摘要
【研究背景】
随着医学模式的转变和人们健康意识的提高,护理已不再是单纯疾病和病症的护理,而应涵盖人的生理、心理、社会、精神、环境等诸方面的健康需求,这带来了护理工作模式的转变和护士角色的扩展,对护理人才的综合素质提出了更高的要求和挑战。作为一名合格的护士,不仅应具备全面的专业知识、高尚的职业道德、良好的心理和身体素质;而且还需要具有智慧、学识、判断力及思考能力。
传统护理教育模式以传授知识和技能为主要目的,而现代生物—心理—社会医学模式的发展赋予护理教育以新的内涵,护理专业被列为国家紧缺人才专业,不仅仅是护理人才数量的需求,更反映了社会对高素质护理人才的强烈需要。呼伦贝尔市地处我国北部边陲,护理人才的培养落后于其他地区,急需培养出更多综合素质较高的护理人才。呼伦贝尔市卫生学校是国家教育部、卫生部等六部委确定的承担护理专业职业教育的实训基地。近年来,该校积极进行了护理专业教育思想、教育观念、人才培养模式、课程设置等方面的改革与实践,以“减数理,增基础,强专业,重实训”为指导思想,提高教育质量,全面推行素质教育,培养具有综合护理职业能力和全面素质,适应各级医疗卫生机构服务、管理第一线需要的高素质护士,以适应经济社会发展的需求,更好地为经济建设服务。
但是,随着医学科学技术的快速发展,知识增长和更新速度的加快,使护理学科知识体系日益丰富,导致传统护理教育模式所面临的有限教学时间与无限教学内容之间的矛盾日益加剧。如何解决这一矛盾,是护理教育改革所面临的重要问题。为了更好地制定护理专业学生的培养目标和方向,使教师的教学实践有的放矢,同时促进教师自身知识体系的完善与提高,我们于2008年7月至8月对呼伦贝尔市及周边地区医院的护理人员整体素质进行了调查,并分析了影响护士整体素质的主要因素,以便为更好地制定护理专业教学改革方向提供科学依据。
【研究目的】
本研究的主要目的是:
1.调查分析呼伦贝尔市护士整体素质状况,为制定高素质护士的培养目标,为社会输送高素质的护理人才提供基础数据。
2.探讨分析呼伦贝尔市护士整体素质的影响因素,为制定教学改革方向提供科学依据。
3.根据呼伦贝尔市护士整体素质状况及影响因素研究,提出护理教育教学改革的建议。
【研究方法】
本研究采用白行设计的《呼伦贝尔市护士整体素质状况及护校教学改革方向调研表》,于2008年7月至8月对呼伦贝尔市及周边城市各医院的护理人员进行了调查。调查对象采用多阶段随机抽样方法抽样,首先用随机整群抽样抽取到16所医院,收集所抽中医院的所有护理人员名单并编号,然后按系统随机抽样方法在每个抽中的医院中随机抽取60名护理人员作为调查对象。
由经过课题组统一培训的调查员,根据事先制定的调查表,采取面谈方式对调查对象进行调查,填写调查表。调查内容主要包括:一般情况,护理人员的思想品德、职业道德、专业技能、心理素质、工作能力、人文综合素质、各级医院及个别科室对护士的特殊要求及对教学的需求等。共收回调查问卷960份,有效问卷941份,应答率为98.02%。
将原始数据资料编码整理后输入计算机,用EXCEL建立数据库,运用SPSS11.5软件进行统计分析。
【研究结果】
研究结果表明,呼伦贝尔市护士整体素质优良、中、差分别占42.3%、41.2%和20.4%,提示呼伦贝尔市护士整体素质偏低。在构成护士整体素质的思想品德、职业道德、专业技能、心理素质、工作能力及人文综合素质共6个条目中,得分优秀的人数分别为37.7%、71.1%、15.5%、25.2%、24.3%和12.9%,提示所调查的护理人员思想品德、职业道德较好,而专业技能和人文综合素质得分较低。说明呼伦贝尔市护理人员的人文综合素质相对较低,这与国内其他研究一致。
在得分最低的专业技能和人文综合素质方面,将优秀和良好两个等级合并,则专业技能优良者占43.8%,人文综合素质优良者占46.5%。在专业技能方面,优良率最低的是病室协调及病人管理能力,为53.0%;其次是改革创新能力,为54.0%。在人文综合素质方面,有自信心、语言表达能力、人际沟通能力、社会适应能力、计算机应用、英语应用能力、教育教学能力、文献检索能力共8项测量指标,其中优良率最低的三项指标是文献检索能力(28.3%),教育教学能力(32.9%)和英语应用能力(34.2%)。
以上结果提示,呼伦贝尔市护士的素质在专业技能的实践能力和创新意识两方面较差。在人文综合素质方面的文献检索能力、教育教学能力和英语应用能力较差。
本文还对影响呼伦贝尔市护士整体素质的因素进行了多元线性逐步回归分析。结果显示,医院级别高低、职称高低、工龄长短、学历高低是影响护理人员整体素质的主要因素。在三级医院工作的护士整体素质高于在二级医院工作的护士,工龄越长护士整体素质越高,职称越高护士整体素质越高,学历越高整体素质越高。
【研究结论】
以上研究结果提示,呼伦贝尔市护理人员的整体素质在专业技能和人文综合素质方面较差,特别是在人文社会科学、外语、计算机应用、文献检索等方面仍然欠缺。因此,呼伦贝尔市在今后的护理人才培养上,应注重加强专业技能和人文综合素质的培养,尤其是实践能力、改革创新意识和社会适应能力、计算机应用能力、英语应用能力、教育教学能力、文献检索能力等人文社科类综合能力的培养。该结论与李秀云、徐蓉观点基本相同。
【Background】
As medical model and health awareness change,nursing is no longer merely care of disease or illness,and it should covered all kinds of health needs in physical, psychological,social,mental and environmental aspects.This brought about changes in nursing model and expansion of the role of nurses,and put forward higher requirements and challenges to the overall quality of nurses.A qualified nurse should not only have a comprehensive professional knowledge,high professional ethics,good psychological and physical qulities;but also have wisdom,knowledge,discretion and thinking ability.
Imparting knowledge and skills is regarded as the main purpose in the traditional model of nursing education,but biology-psychology-society medical model give new meaning to nursing education,and the nursing profession is listed as one of professions that is short of talents.Hunlunbeier City is situated in the northern border,and the training of nurse lags behind other areas,so training more high-quality and comprehensive nursing personnel is in urgent need.Hunlunbeier Health School is identified to assume vocational education in nursing profession by Ministry of Education, Ministry of Health and other six ministries.In recent years,our school has been actively engaged in the reform of education thinking,education concepts,personnel training mode and curriculum choice,we also engaged in fostering high-quality nurses with comprehensive professional abilities and overall quality in order to meet health institutions at all levels.
However,with the development of medical science and technology,the body of knowledge about nursing subject is becoming more and more larger,and it leads to contradiction between limited teaching time and unlimited teaching content in traditional model of nursing education.How to resolve this contradiction is one important issues in reform of nursing education.In order to develop training objectives and promote teachers to improve their own knowledge systems,we conducted a survey and analysis on condition and influencing factors of overall quality in the nurses of Hunlunbeier City during the period from July to August in 2008 in order to provide scientific evidence for the reform of nursing education.
【Objectives】
The main objectives of this study is:
1.Survey on condition and influencing factors of overall quality in the nurses of Hunlunbeier City,and provide basic data for developing training objectives of high-quality nurses.
2.Analyze influencing factors of overall quality in the nurses of Hunlunbeier City,and provide scientific evidence for developing direction of nursing teaching reform.
3.Based on study on condition and influencing factors of overall quality in the nurses of Hunlunbeier City,put forward proposals about educational reform in nursing school
【Methods】
This study used self-designed questionnaire to conduct study on condition and influencing factors of overall quality in the nurses of Hunlunbeier City during the period from July to August in 2008.A multi-stage random sampling method is used in this survey,first of all select 16 hospitals by random cluster sampling method,and then enrolle 60 nursing staff into sample by systematic random sampling method in each selected hospitals.
Investigators by training conduct a survey according to self-designed questionnaire by face-to-face interview.Survey mainly include:ideology,professional ethics, professional skills,psychological qualities,working ability,overall quality of humanities and so on.941 questionnaires are valid of 960 questionnaires collected,and the response rate is 98.02%.
The original data was coded and entered into the computer,using EXCEL to build up a database,then using SPSS11.5 to conduct statistical analysis.
【Results】
The results show that the overall quality of nurses in Hulunbeir is graded as fine, medium or poor,account for 42.3%,41.2%and 20.4%,respectively,this suggesting that the overall quality of nurses in Hulunbeir is slightly low.The overall quality of nurses include six entries,such as ideology,professional ethics,professional skills, psychological qualities,working ability and overall quality of humanities,the number of excellent scores in each entries account for 37.7%,71.1%,15.5%,25.2%,24.3%,12.9%, respectively,this suggesting that the nurses scored high in ideology and professional ethics,but scored lower in professional skills and overall quality of humanities.The overall quality of humanities of nurses in our city is relatively low,which is in line with other studies in our country.
Nurses in Hulunbeir had the lowest score in the aspects of professional skills and overall quality of humanities,if we combined the grades of excellent and good,the results will be 43.8%in professional skill and 46.5%in overall quality of humanities.In the aspects of professional skills,excellent and good rate is the lowest(53.0%)in ward coordination and patient management ability,followed by the reform and innovation ability(54.0%).In the aspects of overall quality of humanities,there are eight measurement indicators:self-confidence,language performance,interpersonal communication skills,social adaptability,computer applications,English proficiency, educating and teaching ability and literature retrieval ability,of which the three lowest rates of fine are literature retrieval ability(28.3%),educating and teaching ability(32.9%) and English proficiency(34.2%).
These results suggest that practical abilities and innovation awareness in professional skills of nurses in Hulunbeir is poor.In the overall quality of the humanities of nurses in Hulunbeir,literature retrieval ability,educating and teaching ability and English proficiency is poor.
We make a multiple linear stepwise regression analysis on the factors influencing the overall quality of nurses in Hulunbeir,which showed that the level of the hospital,the title level,the length of service,and education level are the main influencing factors.The overall quality of nurses in the tertiary hospitals is higher than nurses in the secondary hospital,and longer the length of service is,higher the the title is,higher the education level is,the overall quality of the nurses is higher.
【Conclusion】
The above results suggest that professional skills and overall quality of humanities in the overall quality of nursing staff in Hulunbeir is poor,especially in the humanities and social sciences,foreign languages,computer applications,literature retrieval,etc. Therefore,in Hulunbeir nursing personnel training should focus on professional skills and overall quality of humanities,especially on comprehensive ability of humanities and social sciences,such as practical abilities,innovation and social adaptation,computer application ability,English proficiency,educating and teaching ability,literature retrieval ability.The conclusions is basically the same as the view of Li Xiuyun and Xu Rong. Therefore,when we train specialist nurses,the intensive training of foreign language, literature retrieval by computer and social science knowledge is necessary.
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