目的：探讨家庭医生责任制下社区护士的岗位职责需求，为社区护士职责定位奠定基础。方法分别于2014年6—7月、11—12月，采用便利抽样的方法选取上海市嘉定区外冈镇社区卫生服务中心辖区内居民和社区护士工作伙伴进行2次问卷调查。第1次调查问卷为《社区护士岗位职责问卷调查》，第2次调查问卷为《社区护士岗位职责民意调查问卷》，均分为居民版和专业人士版（用于对社区护士工作伙伴的调查）。结果（1）第1次调查，共回收居民版有效问卷101份，居民对社区护士的岗位职责需求排在前3位的依次为：基本医疗服务、居家护理指导和用药指导、慢性病/残疾/精神障碍患者的住院治疗和康复，评分的Kendall协调系数为0.101（ P﹤0.05）。共回收专业人士版有效问卷17份，工作伙伴对社区护士的岗位职责需求排在前3位的依次为：居家护理指导和用药指导、基本医疗服务、全科医生助手，评分的Kendall协调系数为0.133（ P﹤0.05）。（2）第2次调查，共回收居民版有效问卷30份，居民对社区护士的岗位职责需求排在前10位的分别为：体检（如测量体温、身高、体质量、血糖、腰围、腹围、血压）、输液与注射（如静脉输液、肌内注射、皮内注射、皮下注射、穴位注射）、住院护理、家庭病床上门服务、中医治疗与护理（如中药熏蒸、针灸、拔火罐）、老年保健（运动、休息、睡眠保健护理指导）、协助接种免疫、标本采集与指导（如采集静脉血标本、大小便标本及指导）、临终关怀与安宁护理、老年保健（心理保健护理指导），评分的Kendall协调系数为0.112（P﹤0.05）。共回收专业人士版有效问卷19份，工作伙伴对社区护士岗位职责需求排在前10位的分别为：住院护理、财务管理（用品消毒、医疗废弃物管理）、临终关怀与安宁护理、输液与注射（如静脉输液、肌内注射、皮内注射、皮下注射、穴位注射）、协助接种免疫、家庭病床上门服务、体检（如测量体温、身高、体质量、血糖、腰围、腹围、血压）、信息管理（填报社区卫生信息月、季报表）、健康教育（开展慢性病、常见病、传染病等健康教育讲座）、信息管理（突发公共卫生事件应急预案与总结），评分的Kendall协调系数为0.102（ P﹤0.05）。结论居民和社区护士工作伙伴对社区护士岗位职责的认知一致性较差，居民期望社区护士的主要职责为健康照顾，同时量力兼顾健康教育与咨询；而工作伙伴期望社区护士的主要职责为健康照顾、管理和组织工作，同时量力兼顾健康教育与咨询。%Objective To investigate the demand for the responsibilities of community nurses under the responsibility system of family doctors,in order to provide basis for positioning the responsibilities of community nurses. Methods From June to July in 2014 and from November to December in 2014 , convenience sampling method was used to select residents and the working partners of nurses in the Waigang Community Health Service Center of Jiading District in Shanghai. Two questionnaire surveys were adopted to collect data. The Questionnaire of Responsibilities of Community Nurses and the Questionnaire of the Public Opinions of the Responsibilities of Community Nurses were used respectively in the first and second survey. The two questionnaires were both divided into two versions, one for residents and one for the working partners of community nurses. Results (1)In the first survey,a total of 101 effective questionnaires for residents were collected,and the first three responsibilities of community nurses most demanded by residents were basic medical services,guidance on domestic health care and drug administration,and the hospitalization and rehabilitation of patients with chronic diseases/disability/dysphrenia;the Kendall coordinate coefficient was 0. 101 ( P ﹤ 0. 05 ) . A total of 17 effective questionnaires for the working partners of community nurses were collected,and the first three responsibilities of community nurses most demanded by working partners were guidance on domestic health care and drug administration,basic medical services,and assistants for general practitioners;the Kendall coordinate coefficient was 0. 133(P ﹤0. 05). (2)In the second survey,a total of 30 effective questionnaires for residents were collected, and the first ten responsibilities of community nurses most demanded by residents were physical examinations( body temperature,height,body weight,blood glucose,waist circumference,abdomen circumference and blood pressure ), transfusion and injection ( venous transfusion, intramuscular injection, intracutaneous injection, subcutaneous injection and acupoint injection ), hospital care, domestic sickbed door - to - door service, TCM treatment and nursing (traditional Chinese medicine fumigation,acupuncture and moxibustion and cupping therapy),geriatric care(exercise,rest and guidance on sleep health care),assisted inoculation of vaccines,sample collection and guidance( collection of venous blood and defecation samples and guidance ), hospice care and geriatric care ( guidance on mental health care );the Kendall coordinate coefficient was 0. 112(P﹤0. 05). A total of 19 effective questionnaires for the working partners of community nurses were collected,and the first ten responsibilities of community nurses most demanded by working partners were hospitalized health care,financial management(disinfection of articles and management of medical waste),hospice care,transfusion and injection ( venous transfusion,venous transfusion,intramuscular injection,intracutaneous injection,subcutaneous injection and acupoint injection), assisted inoculation of vaccines, domestic sickbed door - to - door service, physical examination ( body temperature,height,body weigth , blood glucose, waist circumference, abdomen circumference and blood pressure ), information management(monthly and quarterly reports of community health),health education(health education lectures of chronic diseases,common diseases and infectious diseases),and information management( emergency plan and summary of sudden public health events);the Kendall coordinate coefficient was 0. 102(P﹤0. 05). Conclusion Residents and working partners of community nurses have poor consistency in the cognition of responsibilities of community nurses. The major responsibility expected by residents is health care,and health education and consultation are also expected if nurses' time and energy permitted. The major responsibilities expected by working partners are health care,management and organization,and health education and consultation are also expected if nurses'time and energy permitted.
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