上海市安宁疗护政策扩散研究——基于56份安宁疗护政策的文本分析

安宁疗护在改善终末期患者及其家属的生活质量、提高医疗资源效率、提升社会福利水平上发挥着重要作用。本文以政策扩散理论为框架,以上海市2012—2021年56份安宁疗护政策文本为研究对象,利用NVivo、ArcGIS、ROST、UCINET软件,分别从时间、空间、内容、组织维度研究安宁疗护政策扩散现象,分析多重维度下上海市安宁疗护政策扩散的外部表现特征。研究发现：在时间维度上,政策扩散速度由慢变快再减慢,近似表现为“S”型分布;在空间维度上,呈现出吸纳—辐射相结合的试点型扩散;在内容维度上,既有政策领域的拓展,也有政策的细化与深化;在组织维度上,参与主体数量众多且类型多元、部门间协作紧密。该发现丰富了政策扩散理论知识图谱,拓宽了安宁疗护领域的研究视角,为深化开展全国安宁疗护服务工作提供借鉴。

Research on the policy diffusion of hospice care in Shanghai: Text analysis based on 56 hospice policies

Hospice care plays an important role in improving the quality of life of end-stage patients and their families, improving the efficiency of medical resources, and enhancing the level of social welfare.This paper takes the policy diffusion theory as the framework, takes 56 hospice care policy texts in Shanghai from 2012 to 2021 as the research object, and uses NVivo, ArcGIS, ROST and UCINET software to analyze the phenomenon of hospice care policy diffusion from four dimensions: temporal dimension, geographical dimension, content dimension and organizational dimension, and analyze the external characteristics of the policy diffusion of hospice care in Shanghai.The study found that: In the temporal dimension, the speed of policy diffusion changes from slow to fast, and then slowed down, approximately showing an "S"-shaped distribution; In the geographical dimension, it presents a pilot-project-type diffusion combined with absorption and radiation; In terms of content dimension, there is the expansion of policy field, as well as the refinement and deepening of policy content; In the organizational dimension, the number of participants is large, the types of participants is diverse, and the inter-departmental collaboration is close.This study enriches the knowledge map of policy diffusion theory, broadens the research perspective in the field of hospice care, and provides a reference for deepening the development of national hospice care service.