家庭护士胜任力模型的构建研究

发布时间：2018-02-26 17:20

本文关键词： 护士家庭护理家庭护士胜任力胜任力模型　出处：《第二军医大学》2015年硕士论文　论文类型：学位论文

【摘要】：随着人口老龄化、疾病谱的改变和家庭结构小型化,家庭护理的需求不断上升,家庭医生签约制的开展将在未来带动我国家庭护理需求继续上升。本研究基于我国家庭护理稳步发展但家庭护士胜任力标准缺乏的现状,旨在建立一个既符合我国国情又体现未来发展趋势的家庭护士胜任力模型,以期为我国家庭护士的准入及教育培训提供理论依据。本研究主要分为三大部分,首先,通过田野研究从实然层面剖析我国社区卫生发展现状以及国情文化背景下家庭护士在具体家庭服务过程中所需要的胜任力；其次,通过半结构访谈从应然层面了解不同人群对家庭护士胜任力的需求及期望,以补充第一部分的胜任力结果,从而初步构建家庭护士胜任力模型；最后,通过Delphi专家咨询对模型进行修订和完善。第一部分：家庭护士胜任特征的田野研究。研究方法：采用目的抽样法选取能够较全面代表上海市社区卫生发展水平的3.家社区卫生服务中心及其下属的17个社区卫生服务站作为田野地,通过参与式观察法收集资料, 整理成田野笔记进行,然后通过资料沉浸—编码—形成类属—形成主题四步进行胜任力的提炼。研究结果：共解析出家庭护士实际工作所需的胜任力指标22项。第二部分：家庭护士胜任特征的质性访谈。研究方法：采用滚雪球抽样选取10名家庭护士、2名家庭医生、5名社区管理者、3名家庭护理服务对象、2名家庭护理服务对象家属以及2名社区家庭病床协会的主任共24人进行半结构访谈,综合多视角的观点解析出家庭护士胜任力,采用扎根理论中持续比较分析法对访谈资料进行分析。研究结果：获得家庭护士胜任力指标34项,其中20项验证了田野研究所得结果,另外补充贡献14项胜任力指标。第三部分：家庭护士胜任力模型的构建和修订。研究方法：采用目的抽样选取18名社区医疗及护理的专家,通过德尔菲法进行咨询。结果通过SPSS18.0进行汇总,并对数据进行描述性统计整理。研究结果：两轮专家咨询的应答率均为100%,选取18名社区专家的权威度为0.759。咨询过程共修改胜任力指标5项,删除胜任力指标3项,增加胜任力指标2项。最终的形成家庭护士胜任力模型包括4大模块,17项胜任力,35个胜任力维度。结论：本研究摆脱单—视角挖掘胜任特征的局限,从实然和应然两个层面综合了解我国家庭护士所需的胜任力,最终构建的家庭护士胜任力模型结构合理,本研究结果为我国家庭护士的准入以及教育培训提供了胜任力方向的理论指导,对推进我国家庭护士的发展具有一定的实际意义。
[Abstract]:With the aging of the population, the change of disease spectrum and the miniaturization of the family structure, the demand for home care is increasing. The development of the family doctor contract system will further increase the demand for family nursing in China in the future. This study is based on the steady development of family nursing in China but the lack of competency standards of family nurses. The purpose of this study is to establish a competency model of family nurses, which conforms to the situation of our country and reflects the trend of future development, in order to provide the theoretical basis for the admission and education of family nurses in China. This study is divided into three parts: first of all, Through field research, it analyzes the current situation of community health development in China and the competence needed by family nurses in the process of specific family service under the background of national conditions and culture. Secondly, In order to supplement the results of the first part of the competency of the family nurses, the competency model of the family nurses can be preliminarily constructed by the semi-structured interviews at the level of the ought to understand the needs and expectations of the different population to the competence of the family nurses. The model is revised and perfected by Delphi expert consultation. Part I: field study on the competency of family nurses. Research methods: the purpose sampling method is used to select those that can represent the level of community health development in Shanghai. 3. The Family Community Health Service Centre and its 17 community health service stations serve as field fields, Collecting data through participatory observation, organizing them into field notes, Then the competency was extracted by four steps of data immersion, coding, forming genus-forming theme. The results showed that 22 items of competency were analyzed for the actual work of the family nurses. Part 2: the family nurses won the job. Qualitative interviews with random characteristics. Research methods: 10 family nurses, 2 family doctors, 5 community managers, 3 family care clients, 2 family care clients, 2 family members and 2 community nurses were selected by snowball sampling. The director of the Family beds Association conducted semi-structured interviews with 24 people. The competency of family nurses was analyzed from the viewpoint of multiple perspectives, and the interview data were analyzed by the method of continuous comparative analysis in rooted theory. The results showed that 34 items of competency indexes of family nurses were obtained. The results of field studies were verified in 20 items, and 14 competency indexes were supplemented. Part three: the construction and revision of competency model of family nurses. Research methods: 18 community medical and nursing experts were selected by objective sampling. The results are summarized by SPSS18.0. The results showed that the response rate of two rounds of expert consultation was 100, and the authority of 18 community experts was 0.759. In the consultation process, 5 competency indexes were revised and 3 competency indexes were deleted. The final competency model of home nurses includes 17 competency modules and 35 competency dimensions. Conclusion: this study is free from the limitation of single-angle mining competency. The competency of family nurses in China is comprehensively understood from the two levels of reality and ought to be, and the structure of the competency model of family nurses is reasonable. The results of this study provide theoretical guidance for the access of family nurses and education and training in China, and have a certain practical significance for promoting the development of family nurses in China.
【学位授予单位】：第二军医大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R47

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