中国护理学科发展面临的挑战与应对策略_《中国循证医学杂志》

作者：

王应强 ¹ , 韦诗友 ² ,  李幼平 ¹ , 邓绍林 ^1,2,3 , 罗倩倩 ⁴ , 李琰 ^1,5

1. 四川大学华西医院中国循证医学中心（成都 610041）；2. 四川大学华西临床医学院（成都 610041）；3. 四川大学华西医院（成都 610041）；4. 四川大学华西医院国家成都新药（中药）安全性评价中心（成都 610041）；5. 四川大学政治学院（成都 610065）;

关键词：

护理循证医学胜任能力教育灾害护理护理教育定量方法

DOI：

10.7507/1672-2531.20130024

视频：

导出 下载 收藏 扫码 引用

摘要 全文 图表 视频 参考文献 施引文献 补充材料

目的　基于当前可得最佳证据，评价我国护理学科发展面临的挑战及应对策略，为促进护理学科、平台、梯队建设提供建议。
方法　系统检索CNKI（1979～2012.8）、VIP（1989～2012.8）、CBM（1981～2012.8），以及世界卫生组织、国际护士协会、世界银行、中国卫生部、教育部和全国大、中专院校官方网站，收集护理学科发展，人员培养和执业等相关资料，采用SPSS 13.0和Microsoft Excel软件进行统计分析。
结果　① 截至2012年，全国共有855所护理院校，本科和独立学院招收护生38 212名，大专或职业中专招收护生130 837名。② 2010年中国医护比例为1∶0.9，实际需求医生260万，护士短缺34.6万。③ 护理人员 lt;35岁者占50%，低级职称占64%～69%，高级职称 lt;2.5%。④ 中国培养1名医生和护士/助产士的费用仅为印度的2/5，撒哈拉沙漠以南的1/5～1/4。⑤ 截至目前，灾害护理文献中有科研数据者仅占30.1%，体会及综述类分别占30.6%和38.3%。
结论　中国医疗卫生和教育系统尚需深入改革，培养护生核心胜任能力和转化式学习方式，合理增加卫生投入，及时更新护理教材及教学方法。提倡护理学科与各学科间协作及循证护理，改善卫生服务质量和病人满意度。

引用本文： 王应强,韦诗友,李幼平,邓绍林,罗倩倩,李琰. 中国护理学科发展面临的挑战与应对策略. 中国循证医学杂志, 2013, 13(2): 128-136. doi: 10.7507/1672-2531.20130024 复制

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2.	中华人民共和国卫生部疾病预防控制局. 卫生部等15部门关于印发《中国慢性病防治工作规划(2012-2015年)》的通知. 卫疾控发[2012]34号.2012年. Available at: http://www.moh.gov.cn/publicfiles/business/htmlfiles/mohjbyfkzj/s5878/201205/54755.htm.
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10.	World Health Organization. Global survey monitoring progress in nursing and midwifery. Geneva. 2010. Available at: http://whqlibdoc.who.int/hq/2010/WHO_HRH_HPN_10.4_eng.pdf. [Accessed August 20, 2012].
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14.	中华人民共和国卫生部统计信息中心. 2012中国卫生统计提要. 2012年. Available at: http://www.moh.gov.cn/publicfiles/business/htmlfiles/mohwsbwstjxxzx/s9092/201206/55044.htm. [Accessed August 15, 2012].
15.	World Health Organization. World Health Statistics 2011. Geneva. 2011. Available at: http://www.who.int/entity/gho/publications/world_health_statistics/EN_WHS2011_Full.pdf. [Accessed August 10, 2012].
16.	Frenk J, Chen L, Bhutta ZA, et al. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. The Lancet, 2010, 376(9756): 1923-1958.
17.	胡锦梁, 郑小华. 2015年四川省医疗机构卫技人员配置标准测算. 中国卫生事业管理, 2009, (5): 292-294.
18.	中华人民共和国教育部. 2012年具有普通高等学历教育招生资格的高等学校名单. Available at: http://www.moe.edu.cn/publicfiles/business/htmlfiles/moe/moe_634/201206/137993.html. [Accessed August 10, 2012].
19.	人民卫生出版社有限公司. 2012年. Available at: http://www.pmph.com/Page/list.jsp?cid=1641. [Accessed August 15, 2012].
20.	International Council of Nurses. Nursing workforce profile database summary. 2011. Available at: http://www.icn.ch/images/stories/documents/pillars/sew/DATASHEET_SUMMARY_NURSING_PROFILE_2011.pdf. [Accessed August 10, 2012].
21.	International Council of Nurses. An aging nursing workforce. 2008. Available at: http://www.icn.ch/images/stories/documents/publications/fact_sheets/2a_FS-Ageing_Workforce.pdf. [Accessed August 15, 2012].
22.	Canadian Nurses Association. Nursing Education in Canada Statistics 2008-2009.Ottawa. 2010. Available at: http://www2.cna-aiic.ca/CNA/documents/pdf/publications/Education_Statistics_Report_2008_2009_e.pdf. [Accessed August 10, 2012].
23.	International Council of Nurses. Nursing workforce profile database summary. 2011. Available at: http://www.icn.ch/images/stories/documents/pillars/sew/DATASHEET_SUMMARY_NURSING_PROFILE_2011.pdf. [Accessed August 10, 2012].
24.	International Council of Nurses. Nurse wages and their context Asia workforce forum database summary. 2010. Available at: http://www.icn.ch/images/stories/documents/pillars/sew/sew_asia_workforce_forum_database_summary_2010.pdf. [Accessed August 10, 2012].
25.	李静. 护理学学科体系构建的探索性研究. 上海. 第二军医大学. 2010年.
26.	del Bueno, Dorothy J.R.N.Competency based education. Nurs Educ, 1978, 3(3): 10-14.
27.	Luann MD, Janie BB, Kindy KS. The development of organizing framework to implement AACN Guidelines for nursing education. Journal of Nursing Education, 2002, 41(1): 34-37.
28.	曹梅娟, 姜安丽. 护理本科人才培养整体胜任力标准框架模型的构建. 中华护理杂志, 2009, 44(6): 536-538.
29.	Leung Wai-ching. Competency based medical training: review. BMJ, 2002, 325(28): 693.
30.	Lee JY, Lee SL, Jo MW. Lessons from Healthcare Providers’ Attitudes toward Pay-for-performance: What Should Purchasers Consider in Designing and Implementing a Successful Program? J Prev Med Public Health, 2012, 45(3): 137-147. Doi: 10.3961/jpmph.2012.45.3.137.
31.	Castaldi S, Bodina A, Bevilacqua L, et al. Payment for performance (P4P): any future in Italy? BMC Public Health, 2011, 11: 377.doi:10.1186/1471-2458-11-377.
32.	Emmert M, Eijkenaar F, Kemter H, et al. Economic evaluation of pay-for-performance in health care: a systematic review. Eur J Health Econ, 2011. Doi: 10.1007/s10198-011-0329-8.
33.	孙爱红, 姚雅红. 我院护理人员绩效薪酬改革的做法与成效. 中华护理杂志, 2011, 46(2): 141-143.
34.	马巧焕, 褚洪. 高校社区医院护理人员绩效考核体系的应用. 中华护理杂志, 2012, 47(6): 498-499.
35.	Mortar A, Damberg CL, Sorbero ME, et al. Pay for Performance in the Hospital Setting: What Is the State of the Evidence? Am J Med Qual, 2009, 24(1):19-28. Doi: 10.1177/1062860608326634.
36.	Tsai Y, Wu SW. The relationships between organizational citizenship behaviour, job satisfaction and turnover intention. J Clin Nurs, 2010, 19(23-24): 3564-3574.
37.	Hwang JI, Lou F, Han SS, et al. Professionalism: the major factor influencing job satisfaction among Korean and Chinese nurses. Int Nurs Rev, 2009, 56(3): 313-318.
38.	International Council of Nurses. Positive practice environments. International Centre for Human Resources in Nursing. 2007. Available at: http://www.icn.ch/images/stories/documents/publications/fact_sheets/9d_FS-Positive_Practice_Environments.pdf. [Accessed August 10, 2012].
39.	Aiken LH, Sloane DM, Clarke S, et al. Importance of work environments on hospital outcomes in nine countries. Int Jr Qual Health Care, 2011, 23(4): 357-364. Doi: 10.1093/intqhc/mzr022. [Pubmed: 21561979].
40.	沈建通, 姚乐野, 李幼平, 等. 循证医学学科知识可视化研究之一: 循证医学研究主题图谱. 中国循证医学杂志, 2011, 11(6): 613-621.

1. World Bank.2010.Aavailabe at: http://data.worldbank.org/indicator/SP.POP.65UP.TO.ZS.
2. 中华人民共和国卫生部疾病预防控制局. 卫生部等15部门关于印发《中国慢性病防治工作规划(2012-2015年)》的通知. 卫疾控发[2012]34号.2012年. Available at: http://www.moh.gov.cn/publicfiles/business/htmlfiles/mohjbyfkzj/s5878/201205/54755.htm.
3. 刘善明, 魏赓, 张伟, 等. 西藏自治区四类常见神经精神障碍的流行病学调查. 四川大学学报(医学版), 2012, 43(2): 210-213.
4. Bunting BP, Murphy SD, O’Neill SM, et al. Lifetime prevalence of mental health disorders and delay in treatment following initial onset: evidence from the Northern Ireland Study of Health and Stress. Psychol Med, 2012, 42(8): 1727-1739.
5. Vicente B, Saldivia S, de la Barra F, et al. Prevalence of child and adolescent mental disorders in Chile: a community epidemiological study. J Child Psychol Psychiatry, 2012, 53(10): 1026-1035.
6. International Council of Nurses. Nurse: Patient Ratios. 2003. Available at: http://www.icn.ch/images/stories/documents/publications/fact_sheets/9c_FS-Nurse_Patient_Ratio.pdf. [Accessed August 26, 2012].
7. World health organization. The nursing & midwifery programme at WHO Available at: http://www.who.int/hrh/nursing_midwifery/en/. [Accessed 26 August 2012].
8. World Health Organization. Strategic directions for strengthening nursing and midwifery services 2011-2015. Geneva.2010. Available at: http://www.who.int/nursing_midwifery/en/. [Accessed August 26, 2012].
9. Huicho L, Scherpbier RW, Nkowane AM, et al. How much does quality of child care vary between health workers with differing durations of training? An observational multicountry study. The Lancet, 2008, 372(9642): 910-916. Doi: 10.1016/S0140-6736(08)61401-4.
10. World Health Organization. Global survey monitoring progress in nursing and midwifery. Geneva. 2010. Available at: http://whqlibdoc.who.int/hq/2010/WHO_HRH_HPN_10.4_eng.pdf. [Accessed August 20, 2012].
11. 中华人民共和国卫生部.2010中国卫生统计年鉴. 2010年. Available at: http://www.moh.gov.cn/publicfiles/business/htmlfiles/zwgkzt/ptjnj/year2010/index2010.html. [Accessed August 20, 2012].
12. 中华人民共和国卫生部. 2006中国卫生统计年鉴. 2006年. Available at: http://www.moh.gov.cn/publicfiles/business/htmlfiles/zwgkzt/ptjnj/year2006/index.html. [Accessed August 20, 2012].
13. 中华人民共和国卫生部. 2007-2011年我国卫生事业发展统计公报.2007-2011年. Available at: http://www.moh.gov.cn/publicfiles//business/htmlfiles/zwgkzt/pgb/index.htm. [Accessed August 15, 2012].
14. 中华人民共和国卫生部统计信息中心. 2012中国卫生统计提要. 2012年. Available at: http://www.moh.gov.cn/publicfiles/business/htmlfiles/mohwsbwstjxxzx/s9092/201206/55044.htm. [Accessed August 15, 2012].
15. World Health Organization. World Health Statistics 2011. Geneva. 2011. Available at: http://www.who.int/entity/gho/publications/world_health_statistics/EN_WHS2011_Full.pdf. [Accessed August 10, 2012].
16. Frenk J, Chen L, Bhutta ZA, et al. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. The Lancet, 2010, 376(9756): 1923-1958.
17. 胡锦梁, 郑小华. 2015年四川省医疗机构卫技人员配置标准测算. 中国卫生事业管理, 2009, (5): 292-294.
18. 中华人民共和国教育部. 2012年具有普通高等学历教育招生资格的高等学校名单. Available at: http://www.moe.edu.cn/publicfiles/business/htmlfiles/moe/moe_634/201206/137993.html. [Accessed August 10, 2012].
19. 人民卫生出版社有限公司. 2012年. Available at: http://www.pmph.com/Page/list.jsp?cid=1641. [Accessed August 15, 2012].
20. International Council of Nurses. Nursing workforce profile database summary. 2011. Available at: http://www.icn.ch/images/stories/documents/pillars/sew/DATASHEET_SUMMARY_NURSING_PROFILE_2011.pdf. [Accessed August 10, 2012].
21. International Council of Nurses. An aging nursing workforce. 2008. Available at: http://www.icn.ch/images/stories/documents/publications/fact_sheets/2a_FS-Ageing_Workforce.pdf. [Accessed August 15, 2012].
22. Canadian Nurses Association. Nursing Education in Canada Statistics 2008-2009.Ottawa. 2010. Available at: http://www2.cna-aiic.ca/CNA/documents/pdf/publications/Education_Statistics_Report_2008_2009_e.pdf. [Accessed August 10, 2012].
23. International Council of Nurses. Nursing workforce profile database summary. 2011. Available at: http://www.icn.ch/images/stories/documents/pillars/sew/DATASHEET_SUMMARY_NURSING_PROFILE_2011.pdf. [Accessed August 10, 2012].
24. International Council of Nurses. Nurse wages and their context Asia workforce forum database summary. 2010. Available at: http://www.icn.ch/images/stories/documents/pillars/sew/sew_asia_workforce_forum_database_summary_2010.pdf. [Accessed August 10, 2012].
25. 李静. 护理学学科体系构建的探索性研究. 上海. 第二军医大学. 2010年.
26. del Bueno, Dorothy J.R.N.Competency based education. Nurs Educ, 1978, 3(3): 10-14.
27. Luann MD, Janie BB, Kindy KS. The development of organizing framework to implement AACN Guidelines for nursing education. Journal of Nursing Education, 2002, 41(1): 34-37.
28. 曹梅娟, 姜安丽. 护理本科人才培养整体胜任力标准框架模型的构建. 中华护理杂志, 2009, 44(6): 536-538.
29. Leung Wai-ching. Competency based medical training: review. BMJ, 2002, 325(28): 693.
30. Lee JY, Lee SL, Jo MW. Lessons from Healthcare Providers’ Attitudes toward Pay-for-performance: What Should Purchasers Consider in Designing and Implementing a Successful Program? J Prev Med Public Health, 2012, 45(3): 137-147. Doi: 10.3961/jpmph.2012.45.3.137.
31. Castaldi S, Bodina A, Bevilacqua L, et al. Payment for performance (P4P): any future in Italy? BMC Public Health, 2011, 11: 377.doi:10.1186/1471-2458-11-377.
32. Emmert M, Eijkenaar F, Kemter H, et al. Economic evaluation of pay-for-performance in health care: a systematic review. Eur J Health Econ, 2011. Doi: 10.1007/s10198-011-0329-8.
33. 孙爱红, 姚雅红. 我院护理人员绩效薪酬改革的做法与成效. 中华护理杂志, 2011, 46(2): 141-143.
34. 马巧焕, 褚洪. 高校社区医院护理人员绩效考核体系的应用. 中华护理杂志, 2012, 47(6): 498-499.
35. Mortar A, Damberg CL, Sorbero ME, et al. Pay for Performance in the Hospital Setting: What Is the State of the Evidence? Am J Med Qual, 2009, 24(1):19-28. Doi: 10.1177/1062860608326634.
36. Tsai Y, Wu SW. The relationships between organizational citizenship behaviour, job satisfaction and turnover intention. J Clin Nurs, 2010, 19(23-24): 3564-3574.
37. Hwang JI, Lou F, Han SS, et al. Professionalism: the major factor influencing job satisfaction among Korean and Chinese nurses. Int Nurs Rev, 2009, 56(3): 313-318.
38. International Council of Nurses. Positive practice environments. International Centre for Human Resources in Nursing. 2007. Available at: http://www.icn.ch/images/stories/documents/publications/fact_sheets/9d_FS-Positive_Practice_Environments.pdf. [Accessed August 10, 2012].
39. Aiken LH, Sloane DM, Clarke S, et al. Importance of work environments on hospital outcomes in nine countries. Int Jr Qual Health Care, 2011, 23(4): 357-364. Doi: 10.1093/intqhc/mzr022. [Pubmed: 21561979].
40. 沈建通, 姚乐野, 李幼平, 等. 循证医学学科知识可视化研究之一: 循证医学研究主题图谱. 中国循证医学杂志, 2011, 11(6): 613-621.

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《中国循证医学杂志》

中国护理学科发展面临的挑战与应对策略

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《中国循证医学杂志》

中国护理学科发展面临的挑战与应对策略

摘要 全文 图表 视频 参考文献 施引文献 补充材料

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