Goh Leslie, Samanta Jo, Samanta Ash
Department of Rheumatology, Royal Cornwall Hospital, Truro, UK.
Musculoskeletal Care. 2006 Jun;4(2):88-100. doi: 10.1002/msc.81.
To identify the current practices of rheumatology nurse practitioners and ascertain their perceptions of how their role could be enhanced.
A cross-sectional questionnaire study of currently employed nurse practitioners in rheumatology in the United Kingdom (UK) was undertaken.
200 questionnaires were distributed and 118 nurses responded. Ninety-five respondents met the inclusion criteria for undertaking an advanced nursing role. Typical conditions dealt with included: rheumatoid arthritis (96.8%); psoriatic arthritis (95.8%); osteoarthritis (63.2%); ankylosing spondylitis (62.8%); systemic lupus erythematosus (51.6%); and scleroderma (34.7%). Drug monitoring, education, counselling of patients and arranging basic investigations were routinely performed by more than 80% of respondents. A smaller proportion performed an extended role that included dealing with referrals, research and audit, the administration of intra-articular injections, and admission of patients. Specific attributes identified as being necessary for competence were: knowledge and understanding of rheumatic diseases (48.4%); drug therapy (33.7%); good communication skills (35.8%); understanding of the roles of the team (27.4%); working effectively (23.2%) as part of a multidisciplinary team; assessment of patients by physical examination (28.4%); teaching (26.3%), research (17.9%); organizational skills (14.7%); and the interpretation of investigations (9.5%). Factors that could enhance their role included: attendance at postgraduate courses (30.5%); obtaining further qualifications (13.7%); active participation in the delivery of medical education (41.1%); training in practical procedures (31.6%); protected time and resources for audit and research (11.6%); formal training in counselling (11.6%); and implementation of nurse prescribing (10.5%).
Nurse practitioners already have a wide remit and play an invaluable part in the delivery of modern rheumatology services. An extended role could improve patient care and enhance nursing career pathways in rheumatology.
确定风湿病专科执业护士的当前执业情况，并了解他们对如何增强自身角色的看法。
对英国目前受雇的风湿病专科执业护士进行了一项横断面问卷调查研究。
共发放200份问卷，118名护士做出回应。95名受访者符合承担高级护理角色的纳入标准。所处理的典型病症包括：类风湿关节炎（96.8%）；银屑病关节炎（95.8%）；骨关节炎（63.2%）；强直性脊柱炎（62.8%）；系统性红斑狼疮（51.6%）；以及硬皮病（34.7%）。超过80%的受访者常规进行药物监测、教育、患者咨询以及安排基本检查。较小比例的受访者承担扩展角色，包括处理转诊、研究和审核、关节内注射给药以及患者收治。被确定为胜任工作所必需的特定属性包括：对风湿性疾病的知识和理解（48.4%）；药物治疗（33.7%）；良好的沟通技巧（35.8%）；对团队角色的理解（27.4%）；作为多学科团队的一员有效工作（23.2%）；通过体格检查评估患者（28.4%）；教学（26.3%）、研究（17.9%）；组织能力（14.7%）；以及解读检查结果（9.5%）。可增强其角色的因素包括：参加研究生课程（30.5%）；获得进一步资格（13.7%）；积极参与医学教育授课（41.1%）；实践操作培训（31.6%）；用于审核和研究的受保护时间和资源（11.6%）；咨询方面的正规培训（11.6%）；以及实施护士处方权（10.5%）。
专科执业护士已经有广泛的职责范围，在提供现代风湿病服务中发挥着不可或缺的作用。扩展角色可以改善患者护理，并提升风湿病领域的护理职业发展路径。
