基层医院神经科护士卒中护理知信行现状及障碍因素调查
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摘要
目的了解基层医院神经科护士卒中护理知信行状况及障碍因素。方法采用自制神经科护士卒中护理知信行量表对不同级别基层医院神经科467名护士进行调查。结果二级医院和社区医院神经科护士卒中护理知信行评分分别为(56.38±5.95)分、(51.73±8.21)分,均处于偏低水平;神经科护士卒中疾病知识、态度得分二级医院高于社区医院,差异有统计学意义(P<0.01);北京地区基层医院神经科护士卒中疾病知识得分较高,行政职务较高的护士在卒中护理态度、行为维度得分较高(P<0.01);二级医院卒中护理障碍因素排名前3位的依次是人力资源有限(73.54%)、缺乏培训(54.50%)、患者病情重(51.32%);社区医院卒中护理障碍因素排名前3位的依次是缺乏护理规范(89.88%)、缺乏培训(85.39%)、人力资源有限(80.90%)。结论基层医院神经科护士卒中护理知信行水平处于中等偏低水平,面临的障碍因素较多,应增加基层医院投入,强化医联体联动效应,借助上级医院及专科医院对下级医院的帮扶指导,促进基层医院卒中护理的发展与完善。
Objective To investigate the status and obstacle factors of stroke nursing knowledge-attitude-practice in nurses of neurology department in primary hospital.Methods Using self-designed neurologist stroke nursing knowledge scale to investigate 467 nurses of neurology department in primary hospital.Results The scores of neurologist stroke nursing knowledge were(56.38±5.95) and(51.73±8.21) in secondary hospitals and community hospitals,which were at low level.Nurses in secondary hospital had higher scores neurologist stroke nursing knowledge and attitude than those in community hospital,the difference was statistically significant(P<0.01).Neurlolgy nurses in Beijing primary hospitals have higher score of strocke disease knowledge and who had higher administrative posts had higher scores on stroke care attitude and behavior(P<0.01);The top three obstacle factors were human resources(73.54%),lack of training(54.50%) and serious patients(51.32%) in secondary hospital.The top three obstacle factors were the lack of care standard(89.88%),lack of training(85.39%) and human resources(80.90%)in community hospital.Conclusion Knowledge-attitude-practice of neurologist stroke nurses in primary hospitals were at low level,facing many obstacle factors.Manager should increase hospital basic investment,strengthen the linkage effect of couple hospitals,to promote the development and improvement of the basic hospital stroke care.
Objective To investigate the status and obstacle factors of stroke nursing knowledge-attitude-practice in nurses of neurology department in primary hospital.Methods Using self-designed neurologist stroke nursing knowledge scale to investigate 467 nurses of neurology department in primary hospital.Results The scores of neurologist stroke nursing knowledge were(56.38±5.95) and(51.73±8.21) in secondary hospitals and community hospitals,which were at low level.Nurses in secondary hospital had higher scores neurologist stroke nursing knowledge and attitude than those in community hospital,the difference was statistically significant(P<0.01).Neurlolgy nurses in Beijing primary hospitals have higher score of strocke disease knowledge and who had higher administrative posts had higher scores on stroke care attitude and behavior(P<0.01);The top three obstacle factors were human resources(73.54%),lack of training(54.50%) and serious patients(51.32%) in secondary hospital.The top three obstacle factors were the lack of care standard(89.88%),lack of training(85.39%) and human resources(80.90%)in community hospital.Conclusion Knowledge-attitude-practice of neurologist stroke nurses in primary hospitals were at low level,facing many obstacle factors.Manager should increase hospital basic investment,strengthen the linkage effect of couple hospitals,to promote the development and improvement of the basic hospital stroke care.
引文
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[16] 毛琴,王秀霞,周红燕,等.二级医院提升临床护士护理职业素养的策略与成效[J].护理管理杂志,2017,17(1):4-6.
[17] 蒋茜.脑卒中预防及护理的现状与展望[J].护理研究,2017,31(1):7-12.DOI:10.3969/j.issn.1009-6493.2017.01.003.
[18] 李子孝,王伊龙,赵性泉,等.卒中医疗服务结构、过程和结局的评价进展[J].中国卒中杂志,2014,9(4):350-357.DOI:10.3969/j.issn.1673-5765.2014.04.014.
[19] 王艳玲,丁炎明,孙宏玉,等.北京市医疗机构护士继续教育实施现状调研与分析[J].中国护理管理,2015,15(12):1476-1479.DOI:10.3969/j.issn.1672-1756.2015.12.017.
[20] ENDERLIN C A,LESKEY M N,ROOKER J L,et al.Review of currentconceptual models and frameworks to guide transitions ofcare in older adults[J].Geriatric Nursing,2013,34(1):47-52.
[21] 杨琴.以医联体为载体的分级诊疗医疗服务体系下护理管理改革思路[J].中国护理管理,2017,17(5):580-582.DOI:10.3969/j.issn.1672-1756.2017.05.002.
[22] 秦江梅,张丽芳,林春梅,等.我国基层卫生综合改革进展[J].中国全科医学,2017,20(22):2683-2690.DOI:10.3969/j.issn.1007-9572.2017.22.001.
[23] 刘敏,李国宏,张扬.实施医院社区一体化延续护理障碍因素的调查分析[J].护理学杂志,2016,31(19):91-94.DOI:10.3870/j.issn.1001-4152.2016.19.091.
[24] 钟郁鸿.影响二级医院护理队伍建设的瓶颈问题及对策[J].中国护理管理,2015,15(1):105-107.DOI:10.3969/j.issn.1672-1756.2015.01.033.
[2] WANG W,JIANG B,SUN H,et al.Prevalence,incidence,and mortality of stroke in China clinical perspective:results from a nationwide population-based survey of 480687 adults[J].Circulation,2017,135(8):759-771.
[3] 中华人民共和国国家卫生和计划生育委员会.国务院办公厅关于印发深化医药卫生体制改革2016年重点工作任务的通知[EB/OL].(2016-04-26)[2017-01-25].http://www.gov.cn/zhengce/content/2016-04/26/content_5068131.htm.
[4] 高凤莉.推动医联体模式下优质护理资源向基层辐射[J].中国护理管理,2017,17(5):577-579.DOI:10.3969/j.issn.1672-1756.2017.05.001.
[5] 李娟,李乐之,杨玲凤,等.长沙市三级甲等综合医院非内分泌科护士糖尿病护理知信行的调查研究[J].中国护理管理,2013,13(6):91-94.DOI:10.3969/j.issn.1672-1756.2013.06.031.
[6] 郭红,田军,万巧琴.住院脑血管病老年患者陪护人员对跌倒预防知信行的调查研究[J].中华护理杂志,2011,46(3):270-272.DOI:10.3761/j.issn.0254-1769.2011.03.019.
[7] 陈胜云,孙海欣,赵性泉,等.北京市社区卫生服务中心医务人员卒中相关知识调查及干预研究[J].中国卒中杂志,2010,5(9):716-721.DOI:10.3969/j.issn.1673-5765.2010.09.006.
[8] 齐志华,吴冬云.护士对脑卒中病人良肢位知识掌握及执行情况调查[J].护理研究,2012,26(7):603-605.DOI:10.3969/j.issn.1009-6493.2012.07.012.
[9] 张海燕,郭书芹,林秀,等.沧州市社区护士脑卒中知识水平的现状分析[J].护理管理杂志,2012,12(8):590-594.
[10] 简平,刘义兰,李保华,等.社区卫生服务中心护士延续护理现状调查[J].护理学杂志,2013,28(23):12-13.DOI:10.3870/hlxzz.2013.23.012.
[11] 岳高杰,黄娟,程瑞莲,等.神经内科年轻护士脑卒中康复护理知识认知水平的调查分析[J].中国实用护理杂志,2013,29(21):27-29.DOI:10.3760/cma.j.issn.1672-7088.2013.21.009.
[12] 郭红艳,么莉,李昂,等.二级医院护理人力资源现状调查与分析[J].中国护理管理,2013,13(4):57-59.DOI:10.3969/j.issn.1672-1756.2013.04.018.
[13] 谢英.区域医疗联合体构建现状、需求及对策研究--以内江市为例[D].重庆:第三军医大学军事预防医学院,2016.
[14] 林娟娟,陈小嫦.构建医疗联合体的关键问题分析及其对策建议[J].南京医科大学学报,2014,14(2):104-108.DOI:10.7655/NYDXBSS20140207.
[15] 赖伟,许海风,万文.论中长期医疗改革重要任务:推进医疗同质化[J].中国医院管理,2015,35(6):1-3.
[16] 毛琴,王秀霞,周红燕,等.二级医院提升临床护士护理职业素养的策略与成效[J].护理管理杂志,2017,17(1):4-6.
[17] 蒋茜.脑卒中预防及护理的现状与展望[J].护理研究,2017,31(1):7-12.DOI:10.3969/j.issn.1009-6493.2017.01.003.
[18] 李子孝,王伊龙,赵性泉,等.卒中医疗服务结构、过程和结局的评价进展[J].中国卒中杂志,2014,9(4):350-357.DOI:10.3969/j.issn.1673-5765.2014.04.014.
[19] 王艳玲,丁炎明,孙宏玉,等.北京市医疗机构护士继续教育实施现状调研与分析[J].中国护理管理,2015,15(12):1476-1479.DOI:10.3969/j.issn.1672-1756.2015.12.017.
[20] ENDERLIN C A,LESKEY M N,ROOKER J L,et al.Review of currentconceptual models and frameworks to guide transitions ofcare in older adults[J].Geriatric Nursing,2013,34(1):47-52.
[21] 杨琴.以医联体为载体的分级诊疗医疗服务体系下护理管理改革思路[J].中国护理管理,2017,17(5):580-582.DOI:10.3969/j.issn.1672-1756.2017.05.002.
[22] 秦江梅,张丽芳,林春梅,等.我国基层卫生综合改革进展[J].中国全科医学,2017,20(22):2683-2690.DOI:10.3969/j.issn.1007-9572.2017.22.001.
[23] 刘敏,李国宏,张扬.实施医院社区一体化延续护理障碍因素的调查分析[J].护理学杂志,2016,31(19):91-94.DOI:10.3870/j.issn.1001-4152.2016.19.091.
[24] 钟郁鸿.影响二级医院护理队伍建设的瓶颈问题及对策[J].中国护理管理,2015,15(1):105-107.DOI:10.3969/j.issn.1672-1756.2015.01.033.
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