ISSN 2097-6054（网络） ISSN 1672-9234（印刷） CN 11-5289/R
主管：中国科学技术协会　主办：中华护理学会
出版：中华护理杂志社
收录：中国科学引文数据库（CSCD）来源期刊
　　　中国期刊全文数据库
　　　中国核心期刊（遴选）数据库
　　　Scopus
中华护理教育

中华护理教育 ›› 2026, Vol. 23 ›› Issue (6): 663-670.doi: 10.3761/j.issn.1672-9234.2026.06.004

• 专题策划——安宁疗护教育与人才培养 • 上一篇    下一篇

基于多元主体视角的安宁疗护高级实践护士核心能力框架构建的质性研究

许辉1(), 卢美玲2, 郑儒君3, 庄嘉元4, 董雪5, 王娟6, 谌永毅7,*()   

  1. 1 中国医科大学护理学院 沈阳市 110122
    2 天津市肿瘤医院中西医结合病区 天津市 300060
    3 四川大学华西医院生物治疗研究病房 成都市 610041
    4 福建医科大学护理学院 福州市 350122
    5 中国医学科学院肿瘤医院特需医疗部 北京市 100021
    6 新疆医科大学附属肿瘤医院姑息医学科 乌鲁木齐市 830011
    7 湖南省肿瘤医院肿瘤护理教研室 长沙市 410013
  • 收稿日期:2026-01-04 出版日期:2026-06-15 发布日期:2026-06-18
  • 通讯作者: *谌永毅，E-mail：414700595@qq.com
  • 作者简介:许辉：女，博士，教授，主任护师，E-mail：cmuxuhui@163.com
    第一联系人：

    许辉：资料收集、文本分析、论文撰写和修改；卢美玲、郑儒君、庄嘉元、董雪、王娟：资料收集、文本分析；谌永毅：研究构思与设计、总体指导、论文修改和审校。

Construction of a core competency framework for advanced practice nurses in hospice care：a qualitative study from the perspective of multiple subjects

XU Hui1(), LU Meiling2, ZHENG Rujun3, ZHUANG Jiayuan4, DONG Xue5, WANG Juan6, CHEN Yongyi7,*()   

  1. 1 School of Nursing， China Medical University， Shenyang 110122， China
    2 Integrated Traditional Chinese and Western Medicine Ward， Tianjin Cancer Hospital， Tianjin 300060， China
    3 Biotherapy Research Ward， West China Hospital，Sichuan University， Chengdu 610041， China
    4 School of Nursing， Fujian Medical University， Fuzhou 350122， China
    5 Special Medical Services Department， Cancer Hospital Chinese Academy of Medical Sciences， Beijing 100021， China
    6 Palliative Medicine Department， Xinjiang Medical University Affiliated Cancer Hospital， Urumqi 830011， China
    7 Cancer Nursing Teaching and Research Section， Hunan Cancer Hospital， Changsha 410013， China
  • Received:2026-01-04 Online:2026-06-15 Published:2026-06-18
  • Contact: *CHEN Yongyi，E-mail：414700595@qq.com

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摘要：

目的 从护理管理者、安宁疗护专科护士与医生的多元视角出发，探讨安宁疗护高级实践护士（advanced practice nurses，APN）的核心能力构成，为构建本土化APN核心能力框架及后续培训课程开发提供依据。方法 采用描述性质性研究设计，基于Hamric的APN核心能力框架，于2025年8月—10月，通过目的抽样法对来自全国9个省级行政区的13名护理管理者、11名安宁疗护专科护士及5名医生进行半结构式访谈，运用主题分析法进行资料分析。结果 提炼出安宁疗护APN的3个核心能力框架，包含20个具体能力条目：高级临床实践能力（包括复杂症状的评估与管理、多病共存照护能力、伦理法律议题的识别与处理能力等10个条目）；科研能力（包括科研选题能力、循证证据整合能力、质量改进与数据分析能力等6个条目）；人文领导力与教育能力（包括领导多学科与资源协调能力、教育与培训指导能力等4个条目）。结论 安宁疗护APN的核心能力是一个多维度、高阶化的能力体系，建议未来系统开发基于核心能力框架的培训课程，以培养能应对复杂临床情境、推动学科发展的专业人才。

关键词: 安宁疗护, 高级实践护士, 核心能力, 质性研究, 护理

Abstract:

Objective To explore the core competencies for advanced practice nurses （APN） in palliative care from the diverse perspectives of nursing managers，palliative care specialty nurses，and doctors，so as to provide a basis for constructing a localized core competency framework for APN and subsequent training curriculum development. Methods A descriptive qualitative research design was adopted，based on Hamric’s APN core competency framework. From August to October 2025，semi-structured interviews were conducted with 13 nursing managers，11 hospice care specialty nurses，and five physicians from nine province-level region across the country using purposive sampling. Thematic analysis was used for data analysis. Results Three core competency domains for hospice care APN were extracted，containing 20 specific competency items：advanced clinical practice competencies（ten items，including assessment and management of complex symptoms，the ability to provide care for patients with multiple comorbidities，and the ability to identify and address ethical and legal issues，etc.）；research competencies（six items，including research topics selection ability，evidence-based evidence integration ability，quality improvement and data analysis ability，etc.）；and humanistic leadership and educational competencies（four items，including leadership in multidisciplinary and resource coordination，education and training guidance ability，etc.） Conclusion The core competencies of hospice care APN constitute a multidimensional and advanced capability system. It is recommended that training courses based on the core competency framework be systematically developed in the future to cultivate professionals capable of coping with complex clinical situations and promoting the development of the discipline.

Key words: Hospice Care, Advanced Practice Nurse, Core Competency, Qualitative Research, Nursing Care