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
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　　　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 (8): 977-984.doi: 10.3761/j.issn.1672-9234.2026.08.012

• 职业成长与发展研究 • 上一篇    下一篇

基层医疗机构护士COPD肺康复护理培训方案的构建及实证研究

顾叶1(), 浦嘉妍1, 范俊珺2, 刘玲1,*(), 庄心怡3   

  1. 1 上海健康医学院附属嘉定区中心医院护理部 上海市 201800
    2 上海健康医学院附属嘉定区中心医院呼吸与危重症医学科 上海市 201800
    3 上海大学附属嘉定实验学校体卫科艺部 上海市 201899
  • 收稿日期:2026-01-30 出版日期:2026-08-15 发布日期:2026-08-14
  • 通讯作者: *刘玲，E-mail：liuling200718@sina.com
  • 作者简介:顾叶：女，硕士，副主任护师，E-mail：29997560@qq.com
    第一联系人：

    顾叶：研究整体设计、培训方案构建、实证干预实施、论文撰写与修订；浦嘉妍：数据收集、统计学分析、文献整理、稿件修订校对；范俊珺：专家咨询组织、培训质量控制、SP脚本撰写、实训实施；刘玲：质量控制、实训实施、研究方案审核、现场培训指导；庄心怡：文献整理、SP脚本撰写。所有作者均阅读并同意最终发表稿件。

  • 基金资助:
    上海健康医学院校级科研自然一般项目(SSF-23-16-003)

Construction and application of on-the-job training program for COPD pulmonary rehabilitation nursing of primary care nurses

GU Ye1(), PU Jiayan1, FAN Junjun2, LIU Ling1,*(), ZHUANG Xinyi3   

  1. 1 Nursing Department， Jiading District Central Hospital Affiliated to Shanghai University of Medicine & Health Sciences， Shanghai 201800， China
    2 Department of Respiratory and Critical Care Medicine， Jiading District Central Hospital Affiliated to Shanghai University of Medicine & Health Sciences， Shanghai 201800， China
    3 Department of Physical Education， Health，Art and Science，Jiading Experimental School Affiliated to Shanghai University， Shanghai 201899， China
  • Received:2026-01-30 Online:2026-08-15 Published:2026-08-14
  • Contact: *LIU Ling，E-mail：liuling200718@sina.com
  • Supported by:
    School-level General Natural Science Project of Shanghai University of Medicine & Health Sciences(SSF-23-16-003)

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摘要：

目的 针对基层护士COPD肺康复护理专项能力不足、缺乏标准化培训体系的问题，构建一套适配性在职培训方案并验证应用效果。方法 以Kern六步法为核心框架，通过文献研究、基层护士培训需求调研、2轮专家咨询构建培训方案，并设计6套标准化实训脚本。便利选取上海市嘉定区14所一级、二级基层医疗机构在职护士为研究对象，随机分为两组。对照组49名，实施传统培训方案；试验组66名，实施“线上预习—线下实训—课后巩固”的COPD肺康复护理培训方案。培训前后采用汉化版布里斯托慢性阻塞性肺疾病认知问卷、肺康复技能自评量表进行效果评价。结果 形成基层护士COPD肺康复护理培训方案；2轮专家咨询权威系数为0.93，协调系数为0.426、0.513（均P<0.001）。培训后，两组知识、技能得分均较培训前提升（P<0.001），试验组得分高于对照组（P<0.001）。结论 基层需求导向的COPD肺康复护理培训方案科学规范、可落地；可有效提升基层护士肺康复专业能力，适合在基层医疗机构应用。

关键词: 肺疾病, 慢性阻塞性, 肺康复, 在职培训

Abstract:

Objective To address the deficiencies in specialized COPD pulmonary rehabilitation nursing competence among grassroots nurses and the lack of a standardized training system，and to develop an on-the-job training program for COPD pulmonary rehabilitation nursing tailored to grassroots needs and verify its application effect. Methods Guided by Kern’s six-step approach as the core framework，the training program was optimized and refined through literature review，primary care nurses’ training needs investigation，and two rounds of Delphi expert consultation. Six sets of standardized patient training scripts were independently designed. A total of 115 primary care nurses were enrolled by convenient sampling and divided into two groups using random number method. The control group（n=49） received a traditional training program，while the intervention group（n=66） received a COPD training program consisting of “online preview-offline practical training-postcourse consolidation”. The Chinese version of the Bristol COPD Knowledge Questionnaire and Pulmonary Rehabilitation Skills Self-rating Scale were used to evaluate the training effect before and after intervention. Results The training program for primary care nurses was formed. The expert authority coefficients of the two rounds of consultation were both ≥0.93，and the coordination coefficients were 0.426 and 0.513 respectively（both P<0.001）. After training，the scores of knowledge and skills in both groups were significantly improved compared with those before training（P<0.001），and the improvement in the intervention group was significantly better than that in the control group（P<0.001）. Conclusion The primary care needs-oriented on-the-job training program for COPD pulmonary rehabilitation nursing is scientific，standardized，implementable and general. It can effectively improve the pulmonary rehabilitation professional competence of primary care nurses，which is suitable for routine application in primary care institutions.

Key words: Pulmonary Disease, Chronic Obstructive, Pulmonary Rehabilitation, On-the-job Training