新疆中等卫生学校护理专业教师人力资源的调查

目的了解新疆中等卫生学校护理专业教师的人数、年龄、学历、职称,以及是否形成合理的教育梯队、是否满足护理教育的需求等情况。方法采甬自行设计的问卷对新疆12所中等卫生学校护理专业人力资源情况进行调查。结果新疆12所中等卫生学校护理专业教师与在校护生的师生比偏低,护理教师的职称结构、学历结构等未全部达到《中等医学教育主要专业设置标准》要求。结论新疆中等卫生学校的护理专业教师严重匮乏,职称和学历结构偏低,年龄结构不合理,断层现象严重,不能满足教育需求,有待改善和提高。     

中外高等护理教育的比较与思考

从教育理念、培养目标、培养模式、专业结构、课程设置、教学方法、评价体系及管理模式八个方面对中外护理教育进行了比较,并从更新教育理念、明确培养目标、创新培养模式、完善专业结构、改革课程设置、优化教学方法、完善评价体系、健全管理模式八个方面提出了完善护理教育的对策。     

护理专业大学生专业素质结构理论模型的构建

目的构建护理专业大学生专业素质结构理论模型,为制定专业素质评价指标体系提供理论依据。方法应用理论分析法对专业素质进行分析。结果初步界定了护理专业大学生专业素质的定义,依据教育目标分类法对其进行基本的结构划分,并进一步划分其子要素。结论护理专业大学生的专业素质,是在大学环境和护理教育的影响下形成和发展起来的,从事护理工作所必需的较为稳定、内在和基本的身心要素、结构及其质量水平,是其在毕业时应具备的专业知识、技术、能力和态度的总和。     

本科护生专业承诺调查分析与对策思考

[目的]通过了解本科护生专业认同程度和承诺结构特点,更好地实施以人为本的护理教育。[方法]采用问卷调查方式在本科护生入学阶段、专业课学习阶段、毕业实习阶段追踪调查专业承诺情况。[结果]入学阶段专业承诺低于专业课学习阶段,毕业实习阶段专业承诺总体回落,处于最低值,且个体差异较大。承诺结构中感情承诺和理想承诺两因素偏低。[结论]应加强护生入学时及实习期间的专业思想教育,加强就业对策教育,提高护生的竞争力及提高专业承诺程度。     

本科护生专业承诺调查分析与对策思考

[目的]通过了解本科护生专业认同程度和承诺结构特点,更好地实施以人为本的护理教育。[方法]采用问卷调查方式在本科护生入学阶段、专业课学习阶段、毕业实习阶段追踪调查专业承诺情况。[结果]入学阶段专业承诺低于专业课学习阶段,毕业实习阶段专业承诺总体回落,处于最低值,且个体差异较大。承诺结构中感情承诺和理想承诺两因素偏低。[结论]应加强护生入学时及实习期间的专业思想教育,加强就业对策教育,提高护生的竞争力及提高专业承诺程度。     

优化本科护理课程结构的策略与方法

课程是学校教育的核心 ,是实现教育的手段。合理的课程结构不仅有利于学生掌握知识 ,也对学生身心的发展起着决定性的影响作用。作者从培养目标、课程的比例及逻辑关系、国情及社会发展需要及专业特色四个方面 ,探讨了如何优化本科的课程结构 ,建立适合我国国情和护理专业特点的课程结构     

青海高职护理专业教育课程体系改革与思考

]目的 探讨青海高原地区3年制高职护理专业教育课程体系改革方法与实践的经验.方法 根据高等职业技术教育的特点,以突出护理教育特色为原则,通过增设人文社会课程、整合专业基础课程、融合重组护理专业课程、增加护理岗位的专业课程及调整理论与实践教学的结构比例,提出了符合青海高原地区对护理人才需求的高职护理专业教育的改革思路....     

我国护理专业硕士研究生培养的回顾与展望

自1992年北京医科大学开始护理硕士教育[1],目前我国的高等护理教育基本形成了专科、本科、研究生教育的多层次、多形式结构的体系.实践证明,护理硕士承担着具有挑战性的角色和使命,为促进专业发展,提高和增强护理的专业地位做出了积极的贡献.本文就我国护理专业硕士研究生教育状况,回顾总结如下.     

护理专业人文素质教育模式初探

长期以来,受传统的教育思想和教育观念的影响,我国护理专业学生的人文素质教育一直未予以足够重视。如何借鉴国外关于提高护理专业学生人文素质的有益经验,以爱国主义、集体主义和社会主义教育为主旋律,通过第一课堂与第二课堂的有机整合,促进护理教育与人文教育的相互渗透,以形成学生相对稳定的品质结构,这是构建护理专业人文素质教育模式所要探讨的重要课题。     

护理高职男生临床实习前后的心理体验

目的了解高职护理专业男生临床实习前后不同的心理体验,为有针对性地制订护理教育措施提供依据。方法采用半结构访谈法,分别在实习前后对9名男生进行两次深入访谈,将资料进行整理、分析,提炼出主题。结果高职护理专业男生对于从事护理专业的意向倾向于消极,对护理专业的价值认同感低,存在很大的岗位流失率倾向。结论护理教育者应从入学前教育、学校教育、临床教育这一连续过程中做好男生的教育和培养,帮助他们树立正确的职业态度和职业价值观,增强职业认同感。     

湖南省农村老年人社区护理需求调查分析

目的了解湖南农村老年人的健康状况、保健意识及对社区护理的需求状况,探讨社区护理在湖南农村的开展形式,分析社区护理和农村合作医疗相结合的可行性。方法采用自行设计的问卷,对湖南省993户家庭进行调查,从中抽取205份65岁以上老年人填写的问卷进行统计学分析,内容包括人口学资料、健康状况、保健意识、社区护理需求。结果60.5%的老年人患有各种慢性病,退行性骨关节病居首位(23.9%),患1种慢性病以上的比例为26.6%;老年人的生活环境和医疗条件有所改善,49.2%的家庭中备有常备药,当老年人身体不适时找医生和自己找药吃的高达84.9%,53.7%的老年人觉得有必要做体检,但仍存在明显的不良卫生习惯;老年人对社区护理各项需求相差不大,在60%左右;农村老年人选择最多的就医场所是私人诊所(45.8%)和乡卫生院(36.5%)。结论湖南农村老年人患病率高,有一定的保健意识,对社区护理的需求迫切;可以利用农村合作医疗现有的资源,使社区护理模式向农村延伸,以进一步满足农村老年人的卫生服务需求。     

我国农村卫生改革政策系统回顾及绩效评价研究

目的系统回顾和总结我国建国62年农村卫生改革政策,评价各阶段改革绩效。方法采用PICOS要素构建研究问题,系统收集我国农村卫生改革的国、部级政策文件,分阶段分析每一阶段的主要卫生问题和采取的主要改革措施,并以人群健康指标、农村卫生人力和基础设施指标、卫生费用指标及全国卫生服务调查结果为标准,评价各阶段的改革绩效。结果共纳入与我国农村卫生改革相关的国家级政策法规396篇。按照文献计量结果,参照我国经济体制改革阶段性特点,结合医疗改革实际进展情况,可将我国农村卫生改革进程划分为国民经济恢复和经济调整时期(1949～1965)、文化革命时期(1966～1976)、经济体制转型初期(1978～1984)、医改初期(1985～1996)、医改中期(1997～2001)和新农合实施期(2002～2011)等6个阶段。除文革阶段外,其余5个阶段年均政策量均逐年递增,提示政府关注农村医疗卫生改革的力度逐年增大,但整体呈现"重医轻药、最轻医保"的分布特点。人群健康指标、农村每千人口医院床位数和卫技人员数持续增长,有逐渐改善的趋势。但市场机制的引入和国际经济形势的影响,导致卫生保健服务公益性下降,个人支出占卫生总费用比例上升,部分政策内容出现反复。结论公益性导向是健全和完善农村医疗卫生服务体系的基本原则,需科学总结前期政策绩效,结合当前国情、未来需求,循证决策,并在执行过程中提升绩效。     

An interprofessional programme to culturally sensitise students to the needs of patients and realities of practice in rural areas

The University of North Dakota programme, Students/residents Experiences And Rotations in Community Health (SEARCH), was implemented to address recruitment and retention problems and stereotypes associated with practicing in rural areas by providing an opportunity for health profession students to gain experience living and practicing in rural areas and observing interprofessional practice. Each health profession student in the programme (n = 181) from 2001 to 2011 (excluding 2009) kept a four-week journal detailing daily or weekly interactions, general thoughts, and experiences. Students who participated were from medical, psychology, dental, social work, nurse practitioner, and physician assistant professions. Results were grouped into three major themes around whether the experience increased their knowledge of healthcare issues in rural areas in North Dakota, increased their knowledge about interprofessional teams, and expanded their rural awareness. Overall, students valued this interprofessional experience, learned how to work in collaborative teams, and reported having a better understanding of the needs and problems in rural healthcare. Recruitment and retention of healthcare professionals in rural healthcare exhibit many challenges. The SEARCH programme has helped to alleviate some of these challenges; however, continued support for these programmes is necessary to sustain the delivery of interprofessional healthcare in rural areas.     

Attitudes of nursing school deans toward interprofessional education in Western Pacific Region countries

Abstract

A previous survey distributed to medical school deans in the Western Pacific Region (WPR) showed positive attitudes toward collaborative practice and interprofessional education (IPE). This study aimed to clarify the present state of IPE and the attitudes of nursing school deans in the WPR. The modified Attitudes Toward Health Care Teams Scale (ATHCTS) and the modified Readiness of healthcare students for Interprofessional Learning Scale (RIPLS) were used. Unexpectedly, the response rate was less than 20%. Deans of nursing schools with IPE courses showed significantly more positive attitudes than those of schools without IPE courses. The mean score of the modified ATHCTS and RIPLS of deans of nursing schools in rural areas were significantly higher than those in urban areas. Compared with medical schools, nursing schools in the WPR pay less attention to IPE and this may be one of the present characteristics of the region.     

骨质疏松症患者健康管理知识知晓度和需求的调查研究

目的了解骨质疏松症患者自我健康管理知识的知晓情况及相关需求,为形成骨质疏松症患者自我健康管理规范模式提供参考依据。方法选取2018年5月—10月就诊且诊断为骨质疏松症的患者,随机抽取200例进行问卷调查,最终190例纳入统计。调查问卷包括患者个人基本信息、骨质疏松症健康管理知识问卷和需求问卷。结果190例骨质疏松症患者健康管理知识问卷标准分平均为(62.45±16.21)分,处于低水平。不同性别、年龄、受教育程度、职业患者骨质疏松症健康管理知识问卷得分差异有统计学意义(P<0.01)。农村地区患者骨质疏松症健康管理知识问卷得分低于城镇地区(P<0.01)。门诊患者骨质疏松症健康管理知识问卷得分低于住院患者(P<0.05)。82.63%的患者愿意接受健康管理相关知识宣传,63.68%的患者希望通过医务人员指导方式获得健康管理相关知识。结论骨质疏松症患者对自我健康管理知识有较强的需求,护士在健康教育时应根据患者个性化特征实施针对性措施,加强宣传,引导患者形成规范的自我健康管理观念和行为。     

成都市乡镇／社区卫生服务机构人力资源配置现状调查——三圈七院六站预调查报告之二

目的通过调查成都市基层卫生人力资源配置基线，了解该市城乡基本医疗服务和基本公共卫生服务现状，为统筹城乡卫生资源提供决策参考和政策建议。方法分层方便抽样调查成都市三个圈7个乡镇卫生院（乡院）和社区卫生服务中心（中心），综合运用循证医学二次研究方法，参考国家各级机构、WHO相关政策比较分析。结果①成都市三圈7个乡院／中心每千人口卫生人员数仅为全球均值的1％～22％；在编人员数与理论需求数（按2006年行政区域内应服务人数计算）和实际需求数（按2006年实际年诊疗人数计算）间缺口均极大。②基层卫生人员结构不合理，卫生技术人员构成比高于全球均值4％～33％，其中（助理）医师构成比高于全球均值17％～45％，而护理、检验、其他卫生技术人员及管理、支持人员构成比普遍低于全球平均水平。③我国及本次调查的乡院／中心卫生人员以女性，45岁以下，大、中专及以下学历及中低级职称为主。④成都市卫生人员分布密度、学历和职称结构的合理性从一圈到三圈呈依次递减趋势。结论①我国基层卫生人力资源考核指标不健全、数据不完整，卫生人员数量不够，结构不合理，学历、职称偏低。②相比全国及成都市一圈水平，成都市二、三圈基层卫生人员数量缺口更大，结构合理性更差，学历、职称更低。因此建议：加大基层医疗服务亟需人才的招生和定向培养；对现有人员进行全员培训，在提高总体水平和素质基础上转岗分流；切实解决基层卫生人员负担过重、收入过低、素质不高、职称评定等问题，着力打造一支稳定、适用的基层卫生队伍。     

Public health nursing: Challenges and innovations for health literacy in rural area

Health literacy is a critical component of public health nursing, particularly in rural areas where access to health services is severely limited. As it relates to quality of care, cost of care, safety of care, and appropriate decision-making in general public health, health literacy can also be seen as an important public policy issue. Several challenges that can be found in rural communities in terms of access to health literacy, such as limited access to healthcare services, limited resources, low literacy rate, cultural and language barriers, financial constraints, and digital divide. Based on these challenges, several innovations can be pursued such as community-based health education, health literacy training among healthcare professionals, digital health technology, partnerships with community-based organizations, health literacy radio programs, and community health ambassadors. This reflection highlights the challenges and innovations that nurses can do to overcome the problem of low-health literacy in rural communities. In the future, the development of community empowerment and technology will be needed to refine the progress made so that a gradual increase in health literacy in rural communities can be seen.     

农村居民健康状况及卫生服务需求分层整群抽样调查

目的了解我国农村居民的健康状况、卫生服务需求现状及其存在的问题，探索提高我国农村居民健康水平的措施和方法，为培养适合我国城乡社区需求的适宜卫生人才提供依据。方法采用分层整群抽样的方法，在全困东西南北中的13省（直辖市、自治区）26个县（市）52个村中抽取1200户共计4190人进行人户调查。结果居民两周病伤率为27．92％。在两周病伤者中，有32．72％的患者选择找医生看病，有20．46％不采取任何措施，在患病后未采取措施的原因中，大多数患者认为病情较轻，占78．83％，其次是“经济困难”，占36．49％；居民半年慢性痫患病率为24．86％，其中以腰腿疼痛的患病率最高，占7．75％，其次为高血压，占5．48％；居民一年内在乡级卫生院就诊率为43．91％，在村卫生所就诊率为61．54％；居民患病后去卫生机构和找医生看病的占69．97％，采取“不理会”的占8．39％，自己买药吃的占20．77％；患病后就诊医疗机构首选“离家近”的占60．98％，其次是“价格便宜”，占34．02％：半数以上居民（占57．28％近三年内未作过任何体检，不定期体检的人数位居第二（占28．26％）。被查者中，有2495人（占64．19％）是从电视、报刊书籍和广播等途径经常获取保健知识；有67．29％的调查对象希望获得定期的健康检查；认为乡（镇）卫生院和村卫生所医务人员技术水平一般的分别占56．31％和61．72％，较好以上的分别仪占33．07％和24．63％。结论中国农村居民健康现状不容乐观，其保健行为需要正确引导，基层卫生机构设施条件和眼务念噬急需改善。同时提示，为农村培养适宜卫生人才已成为政府及高等医学院校当前重要任务。     

Academic nursing leadership in a rural setting: Different game,same standards

The call for transformation of nursing education and practice continues to be a national priority. The American Association of Colleges of Nursing recommends enhanced partnerships between academic nursing and academic health centers to advance nursing and healthcare. For academic leaders in rural settings, the context of health and healthcare means that these partnerships are vastly different from academic health centers. The purpose of this article is to describe the context of nursing education and practice in regions that are predominantly rural. The challenges and opportunities for rural academic leaders as they respond to calls for transforming the education of the future nursing workforce are described from the perspective of resources, recruitment and retention of faculty, clinical education and faculty practice, scholarship, and fundraising. Meeting rural health workforce needs is a national imperative and a priority of academic nursing leaders in rural settings.     

Barriers to healthcare as reported by rural and urban interprofessional providers

The research literature is replete with reports of barriers to care perceived by rural patients seeking healthcare. Less often reported are barriers perceived by the rural healthcare providers themselves. The current study is an extensive survey of over 1,500 healthcare providers randomly selected from two US states with large rural populations, Alaska and New Mexico. Barriers consistently identified across rural and urban regions by all healthcare professionals were Patient Complexity, Resource Limitations, Service Access, Training Constraints, and Patient Avoidance of Care. Findings confirmed that rural areas, however, struggle more with healthcare barriers than urban and small urban areas, especially as related to Resource Limitations, Confidentiality Limitations, Overlapping Roles, Provider Travel, Service Access, and Training Constraints. Almost consistently, the smaller a provider's practice community, the greater the reports of barriers, with the most severe barriers reported in small rural communities.