中國護理學科發展面臨的挑戰與應對策略_《中國循證醫學雜志》

作者：

王應強 ¹ , 韋詩友 ² ,  李幼平 ¹ , 鄧紹林 ^1,2,3 , 羅倩倩 ⁴ , 李琰 ^1,5

1. 四川大學華西醫院中國循證醫學中心（成都 610041）；2. 四川大學華西臨床醫學院（成都 610041）；3. 四川大學華西醫院（成都 610041）；4. 四川大學華西醫院國家成都新藥（中藥）安全性評價中心（成都 610041）；5. 四川大學政治學院（成都 610065）;

關鍵詞：

護理循證醫學勝任能力教育災害護理護理教育定量方法

DOI：

10.7507/1672-2531.20130024

視頻：

導出 下載 收藏 掃碼 引用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的　基于當前可得最佳證據，評價我國護理學科發展面臨的挑戰及應對策略，為促進護理學科、平臺、梯隊建設提供建議。
方法　系統檢索CNKI（1979～2012.8）、VIP（1989～2012.8）、CBM（1981～2012.8），以及世界衛生組織、國際護士協會、世界銀行、中國衛生部、教育部和全國大、中專院校官方網站，收集護理學科發展，人員培養和執業等相關資料，采用SPSS 13.0和Microsoft Excel軟件進行統計分析。
結果　① 截至2012年，全國共有855所護理院校，本科和獨立學院招收護生38 212名，大專或職業中專招收護生130 837名。② 2010年中國醫護比例為1∶0.9，實際需求醫生260萬，護士短缺34.6萬。③ 護理人員 lt;35歲者占50%，低級職稱占64%～69%，高級職稱 lt;2.5%。④ 中國培養1名醫生和護士/助產士的費用僅為印度的2/5，撒哈拉沙漠以南的1/5～1/4。⑤ 截至目前，災害護理文獻中有科研數據者僅占30.1%，體會及綜述類分別占30.6%和38.3%。
結論　中國醫療衛生和教育系統尚需深入改革，培養護生核心勝任能力和轉化式學習方式，合理增加衛生投入，及時更新護理教材及教學方法。提倡護理學科與各學科間協作及循證護理，改善衛生服務質量和病人滿意度。

引用本文： 王應強,韋詩友,李幼平,鄧紹林,羅倩倩,李琰. 中國護理學科發展面臨的挑戰與應對策略. 中國循證醫學雜志, 2013, 13(2): 128-136. doi: 10.7507/1672-2531.20130024 復制

1.	World Bank.2010.Aavailabe at: http://data.worldbank.org/indicator/SP.POP.65UP.TO.ZS.
2.	中華人民共和國衛生部疾病預防控制局. 衛生部等15部門關于印發《中國慢性病防治工作規劃(2012-2015年)》的通知. 衛疾控發[2012]34號.2012年. Available at: http://www.moh.gov.cn/publicfiles/business/htmlfiles/mohjbyfkzj/s5878/201205/54755.htm.
3.	劉善明, 魏賡, 張偉, 等. 西藏自治區四類常見神經精神障礙的流行病學調查. 四川大學學報(醫學版), 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.	中華人民共和國衛生部.2010中國衛生統計年鑒. 2010年. Available at: http://www.moh.gov.cn/publicfiles/business/htmlfiles/zwgkzt/ptjnj/year2010/index2010.html. [Accessed August 20, 2012].
12.	中華人民共和國衛生部. 2006中國衛生統計年鑒. 2006年. Available at: http://www.moh.gov.cn/publicfiles/business/htmlfiles/zwgkzt/ptjnj/year2006/index.html. [Accessed August 20, 2012].
13.	中華人民共和國衛生部. 2007-2011年我國衛生事業發展統計公報.2007-2011年. Available at: http://www.moh.gov.cn/publicfiles//business/htmlfiles/zwgkzt/pgb/index.htm. [Accessed August 15, 2012].
14.	中華人民共和國衛生部統計信息中心. 2012中國衛生統計提要. 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.	胡錦梁, 鄭小華. 2015年四川省醫療機構衛技人員配置標準測算. 中國衛生事業管理, 2009, (5): 292-294.
18.	中華人民共和國教育部. 2012年具有普通高等學歷教育招生資格的高等學校名單. Available at: http://www.moe.edu.cn/publicfiles/business/htmlfiles/moe/moe_634/201206/137993.html. [Accessed August 10, 2012].
19.	人民衛生出版社有限公司. 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.	李靜. 護理學學科體系構建的探索性研究. 上海. 第二軍醫大學. 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, 姜安麗. 護理本科人才培養整體勝任力標準框架模型的構建. 中華護理雜志, 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.	孫愛紅, 姚雅紅. 我院護理人員績效薪酬改革的做法與成效. 中華護理雜志, 2011, 46(2): 141-143.
34.	馬巧煥, 褚洪. 高校社區醫院護理人員績效考核體系的應用. 中華護理雜志, 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, 姚樂野, 李幼平, 等. 循證醫學學科知識可視化研究之一: 循證醫學研究主題圖譜. 中國循證醫學雜志, 2011, 11(6): 613-621.

1. World Bank.2010.Aavailabe at: http://data.worldbank.org/indicator/SP.POP.65UP.TO.ZS.
2. 中華人民共和國衛生部疾病預防控制局. 衛生部等15部門關于印發《中國慢性病防治工作規劃(2012-2015年)》的通知. 衛疾控發[2012]34號.2012年. Available at: http://www.moh.gov.cn/publicfiles/business/htmlfiles/mohjbyfkzj/s5878/201205/54755.htm.
3. 劉善明, 魏賡, 張偉, 等. 西藏自治區四類常見神經精神障礙的流行病學調查. 四川大學學報(醫學版), 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. 中華人民共和國衛生部.2010中國衛生統計年鑒. 2010年. Available at: http://www.moh.gov.cn/publicfiles/business/htmlfiles/zwgkzt/ptjnj/year2010/index2010.html. [Accessed August 20, 2012].
12. 中華人民共和國衛生部. 2006中國衛生統計年鑒. 2006年. Available at: http://www.moh.gov.cn/publicfiles/business/htmlfiles/zwgkzt/ptjnj/year2006/index.html. [Accessed August 20, 2012].
13. 中華人民共和國衛生部. 2007-2011年我國衛生事業發展統計公報.2007-2011年. Available at: http://www.moh.gov.cn/publicfiles//business/htmlfiles/zwgkzt/pgb/index.htm. [Accessed August 15, 2012].
14. 中華人民共和國衛生部統計信息中心. 2012中國衛生統計提要. 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. 胡錦梁, 鄭小華. 2015年四川省醫療機構衛技人員配置標準測算. 中國衛生事業管理, 2009, (5): 292-294.
18. 中華人民共和國教育部. 2012年具有普通高等學歷教育招生資格的高等學校名單. Available at: http://www.moe.edu.cn/publicfiles/business/htmlfiles/moe/moe_634/201206/137993.html. [Accessed August 10, 2012].
19. 人民衛生出版社有限公司. 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. 李靜. 護理學學科體系構建的探索性研究. 上海. 第二軍醫大學. 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, 姜安麗. 護理本科人才培養整體勝任力標準框架模型的構建. 中華護理雜志, 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. 孫愛紅, 姚雅紅. 我院護理人員績效薪酬改革的做法與成效. 中華護理雜志, 2011, 46(2): 141-143.
34. 馬巧煥, 褚洪. 高校社區醫院護理人員績效考核體系的應用. 中華護理雜志, 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, 姚樂野, 李幼平, 等. 循證醫學學科知識可視化研究之一: 循證醫學研究主題圖譜. 中國循證醫學雜志, 2011, 11(6): 613-621.

上一篇
物質激勵在結核病管理中的應用
下一篇
肺癌患者淋巴結轉移與免疫組化及其病理學改變的相關性分析

《中國循證醫學雜志》

中國護理學科發展面臨的挑戰與應對策略

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

上一篇

下一篇

Format

Content

《中國循證醫學雜志》

中國護理學科發展面臨的挑戰與應對策略

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

上一篇

下一篇

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料