目的:了解管理者对护理员流失的真实感受,为维持养老护理员队伍稳定提供参考和依据.方法:采用目的抽样法选取常州市15家养老机构15名管理者进行半结构式访谈,并运用Colaizzi 7步分析法对访谈内容进行编码、归纳及分析,提炼主题.结果:提炼出5个主题,即养老护理员的流失促使养老机构做出积极改变;流失后去向多样化;担忧养老护理员后续力量;传统观念影响大,缺乏社会的认可和关心;对养老护理员的固有观念亟待转变.结论:在今后发展中,对现存养老护理员,需加强专业技能和职业道德教育;政府通过引导和整合高校教育资源培养养老人才、建立职称晋升通道和合理的绩效评估和薪酬体系等,吸引年轻力量从业;引导社会固有观念转变,增加公众认可和尊重.

目的:了解医院护理管理者对行业需求的真实感受,为高校培养护理人才提供参考和依据.方法:对江苏省7所医院25名护理管理者进行半结构式访谈,并运用Colaizzi的7步分析法对访谈内容进行编码、归纳及分析,提炼主题.结果:提炼出5个主题,即护士数量缺口大,内涵亟待提升;部分专科护理人才明显短缺;临床护理呈专科化发展,专科的再精细化发展是趋势;对男护士和本科及以上护理人才需求大;护士科研实践能力有待强化.结论:高校应结合护理行业需求加强对男护士的职业教育、扩大本科及以上护理人才培养规模,优化护理人员结构;加快老年、重症、传染病及麻醉护理专科人才培养,重视职业内涵提升;强化护生科研实践,提高成果产出和转化能力.

目的 本研究分析子女对老年人陪诊服务的意愿、需求及其接受陪诊服务的影响因素,旨在为解决老年人看病难现状提供依据.方法 于2021年7-9月采用便利抽样方法对1 600名有收入的子女进行问卷调查.结果 68.98％子女愿意使用陪诊服务,其中,74.24％子女存在请假陪同看病的情况,共有53.93％子女接受老年人陪诊服务付费,61.43％认为服务收费1～＜151元/0.5d.子女认为熟悉医院就诊流程人员(24.27％)、护生/实习生(28.10％)和执业护士(29.14％)适合担任陪诊角色.子女希望陪诊人员持证上岗(79.04％),医院对其定期培训和考核(82.61％),分级陪诊(81.64％).子女对陪诊人员首要要求是保障老年人安全.Logistic回归分析显示,请假陪同就诊存在困难(OR=1.42,95％CI:1.11～1.81,P＜0.01)、就医体验满意(OR=1.36,95％CI:1.09～1.70,P＜0.01)、陪诊服务付费使用(OR=2.80,95％CI:2.21～3.55,P＜0.01)、陪诊人员定期培训和考核(OR=3.08,95％CI:2.29～4.15,P＜0.01)、分级陪诊(OR=2.03,95％CI:1.51～2.72,P＜0.01)是子女愿意使用陪诊服务的独立影响因素.结论 子女使用陪诊服务的意愿高、需求迫切.老年人陪诊服务需医院等大力参与和支持,充分利用熟悉医院就诊流程人员、护生/实习生和执业护士资源分级陪诊,规范陪诊服务,解决老年人就诊难问题.

Abstract Background: China is facing big pressure due to its high aging rate. Compared to other age groups, the elderly are characterized by a high number of multiple chronic diseases and need to frequently visit hospitals. However, most seniors are unable to independently complete medical treatments in smart hospitals with complex self-help integrated machines, scattered departments, popular appointment registration, and convenient mobile payment, and need to be accompanied by their adult children. Medical escorts might replace the offspring’s role, but their willingness to utilize elderly medical escort service (EMES) is associated with different factors.Methods: This sequential mixed-methods research was performed in communities across three cities in Jiangsu Province, China. It included a cross-sectional survey with a convenient sample size of 1936 participants having medical experiences with the elderly, and face-to-face interviews with 21 individuals. The quantitative survey was used to determine the participants’ expectations and acceptability of EMES. The semi-structured interview was performed to explore the barriers and facilitators of utilizing EMES.Results: Among 1936 individuals that responded to the questionnaire, 68.2% were willing to use the EMES. The willingness to utilize EMES was associated with long-distance separation from seniors [OR=0.79, 95% CI (0.63-0.98), p=0.033], difficulties in taking leaves to accompany the elderly to medical appointments [OR=1.39, 95% CI (1.11-1.73), p=0.003], outpatient satisfaction [OR=1.24, 95% CI (1.13-1.36), p＜0.001], payment for EMES [OR=2.56, 95% CI (2.07-3.18), p＜0.001], escorts being trained [OR=2.35, 95% CI (1.80-3.07), p＜0.001] and licensed [OR=1.31, 95%CI (1.01-1.72), p=0.044], and EMES being graded [OR=1.93, 95% CI (1.48-2.51), p＜0.001]. Both data suggested that regarding training, participants paid more attention to professional ethics. Additionally, the traditional Chinese culture of filial piety can not be ignored while using EMES.Conclusions: This survey indicated that the demands of the children’s willingness to utilize EMES are high and urgent. The results might guide EMES providers to improve their professional skills especially ethics and combine the need for children to do their filial duty that would be welcomed by users.