标题：培养慢性病管理开业护士阻碍及促进因素的质性研究——以海南自贸港为例

      作者：张小曼 1，2，3，叶曼 1，4    1.中南大学湘雅护理学院，湖南 长沙 410013；2.海南省人民医院，海南 海口 570311；3.海南医学院附属海南医院，海南 海口 570311；4.中南大学湘雅二医院临床护理教研室，湖南 长沙 410011

      卷次： 2022年33卷20期

      【摘要】 目的 描述在海南自由贸易港建设背景下培养慢性病管理开业护士的阻碍及促进因素，并研究其对未来发展的影响。方法 于2021年7~10月采用目的性抽样抽取12名护士和6名医生为研究对象进行半结构式访谈。使用内容分析法对数据进行分析。结果 提炼出培养开业护士的促进及阻碍因素，促进因素包括3个主题：医生护士高度赞同、海南自贸港政策优势、医疗服务需求高，阻碍因素包括4个主题：护士自身阻力、护士角色定位不清、医生及患者的信任度较低、执业环境限制。结论 在海南自贸港背景下培养慢性病管理开业护士存在一定的促进及阻碍因素，应积极应对开业护士自主实践的挑战，培养符合社会背景的开业护士，以满足多元化的健康需求。
      【关键词】 海南；自贸港；开业护士；质性研究；护理
      【中图分类号】 R47 【文献标识码】 A 【文章编号】 1003—6350（2022）20—2676—04

Qualitative study on barriers and promotive factors of cultivating nurses practitioner for chronic diseasemanagement—under the construction of Hainan Free Trade Port.
ZHANG Xiao-man 1,2,3，YE Man1,4. 1. Xiangya ofNursing, Central South University, Changsha 410013, Hunan, CHINA; 2. Hainan General Hospital, Haikou 570311,Hainan, CHINA; 3. Hainan Hospital Affiliated to Hainan Medical University, Haikou 570311, Hainan, CHINA; 4. ClinicalNursing Teaching and Research Section, the Second Xiangya Hospital of Central South University, Changsha 410011,Hunan, CHINA
【Abstract】 Objective To describe the barriers and promotive factors of cultivating nurses practitioner forchronic disease management under the construction of Hainan Free Trade Port, and to study its impact on future develop-ment. Methods A total of 12 nurses and 6 doctors were selected for semi-structured interviews from July to October2021. Data were analyzed using content analysis. Results The promotive factors and barriers of training nurses wereextracted. The promotive factors include high agreement between doctors and nurses, policy advantage of Hainan FreeTrade Port, high medical service demand. The barriers include four themes: nurses' own resistance, unclear role orienta-tion of nurses, low trust between doctors and patients, practice environment restrictions. Conclusion There are somebarriers and facilitators in cultivating nurses practitioner for chronic disease management under the background of Hain-an Free Trade Port. We should actively deal with the challenge of independent practice of nurses practitioner, and culti-vate nurses practitioner with social background to meet the diversified health needs.
      【Key words】 Hainan; Free trade port; Nurse practitioner; Qualitative study; Nursing　　　·护理·doi:10.3969/j.issn.1003-6350.2022.20.025