棋牌大全下载安装

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                              • 当前位置: 代写一篇论文多少钱 > 医学论文 > 影响新护士转型冲击的因素与应对策略

                                影响新护士转型冲击的因素与应对策略

                                时间:2018-12-10 10:12作者:喻雅真 王冬华
                                本文导读:这是一篇关于影响新护士转型冲击的因素与应对策略的文章,目前,护士短缺是一个全球性问题。护理专业在维持和发展技能型劳动力方面面临着重大挑战,难以满足医疗保健快速增长的需求。人口健康趋势需求以及新护士留职率较低导致护理人员短缺。

                                  摘    要: 从新护士转型冲击的概念、评估工具、影响因素、干预措施等方面进行综述,提示应对新护士转型冲击进行大范围深层次评估,准确了解其现状及影响因素,针对主要影响因素进行干预,为缓解新护士转型冲击提供参考。

                                  关键词:棋牌大全下载安装 新护士; 转型冲击; 概念; 评估工具; 影响因素; 干预措施; 综述;

                                  MUQIAN,HUSHIDUANQUESHIYIGEQUANQIUXINGWENTI。HULIZHUANYEZAIWEICHIHEFAZHANJINENGXINGLAODONGLIFANGMIANMIANLINZHEZHONGDATIAOZHAN,NANYIMANZUYILIAOBAOJIANKUAISUZENGZHANGDEXUQIU。RENKOUJIANKANGQUSHIXUQIUYIJIXINHUSHILIUZHILVJIAODIDAOZHIHULIRENYUANDUANQUE[1]。XINHUSHI(ZHIBIYEHOUGONGZUO1NIANYINEIDEHUSHI)JINRULINCHUANGHULIGONGZUOGANGWEI,MIANDUISHEHUIJIAOSEZHUANBIAN,WANGWANGBUZHISUOCUO,KENENGHUIZAISHENGHUO、GONGZUONAIZHIRENJIJIAOWANGDENGFANGMIANCHUXIANZHUDUOBUSHI,QIEBUJUYOUHEGEHUSHIYINGYOUDEZHISHIYUJINENG,ZAIHULIGONGZUOZHONGHUIYUDAOXUDUOKUNNANHEYALI,SHENZHICHUXIANZHUANXINGCHONGJI[2]。ZHUANXINGCHONGJIBUJINDAOZHIXINHUSHICHANSHENGJIAOGAOSHUIPINGDELIZHIYIYUAN,ERQIEJIQIDAILAIJUDADEYALI,WANGWANGHUIZAOCHENGXINHUSHIXINLIZHANGAIHUOXINGWEIGAIBIAN,ZUIZHONGDAOZHIHULIFUWUZHILIANGXIAJIANG,QIEYANZHONGYINGXIANGXINHUSHIDECHENGZHANG[3]。XIANDUIXINHUSHIZHUANXINGCHONGJIDEGAINIAN、PINGGUGONGJU、YINGXIANGYINSUHEGANYUCUOSHIJINXINGZONGSHU,YIQIWEIHUANJIEXINHUSHIZHUANXINGCHONGJITIGONGCANKAO。

                                  1、 新护士转型冲击概述

                                  XINHUSHISHIYIGETEBIECUIRUODEQUNTI,GONGZUOZUICHULIANGNIANLIUZHILVHENDI,GUIYINYUXINHUSHIGANGJINRULINCHUANGMIANLINDEGAODUYALIHEJUANDAI[4]。Kramer[5]RENSHIDAOXINHUSHIDEQIWANGYUSHIJIANDECHAJUDAOZHIJIAOSECHONGTUHEYALI,TICHU“XIANSHICHONGJI”DEGAINIAN。CONGHUSHENGDAOHUSHIDEZHUANBIANSHIYIDUANBUWENDINGDESHIQI,RUOQIBUNENGJISHISHIYINGHUSHIZHEIYIJIAOSE,ZHUANXINGSHIHUIDAILAIBUKEBIMIANDEXIANSHICHONGJI[6]。ZHUANXINGCHONGJISHIZHIGETIYOUYIZHIJIAOSEZHUANXINGWEIMOSHENGJIAOSESHI,SHOUJIAOSE、GUANXI、ZHISHIJIZERENDEYINGXIANGERCHANSHENGDEYIZHONGMIMANG、KUNHUO、HUAIYIJIDINGWEIBUMINGDEGANSHOUHETIYAN[2]。DuchscherDENG[7,8]JIANGXINHUSHIRUZHIZUICHU1NIANNEIDEGUODUMIAOSHUWEIYIGE“CHENGZHANG”DEGUOCHENG,FENJINXING、CUNZAIHELEJIE3GEJIEDUAN,XINHUSHIZAICIGUOCHENGZHONGBUDUANXUEXI、FAZHAN。SUIRANZHEIYIGUOCHENGBUSHIJUEDUIXIANXINGDE、GUIFANDE,YEBUZONGSHIJINBUDE,DANTASHIBUDUANJINHUADE,CHENGZHANGDE、CONGBUSHUXIDEJINZHANGJIAOLVQIJINRUDULIWANCHENGDEMANZUSHUSHIQI,DUIYUXINHUSHIERYANZUIZHONGSHIBIANGEXINGDEGAIZAO。PhillipsDENG[9]FAXIAN,JINRULINCHUANGDEXINHUSHIRENWEIQISUOZHANGWODEJINENGBUNENGYOUXIAOJIEJUEBINGRENDEJIBINGWENTI,WEICIGANDAOYALIBEIZENG。HULIGUANLIZHE、HULIJIAOYUZHEJIXUTANSUOXIANSHIERYOUXIAODEHUANJIEXINHUSHIZHUANXINGCHONGJIDEGANYUFANGFA,ZAIYIYUAN、XUEXIAODEGONGTONGCANYUXIA,JIANQINGXINHUSHIDEZHUANXINGCHONGJI。

                                  2、 新护士转型冲击的评估工具

                                  2015年薛友儒等[10]基于Duchscher[2]提出的转型冲击理论为概念框架编制的新护士转型冲击评价量表为自评量表,广泛用于国内新入职护士转型冲击研究[11,12],具有良好的信效度。该量表包括心理方面、社会文化与发展方面、技能方面、身体方面4个维度,共27个条目,采用Likert 5级计分法,从“完全不符合”到“完全符合”依次计1~5分,得分越高表示新护士转型冲击程度越高。量表Cronbach'sα系数为0.918,内容效度指数(CVI)为0.906。该量表条目数量适中,可以全面地反映新护士转型冲击的体验、感受和变化,可作为测评新护士转型冲击程度的工具,能够为护理管理者及教育者实施针对性的干预措施提供依据;2017年Kim等[13]基于Duchscher[2]提出的转型冲击理论为概念框架编制的量表也是自评量表,具有良好的信效度。该量表包括理论与实践之间的冲突、压倒性的工作量、损失的社会支持、萎缩的同事关系、混淆的专业护理价值观、不协调的工作及个人生活6个维度,共18个条目,采用Likert 4级计分法,从“非常不同意”到“非常同意”依次计1~4分,得分越高表示新护士转型冲击程度越高。量表Cronbach'sα系数为0.89,该量表条目数量较少,能够衡量新护士的转型冲击程度,将成为未来新护士广泛使用的转型冲击测评工具,为缓解新护士转型冲击干预发展奠定基础。
                                 

                                影响新护士转型冲击的因素与应对策略
                                 

                                  3、 新护士转型冲击的影响因素

                                  3.1、 个体因素

                                  3.1.1、 社会人口学特征

                                  YANJIUBIAOMING,HULISHIYIXIANGGAOFENGXIAN、GAOQIANGDUGONGZUO[14]。NANXINGYIBANSHENTIJIANZHUANG、JINGLICHONGPEI,NENGHENHAODISHIYINGGAOQIANGDUDEHULIGONGZUO,ERNVXINGYOUYUSHENTIYUANYINMIANDUIGAOQIANGDUDEGONGZUOYOUSHIHUILIBUCONGXIN,DUOFANGYINSUDEZUOYONGYINGXIANGLENVXINGHUSHIDESHENGLI、XINLI,DAOZHIQIZAIZHUANXINGCHONGJIZHONGCHENGSHOUJIAODADEYALI。LIUJIEDENG[11]YANJIUBIAOMING,XINHUSHIZHONGNVXINGZAIZHUANXINGCHONGJIZHONGCHENGSHOUDAODEYALIDAYUNANXING。NANXINGZAITILI、JINGLI、LUOJISIWEI、YINGJINENGLIDENGFANGMIANJIAONVXINGYOUGENGQIANGDEYOUSHI[15]。GUONEIYANJIUBIAOMING,LIZHIXINHUSHIZHONG,86%YISHANGDEHUSHIRENWEISHOURUGUODI,WUFAMANZUGERENXUQIU[16,17]。LIUJIEDENG[11]YANJIUBIAOMING,GERENYUESHOURUDUIXINHUSHIZHUANXINGCHONGJIYOUYINGXIANG,XINHUSHIDEFULIDAIYUHEXINCHOUYUEGAO,ZHUANXINGCHONGJICHENGDUYUEXIAO;FEIDUSHENGZINV、JIAZAIWAIDIDEXINHUSHIZHUANXINGCHONGJICHENGDUGAOYUDUSHENGZINVJIJIAZAIBENDIZHE。KEJIAN,XINGBIE、GERENYUESHOURU、DUSHENGZINVJIJIATINGSUOZAIDIYINGXIANGXINHUSHIDEZHUANXINGCHONGJI。YINCI,HULIGUANLIZHEYINGZHONGSHINVXING、XINHUSHIDEXUQIU,JIYUQICHONGFENDELIJIEHEZHICHI,BANGZHUQISHIYINGXINDEGONGZUOHUANJINGHESHENGHUOHUANJING,ZHUYIGAISHANXINHUSHIDEFULIDAIYUHEXINCHOU,ZENGQIANGQIZIXINXIN,CONGERTIGAOTAMENDEGONGZUOJIJIXING,BANGZHUXINHUSHIJINKUAISHIYINGXINDEGONGZUOHUANJINGBINGSHUNLIZHUANXING。

                                  3.1.2、 工作时间

                                棋牌大全下载安装   GONGZUOSHIJIANSHIXINHUSHIZHUANXINGCHONGJIDEZHUYAOYINGXIANGYINSU,XINHUSHIGONGZUOSHIJIANYUEDUAN,ZHUANXINGCHONGJICHENGDUYUEGAO[11]。XUEYOURUDENG[18]YANJIUBIAOMING,SUIZHESHIJIANDEYANZHANG,XINHUSHIDEZHISHI、JINENG、YUELI、HUANJING、XINLIDIAOSHINENGLIJUNYOUSUOZENGJIA,ZHUJIANSHIYINGLINCHUANGHULIGONGZUO,ZHUANXINGCHONGJISHUIPINGYEJIANGBUDUANJIANGDI。KEJIAN,SUIZHEGONGZUOSHIJIANDEZENGJIA,HUSHIDEGONGZUOJINGYANHEZHISHICHUBEIGENGFENGFU,DUIZIJIDEGONGZUOXIANGYOUGENGDUODEJUECEQUAN,DULIFENXIWENTIHEJIEJUEWENTIDENENGLIZENGQIANG。YINCI,HULIGUANLIZHEYINGTEBIEGUANZHURUZHISHIJIANJIAODUANDEXINHUSHI,YINCAISHIJIAO,GAIZHENGQUEDIAN,MIBUBORUOHUANJIE,PEIYANGDULIFENXIWENTIHEJIEJUEWENTIDENENGLI。

                                  3.1.3、 心理韧性

                                  XINLIRENXING,ZHINEIZAIDELILIANG、LEGUANYIJIMIANLINNIJINGSHIYOUXIAOYINGDUIDENENGLI,BAOHANJIANRENXING、LILIANGXING、LEGUANXING3GEBUFEN,ZAIYIDINGCHENGDUSHANGFANYINGQIMIANDUIYALISHISUOBIAOXIANCHUDEWANQIANGCHIJIU、JIANRENBUBAYIJIYINGBIANNENGLI[19],SHIHUSHIZAIXUNZHAOQIZHIYEYIYIHEDIAOJIEYALIYINGDUIXINGWEISUOXUDEZHONGYAOJINENG[20,21]。CHENMINGDENG[12]YANJIUBIAOMING,XINHUSHIDEXINLIZIBENRENXINGSHUIPINGYUEDI,ZHUANXINGCHONGJICHENGDUYUEYANZHONG。ZHANGJUNJIEDENG[22]RENWEIXINHUSHIZISHENMIANDUIWEIXIEHEYALISUOJUYOUDEWANQIANGCHIJIU、JIANRENBUBADETEXINGYIJIYINGDUIYALI、CUOZHEDENGXIAOJISHENGHUOSHIJIANDENENGLIHUOTEZHIYUERUO,SHOUDAODEZHUANXINGCHONGJITIYANCHENGDUYUEZHONG,YUEBULIYUQISHIYINGDANGQIANDEHUSHIJIAOSE。LIJIANDENG[23]YANJIUBIAOMING,XINHUSHIZAIMIANLINXINLIKUNRAOSHI,KEYITONGGUODUOZHONGTUJINGTIGAOGETIMIANDUIYALIQINGXINGDEZIWOGUANLINENGLIHESHIYINGNENGLI,JITIGAOQIXINLIDANXING,JINYIBUBANGZHUGETIZAIMIANDUIYALIDEQINGXINGXIA,CAIQUJIJIDEYINGDUICUOSHIHEBAOCHILIANGHAODESHIYINGZHUANGTAI,ZUIZHONGJIANGDIQIZHUANXINGCHONGJICHENGDU。KEJIAN,XINLIRENXINGJIAOHAODEXINHUSHIMIANDUIGAOFENGXIAN、GAOYALIDEHULIGONGZUO,DUOBIAOXIANWEIXINTAIDUANZHENG,JIJIYINGDUI,KEFUNIJING,CONGERSHIQISHENTI、XINLIDENGFANGMIANDECHONGJIJIANGDI。YINCI,HULIGUANLIZHEQUANFANGWEIGUANZHUXINHUSHIXINLI、ZHUANYEZHISHIYUJINENGFANGMIANDEZHENSHITIYAN,JISHIJINXINGXINLISHUDAO,NENGGOUZUIDAXIANDUDIJIANGDIXINHUSHIDEZHUANXINGCHONGJITIYANGAN。

                                  3.1.4、 生涯适应力

                                棋牌大全下载安装   SHENGYASHIYINGLISHIGETIYINSHENGYAJIAOSEFASHENGBIANHUAERYUZHIBAOCHIPINGHENGDENENGLI[24],TASHIGETIHUODEZHIYESHENGYACHENGGONGDEGUANJIANNENGLI。TIANJING[25]YANJIUBIAOMING,ZHICHANGXINRENYINGDUISHENGYAKUNJINGDEGUANJIANDIANZAIYUSHENGYASHIYINGLIDEPEIYANG。LUOLANDENG[26]YANJIUBIAOMING,XINHUSHISHENGYASHIYINGLISHUIPINGYUEHAO,FUMIANQINGXUJIUHUIYUESHAO,SHOUDAODEZHUANXINGCHONGJIXIANGYINGJIANXIAO,YUENENGJINKUAISHENGRENDANGQIANDELINCHUANGGONGZUOGANGWEI,JIANLIQISHENGYAXINXIN,GENGYIQUDEZHIYESHENGYADECHENGGONG。KEJIAN,SHENGYASHIYINGLIQIANGDEXINHUSHINENGGOUTONGGUOZISHENDEDIAOZHENGLAIYINGDUIBUDUANBIANHUADEZHIYEHUANJINGHEGONGZUOXUYAO,JINERTIGAODUIHUSHIJIAOSEDESHIYINGNENGLI,TIGAOZISHENYINGDUISHENGYAKUNJINGDEXIANGYINGZHUNBEICHENGDU,LINGHUOCHULIGONGZUOZHONGCHUXIANDEWENTI,SHIXIANZIWOZHANGYUANDEZHIYESHENGYAFAZHAN。YINCI,YIYUANGUANLIZHEYINGDANGZAIXINHUSHIGUIFANHUAPEIXUNJIGUANLIGUOCHENGZHONG,ZHUZHONGTISHENGXINHUSHIDESHENGYASHIYINGLI,CUSHIQISHUNLIWANCHENGJIAOSEZHUANBIAN,WENDINGYIYUANHULIDUIWU,TIGAOHULIZHILIANG,WEIYIYUANDEFAZHANDIANDINGJIANSHIDERENCAICHUBEIJICHU。

                                  3.1.5、 角色适应

                                棋牌大全下载安装   Lisa[27]YANJIUBIAOMING,XINHUSHIDUIQILINCHUANGJIAOSEZHUNBEIBUGOUCHONGFEN,ZAISHIYINGZHUANYEHULIJIAOSESHI,WANGWANGHUIJINGLIYIDUANSHIJIANDEJIAOLVHEYALI,QIENANYISHIYINGQIJIAOSEJIKEFUZHUANXINGDAILAIDECHONGJI,RONGYIDAOZHILIZHI。ZHONGXINE[28]RENWEI,XINHUSHIYINJIAOSESHIYINGDAILAIDECHONGJIHUISUIZHELINCHUANGSHIJIANJINGYANDEFENGFUERJIANSHAO。Grant[29]RENWEIXINHUSHIJIJIRENZHI、SHIYINGQIJIAOSE,YOULIYUXINHUSHISHUNLIRONGRUXINDELINCHUANGGONGZUOHUANJING。JirovskyDENG[30]YANJIUBIAOMING,XINHUSHIZAIZHUANXINGQIXUANZEJIJIYINGDUIDEFANGSHI,RUJIJIYURENTANXIN、XUNQIUTARENJIANYI、KEZHIZIJIBULIANGQINGXUNENGGOUYOUXIAOJIEJUEWENTI,JIANQINGZHUANXINGCHONGJIYALI。KEJIAN,XINHUSHIBUDUANZENGJIAGONGZUOJIAZHI,JISHISHIYINGHUSHIJIAOSE,TIGAOGONGZUOMANYIDU,YOULIYUJIANQINGZHUANXINGCHONGJICHENGDU[31]。HULIGUANLIZHEYINGGAIJINZUIDANULIWEIXINHUSHIZHENGQUXUEXI、DUANLIANDEJIHUI,CAIYONGKEXUEDEGUANLIFANGSHI,BANGZHUXINHUSHIJINKUAIZHUANHUANJIAOSE,SHIYINGLINCHUANGGONGZUO,JINERTIGAOLINCHUANGHULIFUWUZHILIANG[32]。

                                  3.2、 社会因素

                                  3.2.1、护理工作环境

                                棋牌大全下载安装   HULIGONGZUOHUANJINGBAOKUOHUSHIZIZHUXING、YIHUGOUTONG、LINGDAOGUANLIFANGSHI、SHIJIANHUODONGDENGNEIRONG。KramerDENG[33]YANJIUBIAOMING,HULIGONGZUOHUANJINGYUXINHUSHIZHUANXINGCHONGJICHENGFUXIANGGUAN,XINHUSHIDUIDANWEIGONGZUOHUANJINGYOUJIGAODEQIWANG,TONGSHIXIWANGDUIBINGRENNENGGOUTIGONGGAOZHILIANGDEHULI,XINHUSHIRUODUIHULIGONGZUOHUANJINGBUMANYIHUIDAOZHIZHUANXINGCHONGJIQIANGDUZENGJIA。Lacovara[34]RENWEI,XINHUSHIZAIBUSHUXIDELINCHUANGHULIHUANJINGZHONG,HULIBINGRENDEYINGBIANNENGLIJIAOCHA。WEILIJUNDENG[35]YANJIUBIAOMING,XINHUSHIDUIGONGZUOKESHIDEXIHUANCHENGDUYUEDI,QIGONGZUOYALIYUEDA,MANYIDUYUEDI,SUOYIQIZHUANXINGCHONGJICHENGDUYUEGAO。KEJIAN,LINCHUANGGONGZUOHUANJINGJINJIZHUANGKUANGDUO、BINGRENBEIJINGFUZA,XUSUISHIZHUNBEIYINGDUIGEZHONGTUFAZHUANGKUANG,GONGZUOFUHEZHONG,ZHEIXIEGONGZUOTEDIANYINGXIANGZHEXINHUSHIDEZHUANXINGCHONGJI。YINCI,HULIGUANLIZHEXUYAOCHUANGZAOJIJIDEHULIGONGZUOHUANJING,WEIXINHUSHITIGONGSHUNLIZHUANXINGDEJIHUI。

                                  3.2.2、 社会支持

                                  GUOWAIYANJIUBIAOMING,XINHUSHIZAIZHUANXINGQIPUBIANMIANLINZHICHIQUEFA、ZHIZECHAOCHUZISHENNENGLIDENGWENTI,CONGERZHIYUEQICHENGWEIYIMINGHEGEDEZHUCEHUSHI[36]。DarvillDENG[37]RENWEI,LIANGHAODEZHENGSHIZHICHIKEYIHUANJIEZHUANXINGGUODUQIDECHONGJILI,TIGAOYINGDUIGONGZUOXUQIUHEJIANQINGYALIDENENGLI,YOULIYUJIANQINGXINHUSHIZHUANXINGCHONGJICHENGDU。CHENGGONGDEZHUANXINGYUZUZHIZHICHIMIQIEXIANGGUAN[38]。MellorDENG[39]RENWEI,LINCHUANGJINGYANFENGFUDEHUSHIDEFEIZHENGSHIZHICHISHIXINHUSHIZHUANXINGGUOCHENGZHONGDEZHONGYAOYINGXIANGYINSU,YOUZHUYUPEIYANGXINHUSHIDEHULIZIXINXINYIJIDUIXINHUANJINGDESHIYINGNENGLI,BINGTIGAOXINHUSHIDEJIAOSERENZHI,FAZHANQILINCHUANGHULICAOZUOJINENG。ReganDENG[40]RENWEI,XINHUSHIZHUANXINGQIXUYAOGEFANGMIANDEZHICHIHEBANGZHU,ERDAIJIAOLAOSHIDEZHICHIHEKESHIDETUANJIEDENGSHEHUIZHICHICENGMIANYINSUSHICUJINXINHUSHILIANGHAOZHUANXINGDEHEXINYINSU。YUMINGFENGDENG[32]YANJIUBIAOMING,XINHUSHIZHUANXINGQIJIANHUOQUDESHEHUIZHICHIYUESHAO,ZHUANXINGCHONGJIQIANGDUYUEDA,QIEZHUGUANZHICHIYUZHUANXINGCHONGJIGUANXIMIQIE。KEJIAN,LIANGHAODESHEHUIZHICHIYOUZHUYUTISHENGXINHUSHIDEZHUANYEZHISHISHUIPINGJIZIXINXIN,TIGAOHUANJINGSHIYINGNENGLIHEXINLICHENGSHOUNENGLI,JIANQINGXINHUSHIZHUANXINGCHONGJI。YINCI,YIYUANGUANLIZHEJISHEHUIYINGWEIXINHUSHITIGONGZHUANYEZHICHIHEXINLIZHIDAO,YIJIANGDIXINHUSHIZHUANXINGCHONGJISHUIPING,CUJINXINHUSHISHUNLIWANCHENGZHUANXING。

                                  3.2.3、 临床实习

                                  LINCHUANGSHIXISHIHUSHENGCONGXUEXIAOJIAOYUTARULINCHUANGDEYIGEGUODUJIEDUAN,SHIJILEILINCHUANGSHIJIANJINGYANHEZHISHIBIBUKESHAODEJIEDUAN,YOULIYUXINHUSHIJIANQINGRUZHIHOUZHUANXINGCHONGJIQIANGDU,CONGERSHUNLIWANCHENGZHUANXING[41]。WareingDENG[42]YANJIUBIAOMING,MUQIANDEHULIJIAOYUMOSHIDAOZHIXINHUSHIRUZHIQIANSHIXISHIJIANJIANSHAO,YINGXIANGQIDUILINCHUANGSHIJIANDEZHUNBEI,CONGERJIAJULEXIANSHICHONGJI。Kramer[5]RENWEI,XINHUSHIZAIXUEXIAOSUOJIESHOUDEJIAZHIGUANHEZAILINCHUANGSHIXIZHONGZUOWEIYIMINGZHUANYEHUSHIDEXIANSHIZHIJIANYOUJUDACHONGTU。XINHUSHIRUZHIZAIZHUANXINGQIJINGLIDEXIANSHICHONGJI,ZHUYAOSHIYOUYULILUNYUSHIJIANSHANGCHAJUGUODA,FAXIANZIJISHIJICAOZUOJINGYANYOUXIAN,YURUZHIQIANLINCHUANGSHIXIJINGYANYOUGUAN[43]。KEJIAN,XINHUSHIZAIRUZHIQIANDELINCHUANGSHIXIQISUOXUEXI、LEIJIDEJINGYANYUZHUANXINGQINEIMIANLINDECHONGJIQIANGDUYOUGUAN。YINCI,DUIYUXINRUZHIHUSHIERYAN,RUZHIQIAN10GEYUEDELINCHUANGSHIXIJINGYANYOUWEIZHONGYAO。

                                  4、 护士转型冲击的干预措施

                                  4.1、 威廉姆斯生活技能训练、感知器训练计划

                                棋牌大全下载安装   MUQIANZHUYAOGANYUCUOSHIYOUWEILIANMUSISHENGHUOJINENGXUNLIAN(Williams life skills training,WLST)JIGANZHIQIXUNLIANJIHUA。WLSTSHIYOUMEIGUODUKEDAXUEJINGSHENYIXUEHEXINLIXUEJIAOSHOUWilliamsBOSHIZAIZUICHUDESHENGHUOJINENGXUNLIANJICHUSHANGSUOZUODEZHONGDACHUANGXINHETUPO,QIZONGZHIJIUSHISHICANJIAXUNLIANDEGETIXUEHUICAIQUYOUXIAOFANGSHILAIYINGDUISUOMIANLINDEYALI,CONGERCUJINLIANGHAODEQUTIHEJINGSHENJIANKANGZHUANGTAI[44]。SHENGHUOJINENGSHIZHIYIGERENZAITASUOCHUDESHEHUIHUANJINGZHONG,ZAIYUTARENJIAOWANGGUOCHENGZHONGBAOCHILIANGHAODEJINGSHENZHUANGTAI,NENGGOUYOUXIAOYINGDUIRICHANGSHENGHUODUOZHONGXUQIUHETIAOZHANDEYIZHONGNENGLI。LIYANDENG[45]YANJIUBIAOMING,XINHUSHIGANDAOYOUYALISHI,JIYUXINLIZHICHIHESHENGHUOFUDAO,KEYIMANZUQIXINLI、SHENGHUODENGFANGMIANXUQIU,RUBINGQUMEIYUEZUZHIXINHUSHIZUOTANHUI,LEJIEQIGONGZUOHESHENGHUOQINGKUANG,BINGJISHIJIYUBANGZHUHEJIEJUE,YOULIYUJIANQINGXINHUSHIZHUANXINGCHONGJICHENGDU。ClipperDENG[46]YANJIUBIAOMING,ZAIGANZHIQIXUNLIANJIHUAZHONG,SHIYONGGANZHIQIZUOWEIYIZHONGYOUXIAODEFANGFALAIZHICHIXINHUSHIDUGUOZHEIGEJIANNANDEZHUANXINGSHIQI,JIANQINGZHUANXINGCHONGJICHENGDU。KEJIAN,SHOUGUOLIANGHAOXUNLIANDEXINHUSHIDUITAMENTIGONGANQUAN、ZUIYOUHULIDENENGLIYOUGENGGAODE、GENGJIJIDERENZHI,YOUZHUYUTIGAOXINHUSHILIUZHILV。

                                  4.2、 支持性干预

                                  FitzpatrickDENG[47]YANJIUBIAOMING,JIXUJIAOYUSHIJIANQINGXINHUSHIZHUANXINGCHONGJIZHONGYAODEZHICHIXINGCUOSHI,LINCHUANGDAIJIAOLAOSHIDEZHIDAOKECUJINXINHUSHISHUNLIZHUANBIANWEILINCHUANGHUSHIJIAOSE。GUOWAIYANJIUBIAOMING,HULIGUANLIZHE、JIAOYUZHEYINGZAIXINHUSHIZHUANXINGQIJIYUTAMENYIDINGDEZHICHIBINGMANZUQIGONGZUOXUQIU,JIANQINGXINHUSHIDEZHUANXINGCHONGJICHENGDU,TIGAOXINHUSHILIUZHILV[48]。XINHUSHIBUJINQUEFABIYAODEZHISHIHEJINENGLAISHIYINGHUSHIZHEIYIXINJIAOSE,ERQIEHAIQUEFAZIXINXIN,ZHEISHIFANGAIQIFAZHANZHUANYESHIJIANJINENGDEZHUYAOYINSU[31]。HULIGUANLIZHEKEWEIXINHUSHIJIQIDAIJIAOLAOSHITIGONGLIANGSHENDINGZHIDEDINGXIANGKECHENG,DUIZHIYUANZHIDAOXINHUSHIDEGAOJIHULIRENYUANJIYUJIANGLI[49]。HassonDENG[50]YANJIUBIAOMING,JIANSHAOHULIZHUANYEXUEXIAODEJIAOYUFANGANYULINCHUANGSHIJIANHUANJINGDECHAJU,ZHONGSHILINCHUANGSHIJIANJINENGDEPEIYANG,CUJINXINHUSHISHIYINGBUDUANFAZHANDELINCHUANGHUSHIJIAOSE。EllisDENG[51]YANJIUBIAOMING,XUEXIAOHEYIYUANYOUXIAOGUANLIHEJICHUSHESHIZHICHI、QUANMIANZHIDAO、JIXUJIAOYUYOULIYUXINHUSHICONGXUEXIAODAOYIYUANJIAOSESHIYINGDEPINGWENGUODU,JIANQINGZHUANXINGCHONGJICHENGDU,CUJINCHENGGONGZHUANXING。KEJIAN,ZHUANXINGQINEIJIXUJIAOYU、DAOSHIZHIDAODENGZHICHIXINGGANYUYOULIYUMANZUXINHUSHIGONGZUOXUQIU,JISHIHUANJIEYINJIAOSESHIYINGKUNNANDAILAIDEYALI,JIANQINGZHUANXINGCHONGJICHENGDU。

                                  4.3、 护理实践计划(nursing

                                  residency programs,NRP)DAXUEHULIJIAOYUWEIYUANHUIJIANGNRPDINGYIWEIYIXILIEJIAOYUKECHENGHELINCHUANGSHIJIAN,SHEJI1NIANYISHANGSHIJIANBANGZHUXINHUSHICONGLILUNXUEXIZHUANXIANGSHIJIANCAOZUOJIEDUAN[51]。MEIGUOHUSHIGUANLIZUZHI、YIXUEYANJIUSUODENGZUZHIJIANYIWEIXINHUSHISHISHINRP。WEILECUSHIXINHUSHIZHUANXINGCHENGGONG,HULIGUANLIZHEBIXUZAIMEIGEJIEDUANCAIQUZHENGQUEDECUOSHI,JIANLIJIEGOULIANGHAO,JIYULILUNDEZHUANXINGJIAYITIHUAJIEDUANHULISHIJIANJIHUA[52]。AbualrubDENG[53]RENWEI,YOUBIYAOZHIDINGYIXIANGGUOJIAZHENGCEYIGUIFANSHEJIHESHISHINRP。XINHUSHIDOURENWEINRPSHIYOUYIQIEKEXINGDE。EdwardsDENG[54,55]YANJIUBIAOMING,SHISHINRPKEYITIGAOHUSHILIUZHILVJIMANYIDU,JIANSHAOYALIHEJIAOLV,YOULIYUJIANQINGXINHUSHIZHUANXINGCHONGJICHENGDU。YANJIUBIAOMING,SUIZHELINCHUANGSHIJIANSHIJIAN、JINGYANDELEIJI,XINHUSHIDELINCHUANGSHIJIANNENGLIBUDUANZENGQIANG[31,56],ERTIGAOLINCHUANGSHIJIANJINENGBEIRENWEISHIJIANSHAOZHUANXINGCHONGJIBINGQUEBAOXINHUSHICONGZAIXIAOXUEXIDAOLINCHUANGSHIJIANPINGWENGUODUDEZUIJIATUJING。

                                  4.4 、预先干预

                                  DuchscherDENG[57,58]TONGGUODUOXIANGYANJIUFAXIAN,XINHUSHICHUXIANZHUANXINGCHONGJIDEZHUYAOYUANYINSHIZHUNBEIBUZU,BINGZHICHUDUIXINHUSHIJINXINGYUXIANGANYUKEYIYOUXIAOBIMIANZHUANXINGCHONGJI。BIYESHIXIQISHIHUSHENGZHIYETAIDUXINGCHENGHEZHANGWOJIBENZHISHI、JINENGDEZHUYAOSHIQI[59],SHIYUXIANGANYUDEZUIJIAJIEDUAN,DANSHOULINCHUANGSHIXIJIAOXUEZHONGDUOZHONGYINSUDEYINGXIANG,DANCHUNDELINCHUANGSHIXIBUNENGSHIHULISHIXISHENGZHANGWOHUSHIDESUOYOUGONGZUONEIRONG,QUEFADUIMOUXIELINCHUANGQINGJINGDERENSHIYUCHULINENGLI。YANJIUBIAOMING,ZAILINCHUANGSHIXIDEJICHUSHANGXUANZEQIADANGDEJIAOXUEFANGSHIJINXINGZHENDUIXINGGANYUDUIBIMIANZHUANXINGCHONGJIYOUWEIZHONGYAO[60]。QINGJINGMONIJIAOXUENENGGOUYOUZHENDUIXINGDISHEJIQINGJING,RANGXUEXIZHEBANYANQINGJINGJIAOSE、MONIQINGJINGGUOCHENG,SHIQIZAIGAODUFANGZHENDEQINGJINGZHONGHUODEZHISHIHETIGAONENGLI[61],GAIFANGSHIKEYIPEIYANGXUESHENGDUITESHULINCHUANGQINGJINGDERENSHIYUCHULINENGLI。

                                  5 、小结

                                  MUQIAN,CEPINGXINHUSHIZHUANXINGCHONGJIDELIANGBIAOJIAOSHAO,GETIJISHEHUIDEDUOZHONGYINSUYINGXIANGZHEXINHUSHIDEZHUANXINGCHONGJI。MUQIAN,GUONEIXUEZHEZHUYAOKAIZHANXINHUSHIZHUANXINGCHONGJIJIQIYINGXIANGYINSUDEXIANGGUANXINGYANJIU;YOUXIEXUEZHEJIEHEXINHUSHIZHUANXINGCHONGJIJIQIYINGXIANGYINSUTICHULEYIXIEGANYUCUOSHI,DANSHIZHEIXIECELVEJISHAOTONGGUOSHIZHENGYANJIUYANZHENGQIYOUXIAOXING;YOUXIEGANYUYEYIYINGYONGYUMOUXIEYIYUANHULIRENLIZIYUANYANJIU,BINGQUDELEYIDINGCHENGGUO,DANSHIZAIXIAOFANWEIRENQUNZHONGJINXING,QIYOUXIAOXINGYIJISHIFOUKETUIGUANGHAIYOUDAIJINYIBUYANJIUHEZHENGMING。YINCI,YINGQUANMIANPINGGUXINHUSHIZHUANXINGCHONGJIDEYINGXIANGYINSU,JIEHEGONGZUOHEHUANJINGQINGKUANG,JIAKUAIBINGDALIKAIZHANDUIXIANYOUGANYUCELVEDEXIAOGUOYANJIU,YIQIWEIGUOJIAWEISHENGZHUGUANJIGOUHEHULIGUANLIZHETIGONGZHONGYAOJUECEYIJU,QIESHIJIEJUEHUSHIJINQUEWENTI。

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