社区家庭护理服务内容的探讨

Discussion on the Community Home Care Service

目的探讨社区家庭护理(CHC)服务的内容。方法选择深圳市20家社康中心,抽取20名专家实施两轮针对CHC方面的问卷咨询。另选取社区护士120名,全科医生108名以评测量表对其开展CHC服务内容和工作情况的调查。结果 CHC基本服务项目总计31项:可拓展的服务项目主要是一次性导尿和导尿管更换,以及二期以上的压疮护理等;不适合提供的服务项目有替代疗法、静脉高营养的护理、气管切开的护理、B超检查以及性功能改变的调试指导等。社区护士组在基础护理和社区保健方面的工作比例,显著高于全科医生组,而在社区预防和社区康复等方面则显著低于全科医生组,差异均有统计学意义(P均<0.05)。结论 CHC已取得一些进展,但仍需明确职责,规范实施,以最佳水平服务社区人群。

Objective To investigate the content of community home care （CHC） service. Metaoas 20 experts m zu commumty health centers from Shenzhen city were selected for investigation by CHC questionnaire. 120 community nurses and 108 general practitioners were selected to investigate CHC services and working conditions. Results Basic services included 31 items. The main scalable services were disposable catheterization and catheter replacement, as well as two or more degree pressure ulcer care. The unsuitable providing services included replacement therapy, intravenous high nutrition care, tracheotomy care, B-ultrasound examination and commissioning guidance for changes in sexual function. The proportion of primary care and community health by community nurses was higher than that by general practitioners, but the proportion of community-based prevention and community-based rehabilitation by community nurses was lower than that by general practitioners （both P 〈0.05）. Conclusions We have made some progress in CHC, but still need to clarify responsibilities, standardize the implementation, so as to provide best service to the community groups.