延续护理在区域分级医疗体系构建中的作用研究  

The role of transitional care in the construction of regional hierarchical medical system

作　　者：杜光会[1] 吴玉芬[1] 叶志君[1] 何晓娟[1] 何述萍[1] 漆平[1] 王钧慷[1] DU Guang-hui;WU Yu-fen;YE Zhi-jun;HE Xiao-juan;HE Shu-ping;QI ping;WANG Jun-kang(Sichuan Academy of Medical Sciences ＆ Sichuan Provincial Peopled Hospital,Chengdu 610012,China)

机构地区：[1]四川省医学科学院.四川省人民医院,四川成都610072

出　　处：《实用医院临床杂志》2018年第5期223-226,共4页Practical Journal of Clinical Medicine

基　　金：四川省卫生和计划生育委员会科研课题常规项目(编号:150219)

摘　　要：目的研究参与延续护理的护理人员服务意愿及行为,讨论延续护理实践促进区域分级医疗体系构建的作用。方法通过文献梳理总结我国在医院、社区和科室三个层面开展延续护理的探索实践及其成效,采用调查问卷法,研究279名患者的延续护理需求及175名护士参与延续护理的行为差异。结果现阶段患者对于延续护理的需求主要集中在出院后的携管护理方面,而其他延续护理项目需求更倾向于继续留在医院或返院复诊,与护士更愿意进行的延续护理时间相比,更多的患者希望一年及三年(P<0.05);而希望半年及十年的医患双方差异无统计学意义(P>0.05)。护士参与延续护理的现状和态度在不同年龄段、职称级别和聘用类型上差异有统计学意义(P<0.05),而在学历和护龄上异无统计学意义(P>0.05)。结论从改善社区医院硬件设施条件、提高社区医务人员业务能力水平、构建区域分级医疗体系、促进双向转诊制度建设等方面提出了对策建议,论证了延续护理作为区域分级医疗体系构建推动力的重要因素在体系构建中的作用。Objective To study the willingness and behavior of nurses involved in the transitional care, and discuss whether transitional care can promote the construction of regional hierarchical medical system.Methods This paper summarized China5s ex-ploratory practice of and benefits gained from transitional care in the three levels of department, and conducted a questionnaire survey on the demand of 279 patients for transitional care as well as the behavioral difference of 175 nurses participated in transitional care.Re-sults At present, the patients, demands for transitional care mainly fall into PICC nursing, while for other nursing services, patients would rather receive them in hospital.As for the length of transitional care,there was significant difference （P 〈0.05 ） for the one-year and three-year periods as more patients desired for them than nurses willing to deliver.Such significant difference,however,did not exist （P〉0.05） for the half-year and ten-year periods.And the nurses＊ participation in and attitude towards transitional care are significantly differentiated in the three aspects of age group,title ranks and types of employment （P〈0.05 ） , whereas no significant difference was revealed in the aspects of academic experience and length of employment.Conclusion This paper put forward some suggestions on im-proving the hardware facilities of community hospitals, the professional skills of community medical staff and the constructing regional hierarchical medical system and promoting the two-way referral system.The paper also proved that transitional care plays a promotion role in the construction of regional hierarchical medical system.

关 键 词：延续护理 患者需求 分级诊疗 护士参与行为 

分 类 号：R471[医药卫生—护理学]