社区签约护士叙事护理体验的质性研究

Qualitative study on narrative nursing experience of community contracted nurses

目的了解社区签约护士在运用叙事护理方法为患者实施健康管理过程中,自身护理体验、个人成长收获及职业发展需求,为社区进一步推广叙事护理及人才培养提供依据。方法采用现象学研究方法,对北京市2所开展签约服务工作,且由护士对患者实施叙事护理的社区卫生服务中心(站)的13名护士进行半结构式访谈。采用Colaizzi 7步分析法进行资料分析。结果开展叙事护理后,社区签约护士在工作体验和感受方面提炼出工作成就感增强、职业价值感凸显、叙事护理模式认同感提升、护患关系亲密感增加4个主题;在个人成长收获方面提炼出学会尊重、懂得理解、关爱彼此、自我赋能4个主题;在未来职业发展需求方面提炼出希望人员配置更合理、渴望更多的专业培训机会、期望更大的护理交流平台3个主题。结论通过叙事护理在签约患者中的实施,社区护士职业认同感及自我价值感明显提升。相关机构应给予护士更多学习、培训、交流的机会,以提升护士专业能力,为社区护理事业的发展提供保障。

Objective To understand the nursing experience,personal gain and career development needs of community contracted nurses in the process of implementing health management for patients with narrative nursing method,in order to provide the basis for the development of community narrative nursing and talent training.Methods Using phenomenological research methods,13 nurses from 2 community health service centers(stations)in Beijing who have carried out narrative nursing were interviewed with semi-structured interviews.Colaizzi method was used to analyze the data.Results After the development of narrative nursing,4 themes were extracted in work experience and feelings,namely increased sense of job satisfaction,highlighted sense of professional existence,enhanced sense of identity of nursing model,and increased sense of work pleasure.4 themes were extracted in personal growth and harvest,namely learning to respect,understanding,caring for each other,and enabling the self.3 themes were extracted in future career development needs,namely hoping for reasonable staffing,expecting more professional training opportunities,and expecting to have a bigger nursing development platform.Conclusion Through the narrative nursing,the professional identity and self-value of community nurses were significantly improved.Relevant institutions should also provide more opportunities of learning,training and communicating for nurses,in order to enhance the professional ability and to guarantee the development of community nursing.