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护士对“互联网+居家护理服务”的意愿和需求及影响因素的调查:来自中国市级医院的横断面研究。

Nurses' Willingness and Demand for Internet+Home Care Services and the Associated Factors in Municipal Hospitals in China: Cross-Sectional Survey.

机构信息

Teaching and Research Section of Clinical Nursing, Xiangya Hospital, Central South University, Changsha, China.

National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.

出版信息

J Med Internet Res. 2023 Aug 4;25:e45602. doi: 10.2196/45602.

Abstract

BACKGROUND

Developing Internet+home care (IHC) services is a promising way to address the problems related to population aging, which is an important global issue. However, IHC services are in their infancy in China. Limited studies have investigated the willingness and demand of nurses in municipal hospitals to provide IHC services.

OBJECTIVE

This study aims to investigate the willingness and demand of nurses in municipal hospitals in China to provide IHC services and analyze the factors to promote IHC development in China.

METHODS

This cross-sectional study used multistage sampling to recruit 9405 nurses from 10 hospitals in 5 regions of China. A self-designed questionnaire with good reliability and validity was used to measure nurses' willingness and demand for providing IHC services. Data analysis used the chi-square test, Welch t test, binary logistic regression analysis, and multiple linear regression analysis.

RESULTS

Nurses were highly willing to provide IHC services and preferred service distances of <5 km and times from 8 AM to 6 PM. An individual share >60% was the expected service pay sharing. Job title, educational level, monthly income, and marital status were associated with nurses' willingness to provide IHC services in binary logistic regression analysis. Supervising nurses were 1.177 times more likely to express a willingness to provide IHC services than senior nurses. Nurses with a bachelor's degree had a 1.167 times higher likelihood of expressing willingness to provide IHC services than those with a junior college education or lower. Married nurses were 1.075 times more likely to express a willingness than unmarried nurses. A monthly income >¥10,000 increased the likelihood of nurses' willingness to provide IHC services, by 1.187 times, compared with an income <¥5000. Nurses' total mean demand score for IHC services was 17.38 (SD 3.67), with the highest demand being privacy protection. Multiple linear regression analysis showed that job title, monthly income, and educational level were associated with nurses' demand for IHC services. Supervising nurses (B=1.058, P<.001) and co-chief nurses or those with higher positions (B=2.574, P<.001) reported higher demand scores than senior nurses. Monthly incomes of ¥5000 to ¥10,000 (B=0.894, P<.001) and >¥10,000 (B=1.335, P<.001), as well as a bachelor's degree (B=0.484, P=.002) and at least a master's degree (B=1.224, P=.02), were associated with higher demand scores compared with a monthly income <¥5000 and junior college education or lower, respectively.

CONCLUSIONS

Nurses in municipal hospitals showed a high willingness and demand to provide IHC services, with differences in willingness and demand by demographic characteristics. Accordingly, government and hospitals should regulate the service period, service distance, and other characteristics according to nurses' willingness and demand and establish relevant laws and regulations to ensure the steady and orderly development of IHC services.

摘要

背景

发展互联网+居家护理(IHC)服务是解决人口老龄化问题的一种有前景的方法,人口老龄化是一个全球性的重要问题。然而,IHC 服务在中国还处于起步阶段。有限的研究调查了市级医院护士提供 IHC 服务的意愿和需求。

目的

本研究旨在调查中国市级医院护士提供 IHC 服务的意愿和需求,并分析促进中国 IHC 发展的因素。

方法

本横断面研究采用多阶段抽样方法,从中国 5 个地区的 10 家医院招募了 9405 名护士。使用具有良好信度和效度的自设问卷测量护士提供 IHC 服务的意愿和需求。数据分析采用卡方检验、Welch t 检验、二项逻辑回归分析和多元线性回归分析。

结果

护士提供 IHC 服务的意愿较高,首选服务距离<5 公里,时间为 8 点至 6 点。个人分担>60%是预期的服务薪酬分担。职称、教育水平、月收入和婚姻状况与护士提供 IHC 服务的意愿有关。主管护士比高级护士更有可能表达提供 IHC 服务的意愿,是其 1.177 倍。具有本科及以上学历的护士比具有大专或以下学历的护士更有可能表示愿意提供 IHC 服务,是其 1.167 倍。已婚护士比未婚护士更有可能表示愿意提供 IHC 服务,是其 1.075 倍。与月收入<5000 元相比,月收入>10000 元的护士提供 IHC 服务的意愿增加了 1.187 倍。护士对 IHC 服务的总平均需求评分为 17.38(SD 3.67),需求最高的是隐私保护。多元线性回归分析显示,职称、月收入和教育水平与护士对 IHC 服务的需求有关。主管护士(B=1.058,P<.001)和副护士长或更高职位的护士(B=2.574,P<.001)的需求评分高于高级护士。月收入 5000-10000 元(B=0.894,P<.001)和>10000 元(B=1.335,P<.001)以及本科及以上学历(B=0.484,P=.002)和至少硕士学历(B=1.224,P=.02)与月收入<5000 元和大专及以下学历相比,需求评分更高。

结论

市级医院护士提供 IHC 服务的意愿和需求较高,其意愿和需求存在人口统计学特征的差异。因此,政府和医院应根据护士的意愿和需求规范服务期限、服务距离等特征,并建立相关法律法规,确保 IHC 服务的稳定有序发展。

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