中医护理门诊开展手法通乳技术的焦点问题分析  

Analysis of key issues in the implementation of manual lactation techniques in traditional Chinese medicine nursing clinics

作　　者：邢晅毓 李野 徐京巾 唐玲[2] 王思瑶 XING Xuanyu;LI Ye;XU Jingjin;TANG Ling;WANG Siyao(School of Nursing,Beijing University of Chinese Medicine,Beijing 100020,China;Nursing Department,Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100071)

机构地区：[1]北京中医药大学护理学院,北京100020 [2]北京中医药大学东方医院护理部,北京100071

出　　处：《北京中医药》2025年第2期233-238,共6页Beijing Journal of Traditional Chinese Medicine

基　　金：首都卫生发展科研专项(2022-2-4202)。

摘　　要：目的分析手法通乳技术在中医护理门诊的服务现状,总结焦点问题,从管理者的角度探讨相应的解决途径。方法于2022年12月—2023年6月,采用便利抽样法,在全国16所开展手法通乳技术的三级甲等中医医院中医护理门诊抽取40名医生、140名护士作为定量研究对象。于2023年3—6月,采用目的抽样法,在北京市3所开展手法通乳技术的三级甲等中医医院中医护理门诊抽取医生4名、护士4名、患者8例作为定性研究对象。采用混合研究方法中的聚敛式设计,自设调研问卷和访谈提纲,将高频的质性研究数据与量性研究数据联合呈现、并排比较,以确定焦点问题。结果在中医护理门诊,手法通乳技术的主要操作者是护士(82.78%),技术的主要的培训方式是授课和临床带教结合(52.78%),37.22%的中医护理门诊未形成手法通乳技术的操作规范,88.33%的中医护理门诊未对患者进行随访。将14个综合开放性编码再次归纳分析,抽象概括出6个主轴编码,继续深入分析形成“服务结构”“服务过程”“服务结果”3个核心编码。通过混合研究形成了4个焦点问题包括“如何加强培养中医护理高层次实践人才”“如何促进临床手法通乳技术规范化应用”“如何加强培养护士有效沟通的能力”“如何提高服务的延续性”。结论中医护理门诊医护患对手法通乳技术服务均呈正面态度,但存在缺乏高层次实践人才、技术规范化应用不足、护士有效沟通效果未达预期、服务延续性差等问题,建议加强培养中医护理高层次实践人才,促进临床手法通乳技术规范化应用,加强培养护士有效沟通能力,提高中医护理门诊手法通乳技术服务的延续性。Objective To analyze the service status of manual lactation techniques in traditional Chinese medicine(TCM)nursing clinics,summarize key issues,and explore corresponding solutions from the perspective of management.Methods From December 2022 to June 2023,a convenience sampling method was used to select 40 doctors and 140 nurses as quantitative research participants from 16 tertiary Grade A hospitals across China that implemented manual lactation techniques in their TCM nursing clinics.From March to June 2023,a purposive sampling method was used to select 4 doctors,4 nurses,and 8 patients from TCM nursing clinics in 3 tertiary Grade A hospitals that implemented manual lactation techniques in Beijing for qualitative research.A convergent design within the mixed research method was adopted,using self-designed surveys and interview outlines.High-frequency qualitative data and quantitative data were presented jointly and compared side-by-side to identify the key issues.Results In TCM nursing clinics,the main operators of manual lactation techniques were nurses(82.78%).The primary training method for the technique was a combination of lectures and clinical guidance(52.78%).About 37.22%of TCM nursing clinics did not have standardized operational procedures for manual lactation techniques,and 88.33%of TCM nursing clinics did not conduct follow-up for patients.After reanalyzing the 14 comprehensive open codes,six spindle codes were abstracted and summarized into three core codes,i.e.,"service structure","service process",and"service outcome".Through the mixed research approach,four key issues emerged,including"how to strengthen the cultivation of senior practical talents in TCM nursing","how to promote the standardized application of clinical manual lactation techniques","how to enhance nurses'communication skills",and"how to improve the continuity of services".Conclusion Both medical staff and patients in TCM nursing clinics have a positive attitude toward manual lactation techniques.However,issues such as the lack of se

关 键 词：中医护理门诊 手法通乳技术 焦点问题 混合研究 

分 类 号：R248[医药卫生—中医临床基础]