吉林市社区护理人力资源现状及其干预效果的评价
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摘要
目的了解吉林市社区护理人力分布现状;确认在职社区护士岗位培训的效果;分析社区护士知识、技能及态度的关系。
方法采用自身前后对照的类实验性研究设计,选取2008年参加吉林市岗位培训的在岗社区护士共110名作为研究对象。所有数据采用SPSSfor windows 13.0统计软件进行统计分析。
结果①社区护士的平均年龄为36.29±6.37岁;合同制护士占34.3%;学历主要以中专学历为主占54.3%;毕业后参加过学历教育的占43.8%;96.9%的社区护士由临床护士转型而来;从事社区护理工作时间不超过一年的占91.4%。②社区护士中仅有13.3%的护士接受过系统社区护理培训,而94.3%的社区护士认为有必要参加岗位培训;社区护士对岗位培训内容需求排在前五位的分别是社区护理理念与方法(61.2%)、慢性疾病病人的护理(59.5%)、常见康复护理技术与方法(58.9%)、急救基础知识(58.5%)、家庭访视步骤与家系图使用(54.7%)。③干预后社区护士成绩分布情况明显高于干预前,差异有统计学意义(χ~2=177.95,P＜0.001)。干预后社区护士知识、态度、技能总分与干预前均有显著性差异,其中知识培训前后变化最明显(t=-30.82,P＜0.001),其次为技能培训(t=-22.20,P＜0.001),最后为态度变化(t=-2.14,P＜0.05)。知识各领域得分中,特殊人群保健知识干预前后变化最大(t=-19.71,P＜0.001),而传染病护理知识干预前后变化最小(t=-6.87,P＜0.001)。在干预前后态度的变化中,通过岗位培训获取最新信息、对工作有用处、社区护士能应对护理事故的变化、岗位培训对掌握社区知识及技能有帮助方面在干预前后出现了显著性差异,有统计学意义(P＜0.001),而学习动机是自我提高、做好利用知识处理问题的准备、无偿服务于社区护理工作等方面干预前后变化不明显,无统计学意义(P＞0.05)。④社区护士的知识总分与态度和技能得分具有相关性,三者之间呈正相关。社区护士态度得分与知识中的特殊人群保健和精神护理呈正相关;技能得分与知识中的社区概论和临终关怀呈正相关。
结论①社区护士主要由临床护士转型而来,学历层次以中专为主,社区护士普遍缺乏社区护理知识,建议应结合现状有针对性的对社区护士进行岗位培训。②岗位培训后社区护士专业知识水平大幅度提高。③岗位培训后社区护士接受岗位培训教育的愿望更加强烈,各级主管部门应创造条件并鼓励社区护士继续接受岗位培训教育。④社区护士岗位培训不是一次性的产物,而是一个不断完善的动态过程,因此要从根本上提高社区护士的整体水平,应该制订一个连续的教学计划,包括每年参加培训的时间、内容等,使社区护士的继续教育变为终身教育。
Objective To learn the status of nursing workforce distribution in Jilin City;To confirm post-training effect about on-the-job community nurses;To analyze correlation of the knowledge,attitude and skill of community nurses.
Methods One group pretest-posttest design was used in this research. Participate in the on-the-job training a total of 110 community nurses were extracted by convenient sampling method in Jilin City in 2008.All the data was input computer and analyzed by Spss for Windows 13.0.
Result①The average age of community nurses was 36.29±6.37; contract-nurse took up 34.3%;The diplomas of these nurses were mostly associate degree,which took up 52.6%;nurses who pursed further education during the job took up 43.8%;96.9%of nurses in this investigation were transferred from clinic;nurses which worked as community nurses less than 1 year took up 91.4%.②Only 13.3%of nurses accepted post-training;94.3%of nurses considered it necessary post-training of community nurses be joined;the demand for post-training of the top five are Concept and Method of community nursing(61.2%)、nursing care of chronic diseases(59.5%)、technology and method as rehabilitation nursing(58.9%)、first aid basic knowledge(58.5%)、home visit steps and family structure graph use(54.7%).③Academic achievement of community nurses was significant higher than pre-intervention,there were significant difference in the pre-intervention and post-intervention(χ~2=177.95,P＜0.001)。there were significant difference in the knowledge,attitude and skill of community nurses between the pre-intervention and post-intervention,The biggest change in the knowledge(t=-30.82,P＜0.001),Followed by the skills(t=-22.20, P＜0.001),the last for the attitude(t=-2.14,P＜0.05)。Among knowledge dimensions,the biggest changed in the knowledge of special population health(t=-19.71,P＜0.001),the smallest changed in the knowledge of special population health(t=-6.87,P＜0.001).Among changed attitudes, there were significant difference in the Access to the latest knowledge by post-training,useful work,the ability to deal with care events,and that post-training to acquire knowledge and skills of community nursing were helpful(P＜0.01),there were no significant difference in the Motivation to learn was self-improvement,good use of knowledge to deal with the problem,unpaid care work in community nursing etc(P＞0.05).④The knowledge,attitude and skill of community nurses have positive correlation. the attitude of community nurses、the knowledge of special population health and the knowledge of mental nursing have positive correlation,the skill of community nurses、the knowledge of community nursing conspectus、the knowledge of hospice care have positive correlation.
Conclusion①Community nurses transferred from clinic,the diplomas of these nurses were mostly associate degree,general lack of knowledge of community care,Combined with the status carry out post-training of community nursing.②Knowledge of community nurses promoted substantially.③Community nurses' desire to accept post-training is so strong that related ministry at all levels should encourage community nurses to get further post-training education.④Post-training of community nurses were not the product of one-time,but dynamic process of continuous improvement,In order to fundamentally improve the overall level of community nurses,should make the Continuous plan(training time、training Content every year etc).Community nurses continuing education transferred life-long education
方法采用自身前后对照的类实验性研究设计,选取2008年参加吉林市岗位培训的在岗社区护士共110名作为研究对象。所有数据采用SPSSfor windows 13.0统计软件进行统计分析。
结果①社区护士的平均年龄为36.29±6.37岁;合同制护士占34.3%;学历主要以中专学历为主占54.3%;毕业后参加过学历教育的占43.8%;96.9%的社区护士由临床护士转型而来;从事社区护理工作时间不超过一年的占91.4%。②社区护士中仅有13.3%的护士接受过系统社区护理培训,而94.3%的社区护士认为有必要参加岗位培训;社区护士对岗位培训内容需求排在前五位的分别是社区护理理念与方法(61.2%)、慢性疾病病人的护理(59.5%)、常见康复护理技术与方法(58.9%)、急救基础知识(58.5%)、家庭访视步骤与家系图使用(54.7%)。③干预后社区护士成绩分布情况明显高于干预前,差异有统计学意义(χ~2=177.95,P＜0.001)。干预后社区护士知识、态度、技能总分与干预前均有显著性差异,其中知识培训前后变化最明显(t=-30.82,P＜0.001),其次为技能培训(t=-22.20,P＜0.001),最后为态度变化(t=-2.14,P＜0.05)。知识各领域得分中,特殊人群保健知识干预前后变化最大(t=-19.71,P＜0.001),而传染病护理知识干预前后变化最小(t=-6.87,P＜0.001)。在干预前后态度的变化中,通过岗位培训获取最新信息、对工作有用处、社区护士能应对护理事故的变化、岗位培训对掌握社区知识及技能有帮助方面在干预前后出现了显著性差异,有统计学意义(P＜0.001),而学习动机是自我提高、做好利用知识处理问题的准备、无偿服务于社区护理工作等方面干预前后变化不明显,无统计学意义(P＞0.05)。④社区护士的知识总分与态度和技能得分具有相关性,三者之间呈正相关。社区护士态度得分与知识中的特殊人群保健和精神护理呈正相关;技能得分与知识中的社区概论和临终关怀呈正相关。
结论①社区护士主要由临床护士转型而来,学历层次以中专为主,社区护士普遍缺乏社区护理知识,建议应结合现状有针对性的对社区护士进行岗位培训。②岗位培训后社区护士专业知识水平大幅度提高。③岗位培训后社区护士接受岗位培训教育的愿望更加强烈,各级主管部门应创造条件并鼓励社区护士继续接受岗位培训教育。④社区护士岗位培训不是一次性的产物,而是一个不断完善的动态过程,因此要从根本上提高社区护士的整体水平,应该制订一个连续的教学计划,包括每年参加培训的时间、内容等,使社区护士的继续教育变为终身教育。
Objective To learn the status of nursing workforce distribution in Jilin City;To confirm post-training effect about on-the-job community nurses;To analyze correlation of the knowledge,attitude and skill of community nurses.
Methods One group pretest-posttest design was used in this research. Participate in the on-the-job training a total of 110 community nurses were extracted by convenient sampling method in Jilin City in 2008.All the data was input computer and analyzed by Spss for Windows 13.0.
Result①The average age of community nurses was 36.29±6.37; contract-nurse took up 34.3%;The diplomas of these nurses were mostly associate degree,which took up 52.6%;nurses who pursed further education during the job took up 43.8%;96.9%of nurses in this investigation were transferred from clinic;nurses which worked as community nurses less than 1 year took up 91.4%.②Only 13.3%of nurses accepted post-training;94.3%of nurses considered it necessary post-training of community nurses be joined;the demand for post-training of the top five are Concept and Method of community nursing(61.2%)、nursing care of chronic diseases(59.5%)、technology and method as rehabilitation nursing(58.9%)、first aid basic knowledge(58.5%)、home visit steps and family structure graph use(54.7%).③Academic achievement of community nurses was significant higher than pre-intervention,there were significant difference in the pre-intervention and post-intervention(χ~2=177.95,P＜0.001)。there were significant difference in the knowledge,attitude and skill of community nurses between the pre-intervention and post-intervention,The biggest change in the knowledge(t=-30.82,P＜0.001),Followed by the skills(t=-22.20, P＜0.001),the last for the attitude(t=-2.14,P＜0.05)。Among knowledge dimensions,the biggest changed in the knowledge of special population health(t=-19.71,P＜0.001),the smallest changed in the knowledge of special population health(t=-6.87,P＜0.001).Among changed attitudes, there were significant difference in the Access to the latest knowledge by post-training,useful work,the ability to deal with care events,and that post-training to acquire knowledge and skills of community nursing were helpful(P＜0.01),there were no significant difference in the Motivation to learn was self-improvement,good use of knowledge to deal with the problem,unpaid care work in community nursing etc(P＞0.05).④The knowledge,attitude and skill of community nurses have positive correlation. the attitude of community nurses、the knowledge of special population health and the knowledge of mental nursing have positive correlation,the skill of community nurses、the knowledge of community nursing conspectus、the knowledge of hospice care have positive correlation.
Conclusion①Community nurses transferred from clinic,the diplomas of these nurses were mostly associate degree,general lack of knowledge of community care,Combined with the status carry out post-training of community nursing.②Knowledge of community nurses promoted substantially.③Community nurses' desire to accept post-training is so strong that related ministry at all levels should encourage community nurses to get further post-training education.④Post-training of community nurses were not the product of one-time,but dynamic process of continuous improvement,In order to fundamentally improve the overall level of community nurses,should make the Continuous plan(training time、training Content every year etc).Community nurses continuing education transferred life-long education
引文
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[2]李秀川.社区护理发展方向的研究进展.中华现代护理杂志,2008,8(58)
[3]Standing Committee of Nurses of European Union(SCNEU),(2001).Guidelines:Development of a Continuous Professional training program for Nurses in Public Health within European Union.
[4]KESY.Enactment of new nursing specialties.Central Council of Health,Department of Health and Social Services,1994,11(104):21
[5]Marshall W.Raffel,Camille k.Barsukiewice.The U.S.Health System-origins and Functions.2002,75-76.
[6]李春玉,金胜姬.国内外社区护理的现状及其发展方向.中华护理杂志,2004,39(6):475-477
[7]The Future Community Nursing in the United Kingdom.District nursing health visiting and school nursing.Advanced Nursing,1997,26:257-265
[8]Kevin Gournay.The Mental Health Nursing Review:implications for community psychiatric nurses.Psychiatric Bulletin,1995,19:217-219
[9]周荣慧,陈立,孙佩珍等.德国的医院护理管理及社区护理管理简介.国外医学.医学护理分册,1997,16(4):191-193
[10]夏晓萍.中日社区护理及护理教育现状.中国全科医学,2004,7(11):799-80
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