Longhini Jessica, Ambrosi Elisa, Dal Degan Sonia, Bedin Br Marilena, Saiani Luisa
Assist Inferm Ric. 2019 Apr-Jun;38(2):66-76. doi: 10.1702/3169.31498.
. The team-based care models in primary care: General Practitioners' perspectives on nurses' role.
In the last decade in Italy, different team-based primary care models have been developed that involve the collaboration of General Practitioners (GPs) with other professionals, such as nurses.
To investigate the GPs attitude towards the role and levels of autonomy of nurses in the primary care settings.
A two-phase exploratory study was performed: 1) a focus group with a purposeful sample of 12 GPs was conducted to identify the potential patients-clients/problems and activities that might be assigned to nurses; 2) a questionnaire was developed to analyze the levels of autonomy GPs assigned to nurses for different patients-clients/problems and activities. The questionnaire was administered to a convenience sample of 45 GPs, who were also interviewed to explain their choices.
GPs recognized autonomy to nurses in the assessment, monitoring and education on lifestyles, prevention of falls, malnutrition and compliance with treatments; in performing technical and organizational activities. They believed necessary supervision or providing indications to nurses in the management of chronic patients, especially in the assessment of signs and symptoms of deterioration, in monitoring and follow-up and partly on the contents of health education. Finally, GPs felt responsible of the management of pluri-pathological and unstable patients, such as heart failure patients, due to their highly unpredictable and rapid deterioration.
GPs expressed a positive attitude towards the role of nurses in the primary care setting, which varied depending on patients' instability and clinical complexity.
基层医疗中的团队照护模式：全科医生对护士角色的看法
在过去十年里，意大利开发了不同的基于团队的基层医疗模式，涉及全科医生（GP）与护士等其他专业人员的协作。
调查全科医生对基层医疗环境中护士角色及自主程度的态度。
进行了一项两阶段的探索性研究：1）对12名全科医生进行了有目的抽样的焦点小组讨论，以确定可能分配给护士的潜在患者/客户、问题和活动；2）设计了一份问卷，以分析全科医生针对不同患者/客户、问题和活动赋予护士的自主程度。该问卷被发放给45名全科医生的便利样本，并对他们进行了访谈以解释他们的选择。
全科医生认可护士在生活方式评估、监测和教育、预防跌倒、营养不良及治疗依从性方面的自主权；在开展技术和组织活动方面的自主权。他们认为在慢性病患者管理中，尤其是在评估病情恶化的体征和症状、监测和随访以及部分健康教育内容方面，有必要对护士进行监督或给予指示。最后，由于多病情和不稳定患者（如心力衰竭患者）病情高度不可预测且恶化迅速，全科医生觉得应对这类患者的管理负责。
全科医生对基层医疗环境中护士的角色持积极态度，该态度因患者的不稳定程度和临床复杂性而异。
