Cotton L, Brazier J, Hall D M, Lindsay G, Marsh P, Polnay L, Williams T S
University of Sheffield, Sheffield, England.
J Adv Nurs. 2000 May;31(5):1063-71. doi: 10.1046/j.1365-2648.2000.01389.x.
Previous reports that variations in school nursing resources across the UK had no relationship to deprivation; controversy about the changing role of the school nursing service.
To measure the resources allocated to school nursing, determine whether the variations can be explained by deprivation, and assess whether the allocation of school nursing time to a range of tasks is in line with current evidence and perceptions of changing needs.
Quantitative economic analysis; qualitative descriptive study.
Detailed study of four English districts with diverse characteristics; staffing and service questionnaire and telephone survey of 62 districts.
Staff resources and their salaries; measures of population and deprivation; activity statistics.
There were wide variations in the cost of the school nursing service, but in contrast to previous reports 24% of the variance was explained by deprivation. There were no clear associations with any other social or educational variables. The greatest allocation of time was in routine screening and surveillance tasks. Relatively little time was allocated to other activities such as health promotion, support of special needs or unwell children, or teenage clinics. The expenditure on school nursing is only loosely related to deprivation and the results of this study offer guidance on what districts should spend to achieve equity of provision.
The current allocation of resources to school nursing in between districts comparisons is not equitable and the use of school nursing time is out of step with current evidence of need and effectiveness.
此前有报告称，英国各地学校护理资源的差异与贫困程度无关；关于学校护理服务角色转变存在争议。
衡量分配给学校护理的资源，确定这些差异是否可以用贫困程度来解释，并评估学校护理时间在一系列任务中的分配是否符合当前证据以及对不断变化的需求的认知。
定量经济分析；定性描述性研究。
对四个具有不同特征的英国地区进行详细研究；对62个地区进行人员配备和服务问卷调查及电话调查。
人员资源及其薪资；人口和贫困程度指标；活动统计数据。
学校护理服务成本存在很大差异，但与之前的报告不同，24%的差异可以用贫困程度来解释。与任何其他社会或教育变量均无明显关联。时间分配最多的是常规筛查和监测任务。分配给其他活动的时间相对较少，如健康促进、对特殊需求或身体不适儿童的支持，或青少年诊所。学校护理支出仅与贫困程度存在松散关联，本研究结果为各地区为实现公平提供服务应支出多少提供了指导。
在地区间比较中，目前学校护理资源的分配不公平，学校护理时间的使用与当前需求和有效性的证据不一致。
