Rieder K A, Wood M J
Nurs Res. 1978 Jan-Feb;27(1):25-9.
Using a two-group before--after experimental design, this study explored the effect of problem-orientation on a nursing staff's ability to identify underlying patient problems. Nursing service staff members (registered nurses, licensed vocational nurses, and corps personnel) from two small naval hospitals who met the criteria for inclusion and consented to participate were utilized. Because of staff turnover, the composition of the groups differed from preto posttesting phases. The pretest sample consisted of 47 control/48 experimental subjects; the posttest sample included 38 control/39 experimental subjects. The experimental group was instructed on the independent variable, problem-orientation, by the investigator through a six-hour workshop on the problem-oriented nursing record after which the system was instituted in the experimental setting. After a five-month period posttesting was done to determine if changes had occurred. Analysis of the data supported the hypothesis that problem-orientation does, in fact, substantially increase a nursing staff's ability to identify patient problems. The incorporation of this system into nursing services could provide a vehicle for pinpointing underlying patient problems and dealing with them in a systematic way, thereby upgrading patient care.
本研究采用两组前后对照实验设计，探讨问题导向对护理人员识别患者潜在问题能力的影响。研究选取了来自两家小型海军医院且符合纳入标准并同意参与的护理服务人员（注册护士、执业职业护士和勤务人员）。由于人员流动，两组在预测试阶段和后测试阶段的组成有所不同。预测试样本包括47名对照组/48名实验组受试者；后测试样本包括38名对照组/39名实验组受试者。研究者通过一场关于问题导向护理记录的六小时工作坊，向实验组介绍了自变量——问题导向，之后该系统在实验环境中实施。五个月后进行后测试，以确定是否发生了变化。数据分析支持了以下假设：事实上，问题导向确实能大幅提高护理人员识别患者问题的能力。将该系统纳入护理服务可以提供一种手段，精准定位患者潜在问题并进行系统处理，从而提升患者护理水平。
