全科团队服务模式下社区护士与全科医生工作内容的研究

Work Contents of Community Nurses and General Practitioners in Community Health Service Team Model

目的了解全科团队服务模式下社区护士和全科医生的工作内容,探讨二者工作内容的差异,为社区护士与全科医生的分工提供理论依据。方法采用自制调查问卷对重庆市九大主城区12家社区卫生服务中心的159名社区护士和105名全科医生进行调查,包括社区预防、社区医疗、社区保健、社区康复、健康教育及计划生育指导等6大维度,共40项工作内容,采用描述性分析和χ2检验分析社区护士和全科医生在这些工作内容中的差异。结果在"社区医疗工作内容调查表"的40项条目中,显示社区护士和全科医生的工作内容间差异有统计学意义(P<0.05)的条目有7项,差异有显著统计学意义(P<0.01)的条目有11项;剩余的22项条目间差异无统计学意义(P>0.05),表明社区护士和全科医生是一起协作、共同完成这些工作内容的。结论社区护士和全科医生在为居民提供服务时既有分工又有协作,但是在诸如健康教育、计划生育指导等工作内容中,医护分工尚不明确。为了更好地为社区居民提供社区医疗保健服务,提高工作效率,构建一种科学的医护分工模式势在必行。

Objective To understand the work contents of community nurses（CNs） and general practitioners（GPs） in community health service team model and explore the differences of the work contents between CNs and GPs,so as to provide the theoretical basis for the division of labor. Methods A self-designed questionnaire survey was conducted among 159 CNs and 105 GPs for 12 community health service centers of nine urban areas in Chongqing,including 40 items of the working contents in 6 dimensions of community prevention,medical treatment,health care,rehabilitation,health education,and family planning guidance,And the descriptive analysis and chi-square analysis were used to analyze the differences of the work content between CNs and GPs. Results In the 40 items of the community work contents,there were statistically differences in 7 items（P0.05） and in 11 items（P〈0.01） between CNs and GPs.There were no statistically significant differences in the rest 22 items between CNs and GPs（P〉0.05）,which showed their working together to complete the work content. Conclusion There are both labor division and collaboration when CNs and GPs provide services for community residents.However,the division of labor is not clear in some items,such as health education and family planning guidance.It is imperative to establish a scientific labor division model for providing a better service and improving work efficiency.