芬兰高级实践角色界定：一项比较描述性研究。
Advanced practice role delineation within Finland: A comparative descriptive study.
机构信息
Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
Development Services, Hospital District of Southwest Finland, Turku, Finland.
出版信息
J Adv Nurs. 2022 Jun;78(6):1665-1675. doi: 10.1111/jan.15074. Epub 2021 Oct 15.
AIM
To identify and differentiate the practice patterns of generalist, specialist and advanced practice nursing roles in specialist and central hospital contexts.
BACKGROUND
In Finland, as in other Nordic countries, advanced practice nursing roles emerged around 2000. There are over 60,000 registered nurses/midwives in Finland and the clinical career pathway from a registered nurse to advanced practice nurse has been described yet not fully implemented in healthcare organizations. However, the number and activities of nonadvanced and advanced practitioner roles are not well known.
DESIGN
A descriptive comparative study.
METHODS
An online self-report survey was conducted between August and October 2020 using an advanced practice role delineation tool. A census sample of registered nurses, registered midwives, specialist nurses and advanced practice nurses in five university hospitals and one central hospital was recruited. Descriptive statistics were used to summarize the characteristics of participants and group differences were compared using analysis of variance (ANOVA). The STROBE checklist was used as the reporting guideline.
RESULTS
A total of 1497 responses were obtained (response rate = 10%). Overall, nurses used comprehensive care and education activities most frequently. The least used activities were research and publication and professional leadership. Univariate analysis of variance test between role effects, when education and grouped age were taken into account, showed statistically significant difference in all of the observed five activities (p < .001).
CONCLUSION
Identifying activities in different levels of nursing is a crucial first step in delineating nursing roles thus improving the governance of the human resource management.
IMPACT
The study results add to the international literature, delineating nursing roles in the spectrum of generalist to advanced practice nursing. As these roles become more formalized, we may incorporate novel ways of promoting the career development and optimal use and assessment of nursing roles and practice in various career levels.
目的
在专科医院和中心医院的背景下，识别和区分全科医生、专科医生和高级实践护理角色的实践模式。
背景
在芬兰，与其他北欧国家一样，高级实践护理角色于 2000 年左右出现。芬兰有超过 60,000 名注册护士/助产士，从注册护士到高级实践护士的临床职业道路已经描述过，但尚未在医疗保健组织中完全实施。然而，非高级和高级执业者角色的数量和活动并不为人所知。
设计
描述性比较研究。
方法
2020 年 8 月至 10 月期间，使用高级实践角色描述工具在线进行了自我报告调查。在五所大学医院和一所中心医院中招募了注册护士、注册助产士、专科护士和高级实践护士的普查样本。使用描述性统计来总结参与者的特征，并使用方差分析（ANOVA）比较组间差异。使用 STROBE 清单作为报告准则。
结果
共收到 1497 份回复（回复率为 10%）。总体而言，护士最常进行全面护理和教育活动。使用最少的活动是研究和出版以及专业领导。当考虑教育和分组年龄时，对角色效果进行单变量方差分析测试显示，在所有观察到的五项活动中均存在统计学上的显著差异（p<.001）。
结论
确定不同级别护理的活动是划定护理角色的关键第一步，从而改善人力资源管理的治理。
影响
研究结果增加了国际文献，划定了从全科医生到高级实践护理的护理角色范围。随着这些角色变得更加正式，我们可以采用新的方式来促进职业发展，并在各种职业水平上优化护理角色和实践的使用和评估。
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