Brewer Carol S
University of Buffalo School of Nursing, 918 Kimball Tower, Buffalo, NY 14214, USA.
Nurs Outlook. 2005 Nov-Dec;53(6):281-90. doi: 10.1016/j.outlook.2005.08.001.
Access to personal health services is only possible if there are an adequate number and distribution of qualified nurses. However, most work on access has been conceptualized as access to physician services or particular types of settings such as hospital care, not as access to nurses. In this paper I have used the Institute of Medicine Access framework to conceptualize the relationship of the nursing workforce to several aspects of access, and evaluated both the current state of research and existing gaps. Some of the gaps identified in the research that need to be included in a health services research agenda for nursing are: (1) the effect of regional market factors (such as physician ratios and poverty), or attitudes on the supply of nurses; (2) the lack of a critical analysis of staffing and outcome research, and measures of utilization and access specific to nurses in a variety of settings; (3) the need for more and better data to evaluate nurse career patterns, nursing workforce educational capacity, and effectiveness; and (4) relevant workforce policies.
只有当有足够数量且分布合理的合格护士时，人们才有可能获得个人健康服务。然而，大多数关于医疗服务可及性的研究都将其概念化为获得医生服务或特定类型的医疗环境（如医院护理）的可及性，而非获得护士服务的可及性。在本文中，我运用了医学研究所的可及性框架来概念化护理劳动力与可及性若干方面的关系，并评估了当前的研究现状和存在的差距。在护理健康服务研究议程中需要纳入的一些已在研究中发现的差距包括：（1）区域市场因素（如医生比例和贫困状况）或态度对护士供应的影响；（2）缺乏对人员配备和结果研究的批判性分析，以及在各种环境中针对护士的利用和可及性的衡量标准；（3）需要更多更好的数据来评估护士职业模式、护理劳动力教育能力和有效性；以及（4）相关的劳动力政策。
