脑卒中患者连续康复中社区护士的角色定位研究

发布时间：2018-01-30 20:09

本文关键词： 脑卒中连续康复社区护士角色　出处：《郑州大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的探索符合国情的脑卒中患者连续康复中社区护士的角色定位,明确其在多学科团队模式中的角色和工作内容,确保社区脑卒中患者连续康复的顺利开展。方法本研究分三个部分。第一部分为护理慢性病患者的社区护士角色问卷的汉化与修订。引进Lesley编制的护理慢性病患者的社区护士角色问卷(The community nurse role questionnaire for clients with chronic conditions,CNRQ),汉化并在郑州市社区护士群体中调研,检验其信效度,构建适合测评我国社区护士在慢性病患者管理中角色的有效工具。第二部分为社区护士角色与工作内容的现况研究。现况研究包括问卷调查和半结构访谈两部分。问卷调查以简体中文版CNRQ(C-CNRQ)作为研究工具,选取郑州市社区卫生服务中心的社区护士,了解郑州市社区护士对自身在脑卒中连续康复中的角色定位的认识和执行情况。半结构访谈选取郑州市社区卫生服务中心的社区护士和社区医生,以访谈提纲为指导,重点了解社区领域的护理专家和社区医生对社区护士应承担的角色与工作内容的看法与期望。第三部分为脑卒中患者连续康复中社区护士的角色定位。以ARN专业康复护士胜任力模型为理论基础,结合现况研究结果,定义脑卒中患者连续康复中社区护士的角色。结果问卷汉化的结果显示,C-CNRQ的信度、效度良好,汉化后的社区护士角色问卷包含38个条目,5个维度,总的Cronbach’sα系数为0.963,5个维度的Cronbach’sα系数为0.630~0.923,可用于我国社区护士慢性病患者管理中角色的测量。现况研究的量性研究部分结果显示,对重要性的认可度和执行频率均高的服务内容有为患者提供健康教育,倾听患者诉说,评估患者病情、与全科医生联络等;对重要性的认可度高而执行频率低的有与其他卫生事业工作者建立联系,获取其支持、与临床护理专家(资深护士)建立伙伴关系、与连续护理协调员保持联系;对重要性的认可度和执行频率均低的条目有给其他成员指导、照顾者提供心理社会支持。质性研究部分结果显示,社区卫生服务中心的护士和医生对社区护士的角色定位可提炼出6大主题:教育者、协调者、评估者、支持者、管理者和研究者。结论本研究结合ARN专业康复护士胜任力模型、量性和质性研究的结果,明确定义了脑卒中患者连续康复中社区护士的角色,验证并完善了前期的研究雏形,主要包括7个方面内容:教育者,协调者,团队合作者,评估者,支持者,管理者和研究者。该角色定位具有较强的应用性,为社区脑卒中患者连续康复的开展、社区护士的人才培养及政策导向一定的指导意义。
[Abstract]:Objective to explore the role orientation of community nurses in the continuous rehabilitation of stroke patients in accordance with the national conditions, and to clarify their roles and work contents in the multidisciplinary team model. Methods this study is divided into three parts. The first part is the Chinese version and revision of community nurse role questionnaire for chronically ill patients. The introduction of nursing care developed by Lesley. Community Nurses role questionnaire for patients with chronic Diseases (. The community nurse role questionnaire for clients with chronic. Conditions. CNRQN, Sinicized and investigated among community nurses in Zhengzhou City, to test its reliability and validity. The second part is the current research on the role and work content of community nurses. The present study includes two parts: questionnaire survey and semi-structured interview. . the Chinese version of the questionnaire in simplified Chinese (. C-CNRQ) as a research tool. Select community nurses in Zhengzhou community health service center. To understand the understanding and implementation of the role orientation of community nurses in the continuous rehabilitation of stroke in Zhengzhou. Semi-structured interviews were conducted to select community nurses and community doctors from Zhengzhou Community Health Service Center. Guided by the outline of the interview. Focus on community nursing experts and community doctors on the role of community nurses and job content and expectations. The third part is the role of community nurses in the continuous rehabilitation of stroke patients. ARN. The competency model of professional rehabilitation nurses is the theoretical basis. Combined with the results of the current study, the role of community nurses in the continuous rehabilitation of stroke patients was defined. Results the results of Chinese questionnaire showed the reliability and validity of C-CNRQ were good. The role questionnaire of community nurses included 38 items, 5 dimensions, and the total Cronbach's 伪 coefficient was 0.963. The Cronbach's 伪 coefficient of five dimensions is 0.630 ~ 0.923, which can be used to measure the role of chronic patients in community nurses in China. Services with high recognition and execution frequency of importance include providing health education for patients, listening to patients' complaints, evaluating patients' condition, contacting general practitioners and so on. Among those with high recognition of importance and low implementation frequency are contacts with other health workers, access to their support, and partnerships with clinical nursing specialists (senior nurses). Maintain contact with the continuous care coordinator; Items with low recognition of importance and low execution frequency provide guidance to other members, and caregivers provide psychosocial support. Qualitative studies show that. The role of nurses and doctors in community health service centers can be abstracted into six main themes: educators, coordinators, evaluators, and supporters. Conclusion the role of community nurses in the continuous rehabilitation of stroke patients is clearly defined by the results of quantitative and qualitative studies on the competency model of rehabilitation nurses in ARN major. Verify and improve the prototype of the previous research, mainly including seven aspects: educators, coordinators, team collaborators, evaluators, supporters, managers and researchers. This role has a strong application. In order to carry out the continuous rehabilitation of stroke patients in the community, the talent training and policy guidance of community nurses are of certain guiding significance.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R473.2

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