基于结构—过程—结果模型的多视角下口腔门诊护理质量认知的质性研究  

Perceived quality of dental outpatient care from multiple perspectives based on Structure-Process-Outcome model

作　　者：马永红 刘帆[1] 杨春霞 杨金容 许力升 谢静颖 王敬钧 韦靖怡 Ma Yonghong;Liu Fan;Yang Chunxia;Yang Jinrong;Xu Lisheng;Xie Jingying;Wang Jingjun;Wei Jingyi(State Key Laboratory of Oral Diseases&National Center for Stomatology&National Clinical Research Center for Oral Diseases&West China Hospital of Stomatology,Sichuan University,Chengdu 610041,China)

机构地区：[1]口腔疾病防治全国重点实验室,国家口腔医学中心,国家口腔疾病临床医学研究中心,四川大学华西口腔医院,成都610041

出　　处：《华西口腔医学杂志》2025年第2期227-235,共9页West China Journal of Stomatology

基　　金：四川大学华西口腔医院软科学研究项目(RD-01-2024-01)。

摘　　要：目的探究管理者、医生、护士以及患者多视角下口腔门诊护理质量的认知,提出符合临床实际的护理质量评价指标,为构建科学、系统、全面的口腔门诊护理质量评价体系提供参考。方法于2024年1—4月采用多阶段抽样方法,在全国具有区域代表性的5家三级甲等口腔专科医院中选取7名管理者、11名医生、11名门诊护士及10名患者,共39名访谈对象进行半结构化深度访谈。采用Colaizzi七步法对访谈资料进行分析和归纳,并基于结构−过程−结果(SPO)三维质量评价模型提炼主题。结果研究从结构、过程及结果3个质量维度提取了5个主要主题,15个次要主题。析出的结构质量相关主题:消毒隔离规范、仪器设备和耗材管理、护理人力配比和护士学历架构、应急能力;过程质量相关主题:诊前风险评估、患者分诊与引导、沟通与态度、健康宣教、人文关怀、延续性护理、专科护理操作、四手操作;结果质量相关主题:满意度、不良事件管理与分析、有效投诉和纠纷。结论在口腔门诊护理质量评价内容中结构质量是基础,过程质量是核心,结果质量是重点。规范消毒隔离、仪器设备以及耗材管理,配置合理的护理人力和岗位能力,落实优质护理服务,提升医护配合质量和满意度是确保口腔门诊护理质量的必要保证。Objective This study aimed to investigate the perception of dental outpatient care quality from multiple perspectives of administrators,physicians,nurses,and patients and propose nursing care quality evaluation indices that are consistent with the clinical reality to provide reference for the construction of a scientific,systematic,and comprehensive dental outpatient care quality evaluation system.Methods A total of 39 interviewees,including 7 administrators,11 doctors,11 nurses,and 10 patients,were selected for semi-structured in-depth interviews in five regionally representative tertiary-level A stomatological specialty hospitals nationwide during January-April 2024 by using a multistage sampling method.Colaizzi 7-step analysis was used to analyze and summarize the interview data.Themes were extracted on the basis of the Structure-Process-Outcome(SPO)threedimensional quality assessment model.Results Five main themes and 15 secondary themes were extracted from three quality dimensions:structure,process,and result.The related topics of structural quality were as follows:disinfection and isolation norms,equipment and consumable management,nursing manpower ratio and nurse education structure,and emergency capability.The related topics of process quality were as follows:pre-diagnosis risk assessment,patient triage and guidance,communication and attitude,health education,humanistic care,continuous care,specialty operation,and four-hand operation.The related topics of result quality were as follows:satisfaction,adverse event management and analysis,effective complaints and disputes.Conclusion Structure quality is the foundation,process quality is the core,and result quality is the key in the evaluation of the quality of oral outpatient care.The standardization of disinfection and isolation,equipment and consumable management,allocation of reasonable nursing manpower and post capacity,implementation of high-quality nursing services,and improvement of the quality and satisfaction of medical cooperation are necessary gua

关 键 词：口腔门诊 护理质量 指标 质量评价 结构−过程−结果 质性研究 

分 类 号：R473.78[医药卫生—护理学]