基于内容分析法对延续性护理定义的基本元素解析

Concept analysis of transitional care based on content analysis method

目的对延续性护理的概念进行解析,理清延续性护理的概念内涵,为临床护理工作提供借鉴。方法通过检索科学英文索引扩展版(SCI-EXPANDED)、中国生物医学文献数据库、维普中文科技期刊全文数据库和中国期刊全文数据库的有关延续性护理的文献,基于内容分析法对文献中延续性护理定义从住院患者、出院患者、涵盖患者住院期及家庭角度3个方面进行分析,提出最能代表延续性护理内涵的指标。结果延续性护理定义涉及16个具体指标,包括患者、出院患者、院内、院外、从院内到院外、不同照护地点、同照护地点不同照护层次、不同照护地点不同照护层次等。2名编码员对16个相关指标编码一致性水平介于0.81～1.00,综合一致性值为0.953。出现频率最高的延续性护理具体指标是"连续性、协调性服务"(国内文献与国外文献全部提及此指标),其次为"维护健康"(国内文献有73.68%提及,国外为70.59%)。其他指标出现频率国内外存在着差异。结论延续性护理的基本元素体现为患者提供延续性、协调性照护服务,服务地点涵盖住院期及家庭,照护层次多样化等特点。应构建适合我国国情的延续性护理模式,以提高医疗护理服务的连续性、协调性、整体性。

Objective To parse the concept of transitional care, to straighten out the contonation of transitional care, and to provide a reference for clinical nursing practice. Methods We searched the database of Science Citation Index Expanded, Chinese Biomedical Literature Database,Chinese Academic Journal and Chinese Journal Full-text Database for literature on transitional care. Based on the content analysis,we broke the concepts of transitional care into such three aspects as hospitalized patients, discharged patients and coverage of hospitalization and family life. Then we refined the indicators which were most representative of the connotation of transitional care. Results The representative indicators of transitional care definition included 16 specific aspects：patients, discharged patients, care within the hospital, care out of the hospital, different sites of care, different care levels at the same place, different care levels at different places,etc. The coding consistency of 16 indicators by two coders was 0.81 to 1.00 and general consistency was 0. 953. The most frequently seen indicators in foreign and domestic literature were continued and coordinative care,and the in- cator of health maintenance came second, which was mentioned by 73.68 % of domestic literature and 70.59 % of foreign literature. Conclusion The concept of transitional care features itself with providing continuous and coordinative caring services for patients, and covers not only care service in the hospital,but also the care out of the hospital and different care levels. A transitional care mode that fits into our national conditions should be built in an effort to solidate continued, coordinative, and holistic caring services.