护士开展老年患者出院计划能力现状及影响因素研究

doi:10.3761/j.issn.1672-9234.2020.10.004

摘要/Abstract

摘要：

目的了解护士开展老年患者出院计划能力现状并分析其影响因素,为推进出院计划在临床发展提供参考依据。方法采用一般资料调查表、护士主导老年患者出院计划核心能力量表、中文版护士职业认同量表,对通过3阶段分层抽样选取的宁夏17所公立综合性医院的1 021名护士进行问卷调查。结果护士开展老年患者出院计划能力得分为（204.02±43.95）分,追踪随访和效果评价能力维度标准化得分最低,为（68.62±18.41）分。分层回归分析结果显示,护士职业认同、参加出院计划相关培训频次、是否为带教教师、工作年限可以解释护士开展老年患者出院计划能力总变异的34.1%;职业认同能独立解释护士开展老年患者出院计划能力总变异的25.2%。结论护士开展老年患者出院计划能力处于中等偏上水平;护理管理者应注重提升护士职业认同,增设出院计划相关知识培训讲座,从而提高护士开展老年患者出院计划能力。高年资、具备带教经验的护士具备更强的开展老年患者出院计划能力。

关键词: 护士, 出院计划, 老年人, 专业能力, 问卷调查

Abstract:

Objective To know the status and influencing factors of the nurses’ competence in implementing the discharge planning for older patients. Methods A questionnaire survey was conducted among 1 021 nurses from 17 public general hospitals in Ningxia through three stages of stratified sampling by using the Core Competence Scale of Nurse-led Discharge Planning for Elderly Patients and Chinese version of the Nurse’s Career Identity Scale. Results The nurses’ competence in implementing the discharge planning for older patients were（204.02±43.95）. The lowest score was（68.62±18.41） for “ability of follow-up and effect evaluation” dimension. Hierarchical regression analysis showed that nurse’s career identity,number of training related to the discharge planning each month,being a clinical instructor or not, and working years could explain 34.1% of the total variation. After controlling the general demographic variables,career identity could independently explain 25.2% of the total variation. Conclusion The nurses’ competence in implementing the discharge planning for elderly patients was above the middle level. The nursing managers should pay attention to improve the nurses’ career identity and increase knowledge training related to discharge planning in order to improve nurses’ competence level. In addition,nurses with long working years and teaching experience are more likely to be qualified for discharge planning.

Key words: Nurses, Discharge Planning, Aged, Professional Competence, Questionnaires

路露,丁玲,芦鸿雁. 护士开展老年患者出院计划能力现状及影响因素研究[J]. 中华护理教育, 2020, 17(10): 886-890.

LU Lu,DING Ling,LU Hong-yan. The current status and influencing factors of nurses’ competence in implementing the discharge planning for older patients[J]. Chinese Journal of Nursing Education, 2020, 17(10): 886-890.

图/表 5

参考文献 16

[1]	曹丰, 王亚斌, 薛万国, 等. 中国老年疾病临床多中心报告[J]. 中华老年多器官疾病杂志, 2018,17(11):801-808.
[2]	国家卫生计生委医政医管局. 国家卫生计生委关于印发全国护理事业发展规划(2016-2020年)的通知[EB/OL]. [2018-10-11]. http://www.nhfpc.gov.cn/yzygj/s3593/201611/92b2e8f8cc644a899e9d0fd572aefef3.shtml.
[3]	席淑华, 赵继军, 赵建华, 等. 成功大学附属医院出院准备服务概况与启示[J]. 中华护理杂志, 2007,42(4):341-342.
[4]	Fox M. Nurse-led early discharge planning for chronic disease reduces hospital readmission rates and all-cause mortality[J]. Evid Based Nurs, 2016,19(2):62. doi: 10.1136/eb-2015-102197 pmid: 26701748
[5]	赵岳. 护士在实施出院计划中的角色[J]. 天津护理, 2005,13(3):185.
[6]	Eaton CK. Social workers,nurses,or both:who is primarily responsible for hospital discharge planning with older adults?[J]. Social Work in Health Care, 2018,57(10):851-863. doi: 10.1080/00981389.2018.1521892 pmid: 30300115
[7]	Rahayu CD, Hartiti T, Rofi’i M. A review of the quality improvement in discharge planning through coaching in nursing[J]. Nurse Media Journal of Nursing, 2016,6(1):19-29.
[8]	段应龙, 吴小霞, 钟竹青, 等. 护士职业认同、职业倦怠对离职意愿影响的研究[J]. 中国护理管理, 2017,17(3):368-373.
[9]	Johnson M, Cowin LS, Wilson I, et al. Professional identity and nursing:contemporary theoretical developments and future research challenges[J]. Int Nurs Rev, 2012,59(4):562-569. pmid: 23134142
[10]	路露, 芦鸿雁, 丁玲. 护士主导老年患者出院计划核心能力评价指标体系的构建[J]. 中华现代护理杂志, 2019,25(8):945-950.
[11]	赵红, 路迢迢, 张彩云, 等. 护士职业认同量表中文版的信度与效度研究[J]. 中国护理管理, 2010,10(11):49-51.
[12]	O’Connell Francischetto E, Damery S, Davies S, et al. Discharge interventions for older patients leaving hospital:protocol for a systematic meta-review[J]. Syst Rev, 2016,5:46. doi: 10.1186/s13643-016-0222-8 pmid: 26984024
[13]	娄兰兰, 甘秀妮. 以专科护士为主导的慢性病延续性护理方案的研究[J]. 护理研究, 2015,29(5C):1793-1795.
[14]	张希, 戴付敏, 陈玉荣, 等. 公立医院改革进程中开展延续护理服务的SWOT分析[J]. 中国实用护理杂志, 2014,30(11):8-11.
[15]	Day MR, McCarthy G, Coffey A. Discharge planning:the role of the discharge co-ordinator[J]. Nurs Older People, 2009,21(1):26-31;quiz 32. doi: 10.7748/nop2009.02.21.1.26.c6871 pmid: 19248440
[16]	Denise Bryant-Lukosiu, 刘晓航, 张俊娥,. 由高级实践护士主导的延续护理现状与展望[J]. 中国护理管理, 2017,17(4):439-443.