Clendon J, White G
School of Health Sciences, Massey University at Albany, Auckland, New Zealand.
J Adv Nurs. 2001 Apr;34(2):171-8. doi: 10.1046/j.1365-2648.2001.01742.x.
The aim of this New Zealand study was to determine the feasibility of establishing a nurse practitioner-led, family focused, primary health care clinic within a primary school environment as a means of addressing the health needs of children and families. A secondary aim was to ascertain whether public health nurses (PHNs) were the most appropriate nurses to lead such a clinic.
Utilizing a community needs analysis method, data were collected from three sources --known demographic data, 17 key informant interviews and two focus group interviews. Questions were asked regarding the health needs of the community, the perceptions of participants regarding the role of the PHN, and the practicalities of establishing a clinic including the services participants would expect a clinic to provide. Analysis was exploratory and descriptive.
Findings included the identification of a wide range of health issues. These included asthma management and control issues, the need to address poor parenting, and specific problems of the refugee and migrant population. Findings also demonstrated that participant understanding of the role of the PHN was less than anticipated and that community expectations were such that for a PHN to lead a primary health care clinic it would be likely that further skills would be required. Outcomes from investigating the practicalities of establishing a nurse practitioner-led clinic resulted in the preparation of a community-developed plan that would serve to address the health needs of children and families in the area the study was undertaken. Services that participants identified as being appropriate included health information, health education, health assessment and referral.
Overall findings indicated that the establishment of a nurse practitioner-led, family focused, primary health care clinic in a primary school environment was feasible. While a PHN may fulfil the role of the nurse practitioner, it was established that preparation to an advanced level of practice would be required.
这项新西兰研究的目的是确定在小学环境中建立一个由执业护士主导、以家庭为重点的初级卫生保健诊所作为满足儿童和家庭健康需求的一种方式的可行性。第二个目的是确定公共卫生护士(PHN)是否是领导此类诊所的最合适人选。
采用社区需求分析方法,从三个来源收集数据——已知人口统计数据、17次关键 informant 访谈和两次焦点小组访谈。询问了有关社区健康需求、参与者对公共卫生护士角色的看法以及建立诊所的实际情况,包括参与者期望诊所提供的服务。分析是探索性和描述性的。
研究结果包括识别出广泛的健康问题。这些问题包括哮喘管理和控制问题、解决不良育儿问题的必要性以及难民和移民人口的具体问题。研究结果还表明,参与者对公共卫生护士角色的理解低于预期,并且社区期望如果由公共卫生护士领导初级卫生保健诊所,可能需要进一步的技能。对建立由执业护士主导的诊所的实际情况进行调查的结果是制定了一项由社区制定的计划,该计划将有助于满足研究开展地区儿童和家庭的健康需求。参与者认为合适的服务包括健康信息、健康教育、健康评估和转诊。
总体研究结果表明,在小学环境中建立一个由执业护士主导、以家庭为重点的初级卫生保健诊所是可行的。虽然公共卫生护士可能履行执业护士的职责,但确定需要准备到高级实践水平。