摘要
目的通过访谈医护人员及患者,了解医院实施“无陪护”住院模式的阻碍及促进因素,为相关工作的开展提供参考。方法运用描述性质性研究方法,2022年7-8月,采用目的抽样法,选取上海交通大学医学院附属仁济医院开展“无陪护”住院模式试点病区的医护人员及住院患者进行半结构式访谈。采用Colaizzi七步分析法进行资料分析。结果共访谈医护人员21名、患者5例;围绕开展“无陪护”住院模式的体会,归纳出3方面的阻碍因素(医患关系多元协同困境、医疗服务流程关键环节梗阻和社会认同度不高)及2方面的促进因素(医疗服务供需双方的自身内驱力及互动模式创新),共提炼出12个亚主题(阻碍因素:医疗护理员专业信任度有待建立、多元主体间信息共享困难、各主体对患者陪护需求存在认知分歧、科室安全管理面临系统性挑战、医疗服务关键环节流程梗阻、后勤保障不足、患者情感需求被抑制、医疗资源供给不足;促进因素:病区环境改善、家属陪护压力释放、提升医院运营效能的期待、探视与沟通模式创新)。结论多数受访者均认同“无陪护”住院模式的益处,但同时认为该模式在临床实施中面临诸多挑战;期待政府、社会、医疗机构提供针对性支持,以推进“无陪护”住院模式的顺利实施。
Objective To understand the barriers and facilitators to implementing the"unaccompanied"hospitalization model in hospitals through interviews with healthcare providers and patients,aiming to provide a reference for related activities.Methods A descriptive qualitative study was conducted.Specifically,from July to August 2022,healthcare providers and inpatients in pilot wards implementing the"unaccompanied"hospitalization model at Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were selected by purposive sampling to participate in semi-structured interviews.Their interview data were analyzed using Colaizzi's seven-step method.Results A total of 21 healthcare providers and 5 patients were interviewed.Based on their experiences with"unaccompanied"hospitalization,3 barriers and 2 facilitators were identified as follows:challenges in multifaceted coordination within doctor-patient relationships,bottlenecks in critical medical service processes,and low social recognition;intrinsic motivation from both medical service providers and consumers,and innovation in interaction models.On this basis,12 sub-themes were yielded(barriers:insufficient trust in the professionalism of healthcare providers,difficulties in information sharing among multiple parties,cognitive differences regarding patients'accompanying needs among parties,systemic challenges in departmental safety management,bottlenecks in critical medical service processes,inadequate logistics support,suppression of patients'emotional needs,insufficient supply of medical resources;facilitators:ward environment improvement,reduced pressure on family caregivers,expectations for enhanced hospital operational efficiency,innovation in visitation and communication models).Conclusion Most respondents acknowledge the benefits of the"unaccompanied"hospitalization model.However,they also recognize numerous challenges in its clinical implementation.Targeted support from the government,society and medical institutions is expected to facilitate the successful implementation of this model.
作者
刘梦祥
王贝贝
倪科春
徐于睿
奚慧琴
LIU Mengxiang;WANG Beibei;NI Kechun;XU Yurui;XI Huiqin(Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200127)
出处
《上海护理》
2025年第10期17-23,共7页
Shanghai Nursing
关键词
陪护
“无陪护”住院模式
免陪照护
阻碍因素
促进因素
半结构式访谈
质性研究
Accompanying
"Unaccompanied"hospitalization model
Unaccompanied care
Barrier
Facilitator
Semi-structured interview
Qualitative study
