安宁疗护高级实践护士发展现状及启示

doi:10.3761/j.issn.1672-9234.2026.05.006

Abstract

Abstract:

Advanced practice nurses(APNs) in palliative care,as a vital workforce with strong clinical decision making capacity and interdisciplinary collaboration skills,play a vital role in symptom management,care coordination,and psychosocial support for patients and their families. However,the development of palliative care APNs in China is still at an exploratory stage. This article reviews the development,cultivation(admission and certification,education and training),core competencies,and practice scope of palliative care APNs at home and abroad. It proposes that in the future,China needs to establish an admission and qualification certification system for palliative care APN,with a focus on improving the existing education and training system,further optimize the practice environment and interdisciplinary mechanism,so as to provide a theoretical and practical implications for the construction of a localized development model for palliative care APNs in China.

Key words: Palliative Care, Advanced Nursing Practice, Advanced Practice Nurses, Specialist Nurses, Nursing, Review

GUO Junchen, LIU Xiangyu, LIU Gaoming, LEI Xinyao, LI Li, CHEN Shengli, CHEN Yongyi. The development status and implications of advanced practice nurses in palliative care[J].Chinese Journal of Nursing Education, 2026, 23(5): 547-553.

References 34

[1]	谌永毅, 肖亚洲, 朱丽辉, 等. 十年砥砺奋进,擘画安宁疗护护理事业蓝图[J]. 中国护理管理, 2022, 22(12):1771-1775.
	Chen YY, Xiao YZ, Zhu LH, et al. Ten years of hard work and a new chapter of palliative care nursing career[J]. Chin Nurs Manag, 2022, 22(12):1771-1775.
[2]	谌永毅, 刘翔宇. 安宁疗护专科护理[M]. 北京: 人民卫生出版社, 2020.
	Chen YY, Liu XY. Hospice nursing specialist nursing[M]. Beijing: People’s Medical Publishing House, 2020.
[3]	Ferrell BR, Virani R, Han E, et al. Integration of palliative care in the role of the oncology advanced practice nurse[J]. J Adv Pract Oncol, 2021, 12(2):165-172. doi: 10.6004/jadpro.2021.12.2.4 pmid: 34109048
[4]	George T. Role of the advanced practice nurse in palliative care[J]. Int J Palliat Nurs, 2016, 22(3):137-140. doi: 10.12968/ijpn.2016.22.3.137 pmid: 27018740
[5]	O’Mahony S, Johnson TJ, Amer S, et al. Integration of palliative care advanced practice nurses into intensive care unit teams[J]. Am J Hosp Palliat Care, 2017, 34(4):330-334. doi: 10.1177/1049909115627425 pmid: 26917789
[6]	Skilbeck J, Corner J, Bath P, et al. Clinical nurse specialists in palliative care. Part 1. A description of the MacMillan nurse caseload[J]. Palliat Med, 2002, 16(4):285-296. pmid: 12132541
[7]	Kuebler KK. The palliative care advanced practice nurse[J]. J Palliat Med, 2003, 6(5):707-714. pmid: 14622450
[8]	Canadian Nurse Association. Advanced practice nursing[EB/OL]. [2025-12-10]. https://www.cna-aiic.ca/en/nursing/advanced-nursing-practice.
[9]	Hospice and Palliative Credentialing Center. Certification[EB/OL]. (2025-01-30)[2025-12-10]. https://www.advancingexpertcare.org/hpcc/.
[10]	张蕾, 孙冠贤, 单良, 等. 我国安宁疗护社会工作介入对策探索[J]. 医学与哲学, 2024, 45(18):45-49.
	Zhang L, Sun GX, Shan L, et al. Exploration of hospice care social work intervention strategies in China[J]. Med Philos, 2024, 45(18):45-49.
[11]	卜小丽, 张宏晨, 王艳红, 等. 护理本科生安宁疗护课程的建设与教学实践[J]. 中华护理教育, 2022, 19(11):970-975.
	Bu XL, Zhang HC, Wang YH, et al. Construction and teaching practice of Hospice Nursing course for nursing undergraduates[J]. Chin J Nurs Educ, 2022, 19(11):970-975.
[12]	李惠玲, 莫圆圆, 李春会. 高级护理实践专业课程思政建设思考与实践[J]. 中国护理管理, 2020, 20(7):966-970.
	Li HL, Mo YY, Li CH. Thinking and practice on the construction of ideological and political education in advanced nursing practice course[J]. Chin Nurs Manag, 2020, 20(7):966-970.
[13]	殷钰, 姚金兰, 付晓凡, 等. 情境模拟教学法在高级护理实践课程教学中的应用[J]. 中华护理教育, 2018, 15(4):272-275.
	Yin Y, Yao JL, Fu XF, et al. The effects of a situational simulation teaching applied in the advanced nursing practice course[J]. Chin J Nurs Educ, 2018, 15(4):272-275.
[14]	Hospice and Palliative Credentialing Center. Scaled scores[EB/OL].(2025-01-30)[2026-02-19]. https://portal.advancingexper-tcare.org/Portal/HPCC/CertificationWeb/Scaled_Scores.aspx.
[15]	NHS England. Palliative and end-of-life care advanced practice area specific capability and curriculum framework[EB/OL].[2025-12-12]. https://advanced-practice.hee.nhs.uk/wpcon-tent/uploads/sites/28/2025/01/Palliative-and-end-of-life-care-ad-vanced-practice-area-specific-capability-and-curriculum-frame-work-NHSE.pdf.
[16]	Health and Care Professional Council. Multi-professional framework for advanced clinical practice in England[EB/OL]. (2017-11-23)[2025-12-13]. https://www.hcpc-uk.org/news-and-events/news/2017/multi-professional-framework-for-advanced-cli-nical-practice-in-england/.
[17]	Canadian Council of Registered Nurse Regulators. Nurse practitioners[EB/OL]. [2026-02-23]. https://www.ccrnr.ca/nurse-practitioners?utm_source.
[18]	Rounds LR, Zych JJ, Mallary LL. The consensus model for regulation of APRNs:implications for nurse practitioners[J]. J Am Assoc Nurse Pract, 2013, 25(4):180-185. doi: 10.1111/j.1745-7599.2013.00812.x pmid: 24218235
[19]	Registered Nursing. APRN programs[EB/OL]. [2026-03-09]. https://www.registerednursing.org/aprn/programs/.
[20]	Hospice and Palliative Nurses Association. Fellowship programs[EB/OL]. [2025-12-16]. https://www.advancingexpertcare.org/practice-research/fellowship-programs/.
[21]	Dahlin C, Coyne PJ, Cassel JB. The advanced practice registered nurses palliative care externship:a model for primary palliative care education[J]. J Palliat Med, 2016, 19(7):753-759. doi: 10.1089/jpm.2015.0491
[22]	King’s College London. Palliative Care MSc/PGDip/PGCert-teaching & modules[EB/OL]. [2025-12-15]. https://www.kcl.ac.uk/study/postgraduate-taught/courses/palliative-care-msc-pg-dip-pg-cert/teaching?utm_source.
[23]	University of Toronto. Palliative care certificate courses[EB/OL]. [2025-12-16]. https://bloomberg.nursing.utoronto.ca/cpd-course/approach-to-care-and-communication-skills/?utm_source.
[24]	Hospital Authority(Hong Kong). Strategic service framework for palliative care[EB/OL]. [2025-12-16]. https://www.ha.org.hk/haho/ho/ap/pcssf_1.pdf.
[25]	Cheng QQ, Zhang QH, Liu XY, et al. Initial exploration of training for palliative care specialist nurses in mainland China[J]. Nurse Educ Today, 2021, 101:104869. doi: 10.1016/j.nedt.2021.104869
[26]	马蕊蕊, 许凤琴, 吕娜, 等. 基于核心能力的安宁疗护高级实践护士培训内容的构建[J]. 中华现代护理杂志, 2026, 32(2):265-271.
	Ma RR, Xu FQ, Lü N, et al. Construction of training content for hospice care advanced practice nurses based on core competencies[J]. Chin J Mod Nurs, 2026, 32(2):265-271.
[27]	Palliative Care Nurses Australia. Competency standards[EB/OL]. [2025-12-12]. https://www.pcna.org.au/competency-standards.
[28]	Reville B, Foxwell AM. Competency milestones:guidelines for advanced practice palliative nurses[J]. J Hosp Palliat Nurs, 2017, 19(4):339-342. doi: 10.1097/NJH.0000000000000352
[29]	赵艺媛, 陆宇晗, 王云, 等. 安宁疗护高级实践护士核心能力指标体系的构建[J]. 中国护理管理, 2021, 21(2):268-273.
	Zhao YY, Lu YH, Wang Y, et al. The research in core competencies of Hospice Advanced Practice Nurse[J]. Chin Nurs Manag, 2021, 21(2):268-273.
[30]	Carpenter JG, Murthi J, Langford M, et al. A nurse practitioner-driven palliative and supportive care service in nursing homes:evaluation of a quality improvement project[J]. J Hosp Palliat Nurs, 2024, 26(4):205-211. doi: 10.1097/NJH.0000000000001028 pmid: 38529958
[31]	Poghosyan L, Stein JH, Liu JF, et al. State-level scope of practice regulations for nurse practitioners impact work environments:six state investigation[J]. Res Nurs Health, 2022, 45(5):516-524. doi: 10.1002/nur.22253 pmid: 35852444
[32]	张青青, 王文超, 顾莺. 成人安宁疗护相关临床实践指南的内容分析[J]. 护理学杂志, 2022, 37(9):99-102,110.
	Zhang QQ, Wang WC, Gu Y. Content analysis of clinical practice guidelines on palliative care for adults[J]. J Nurs Sci, 2022, 37(9):99-102,110.
[33]	王雯静, 苑秋辰, 郭爱敏. 我国高级实践护士发展的态势分析[J]. 中华护理教育, 2024, 21(12):1443-1448.
	Wang WJ, Yuan QC, Guo AM. Analysis of the development trends of advanced practice nurses in China[J]. Chin J Nurs Educ, 2024, 21(12):1443-1448.
[34]	陈佳丽, 王立群, 周旭华, 等. 高级实践护士核心能力培养与思考[J]. 中华护理教育, 2025, 22(8):901-905.
	Chen JL, Wang LQ, Zhou XH, et al. Cultivation and reflection on the core competencies of advanced practice nurses[J]. Chin J Nurs Educ, 2025, 22(8):901-905.

The development status and implications of advanced practice nurses in palliative care

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