中国全科医学2017，Vol.20Issue(22)：2703-2709,7.DOI:10.3969/j.issn.1007-9572.2017.22.005
家庭医生制度下居家护理员的IMPACT管理模式及其实践效果评价
IMPACT Management Model Based on Family Doctor System for Nursing Assistants Delivering Home-based Care and Its Application Effect
摘要
Abstract
Objective To explore the IMPACT management model based on family doctor system for nursing assistants delivering home-based care and its application effect.Methods This study was conducted between January 2014 and December 2015.We developed the IMPACT management model(building the management team-defining the management objects-implementing the IMPACT training) for nursing assistants delivering home-based care in China on the basis of referring the family doctor system,in-depth discussions of nursing education specialists from universities,hospital-based or community-based nursing specialists and general practitioners,advanced training models of enterprises in accordance with the current characteristics of home-based care and the social needs.After that,by using quota sampling,we enrolled 200 nursing assistants delivering home-based care from 20 village neighborhood committees of Datuan Community,Pudong New Area,Shanghai based on the rule of selecting 10 from each village neighborhood committee.Then the model was applied to the integrated management of the nursing assistants by means of hospital-based care teaching-community-based speaking tour on care-guidance for home-based care.The nursing assistants and elderly patients receiving home-based care were followed up.The self-assessed common knowledge of care for elderly patients and results of examination of professional care knowledge and skills of the nursing assistants,and self-assessed quality of life of the elderly care receivers before and after the training for the nursing assistants were compared.Results The scores of daily care,safety-related care,mental care,illness-related care,rehabilitation care and hospice care and the total scores self-assessed by the nursing assistants before the IMPACT training,at 3,6 and 12 months after training were all significantly different(P<0.05).Significant differences were found in the scores of healthcare knowledge,safety-related knowledge,illness-related knowledge,and care knowledge and the total scores of professional knowledge of care of the nursing assistants examined before the training,at 3,6 and 12 months after the training (P<0.05).The qualified rate of the nursing assistants in the skills of care examined before the training,3,6 and 12 months after training was respectively 17.5%(32/183),98.4%(180/183),97.3%(178/183),97.3%(178/183)with obvious difference between them (X2=507.195,P<0.001).The self-assessed scores in the items of the domains of physical health,psychological health,social relationships and environmental health by the elderly care receivers at 6 months after the training for nursing assistants were all substantially higher than those assessed before the training(P<0.05).Conclusion IMPACT management model based on family doctor system for nursing assistants delivering home-based care can effectively improve their common care knowledge,professional care knowledge and skills for elderly patients,as well as advance the quality of life of the elderly.关键词
家庭医生制度/居家护理员/社区卫生服务/IMPACT管理模式/培训Key words
Family doctor system/Nursing assistant delivering home-based care/Community health services/IMPACT management model/Training分类
医药卫生引用本文复制引用
方水芹,侯进,陆新建,陈美,张景慧,张小梅,张春华..家庭医生制度下居家护理员的IMPACT管理模式及其实践效果评价[J].中国全科医学,2017,20(22):2703-2709,7.基金项目
2013年上海市浦东新区科技发展基金创新资金卫生项目(PKJ2013-Y55) （PKJ2013-Y55）
