目的 分析影响不良事件上报行为的因素及其作用机制，为制定针对性的干预策略提供科学依据。方法 通过便利抽样法选取某公立医院392名护士为研究对象，采用不良事件知信行问卷、不良事件报告障碍量表等对其进行调查。构建结构方程模型并检验影响因素的中介效应。结果 结构方程模型拟合较好，组织层面医院安全文化、培训正向影响上报行为，总效应值分别为0.295和0.206；报告障碍对上报行为产生负向影响，总效应值为-0.114，工作满意度正向调节上报态度对上报行为的影响；个人层面上报认知、态度正向影响上报行为，总效应值分别为0.287、0.565。结论 医院安全文化、培训、工作满意度、上报认知及态度对护士不良事件上报行为具有重要促进作用；医院管理者宏观层面应完善制度建设，打造安全文化，加强社会支持水平，同时关注护士个人上报认知及态度情况，从根源上寻找解决方案。

Objective To analyze the influencing factors and its mechanism of reporting adverse events in nursing care,and provide a scientific basis for formulating targeted intervention strategies.Methods A total of 392 nurses in a public hospital selected by cluster sampling method were surveyed by adverse events knowledge,attitude,and practice questionnaire and scale of barriers to adverse events reporting.Structural equation model was constructed and used to test the mediating effect of the influencing factors.Results The structural equation model was fitted well.On organizational level,the total effect value of hospital safety culture and training to positively influence reporting behavior were 0.295 and 0.206,respectively.The reporting barriers had a negative impact on the reporting behavior,with the total effect value of -0.114.Job satisfaction positively mediated the impact of reporting attitude on reporting behavior.On individual level,reporting cognition and reporting attitude positively affected reporting behavior,and the total effect values were 0.287 and 0.565,respectively.Conclusions Hospital safety culture,training,job satisfaction,and reporting awareness and attitude are important for promoting the reporting behavior of adverse events in nursing care.Hospital administration should improve management system at the macro level,create a safety culture,strengthen social support,and pay attention to individual reporting cognition and attitude,to find solutions to the root causes.

R47-05

苏州高新区人民医院科学创新基金联合项目（SGY2022D01）；苏州市医学重点扶持学科建设项目（SZFCXK202110）