国内60所医院淋巴水肿护理门诊开展现状的调查研究

Analysis on the status quo of lymphedema nursing clinics in 60 hospitals

目的调查国内60所医院淋巴水肿护理门诊开设现状,为淋巴水肿护理门诊的管理及发展提供参考。方法采用方便抽样法,抽取60所已正式开设淋巴水肿护理门诊的医院作为调查对象。自行设计问卷,于2021年6月10日至8月15日以电子问卷形式对国内淋巴水肿护理门诊进行调查。结果国内淋巴水肿护理门诊自2015年起陆续开设,近年来发展迅速;以淋巴水肿专科护理门诊形式占61.67%(37/60),同时存在联合乳腺康复、造口、导管维护等门诊形式;各医院门诊频率差异较大,46.67%(28/60)的医院每天都有门诊,36.67%(22/60)的医院每周仅半天门诊;门诊患者量偏少,61.67%(37/60)的医院每周患者门诊量≤10例,仅8.33%(5/60)的门诊每周接诊量达到50例以上;门诊人员资质不足,专职护士仅占14.94%(26/174),国际淋巴水肿治疗师认证率为36.21%(63/174);培训机构包括国外引进培训项目、国内外合作项目、外出进修以及本地培训等;治疗以综合消肿治疗占100.00%(60/60)、运动肌能贴扎技术占51.67%(31/60)、空气波压力治疗占48.33%(29/60)、中医疗法占16.67%(10/60)等;收费情况仅23.33%(14/60)的医院有专项收费,其中有正式收费批文医院占20.00%(12/60)。结论淋巴水肿护理门诊已初具规模,治疗师队伍逐渐壮大;应加强淋巴水肿护理门诊的规范管理,明确出诊人员资质,制订门诊收费标准,促进门诊可持续性发展,最终达到提高淋巴水肿患者生命质量的目的。

Objective To investigate the present situation of lymphedema clinics in 60 hospitals and provide reference for the management and development of lymphedema nursing clinic.Methods Convenience sampling method was used to select 60 hospitals that had set up lymphedema nursing outpatient service.A self-designed questionnaire was conducted for the heads of lymphedema nursing clinics from June 10th 2021 to August 15th,2021 using electronic questionnaires.Results Lymphedema clinics had been opened since 2015 and developed rapidly in recent years.The outpatient service mainly took the form of specialized outpatient service for lymphedema,accounted for 61.67%(37/60),and also existed in the form of combined breast rehabilitation,ostomy,catheter maintenance,etc.There was a great difference in the frequency of outpatient service in hospitals,46.67%(28/60)had outpatient service every day,36.67%(22/60)had outpatient service only half a day every week.The number of outpatient patients was relatively low,61.67%(37/60)of the hospitals had no more than 10 patients per week,and only 8.33%(5/60)had more than 50 patients per week.There were only 26 full-time nurses accounted for 14.94%(26/174),and the international lymphedema therapist certification rate was 36.21%(63/174).Training institutions included foreign introduced training programs,domestic and foreign cooperation programs,overseas training and local training,etc.100.00%(60/60)of the hospitals participating in the survey adopted comprehensive detumescence therapy,combined with auxiliary motor muscle energy binding technology 51.67%(31/60),air wave pressure therapy 48.33%(29/60),traditional Chinese medicine therapy 16.67%(10/60),etc.According to the survey of charging situation,only 14 hospitals accounted for 23.33%(14/60)had special charging,among which 12 hospitals accounted for 20.00%(12/60)had official charging approval.Conclusions Lymphedema clinics have been developed and the ranks of lymphedema therapists are growing.The relevant departments should strengthen the standard management of lymphedema clinic,clarify the qualifications of visiting personnel,establish the standard of outpatient fees,promote the sustainable development of lymphedema clinic,and finally improve the quality of life of patients with lymphedema.