Bellack J P, Musham C, Hainer A, Graber D R, Holmes D
Medical University of South Carolina, Charleston 29425, USA.
J Nurs Educ. 1996 Feb;35(2):74-81. doi: 10.3928/0148-4834-19960201-07.
Because of widespread public and governmental concern about the health effects of environmental hazards and exposure in recent years, and the increasing incidence of environmentally-induced diseases, it is important that primary care nurse practitioners possess the knowledge and skills to effectively address environmental health as a component of their practice. A mailed questionnaire survey of 187 U.S. nurse practitioner (NP) programs was conducted, with a response rate of 64%, to determine: 1) current and ideal emphasis on environmental health, 2) faculty preparation for teaching environmental health, 3) environmental health competencies expected of graduates, 4) didactic and clinical contact hours devoted to environmental health, and 5) barriers and incentives to greater emphasis on environmental health. Findings reveal that more than two-thirds of NP program directors believe there should be greater emphasis on environmental health in their programs, but expressed concerns about overcrowded curricula and lack of faculty preparation as barriers to change. Competencies with the highest mean ratings included understanding the relationship between environmental hazards and human health, accessing information resources related to environmental hazards and health, and counseling clients about how they can reduce risks associated with environmental hazards. The two factors identified as most likely to increase the emphasis on environmental health in NP programs were having nurse faculty with expertise and being able to access information resources related to environmental health. Currently, insufficient attention is given to environmental health in nurse practitioner education programs.
近年来，由于公众和政府对环境危害及暴露对健康影响的广泛关注，以及环境诱发疾病发病率的不断上升，初级护理执业医师具备有效应对环境健康问题的知识和技能，将其作为执业的一部分，这一点至关重要。对187个美国护理执业医师（NP）项目进行了邮寄问卷调查，回复率为64%，以确定：1）当前和理想情况下对环境健康的重视程度；2）教师在环境健康教学方面的准备情况；3）对毕业生的环境健康能力期望；4）用于环境健康的理论和临床接触时间；5）加大对环境健康重视的障碍和激励因素。调查结果显示，超过三分之二的NP项目主任认为，他们的项目应更加强调环境健康，但对课程拥挤和缺乏教师准备表示担忧，认为这是变革的障碍。平均评分最高的能力包括理解环境危害与人类健康之间的关系、获取与环境危害和健康相关的信息资源，以及就客户如何降低与环境危害相关的风险提供咨询。被确定为最有可能增加NP项目对环境健康重视程度的两个因素是拥有具备专业知识的护士教师以及能够获取与环境健康相关的信息资源。目前，护理执业医师教育项目对环境健康的关注不足。
