Abhicharttibutra K, Kunaviktikul W, Turale S, Wichaikhum O-A, Srisuphan W
Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand.
Int Nurs Rev. 2017 Mar;64(1):22-32. doi: 10.1111/inr.12257. Epub 2016 Apr 5.
A well-educated, sufficient nursing workforce improves population health and standards of nursing care. Analysing workforce policies assists nurses to learn from the past and develop better future policies.
Describe policy-making processes in the first Thai government plan to increase nursing capacity and improve nursing education quality.
A qualitative study employing Longest's model to examine policy-making processes.
Data were obtained from 28 in-depth interviews with key informants, who had been committee members and former deans of nursing involved with the policy processes in the 1990s. Both qualitative and quantitative data were extracted from relevant documents, and content analysis employed with all data.
Three policy phases were identified. Policy formulation, where three streams of problems, politics and policy resulted in identification of nursing shortage, changes of government incumbents and needing to increase nurse production; Policy implementation included creating methods of implementation, appointing responsible people and committees, creating operational plans, producing more nurses and faculty development projects and Policy modification which incorporated implementing the first Thai international doctoral degree in English, a collaborative programme between universities.
Not all key informants could be accessed due to the passage of time. Findings are unique to Thailand but inform internationally of nurses' abilities and need to be involved in policy.
Nurses were involved in all policy phases. While the policy produced positive developments in growing nursing capacity and education in the past, nursing shortages remained and are now acute in Thailand.
IMPLICATIONS FOR NURSING/HEALTH POLICY: Lessons learned from this policy analysis help explain why the nursing education and nursing shortage policy was legislated through the government agenda, and the active involvement of Thai nurses in this process. Nurses globally need to be at the policy-making table to try to reduce nursing shortages, and enhance practice and education environments.
一支受过良好教育、数量充足的护理队伍可改善民众健康状况及护理服务标准。分析劳动力政策有助于护士借鉴过去的经验，制定出更完善的未来政策。
描述泰国首个旨在提高护理能力及提升护理教育质量的政府计划中的决策过程。
采用朗格斯特模型进行定性研究以审视决策过程。
通过对28名关键 informant 进行深度访谈获取数据，这些 informant 曾是20世纪90年代参与政策制定过程的委员会成员及护理学院前任院长。从相关文件中提取定性和定量数据，并对所有数据进行内容分析。
确定了三个政策阶段。政策制定阶段，问题、政治和政策这三个因素导致确定护理人员短缺、政府换届以及需要增加护士培养数量；政策实施包括制定实施方法、任命负责人和委员会、制定运营计划、培养更多护士及开展师资发展项目；政策修订阶段包括实施首个泰国英语国际博士学位项目，这是一项大学间的合作项目。
由于时间推移，并非所有关键 informant 都能联系到。研究结果仅适用于泰国，但可为国际上了解护士的能力及参与政策制定的必要性提供参考。
护士参与了所有政策阶段。尽管该政策过去在提高护理能力和教育方面取得了积极进展，但泰国的护理人员短缺问题依然存在且目前较为严重。
对护理/卫生政策的启示：从该政策分析中吸取的经验教训有助于解释为何护理教育和护理人员短缺政策是通过政府议程立法的，以及泰国护士在此过程中的积极参与。全球护士都需要参与到政策制定中来，以努力减少护理人员短缺，改善实践和教育环境。
