分级诊疗“厦门模式”下鼓浪屿社区健康管理师工作体验的质性研究

Qualitative research on the work experience of Gulangyu Islet community health managers in Gulangyu under the "Xiamen model" of hierarchical diagnosis and treatment

[目的]了解鼓浪屿社区健康管理师在"三师共管"模式的真实工作体验,为促进社区慢性病管理发展提供借鉴。[方法]采用质性研究中的现象学研究方法,对健康管理师进行半结构式面对面深度访谈,运用Colaizzi资料分析原则进行资料整理分析,提炼主题。[结果]提炼出6个主题:工作主动性强、积极性高;强烈的职业认同感和价值感;积极的自我肯定;对"上下联动"支持及培训体系的认同;绩效改革的正性激励作用突出;健康管理师支持需求明确。[结论]以健康管理师为主体的鼓浪屿社区慢性病护理干预新模式提高了健康管理师工作积极性和职业认同感,满足了居民健康需求,社会效益良好;三级医院-社区双向联动技术支持体系和培训模式为健康管理师工作的开展提供了有力支持。建立系统化专科支持路径和护理风险评估系统,实现健康管理师日常工作信息化是今后努力方向。

Objective:To understand the real work experience of Gulangyu Community Health Manager in the mode of"three divisions co management"and to provide reference for promoting the development of chronic disease management in community.Methods:By using the method of phenomenal research in qualitative research,the health manager conducted semi structured face to depth interviews,used the principle of Colaizzi data analysis to organize data collation and analysis,refining the theme.Results:Abstract six themes Strong work initiative and high enthusiasm;a strong sense of professional identity and value;positive affirmation;recognition of the support and training system of"up and down linkage";the positive incentive function of performance reform is outstanding;Health manager support needs are clear.Conclusions:The new model of chronic disease nursing intervention in Gulangyu community,with health manager as the main body,has significantly improved the enthusiasm and professional identity of health managers,met the health needs of residents and had good social benefits,and the three level hospital community two way linkage technical support system and training model have provided strong support for the development of health management.The establishment of systematic specialist support path and nursing risk assessment system to realize the daily work informationization of health Manager is the direction of future efforts.