Koponen P, Heliö S L, Aro S
Seinäjoki Polytechnic, Health Care Institute, Finland.
J Adv Nurs. 1997 Jul;26(1):41-8. doi: 10.1046/j.1365-2648.1997.1997026041.x.
Implementation of a 'population responsibility' principle in Finnish health centres began in the late 1980s. The aim of this study was to describe public health nurses' (PHNs') experiences of primary health care based on this principle and to identify contextual and personal factors related to their experiences. The sample consisted of PHNs in 10 health centres. A questionnaire was developed based on a qualitative study. The survey was conducted in 1990 and repeated in 1992. The response rate was 84% for the 1990 sample (n = 102) and 91% for the 1992 sample (n = 131). In the multivariate analysis of variance type of community (urban/rural), size of the target population, task division model and existence of regular teamwork between social and health care personnel were chosen as contextual factors studied. Age, length of professional experience and having specialist education in midwifery were chosen as personal factors. Dependent variables were subscales on: experiences of planning and implementation, perceived influence of population responsibility on nurse-client relationships, comparison with previous experiences, views and experiences on comprehensiveness of care and job satisfaction. The majority of the PHNs experienced only minor changes in their work after the implementation of population responsibility. They were most critical about the way these changes were planned and implemented. Changes were mainly perceived as positive. There were some differences in the two samples, reflecting a shift from both positive and negative responses towards more neutral or more positive responses. Several contextual factors were multi-dimensionally related to the PHNs' experiences.
芬兰健康中心在20世纪80年代末开始实施“人群责任”原则。本研究的目的是描述基于这一原则的公共卫生护士（PHNs）在初级卫生保健方面的经历，并确定与其经历相关的背景和个人因素。样本包括10个健康中心的公共卫生护士。基于一项定性研究编制了一份问卷。该调查于1990年进行，并于1992年重复进行。1990年样本的回复率为84%（n = 102），1992年样本的回复率为91%（n = 131）。在多变量方差分析中，选择社区类型（城市/农村）、目标人群规模、任务分工模式以及社会和卫生保健人员之间定期团队合作的存在作为研究的背景因素。选择年龄、专业经验长度和拥有助产专业教育作为个人因素。因变量是关于以下方面的子量表：规划和实施的经历、人群责任对护士与客户关系的感知影响、与以前经历的比较、对护理全面性的看法和经历以及工作满意度。大多数公共卫生护士在实施人群责任后，其工作仅经历了微小变化。他们对这些变化的规划和实施方式最为不满。这些变化主要被视为积极的。两个样本存在一些差异，反映出从积极和消极反应向更中立或更积极反应的转变。几个背景因素在多方面与公共卫生护士的经历相关。
