MS, RN, Professor, Department of Nursing, Tianjin Medical University Metabolic Diseases Hospital, Tianjin, China.
BSN, RN, Associate Professor of Nursing, Department of Endocrinology, Peking University People's Hospital, Beijing, China.
J Nurs Res. 2019 Dec;27(6):e53. doi: 10.1097/jnr.0000000000000330.
The number of patients with diabetes has been increasing rapidly according to a 2017 report by the International Diabetes Federation. Diabetes has become one of the most challenging public health problems, and there will be an estimated 143 million patients with diabetes in China by 2035. This puts considerable pressure on nurses who specialize in the care of patients with diabetes in China and increases related social and financial burdens. Clinical practice has proven that strengthening the core competencies of nurses and establishing an evaluation system of core competencies improve both healthcare quality and patient quality of life. However, no core-competence system framework currently addresses the unique characteristics of nurses in China.
The purpose of this study was to construct a core-competence system framework for primary nurse specialists in diabetes care.
A brainstorming approach was conducted that worked to conceptualize the core competencies of nurse specialists in diabetes care in China. Next, a study group organized this information and conducted a seminar; 50 experts and patients with diabetes were invited to develop the first draft of the framework. Afterward, 50 experts were selected to participate in the Delphi survey. Most indicators were retained after a three-round Delphi process, and the superiority chart was used to determine the weights of the six dimensions.
Forty-seven experts completed the consultation. The experts' rate of response ranged from 94% to 100%, the authority coefficient was .91, and the Kendall's coefficients of concordance in Grades 1-3 were .793, .418, and .542, respectively. An increasingly detailed, three-grade system framework was developed, including six first-grade indicators (diabetes professional knowledge, diabetes-related knowledge, communication skills and health education ability, specialized skills, clinical judgment, and specialty development capacity), 23 second-grade indicators, and 87 third-grade indicators. The weights of the six first-grade indicators were .221, .149, .192, .209, .160, and .069, respectively.
The core-competence system framework includes six core competencies, which represent the main characteristics of primary nurse specialists in diabetes care who are highly recommended by experts. It is important to keep in mind that this is only a theoretical framework and thus must be further tested in clinical practice settings in China.
根据国际糖尿病联合会 2017 年的报告，糖尿病患者人数迅速增加。糖尿病已成为最具挑战性的公共卫生问题之一，预计到 2035 年中国将有 1.43 亿糖尿病患者。这给中国专门护理糖尿病患者的护士带来了相当大的压力，并增加了相关的社会和经济负担。临床实践证明，加强护士的核心能力并建立核心能力评估体系，既能提高医疗质量，又能提高患者的生活质量。然而，目前没有一个核心能力体系框架能够解决中国护士的独特特征。
本研究旨在构建中国初级护士糖尿病专科护理的核心能力体系框架。
采用头脑风暴法对中国糖尿病专科护士的核心能力进行概念化。然后，一个研究小组组织了这次信息，并进行了研讨会；邀请了 50 名专家和糖尿病患者来制定框架的初稿。之后，选择了 50 名专家参加德尔菲调查。经过三轮德尔菲调查后，大多数指标被保留下来，优势图表用于确定六个维度的权重。
47 名专家完成了咨询。专家的回复率在 94%到 100%之间，权威系数为.91，1-3 级的肯德尔协调系数分别为.793、.418 和.542。一个越来越详细的三级系统框架被开发出来，包括六个一级指标（糖尿病专业知识、糖尿病相关知识、沟通技巧和健康教育能力、专业技能、临床判断和专业发展能力）、23 个二级指标和 87 个三级指标。六个一级指标的权重分别为.221、.149、.192、.209、.160 和.069。
该核心能力体系框架包括六项核心能力，这是专家高度推荐的初级护士糖尿病专科护理的主要特征。需要注意的是，这只是一个理论框架，因此必须在中国的临床实践环境中进一步测试。
