摘要
目的从历史纵深角度,探讨我国护理的发展沿革及社区护理面临的严峻挑战,揭示阻碍社区护理发展的历史和文化渊源,从而为制定发展社区护理的政策,迎接老龄化社区卫生服务挑战,提供有意义的依据。方法以文献研究和政策分析作为主要的研究手段。结果中国的护士源于鸦片战争后医学传教士带来的西医技术医学体系,从传统的家庭护理一步跨入医院为中心的护理。然而机构内护理与东方文化传统的矛盾,医护比例的严重倒置,以及护理培训制度不健全,不但影响了医院护理质量,也使得社区护理资源奇缺。社区护理教育边缘化和人力发展严重滞后,是困扰我国社区卫生服务发展的主要障碍。结论大力发展社区护理是保证社区协调发展和满足人群健康需要的关键战略。我国的社区护理发展与其他国家一样,受到历史传承因素的影响,面临迅速增长的社区需要与发育不良的社区护理之间的矛盾,医学界和政府都应该从历史和文化的角度理解这个问题的背景,并从中获得启迪。
Objective To explore evolution of nursing in China with historical perspective. To analysis challenges of community nursing based historical and cultural context analysis. The article contributes to improve community nursing policy - making and practice for successful ageing and harmonised society. Methods literature review and document analysis. Results Nurse introduced into China right after the Opium War, .as medical missionary＇s oriental discovery. Western medicine, along with western religion and education, then developed in China in institutionalized formats, labeled as missionary hospital, church and school. With strong oriental cultural influence however, family - based nursing, as realising of filial duty （ Xiao）, has been maintained to present Chinese community, although modern nursing in health facilities has quickly developed, especially in metropolitans of China. Structure, quality an quantity of nurses in China were suggested as problematic situation, for instance number of nurse professionals is always less than that of medical professionals. Nursing schools provided training only for general nurses who worked in hospital wards. Policy window of opportunity appeared when community health services （CHS） program released by Central Government of China in late 1990s, in which community nursing seems as important part of CHS. Although the policy initially targeted on ＇providing the most basic medical are with lower cost of health resources＇, the institutional arrangement and structural reengineering did have no significant change. Community nursing has been marginalized in ＇formal＇ health system. About 40% of current nurses intended to jump out of the nursing professional; Community nurses reported their job as lower salary, little chance of professional development and poor working environment. Conclusion China is facing similar challenge of community nursing of other countries. However, the hospital - centred nursing training and practice and marginalization are significant roots of the problem. Chinese community nurses are in extremely shortage and unsatisfied on their income, development and working condition. However, China needs nurse＇s contribution for promoting health and well - being in the ageing communities. Looking backward farther for seeing forward farther likely. The analysis could help decision - makers having wisdom thinking when designing community health for successful ageing.
出处
《中国全科医学》
CAS
CSCD
2008年第9期723-726,共4页
Chinese General Practice
关键词
护士
历史演变
社区护理
中国
Nurses
Historical evolution
Community nursing
China
