三甲医院病人分级护理服务需求影响因素及对策研究

Study on the Influencing Factors and Countermeasures of Patients' Grading Nursing Service Demand in Top Three Hospitals

目的通过对病人分级护理服务现状的调查,分析病人分级护理服务需求的影响因素。方法对6家三甲医院主管临床护理的管理者进行分级护理方面的调研,对6家三甲医院的病人进行病人分级护理服务需求问卷调查。结果不同职业、文化程度、自理能力、护理等级的护理服务需求比较,差异有统计学意义(P<0.05)。0.004%的病人暂时尚无分级护理服务需求。在7 911名有分级护理服务需求的病人中,97.5%的病人希望有基本治疗服务,95.9%的病人希望有病情观察服务,95.7%的病人希望有健康教育服务,87.5%的病人希望有清洁服务,36.8%的病人希望有帮助活动服务,26.1%的病人希望有饮食指导服务,22.7%的病人希望有帮助排泄服务。相关性分析结果显示,经济状况与文化程度有关(r=0.288,P<0.01),年龄和病人自理能力有关(r=0.266,P<0.01)。多因素logistic回归分析结果显示,自理能力、护理等级是分级护理服务需求的影响因素(P<0.05)。结论自理能力越差,护理等级越高,病人分级护理服务需求度越高。社会与政府应当重视病人的分级护理,明确等级划分标准,规范分级护理服务内容,加强分级护理服务建设。

Objective Through the investigation on the status quo of nursing service for patients with adult ward, to analyze the influence factors of grading nursing service needs of patients. Methods From January to December, 2016, grading nursing research of clinical nursing managers in 6 top three hospitals were done; grading nursing service de- mand questionnaire survey was done on patients in 6 top three hospitals. Results There were significant differences in nursing service demands between among occupations, educational levels, self-care ability and nursing level （P〈 0.05）. 0.004% patients don＇t need grading nursing service. In 7 911 patients who have demands of grading nursing, 97.5% need to have basic treatment services, 95.9% need the observation service, 95.7% need to have health edu- cation services, 87.5% need cleaning services, 36.8% need helping service activities, 26.1% need diet guidance ser- vices, and 22.7% need helping the excretion of service. Correlation analysis shows that economic status is related with educational level （r=0.288, P〈0.01）, age is related with patient care ability （r=0.266, P〈0.01 ）. Multivariate lo- gistic regression analysis shows that self-care ability and nursing level are the influencing factors of grading nursing service demand （P〈0.05）. Conclusion The worse the self-care ability and the higher nursing level, the higher the pa- tients＇ demand for graded nursing services. Society and government should pay attention to the grading nursing of pa- tients, clear the grading standards, standards of grading nursing service content, strengthen the service construction of grading nursing.