摘要
Objectives:This integrative review aimed to examine and synthesize existing empirical evidence on nurse-led clinics(NLCs)in primary care settings,with a focus on models of care implemented globally.Methods:The review adhered to PRISMA guidelines,with rigorous inclusion and exclusion criteria applied.A systematic search was conducted across the Cochrane Library,EMBASE,Medline via EBSCO,PubMed,ScienceDirect,Scopus,and bibliographic databases for studies published between 2014 and 2024.Eligible studies included original,peer-reviewed research focused on nurse-led or nurse-managed clinics.A convergent integrated synthesis approach and thematic analysis were employed to identify key models of care.Results:The search yielded 1,651 records;13 studies met the inclusion criteria.Data synthesis revealed six distinct models of care implemented in community-based nurse-led clinics:Innovative Cognitive Care,Integrated Multidisciplinary Care,Community-Driven Underserved Population Care,Reproductive and Women's Health Innovation,Palliative Care Model,and Behavioral Health Integration.Conclusions:Nurse-led models of care are crucial for strengthening primary healthcare,particularly in underserved settings.Further research and policy support are needed to expand nurses'roles,enhance their competencies,and promote interdisciplinary collaboration for the delivery of sustainable and equitable health services.
目的考察并整合初级保健环境中专科护理门诊的现有实证证据,重点关注全球范围内实施的护理模式。方法计算机检索the Cochrane Library、Embase、PubMed、ScienceDirect、Scopus等数据库,纳入护士主导或管理的诊所相关文献。采用聚合综合分析法与主题分析法识别关键护理模式。结果最终纳入13篇文献。数据整合揭示了社区专科护理门诊实施的6种护理模式:创新认知护理、整合多学科护理、社区驱动的弱势群体护理、生殖与女性健康创新、姑息护理及行为健康整合模式。这些模式展现了护士在提升医疗可及性、改善患者预后及响应社区特定健康需求方面多元且不断演进的角色。结论以护士为主导的护理模式对于加强基层医疗保健至关重要,尤其是在医疗资源匮乏的地区。还需要开展更多研究并提供政策支持,以扩大护士的职责范围、提升其专业能力,并促进跨学科合作,从而提供可持续且公平的医疗服务。
基金
supported by the Health Systems Research Institute(HSRI),Thailand。
