护士开展老年多重慢病患者出院准备服务体验的质性研究  

Nurses'experience in providing discharge preparation services for elderly patients with multiple chronic diseases:a qualitative study

作　　者：刘艳[1] 王海荣[2] 周美 庾维 陈秀春[3] 廖芳慧 杨平 莫亚旦 Liu Yan;Wang Hairong;Zhou Mei;Yu Wei;Chen Xiuchun;Liao Fanghui;Yang Ping;Mo Yadan(Department of Nursing,Affiliated Hospital of Guilin Medical University,Guilin 541001,China;No 1 Departmentof Cardiovascular Medicine,Affiliated Hospital of Guilin Medical University,Guilin 541001,China;Department of General Medicine,Affiliated Hospital of Guilin Medical University,Guilin 541001,China;Department of Geriatrics,Affiliated Hospital of Guilin Medical University,Guilin 541001,China;No 2 Department of Cardiovascular Medicine,Affiliated Hospital of Guilin Medical University,Guilin 541001,China;Jiashan Community Health Service Center,Affiliated Hospital of Guilin Medical University,Guilin 541001,China)

机构地区：[1]桂林医学院附属医院护理部,桂林541001 [2]桂林医学院附属医院心血管内科一病区,桂林541001 [3]桂林医学院附属医院全科医疗科,桂林541001 [4]桂林医学院附属医院老年内科,桂林541001 [5]桂林医学院附属医院心血管内科二病区,桂林541001 [6]桂林市甲山社区卫生服务中心,桂林541001

出　　处：《中华现代护理杂志》2025年第9期1147-1153,共7页Chinese Journal of Modern Nursing

基　　金：广西壮族自治区卫生健康委自筹课题(Z-C20230857,Z20200346);桂林市科学研究与技术开发计划(20190218-5-2,2020011204-8);2020年度广西高校中青年教职工科研能力提升项目(2018glmcy084)。

摘　　要：目的了解护士开展老年多重慢病患者出院准备服务的体验,为制订老年多重慢病患者出院准备服务干预策略提供参考。方法采用目的抽样法,于2024年3—4月选取桂林市3所三级甲等医院、4所二级甲等医院和1所社区卫生服务中心的心血管内科、老年病区等内科的24名护士为受访者。基于社会生态系统理论制订访谈提纲,通过半结构式访谈收集资料,采用定向内容分析方法分析资料。结果共提炼出3个主题,即微观层面:具备正向态度但存在适老化出院准备服务短板;中观层面:团队协作机制保障力度不强;宏观层面:期望链接社会资源。结论护士为多重慢病老年患者提供的出院准备服务不到位。建议通过以核心素养为导向培养和提升护士出院准备服务能力、完善智慧医疗平台搭建、推进多元社会照护支持体系建设等措施提高老年多重慢病患者出院准备服务质量。ObjectiveTo understand nurses'experiences providing discharge preparation services for elderly patients with multiple chronic diseases and offer references for developing intervention strategies for discharge preparation services for these patients.MethodsA purposive sampling method was used to select 24 nurses from the cardiovascular departments,geriatrics wards,and other internal medicine departments of three Grade A tertiary hospitals,four Grade B hospitals,and one community health service center in Guilin City between March and April 2024.An interview outline was developed based on the social-ecological system theory,and semi-structured interviews were conducted to collect data.A directed content analysis method was used to analyze the data.ResultsA total of three themes were identified:micro-level(nurses have a positive attitude but face shortcomings in age-appropriate discharge preparation services),meso-level(team collaboration mechanisms are weak),and macro-level(there is a desire to link social resources).ConclusionsNurses'discharge preparation services for elderly patients with multiple chronic diseases are inadequate.It is recommended to enhance nurses'discharge preparation skills through core competency-based training,improve the development of innovative healthcare platforms,and promote establishing of a multi-dimensional social care support system to improve the quality of discharge preparation services for elderly patients with multiple chronic diseases.

关 键 词：老年人 慢性病 出院计划 出院准备服务 社会生态系统理论 质性研究 

分 类 号：R47[医药卫生—护理学]