本文關鍵詞： 護士 家庭護理 家庭護士 勝任力 勝任力模型　出處：《第二軍醫(yī)大學》2015年碩士論文　論文類型：學位論文

【摘要】：隨著人口老齡化、疾病譜的改變和家庭結構小型化,家庭護理的需求不斷上升,家庭醫(yī)生簽約制的開展將在未來帶動我國家庭護理需求繼續(xù)上升。本研究基于我國家庭護理穩(wěn)步發(fā)展但家庭護士勝任力標準缺乏的現(xiàn)狀,旨在建立一個既符合我國國情又體現(xiàn)未來發(fā)展趨勢的家庭護士勝任力模型,以期為我國家庭護士的準入及教育培訓提供理論依據(jù)。本研究主要分為三大部分,首先,通過田野研究從實然層面剖析我國社區(qū)衛(wèi)生發(fā)展現(xiàn)狀以及國情文化背景下家庭護士在具體家庭服務過程中所需要的勝任力；其次,通過半結構訪談從應然層面了解不同人群對家庭護士勝任力的需求及期望,以補充第一部分的勝任力結果,從而初步構建家庭護士勝任力模型；最后,通過Delphi專家咨詢對模型進行修訂和完善。第一部分：家庭護士勝任特征的田野研究。研究方法：采用目的抽樣法選取能夠較全面代表上海市社區(qū)衛(wèi)生發(fā)展水平的3.家社區(qū)衛(wèi)生服務中心及其下屬的17個社區(qū)衛(wèi)生服務站作為田野地,通過參與式觀察法收集資料, 整理成田野筆記進行,然后通過資料沉浸—編碼—形成類屬—形成主題四步進行勝任力的提煉。研究結果：共解析出家庭護士實際工作所需的勝任力指標22項。第二部分：家庭護士勝任特征的質性訪談。研究方法：采用滾雪球抽樣選取10名家庭護士、2名家庭醫(yī)生、5名社區(qū)管理者、3名家庭護理服務對象、2名家庭護理服務對象家屬以及2名社區(qū)家庭病床協(xié)會的主任共24人進行半結構訪談,綜合多視角的觀點解析出家庭護士勝任力,采用扎根理論中持續(xù)比較分析法對訪談資料進行分析。研究結果：獲得家庭護士勝任力指標34項,其中20項驗證了田野研究所得結果,另外補充貢獻14項勝任力指標。第三部分：家庭護士勝任力模型的構建和修訂。研究方法：采用目的抽樣選取18名社區(qū)醫(yī)療及護理的專家,通過德爾菲法進行咨詢。結果通過SPSS18.0進行匯總,并對數(shù)據(jù)進行描述性統(tǒng)計整理。研究結果：兩輪專家咨詢的應答率均為100%,選取18名社區(qū)專家的權威度為0.759。咨詢過程共修改勝任力指標5項,刪除勝任力指標3項,增加勝任力指標2項。最終的形成家庭護士勝任力模型包括4大模塊,17項勝任力,35個勝任力維度。結論：本研究擺脫單—視角挖掘勝任特征的局限,從實然和應然兩個層面綜合了解我國家庭護士所需的勝任力,最終構建的家庭護士勝任力模型結構合理,本研究結果為我國家庭護士的準入以及教育培訓提供了勝任力方向的理論指導,對推進我國家庭護士的發(fā)展具有一定的實際意義。
[Abstract]:With the aging of the population, the change of disease spectrum and the miniaturization of the family structure, the demand for home care is increasing. The development of the family doctor contract system will further increase the demand for family nursing in China in the future. This study is based on the steady development of family nursing in China but the lack of competency standards of family nurses. The purpose of this study is to establish a competency model of family nurses, which conforms to the situation of our country and reflects the trend of future development, in order to provide the theoretical basis for the admission and education of family nurses in China. This study is divided into three parts: first of all, Through field research, it analyzes the current situation of community health development in China and the competence needed by family nurses in the process of specific family service under the background of national conditions and culture. Secondly, In order to supplement the results of the first part of the competency of the family nurses, the competency model of the family nurses can be preliminarily constructed by the semi-structured interviews at the level of the ought to understand the needs and expectations of the different population to the competence of the family nurses. The model is revised and perfected by Delphi expert consultation. Part I: field study on the competency of family nurses. Research methods: the purpose sampling method is used to select those that can represent the level of community health development in Shanghai. 3. The Family Community Health Service Centre and its 17 community health service stations serve as field fields, Collecting data through participatory observation, organizing them into field notes, Then the competency was extracted by four steps of data immersion, coding, forming genus-forming theme. The results showed that 22 items of competency were analyzed for the actual work of the family nurses. Part 2: the family nurses won the job. Qualitative interviews with random characteristics. Research methods: 10 family nurses, 2 family doctors, 5 community managers, 3 family care clients, 2 family care clients, 2 family members and 2 community nurses were selected by snowball sampling. The director of the Family beds Association conducted semi-structured interviews with 24 people. The competency of family nurses was analyzed from the viewpoint of multiple perspectives, and the interview data were analyzed by the method of continuous comparative analysis in rooted theory. The results showed that 34 items of competency indexes of family nurses were obtained. The results of field studies were verified in 20 items, and 14 competency indexes were supplemented. Part three: the construction and revision of competency model of family nurses. Research methods: 18 community medical and nursing experts were selected by objective sampling. The results are summarized by SPSS18.0. The results showed that the response rate of two rounds of expert consultation was 100, and the authority of 18 community experts was 0.759. In the consultation process, 5 competency indexes were revised and 3 competency indexes were deleted. The final competency model of home nurses includes 17 competency modules and 35 competency dimensions. Conclusion: this study is free from the limitation of single-angle mining competency. The competency of family nurses in China is comprehensively understood from the two levels of reality and ought to be, and the structure of the competency model of family nurses is reasonable. The results of this study provide theoretical guidance for the access of family nurses and education and training in China, and have a certain practical significance for promoting the development of family nurses in China.
【學位授予單位】：第二軍醫(yī)大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R47

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本文編號：1538981