Maijala Virpi, Tossavainen Kerttu, Turunen Hannele
Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
J Clin Nurs. 2015 Sep;24(17-18):2554-61. doi: 10.1111/jocn.12855. Epub 2015 May 6.
The aims of this study were to identify and reach consensus among municipal primary health care participants on nurse practitioners' (NPs') required case management competencies in health promotion practices in eastern Finland.
The NP's role as a case manager of patients with chronic conditions has been found to have positive outcomes in health promotion, such as reduced hospital lengths of stay and readmission rates. However, the challenging work of health promotion requires NPs to have multidimensional competencies in health promotion, including communication, advocacy, assessment, planning, consultation and implementation.
A two-stage modified Delphi study.
Round 1 semi-structured interviews were conducted among municipal primary health care participants (n = 42) in 11 health centres from April-July 2009, and the round 2 questionnaire survey was conducted in the same health centres in eastern Finland in January and March 2011. The questionnaire was answered by 64% of those surveyed (n = 56). Content analysis and descriptive statistics were used for data analysis.
We identified a total of 18 required case management competencies for NPs' health promotion practices in municipal primary health care. In 17 of these competencies (such as knowledge, skills and ability to work independently in health promotion), a consensus was reached (51% or over). However, the need to be interested in municipal decision-making (44·6%) did not reach consensus.
Consensus was clearly achieved for 17 competencies that NPs were required to have, and these indicated the knowledge or abilities of health promotion. Nevertheless, there was no agreement on the NPs' need to be interested in municipal decision-making.
NPs need a variety of case management skills and abilities to realise health promotion in municipal primary health care and they need to be supported by primary health care leaders to develop health promotion activities.
本研究的目的是确定芬兰东部市政初级卫生保健参与者对于护士从业者在健康促进实践中所需的病例管理能力的看法，并达成共识。
护士从业者作为慢性病患者的病例管理者，其角色在健康促进方面已被发现具有积极成果，如缩短住院时间和降低再入院率。然而，健康促进这项具有挑战性的工作要求护士从业者具备健康促进方面的多维度能力，包括沟通、宣传、评估、规划、咨询和实施。
两阶段改良德尔菲研究。
2009年4月至7月，在11个健康中心对市政初级卫生保健参与者（n = 42）进行了第一轮半结构化访谈；2011年1月和3月，在芬兰东部的同一健康中心进行了第二轮问卷调查。64%的受访者（n = 56）回答了问卷。采用内容分析和描述性统计进行数据分析。
我们确定了护士从业者在市政初级卫生保健健康促进实践中总共18项所需的病例管理能力。其中17项能力（如在健康促进方面独立工作的知识、技能和能力）达成了共识（51%及以上）。然而，对市政决策感兴趣这一需求（44.6%）未达成共识。
对于护士从业者所需的17项能力明确达成了共识，这些能力表明了健康促进方面的知识或能力。然而，对于护士从业者对市政决策感兴趣的必要性未达成一致意见。
护士从业者需要各种病例管理技能和能力来在市政初级卫生保健中实现健康促进，并且他们需要得到初级卫生保健领导者的支持以开展健康促进活动。
