妊娠期糖尿病临床护理实践指南实施的障碍因素分析  

Barriers analysis of implementation of clinical nursing practice guideline for gestational diabetes mellitus

作　　者：周英凤[1] 钟婕 李丽[2] 章孟星 潘秀红 赵杏珍[4] 郭娜菲 Zhou Yingfeng;Zhong Jie;Li Li;Zhang Mengxing;Pan Xiuhong;Zhao Xingzhen;Guo Nafei(School of Nursing,Fudan University,JBI Evidence-based Nursing Cooperation Center,Fudan University,Shanghai 200032;Obstetrics and Gynecology Hospital,Fudan University,Shanghai 200011;Pudong Hospital,Fudan University,Shanghai 200433;Shanghai Jiading Maternal and Child Health Hospital,Shanghai 201821;Shanghai First Maternal and Child Health Hospital,Shanghai 201204)

机构地区：[1]复旦大学护理学院复旦大学JBI循证护理合作中心,上海200032 [2]复旦大学附属妇产科医院,上海200011 [3]复旦大学附属浦东医院,上海200433 [4]上海市嘉定区妇幼保健院,上海201821 [5]上海市第一妇婴保健院,上海201204

出　　处：《护士进修杂志》2021年第4期307-310,316,共5页Journal of Nurses Training

基　　金：国家自然科学基金面上项目(编号:71874035)。

摘　　要：目的从实践者角度对妊娠期糖尿病临床护理实践指南实施过程中潜在的障碍因素进行分析。方法采用焦点小组访谈的方法,对来自上海市4家医院与妊娠期糖尿病管理/护理相关的47名专业人员进行了4次访谈,采用内容分析法进行资料分析。结果实施妊娠期糖尿病临床护理实践指南在证据方面障碍因素包括证据的可操作性差、护士缺乏变革权限及证据应用后结果不易被测量、证据应用复杂性高;在潜在采纳者方面。障碍因素包括护理人员信息与动机缺乏、患者知识、信念、行为欠佳;在实践环境方面障碍因素包括:缺乏护理规范和操作流程、健康教育内容简单且形式单一、缺乏完善的专科护理管理团队、未建立多学科合作机制。结论本研究以渥太华研究应用模式为指导,从证据、潜在采纳者及实践环境3个方面确定了妊娠期糖尿病临床护理实践指南实施的10大障碍因素,为后续构建实践方案和干预策略推动指南的实施提供了依据。Objective To analyze the barriers of implementation of clinical nursing practice guideline for gestational diabetes mellitus from the point of practitioner.Method A purposive sampling was used to select 47 professionals related to management nursing of gestational diabetes.Four focus groups interview were conducted and analyzed by qualitative content analysis.Results Four barriers including lack of feasibility,limit of authority,outcomes unavailability and evidence complexity related to recommendations of guideline.Two barriers including lack of information motivation for nurses and lack of KAP for patients connected to adopters.Four barriers including lack of nursing guideline/procedure,education simplicity,lack of nursing specialist team and lack of MDT mechanism were related to practice environment.Conclusion Guided by Ottawa model of research utilization,this study identified ten barriers from three levels of evidence,practitioner and practice environment.The findings provided support for strategy development to promote the implementation of guideline.

关 键 词：妊娠期糖尿病 临床护理实践指南 障碍因素 焦点小组访谈 

分 类 号：R473.58[医药卫生—护理学]