专科护士主导的糖尿病个案管理临床实践体验的质性研究

Qualitative study on experience of clinical practice of diabetes case management led by specialist nurses

目的了解专科护士开展糖尿病个案管理实践以来的相关体验,以期为持续改善和推广糖尿病个案管理模式提供有效依据。方法采用目的抽样法于2019年5月选取湖南省人民医院8名从事过糖尿病个案管理的专科护士作为研究对象,应用现象学研究方法对其进行深入访谈。访谈资料采用Colaizzi现象学7步分析法进行整理分析。结果通过阅读、分析、反思、分类和提炼,得到关于专科护士主导的糖尿病个案管理临床实践现状的3个主题,即专科护士主导的糖尿病个案管理模式中患者、专科护士、医生均可受益,专科护士主导的糖尿病个案管理模式需要多学科团队协作与完善的服务体系,专科护士主导的糖尿病个案管理临床实践的发展面临阻碍。结论专科护士主导的糖尿病个案管理模式优势明显,但存在阻碍,需提供针对性支持措施以更好地落实及推广。

Objective To explore the relevant experience of specialist nurses since the implementation of diabetes case management practice,and provide an effective basis for continuous improvement and promotion of the diabetes case management model.Methods Totally 8 specialist nurses who had been engaged in diabetes case management in Hunan Provincial People's Hospital were selected by purposive sampling in May 2019,and in-depth interviews were conducted on them using phenomenological research methods.The interview materials were organized and analyzed using Colaizzi's seven-step analysis method.Results Totally three themes about the clinical practice of diabetes case management led by specialist nurses were obtained through reading,analyzing,reflecting,classifying and refining the materials:patients,specialist nurses and doctors could benefit from the diabetes case management model led by specialist nurses;the diabetes case management model led by specialist nurses required multi-disciplinary team collaboration and a perfect service system;the clinical practice of the diabetes case management model led by specialist nurses faced obstacles.Conclusions The diabetes case management model led by specialist nurses has obvious advantages,but faces obstacles,and it is necessary to provide targeted support measures to better implement and promote it.