A qualitative study of cognition of community nursing administrators on standardized pressure ulcer management at home
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摘要: 目的 了解上海市社区护理管理者对居家压疮规范管理的认知现状和上海市浦东新区开展居家压疮管理的必要性、现实可行性以及实际情况下政策、人力、人员资质方面的障碍和困难,为以后浦东新区全面推行社区居家压疮规范管理扫清障碍和困难,并为上海市全面推广社区居家压疮管理提供先行、先试的参考依据。 方法 采用质性研究的现象学研究法,通过立意抽样法对10名上海浦东新区社区卫生服务中心的总护士长进行半结构式访谈,3个核心问题:“为您认为社区对于居家卧床压疮患者进行规范管理是否必要及其原因”;“您单位的开展现状如何”;“您单位进行居家压疮规范管理存在哪些障碍和有利因素”。将访谈资料进行录入、整理并编码,运用Colaizzi内容分析法分析。 结果 访谈结果分析后呈现出3大问题,社区护理管理者普遍认识到居家压疮规范管理的必要性,但对开展居家压疮管理积极性不高,实施居家压疮管理存在障碍和困难。 结论 目前上海的社区护理管理者对居家压疮管理的必要性认识充分,但还需要进一步加大对居家压疮护理服务的宣传教育,居家压疮管理实践中还存在不完善的环节,需要加大对社区护士相应的培训和教育,建立适合社区的压疮伤口培训模式,卫生主管部门应出台相应的政策和激励措施。Abstract: Objective To understand the cognitive status quo of the pressure ulcer management at home in the community of Shanghai city,understand the necessity,feasibility,obstacles and difficulties of the policy,manpower and personnel qualification when we carry out pressure ulcer management at home,to clear away the obstacles and difficulties when the full implementation of pressure ulcer management will be carried out in the future in Pudong New Area,and provide references for the first try when comprehensive promotion community pressure ulcer management at home in the future. Methods The phenomenology of the qualitative research was adopted,10 community nursing administrators in Pudong New District were conducted semi-structured interviews through purposive sampling method.All the interviewee was asked three core issues:do you think whether it is necessary to carry out standardized pressure ulcers management in community home bed patients and the reason;what is the current status for pressure ulcers management in your unit;what obstacles and favorable factors you encounter when you do it.The data was analyzed using Colaizzi content analysis. Results The interview result presents three main themes.Community nursing managers generally recognized the necessity of standardized management of pressure ulcer at home in community,and the enthusiasm for the pressure ulcer management at home was not high.There were barriers and difficulties in implementation of home pressure ulcer management. Conclusion Shanghai community nursing management directors have fully understood the necessity of pressure ulcer management at home at present,to further strengthen publicity and education for pressure ulcers home care services is necessary.The imperfect practice of pressure ulcers management at home also exists.We also need to increase the corresponding training and education,and then to establish a suitable wound training mode for community management of pressure ulcers,health policy support and economic incentives for the community nurses health issued by the competent department.
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