Spitzer Ada, Perrenoud Béatrice, Desaulles Cécile, Camus Didier, Van Gele Patrick, Périer Jacques
Department of Nursing, University of Haifa, Haifa, Israel.
J Adv Nurs. 2002 May;38(4):329-40. doi: 10.1046/j.1365-2648.2002.02195.x.
This study examines health care reforms' implementation processes from the perspective of nurses' knowledge regarding the reforms. The research has been carried out in the Swiss (Canton Vaud) context, where health care reforms have been initiated, on the National (Federal) level, in 1996.
Three research questions were formulated: (a) What is the level of nurses' knowledge regarding the basic principles of LAMal (Loi fédérale sur l'assurance maladie, Federal Health Insurance Law)? (b) What is the level of nurses' knowledge concerning the principles of health care reforms in Canton Vaud (NOPS, Nouvelles Orientations de la Politique Sanitaire)? and (c) Are there knowledge differences relating to employment setting (hospital, community, and education), nurses' roles (managerial vs. staff nurses) and level of education?
The sample consisted of a total of 74 nurses. Of these, 20 were employed in the community, 30 in hospital settings and 24 worked in schools of nursing. The research tool utilized was 40-items nurses' knowledge questionnaire developed for the purpose of this study. Three knowledge subscales and a subscale of certainty were constructed.
Overall, data showed a moderate to high mean level of knowledge (around 70% correct responses) on all knowledge scales considered. Community setting, managerial position, and a nonacademic nursing degree were all positively related to higher levels of reforms' knowledge. On the contrary, employment in a hospital setting and having a university degree had both negative impacts on achieving a high score of knowledge. Levels of certainty were significantly higher for LAMal than NOPS and for correct rather than for wrong responses.
本研究从护士对医疗改革的了解角度审视医疗改革的实施过程。该研究在瑞士沃州开展，1996年国家（联邦）层面已启动医疗改革。
提出了三个研究问题：（a）护士对《联邦医疗保险法》（Loi fédérale sur l'assurance maladie, LAMal）基本原则的了解程度如何？（b）护士对沃州医疗改革原则（《新卫生政策方向》，Nouvelles Orientations de la Politique Sanitaire, NOPS）的了解程度如何？（c）在工作环境（医院、社区和教育机构）、护士角色（管理护士与普通护士）和教育水平方面是否存在知识差异？
样本共包括74名护士。其中，20名受雇于社区，30名在医院工作，24名在护理学校工作。所使用的研究工具是为本研究目的编制的40项护士知识问卷。构建了三个知识子量表和一个确定性子量表。
总体而言，数据显示在所考虑的所有知识量表上，平均知识水平为中等至高（约70%的正确回答）。社区工作环境、管理职位和非学术护理学位都与更高水平的改革知识呈正相关。相反，在医院工作和拥有大学学位对获得高知识得分均有负面影响。对于《联邦医疗保险法》，确定性水平显著高于《新卫生政策方向》，正确回答的确定性水平高于错误回答。
