上海市老年护理体系存在的突出问题探索

Exploration on the key problem of the elderly nursing care system in Shanghai

目的 :界定上海市老年护理体系存在的问题,确认突出问题及解决突出问题的切入点。方法 :基于文献归纳法界定的全国层面老年护理体系中的问题,对上海市18个区(县)的986名老年护理服务组织者和提供者进行定性深入访谈。结果 :上海市老年护理体系存在25类问题,"护理服务供不应求"最突出,为诸多问题相互作用的系统结果。突出问题的解决需以功能定位不清及缺乏评估标准、政府财政补助不足、护理专业人员缺乏、激励机制不健全和缺乏法律保障5个问题的解决为着眼点。结论 :上海市老年护理体系中"供不应求"问题表现突出,功能定位不清及政府财政补助不足是造成突出问题的主要原因,加强功能定位等是解决突出问题的抓手。

Objective ：To make clear the existing problems of the elderly nursing care system in Shanghai and to confirm challenges and strategies to resolve the problems. Methods ：A qualitatively in-depth interview with 986 elderly nursing care organizers and providers in 18 Shanghai districts based on the problems at national level defined by literature induction was conducted. Results ：There were 25 kinds of problems existing in the system in Shanghai, of which ＂care services in short supply＂ was the most serious and the most important one. It was also the result of many problems interacted. Solution to the key problem,which referred to the most serious and important problem among all, relied on the following five aspects,including ＂lack of function orientation and assessment standard＂,＂insufficient government financial aid＂,＂lack of nursing professionals＂,＂imperfect incentive mechanism＂ and ＂lack of legal protection＂. Conclusion ：＂Services shortage＂ problem is prominent in the elderly nursing care system in Shanghai, which was mainly caused by unsure function orientation and insufficient government financial aid. Thus,strengthening the function orientation is the key point to solving the key problem.