School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China.
Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
J Nurs Manag. 2022 Jan;30(1):345-355. doi: 10.1111/jonm.13479. Epub 2021 Oct 26.
To investigate the level of implicit care rationing and its association with training needs in nursing homes in Shanghai, China.
Nursing homes in Shanghai are confronted with a lack of care resources. Implicit care rationing can emerge due to inadequate training of care workers.
A cross-sectional survey was conducted between 10 September and 17 November 2020. A total of 374 care workers from 16 randomly were selected nursing homes from each of the administrative districts participated the surveys. The Basel Extent of Rationing of Nursing Care-Nursing Home instrument and the training needs analysis were adopted to measure implicit care rationing and training needs, respectively. Multiple regression techniques were used to explore the factors associated with implicit care rationing.
Activities related to social care, documentation and activation/rehabilitation (mean rating = 2.8, 1.89 and 1.93 respectively) were mostly likely to be rationed. Training needs of activities of daily living (ADL), activation/rehabilitation and documentation were significantly related to their implicit rationing (β = 0.864, 0.21 and 0.166, respectively, p < .01).
Training needs are crucial determinants of implicit care rationing.
Quality control systems are needed to ensure care comprehensiveness. The current training system should be re-designed according to results of training needs analysis.
调查中国上海养老院隐性护理配给的水平及其与培训需求的关系。
上海的养老院面临着护理资源不足的问题。由于护理人员培训不足，可能会出现隐性护理配给。
本研究于 2020 年 9 月 10 日至 11 月 17 日期间进行了横断面调查。从每个行政区中随机选择了 16 家养老院，共 374 名护理人员参与了调查。采用巴塞尔护理配给量表和培训需求分析分别测量隐性护理配给和培训需求。采用多元回归技术探索与隐性护理配给相关的因素。
与社会护理、文档记录和激活/康复相关的活动（平均评分分别为 2.8、1.89 和 1.93）最有可能被配给。日常生活活动（ADL）、激活/康复和文档记录的培训需求与隐性配给显著相关（β分别为 0.864、0.21 和 0.166，均 p < 0.01）。
培训需求是隐性护理配给的重要决定因素。
需要质量控制系统来确保护理的全面性。应根据培训需求分析的结果重新设计当前的培训系统。
