基于变革理论的社区护士角色职能转型策略分析

Role and function transformation strategies of community nurses:a qualitative research based on the theory of change

目的:了解天津市社区卫生服务中心护士在居家养老形式下的角色职能现状,并基于变革理论分析促进其转型的策略。方法:采用半结构式访谈法于2019年2月—2019年5月选取天津市市内六区社区卫生服务中心护士进行深度访谈,运用Graneheim和Lundma提出的内容分析法整理和分析资料。结果:依据Lewin的变革理论研究提取了在居家养老形式下社区护士角色职能认知现状、角色职能转型的阻碍因素即社区护士在实践过程中存在的问题以及角色职能转型的驱动因素即社区护士所期望得到的支持3个主题。结论:社区护士存在角色职能认知不到位、发挥不充分的问题,与当前医疗卫生服务发展的本质要求存在较大偏差,护理管理者和护理科研工作者需要积极推动变革,以促进居家养老背景下社区护士多元角色与职能的形成。

Objective:To explore the role and function status of nurses working in the community health service center of Tianjin,and put forward suggestions for transformation based on theory of change.Methods:The semi-structured interview method was used to conduct in-depth interviews with nurses in the community health service centers in the six districts of Tianjin from February 2019 to May 2019.The interview information was organized,analyzed and generalized by content analysis method proposed by Graneheim and Lundma.Results:Three themes were extracted according to Lewin′s theory of change:the self-role cognition status of community nurses during the practice of home-based care,the obstacles to the transformation of role functions,that is,the problems encountered by community nurses during the practice of home-based care,and the driving factors of role function transformation,which were the expected supports of community nurses.Conclusions:Community nurses have the problems of insufficient cognition of their role and inadequate exertion of their function,which is deviated from the essential requirement of the current development of medical and health services.Nursing managers and nursing researchers need to actively act and promote changes to promote the transformation of multiple roles and functions of community nurses in the context of home-based care.