Biron Alain D, Richer Marie-Claire, Ezer Hélène
School of Nursing, McGill University, Montreal, Québec, Canada.
J Nurs Manag. 2007 Mar;15(2):188-96. doi: 10.1111/j.1365-2834.2007.00661.x.
The health care system has undergone major changes in the last decade. With greater acuity and complexity of illness, the adoption of innovative technologies and the shortage of health care personnel, the coordination and integration of health care services has become increasingly demanding for administrators. Growing dissatisfaction and concerns about safety issues are being expressed by the users of care who need to navigate through an increasingly complex system and by health care personnel who feel less efficient within the organization. Nursing administrators have a responsibility to address these issues but there is little scientific evidence to guide their actions. There are also few comprehensive models highlighting the main components of nursing administration - models that could guide nursing administration research. This paper presents a conceptual framework for nursing administration and research that links patient health care needs, nursing resources and the nursing care processes to the context of the health care system, and the social, political and cultural environments of care. A selected review of the oncology and cancer care literature is presented to demonstrate how this framework can organize existing knowledge about these concepts in the context of cancer care.
在过去十年中，医疗保健系统经历了重大变革。随着疾病的严重程度和复杂性增加、创新技术的采用以及医疗保健人员的短缺，医疗保健服务的协调与整合对管理人员来说要求越来越高。需要在日益复杂的系统中寻求医疗服务的使用者以及在组织内感到效率低下的医疗保健人员，都表达了越来越多的不满和对安全问题的担忧。护理管理人员有责任解决这些问题，但几乎没有科学证据来指导他们的行动。也很少有全面的模型突出护理管理的主要组成部分——这些模型可以指导护理管理研究。本文提出了一个护理管理与研究的概念框架，该框架将患者的医疗保健需求、护理资源和护理过程与医疗保健系统的背景以及护理的社会、政治和文化环境联系起来。本文还对肿瘤学和癌症护理文献进行了精选综述，以展示该框架如何在癌症护理背景下组织有关这些概念的现有知识。
