A combination of stratified sampling and random sampling was used to select 199 nurses from hemodialysis centers in 30 hospitals of different tiers(including tertiary grade A,tertiary grade B,secondary,and primary hospitals)in Jiangsu Province from January to February 2026.Data were collected using a general information questionnaire,the Ultrasound Technology Acceptance Scale for Hemodialysis Nurses Regarding Arteriovenous Fistula,the Nurse Version of the NASA Task Load Index,the Nurse Professional Identity Scale,and the Multidimensional Scale of Perceived Social Support(MSPSS).fsQCA was applied to explore configurational factors influencing ultrasound acceptance among hemodialysis nurses. Results:A total of 210 questionnaires were distributed,and 199 valid questionnaires were collected,yielding a valid response rate of 94.8%.The mean ultrasound acceptance score among the 199 hemodialysis nurses was 148.06±21.39,indicating a moderate level of acceptance.Univariate analysis showed significant differences in ultrasound acceptance scores among nurses with different hospital levels(F=16.778,P<0.001),specialty working years(F=9.405,P<0.001),and job positions(F=20.869,P<0.001).Correlation analysis demonstrated that ultrasound acceptance scores were positively correlated with professional identity scores(r=0.750,P<0.001)and perceived social support scores(r=0.573,P<0.001),while negatively correlated with task load scores(r=-0.675,P<0.001).Configurational analysis identified 3 pathways associated with higher ultrasound acceptance among hemodialysis nurses:1)Pathway 1,a low hospital-level,long specialty experience,low task load,and high professional identity dominant pathway;2)Pathway 2,a long specialty experience,holding a professional position,low task load,and high perceived social support dominant pathway;and 3)Pathway 3,a low task load,high professional identity,and high perceived social support pathway. Conclusion:Ultrasound acceptance among hemodialysis nurses is influenced by complex interactions among multiple factors,including hospital level,years of specialty experience,job position,task load,professional identity,and perceived social support,rather than being determined by a single linear factor.All 3 configurational pathways could improve ultrasound acceptance among hemodialysis nurses,highlighting the critical role of low task load.Nursing managers should develop targeted training and guidance strategies based on the synergistic effects of multiple influencing factors.Future studies should expand sample sizes and improve the balance of sampling across different hospital levels to further validate differences in ultrasound acceptance among hemodialysis nurses across hospital levels and identify associated influencing factors.