以三级医院为主导互联网为核心的居家延续护理服务模式构建

doi:10.3760/cma.j.issn.1007-1245.2024.19.034

国际医药卫生导报 ›› 2024, Vol. 30 ›› Issue (19): 3332-3337.DOI: 10.3760/cma.j.issn.1007-1245.2024.19.034

以三级医院为主导互联网为核心的居家延续护理服务模式构建

杜娟¹ 宋媛媛² 李艳² 张小栋³ 张玲⁴

¹汉中市人民医院介入科，汉中　723000；²汉中市人民医院护理部，汉中　723000；³汉中职业技术学院附属医院骨科，汉中　723000；⁴汉中市人民医院肛肠康复科，汉中　723000

收稿日期:2024-06-04 出版日期:2024-10-01 发布日期:2024-10-18
通讯作者: 张玲，Email：zhangling234091@163.com
基金资助:
国家重点研发计划（2021YFC2500600、2021YFC2500601）；2024年度市级中医医院中医药科研能力提升项目（SZY-NLTL-2024-023）

Construction of a home extended care service mode leaded by tertiary hospitals and with internet as the core

Du Juan¹, Song Yuanyuan², Li Yan², Zhang Xiaodong³, Zhang Ling⁴

¹Interventional Department, Hanzhong People's Hospital, Hanzhong 723000, China; ²Nursing Department, Hanzhong People's Hospital, Hanzhong 723000, China; ³Department of Orthopedics, Hospital Affiliated to Hanzhong Vocational Technical Institute, Hanzhong 723000, China; ⁴Department of Anus and Intestine Rehabilitation, Hanzhong People's Hospital, Hanzhong 723000, China

Received:2024-06-04 Online:2024-10-01 Published:2024-10-18
Contact: Zhang Ling, Email: zhangling234091@163.com
Supported by:
National Key Plan of Research and Development (2021YFC2500600 and 2021YFC2500601); Project for Improving Scientific Research Ability of Municipal Hospitals of Traditional Chinese Medicine in 2024 (SZY-NLTL-2024-023)

摘要/Abstract

摘要：

目的　构建以三级医院为主导互联网为核心的居家延续护理服务模式，为老年居家患者实施个性化的护理服务提供一定参考。方法　回顾性研究，选取2021年12月至2022年11月在汉中市人民医院接受“互联网+”及“医养结合居家养老”护理模式的居家老年患者60例作为研究对象，其中男35例、女25例，年龄（70.34±3.57）岁。平台注册护士共125例，其中男8例、女117例，年龄（34.12±3.23）岁。主要照顾者60例，其中男15例、女45例，年龄（45.23±5.51）岁。统计完成居家护理服务项目的结果，并对患者满意度进行调查，对比实施护理模式前后患者主要照顾者负担评分及护士职业认同感评分。统计学方法采用t检验、χ²检验。结果　共服务老年居家患者60例，完成居家护理155次，无不满意评价，各项满意度均为100.00%。实施“互联网+”及“医养结合居家养老”延续性护理模式后，患者主要照顾者责任负担、个人负担及总分均低于实施前［（12.12±2.28）分比（15.23±3.23）分、（22.34±4.78）分比（27.22±5.23）分、（35.17±6.23）分比（43.21±6.56）分］，差异均有统计学意义（t=4.975、4.356、5.621，均P<0.05）；实施后，护士职业认知评价、职业社会支持、职业社会交往技能、职业挫折应对、职业自我反思及总分均高于实施前［（33.24±3.12）分比（30.23±3.23）分、（24.24±2.67）分比（20.23±3.11）分、（25.45±2.56）分比（21.12±3.11）分、（24.34±2.56）分比（21.23±2.89）分、（13.68±1.67）分比（10.23±1.89）分、（120.56±5.56）分比（112.23±4.87）分］，差异均有统计学意义（t=3.671、5.358、5.888、4.412、7.492、6.173，均P<0.05）。结论　在医养结合政策背景下，开展“互联网+”及“医养结合居家养老”护理模式可提升老年居家患者满意度，同时减轻照顾者的负担，并提升护士职业认同感，推动护理服务业向更高层次发展。

关键词:

互联网, 三级医院, 居家, 延续护理服务

Abstract:

Objective　To construct a home extended care service mode leaded by tertiary hospitals and with internet as the core, and to provide references for the implementation of personalized nursing service for elderly homebound patients. Methods　This was a retrospective study. Sixty patients taking the "internet+" and "combining medical care with home care" nursing mode in Hanzhong People's Hospital from December 2021 to November 2022 were selected as the research objects, including 35 males and 25 females who were (70.34±3.57) years old. There were 125 registered nurses on the platform, including 8 males and 117 females who were (34.12±3.23) years old. There were 60 main caregivers for the patients, including 15 males and 45 females who were (45.23±5.51) years old. The results of completed home care projects were statistically calculated. The patients' satisfaction was investigated. The burden scores of the caregivers and the scores of professional identity of the nurses before and after the implementation of this service were compared. t and χ² tests were applied. Results　A total of 60 elderly homebound patients were served, with a total of 155 cases and a patient satisfaction rate of 100.00%. The scores of responsibility burden and personal burden and total score of the patients' primary caregivers were lower after than before the implementation of the "internet+" and "combining medical care with home care" continuous nursing mode [(12.12±2.28) vs. (15.23±3.23), (22.34±4.78) vs. (27.22±5.23), and (35.17±6.23) vs. (43.21±6.56)], with statistical differences (t=4.975, 4.356, and 5.621; all P<0.05). The scores of professional cognition, social support, social communication skills, frustration coping, and self-reflection and total score of the nurses were higher after than before the implementation [(33.24±3.12) vs. (30.23±3.23), (24.24±2.67) vs. (20.23±3.11), (25.45±2.56) vs. (21.12±3.11), (24.34±2.56) vs. (21.23±2.89), (13.68±1.67) vs. (10.23±1.89), and (120.56±5.56) vs. (112.23±4.87)], with statistical differences (t=3.671, 5.358, 5.888, 4.412, 7.492, and 6.173; all P<0.05). Conclusions　Under the policy background of medical and nursing integration, the implementation of the "internet+" and "combining medical care with home care" nursing mode can improve the satisfaction of elderly homebound patients, reduce the burden of caregivers, and improve the professional identity of nurses. It can promote the development of the nursing service industry to a higher level.

Key words:

Internet, Tertiary hospitals, Homebound, Extended nursing care service

杜娟宋媛媛李艳张小栋张玲.

以三级医院为主导互联网为核心的居家延续护理服务模式构建 [J]. 国际医药卫生导报, 2024, 30(19): 3332-3337.

Du Juan, Song Yuanyuan, Li Yan, Zhang Xiaodong, Zhang Ling.

Construction of a home extended care service mode leaded by tertiary hospitals and with internet as the core [J]. International Medicine and Health Guidance News, 2024, 30(19): 3332-3337.

参考文献

[1] 刘坤,王珂,张雨晨,等. 大型公立医院引领的同质化"互联网十护理服务"模式构建与应用[J]. 护士进修杂志,2021,36(20):1871-1875.DOI:10.16821/j.cnki.hsjx.2021.20.011.
[2] 陆柳雪,王巧娜,韦素雨,等. 以三级医院为主导的"互联网+护理服务"模式在慢性病患者延续性护理的可行性研究[J]. 右江民族医学院学报,2023,45(3):539-543.DOI:10.3969/j.issn.1001-5817.2023.03.033.
[3] 岳林,阎玲,田畅,等. "互联网+"癌痛患者管理及延续护理信息平台功能模块的初步构建[J]. 护士进修杂志,2023,38(9):785-788,794.DOI:10.16821/j.cnki.hsjx.2023.09.003.
[4] 王清,陈雁,夏冬云,等. 以三级综合性医院为主体的"互联网+护理服务"信息平台的构建与运行[J]. 护理学杂志,2020,35(8):53-56.DOI:10.3870/j.issn.1001-4152. 2020.08.053.
[5] 刘晓晨,王秀丽,马月珍. 基于"互联网+医联体"的老年慢病患者延续护理实践[J]. 护理学杂志,2023,38(2):100-104.DOI:10.3870/j.issn.1001-4152.2023.02.100.
[6] 李燕梅,林岩,陈春英,等. "互联网+"延续护理服务模式构建在三级综合医院的实践研究[J]. 科学与信息化,2021(29):182-186.
[7] 王烈,杨小湜,侯哲,等. 护理者负担量表中文版的应用与评价[J]. 中国公共卫生,2006,22(8):970-972.DOI:10.3321/j.issn:1001-0580.2006.08.040.
[8] 卢璇,张建薇,邓小岚,等. 以专科护士为主导的老年慢病"互联网+护理服务"模式构建与实施[J]. 实用临床医药杂志,2021,25(9):86-89,93.DOI:10.7619/jcmp.20201691.
[9] Lu L, Wang L, Yang X, et al. Zarit caregiver burden interview: development, reliability and validity of the Chinese version[J].Psychiatry Clin Neurosci,2009,63(6):730-734.DOI:10.1111/j.1440-1819.2009.02019.x.
[10] 刘玲,郝玉芳,刘晓虹. 护士职业认同评定量表的研制[J]. 解放军护理杂志,2011,28(3):18-20.DOI:10.3969/j.issn.1008-9993.2011.03.006.
[11] 冯文艳,聂臣聪. 以互联网为基础的延续性护理在乳腺癌术后患者中的应用效果[J]. 河北医药,2022,44(5):798-800.DOI:10.3969/j.issn.1002-7386.2022.05.040.
[12] 张怡,付阿丹,王莉,等. 以延续护理服务中心为主导的居家老年患者"互联网+护理服务"模式的构建与实施[J]. 中国实用护理杂志,2023,39(3):182-188.DOI:10.3760/cma.j.cn211501-20220402-00993.
[13] Yao J, He W, Chen H, et al. Nursing effect of continuous nursing intervention based on "internet plus" on patients with severe adrenal tumor[J].Medicine (Baltimore),2023,102(10):e33187.DOI:10.1097/MD.0000000000033187.
[14] Peng Y, Wan H, Hu X, et al. Internet+continuous nursing mode in home nursing of patients with T-tube after hepatolithiasis surgery[J].Comput Math Methods Med,2022,2022:9490483.DOI:10.1155/2022/9490483.
[15] 王琳,黄瑞英,陈志丽. 三级医院老年慢性病延续性管理系统的开发及应用[J]. 全科护理,2022,20(34):4840-4842.DOI:10.12104/j.issn.1674-4748.2022.34.020.
[16] 余文霞,唐青,李海艳,等. 以三级综合性医院为主导的护联体内"互联网+护理服务"模式构建与实施[J]. 中国临床研究,2020,33(12):1740-1744.DOI:10.13429/j.cnki.cjcr.2020.12.038.
[17] 蒋芙蓉,房志兰,黎红梅. 三级综合医院"互联网+护理服务"模式的构建与应用[J]. 重庆医学,2023,52(10):1593-1597.DOI:10.3969/j.issn.1671-8348.2023.10.031.
[18] 陈海婷,岳利群,陈汝文,等. 以专科服务小组为主导的"互联网+护理服务"模式构建与实践[J]. 护理学报,2020,27(4):7-10.DOI:10.16460/j.issn1008-9969.2020.04.007.
[19] 涂文菲,甘甜,章花,等. "互联网+"居家医疗服务平台应用效果分析[J]. 护理学杂志,2022,37(21):82-85.DOI:10.3870/j.issn.1001-4152.2022.21.082.
[20] Shi W, Cheng L, Li Y. Influence of "hospital-community-family" integrated management on blood pressure, quality of life, anxiety and depression in hypertensive patients[J].Comput Math Methods Med,2022,2022:1962475.DOI:10.1155/2022/1962475.
[21] 孙丽霞,杨兴菊,段红伟,等. 以三级综合医院为主导的"互联网+护理服务"三级联动模式的构建与实施[J]. 齐鲁护理杂志,2021,27(23):177-179.DOI:10.3969/j.issn.1006-7256. 2021.23.067.
[22] 高婷婷,武利萍,李慧. 延续性护理对恶性梗阻性黄疸患者术后恢复、不良情绪和并发症的影响[J]. 国际医药卫生导报,2022,28(6):777-780.DOI:10.3760/cma.j.issn.1007-1245.2022.06.011.
[23] 陈海婷,岳利群,陈汝文,等. 以专科服务小组为主导的"互联网+护理服务"模式构建与实践[J]. 护理学报,2020,27(4):7-10.DOI:10.16460/j.issn1008-9969.2020.04.007.
[24] 黄阿美,孟英涛,王兴莉,等. 基于"互联网+"信息化医护平台造口患者延续性护理服务模式的构建及应用[J]. 护理管理杂志,2023,23(5):350-354.DOI:10.3969/j.issn.1671- 315x. 2023.05.007.
[25] 王巧娜,黄秋环,陆柳雪,等. "互联网+护理服务"在SuperPATH全髋关节置换术后患者延续性护理中的应用效果[J]. 中国医药导报,2024,21(1):168-171.DOI:10.20047/j.issn1673-7210.2024.01.36.
[26] 盛芝仁,柳春波,郭晓莉,等. "互联网+护理服务"老年慢性病智能随访系统的构建及应用[J]. 中国护理管理,2023,23(2):166-170.DOI:10.3969/j.issn.1672-1756.2023.02.002.
[27] 杨敏,孙跃明,姚翠. 基于"互联网+"平台的医院-家庭一体化延续性护理在结肠造口患者中的应用效果[J]. 实用临床医药杂志,2022,26(23):46-49.DOI:10.7619/jcmp.20222326.

以三级医院为主导互联网为核心的居家延续护理服务模式构建

Construction of a home extended care service mode leaded by tertiary hospitals and with internet as the core

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 6

编辑推荐

Metrics

[1]	李佩君陈翠萍林禧卓姝妤李晓芳彭敏. 互联网+护理服务在老年居家髋关节置换术后患者中的应用 [J]. 国际医药卫生导报, 2023, 29(23): 3492-3496.
[2]	方耿娜卢丽冰谢梦娜谢漫黄琼珊林楚东王育胜林芳. 颈部牵伸训练在颈动脉内膜切除术后患者居家康复中的应用 [J]. 国际医药卫生导报, 2023, 29(19): 2819-2823.
[3]	孔敏靳欣赵琴. 微信群为基础的短视频远程干预联合IMB模型在肝硬化患者居家护理效果指导 [J]. 国际医药卫生导报, 2023, 29(18): 2649-2654.
[4]	黄欢欢吕林华陈碧娇吴钟凯彭芬芬杨鹤. 可穿戴移动医疗设备在心脏术后患者居家运动中使用意愿的影响因素分析 [J]. 国际医药卫生导报, 2023, 29(1): 128-.
[5]	魏晓燕. 居家延续护理模式在门诊患者使用留置针中的应用体会[J]. 国际医药卫生导报, 2022, 28(24): 3568-.
[6]	吴冬玲, 刘婉明, 蔡银燕, 刘琳. 基于授权理论的健康教育路径在经皮肝Ⅰ期胆道造瘘取石术后带管出院患者中的应用[J]. 国际医药卫生导报, 2022, 28(2): 266-269.