基于理论域框架的口腔专科护士线上咨询服务障碍因素的质性研究

Barriers of online consulting services by dental specialist nurses based on theoretical domains framework:a qualitative study

目的探讨口腔专科护士开展线上咨询服务的障碍因素,为构建口腔专科护士线上服务模式提供理论依据。方法本研究为质性研究。基于理论域框架(TDF)制订访谈提纲,采用目的抽样法,于2023年1—2月选取上海市口腔医院参加口腔专科护理线上咨询服务的12名护士为研究对象,对其进行半结构式访谈。根据TDF的相关领域,对转录后的资料进行归类,并采用Colaizzi 7步分析法对访谈资料进行分析。结果共提炼出3个主题和8个亚主题,分别为能力障碍因素(口腔专科理论知识水平较低、文字沟通技巧欠缺)、环境障碍因素(专项宣传推广不足、规范化服务标准和流程不健全、线上咨询平台功能限制、预约资源分散)、目标障碍因素(职业价值感低、绩效考核制度不完善)。结论医院相关管理部门应规范口腔专科护士线上咨询服务管理制度,优化口腔专科护士线上咨询服务流程;同时口腔专科护士应提升自身能力,为患者提供优质的线上咨询服务,提高患者线上咨询满意度。

Objective To explore the barriers of online consulting services by dental specialist nurses,so as to provide theoretical basis for constructing an online service model of dental specialist nurses.Methods This study was a qualitative study.Based on the theoretical domains framework(TDF),an interview outline was developed.From January to February 2023,purposive sampling was used to select 12 nurses from Shanghai Stomatological Hospital who participated in online consulting services for dental specialist nursing as the research subject,and semi-structured interviews were conducted on the nurses.According to the relevant fields of TDF,the transcribed data was sorted and the interview data was analyzed using the Colaizzi 7-step analysis method.Results A total of three themes and eight sub-themes were extracted,including ability barriers(low level of dental knowledge,lack of written communication skills),environmental barriers(insufficient special publicity and promotion,inadequate standardized service standards and processes,limited online consulting platform functions,distributed appointment resources),and goal barriers(low sense of professional value,incomplete performance evaluation system).Conclusions The relevant management departments of hospitals should standardize the management system of online consulting services by dental specialist nurses and optimize the process of online consulting services by dental specialist nurses.At the same time,dental specialist nurses should enhance their abilities,provide high-quality online consulting services for patients,and improve patients'satisfaction with online consulting.