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社区卫生从业者应对不断变化的医疗保健的实践指南:韩国的贡献。

Community health practitioner's practice guideline for a changing health care: Korean contribution.

作者信息

Ko Il Sun, Lee Tae Wha, Lee In Sook

机构信息

Department of Clinical Nursing Science, Yonsei University, College of Nursing, Soeul, Korea.

出版信息

J Clin Nurs. 2009 Apr;18(8):1190-8. doi: 10.1111/j.1365-2702.2008.02664.x.

Abstract

AIMS AND OBJECTIVES

The specific aims of the study were (1) to identify community residents' health problems and community health practitioners' activities, (2) to explore community health practitioners' perception of the practice guidelines and (3) to provide recommendations for the development of a new practice guideline in the future.

BACKGROUND

Community health practitioners in Korea are recognised as a critical component of the public health workforce in rural areas. Community health practitioners are registered nurses with six months special training, who have the chief responsibility of delivering primary health care to remote or isolated communities. Although there has been numerous changes in focus of community health practitioners practice over the two decades, community health practitioners guidelines have never been updated since being first developed in 1981.

DESIGN

This investigation employed a cross-sectional survey and focus group interview.

METHODS

The samples included two different groups: 1003 community health practitioners participated in a survey and a group of 12 community health practitioners participated in a focus group interview. A measure of perception of the guideline was developed from Mansfield's work. Goolsby's criteria were revised and used to guide the focus group interview.

RESULTS

The participants recognised that the role of community health practitioners is in a process of transition and expect to use well developed guidelines that will allow an appropriate response to the needs of the community. Community health practitioners are generally supportive of practice guidelines although they report various contextual, social and resource barriers to the use of practice guidelines. Finally, the researchers have provided recommendations for the development of new community health practitioners practice guidelines.

CONCLUSION

A newly developed community health practitioners guideline should assist in articulating new roles and responsibilities in the practice of community health practitioners and establish a foundation for knowledge, skills and training necessary for them to work independently.

RELEVANCE TO CLINICAL PRACTICE

New services made available for under-recognised health problems may be a direct outcome of newly developed guidelines.

摘要

目的与目标

本研究的具体目的为:(1)识别社区居民的健康问题及社区卫生从业者的活动;(2)探究社区卫生从业者对实践指南的看法;(3)为未来新实践指南的制定提供建议。

背景

韩国的社区卫生从业者被视为农村地区公共卫生人力的重要组成部分。社区卫生从业者是经过六个月特殊培训的注册护士,主要负责为偏远或孤立社区提供初级卫生保健。尽管在过去二十年里,社区卫生从业者的工作重点发生了诸多变化,但自1981年首次制定以来,社区卫生从业者指南从未更新过。

设计

本调查采用横断面调查和焦点小组访谈。

方法

样本包括两个不同群体:1003名社区卫生从业者参与了调查,12名社区卫生从业者组成的小组参与了焦点小组访谈。从曼斯菲尔德的研究成果中开发了一项对指南看法的测量工具。对古尔斯比的标准进行了修订,并用于指导焦点小组访谈。

结果

参与者认识到社区卫生从业者的角色正处于转变过程中,并期望使用完善的指南,以便能够对社区需求做出适当回应。社区卫生从业者总体上支持实践指南,尽管他们报告了在使用实践指南时存在各种背景、社会和资源方面的障碍。最后,研究人员为新的社区卫生从业者实践指南的制定提供了建议。

结论

新制定的社区卫生从业者指南应有助于明确社区卫生从业者实践中的新角色和责任,并为他们独立工作所需的知识、技能和培训奠定基础。

与临床实践的相关性

针对未得到充分认识的健康问题提供的新服务可能是新制定指南的直接成果。

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