| ObjectiveBased on researches on the cultivation of international and domestic master of nursing specialist,taken the competencies of community/public health nursing as the theoretical basis and referred to the status of the development of community health in China,to construct a clinical practice pattern for master of nursing specialist in community health nursing initially,which can promote specialization progress of community health nursing in China and provide a reference for the clinical practice training of master of nursing specialist in community health nursing in China.Methods1.Literature review: We searched and filtered the relevant information about the topic of advanced competencies in community/public health nursing,cultivate program for the master of nursing specialist in community health nursing and the training plan towards community nurses from the domestic and international databases,websites of schools of nursing and relevant organizations.Based on the results of the literature review,to draft a list of community nursing indicator items of clinical practice pattern for the postgraduates majored in Master of Nursing Specialist initially.2.Semi-structured interviews: We interviewed six experts in the research fields of nursing education,nursing management,community/public health nursing and general practice education using the outline designed by our research team to access the pivotal information related to the demand for advanced nursing practice in community/public health nursing now,community nursing service contents and community/public health nursing competencies.The indicator system would be more comprehensive based on the results of the semi-structured interviews.3.Delphi Expert inquiry: 35 domestic experts content with the inclusion criteria were selected to participate in two rounds Delphi study.The ultimate clinical practice plan for master of nursing specialist in community health nursing would be confirmed after comprehensive consideration of expert opinions,criteria for exclusion and inclusion,and opinions of the research group.4.Statistical Methods: SPSS 22.0 and Excel 2016 were used to sort and analyze the obtained data.The general data of the experts were described by the mean,standard deviation and composition ratio;Expert positive coefficient was represented by the effective questionnaire recovery rate;The degree of expert authority is expressed by the authority coefficient of experts(which was determined by the level of scholarship,the degree of familiarity with the research,and the basis of their judgment);The coordination degree of experts opinions was described by the Kendall's W;The concentration degree and importance degree of expert opinions were indicated by the mean value of the importance assignment,the full marks ratio,and the weight value.The proportional distribution method was used to calculate the weight in this study.Results1.The results of literature review: After analyzing the relevant literature and website information,clinical nursing specialists' competence in community health nursing was determined as the core element of the practice training of MNS in community health nursing in this study.Based on the above objectives,the primary framework of the practice model was initially designed,which included the cultivate objectives,cultivate details,examination and evaluation,quality control during cultivation.2.The results of semi-structured interview: After collating and analyzing the interview data,three themes which included the recognition of MNS specialized cultivation,the theoretical keys for community health nursing MNS specialized cultivation,and the control of the quality of clinical cultivation for community nursing MNS and six subthemes which included role position-setting,objectives of clinical cultivation,community health nursing specialty practical arrangements,examination and evaluation system,the quality of practice base and clinic teachers,the communication between colleges and practice bases were determined.3.The results of Delphi: A total of 27 experts took part in all the two rounds of Delphi expert inquiry.The respond rates of the two rounds of consultation were 85.71% and 90.00% respectively.The experts came from 17 provinces/cities,included Beijing,Shanghai,Guangdong Province,Shandong Province,and Chongqing and etc.Their research fields included nursing education,nursing management,and community health nursing and general practice medicine.Authority coefficient of experts were(0.92 ± 0.05).The Kendall's W of the first round inquiry was 0.187(P<0.05),and the Kendall's W of the second round inquiry was 0.195(P<0.05).4.The results of item modification: After two rounds of Delphi expert inquiry,13 items were deleted,19 items were increased and 36 items were modified.Eventually,a preliminary clinical practice pattern for the Master of Nursing Specialist in community health nursing was formed,which included 4 first-level indicators(cultivate objectives,cultivate details,examination and evaluation,quality control during cultivation),21 second-level indicators and 171 third-level indicators.Among all the first-level indicators,“cultivate objectives” accounted for the highest proportion.Among the “cultivate objectives”,the top three indicators were “general nursing practice in community”,“communicating & cooperating” and "educating & instructing".ConclusionThe positive coefficient,authority coefficient and geographical representation of the experts participated in this study are high.The opinions of experts are comparatively consistent.The indicator system reflects the characteristics of advanced nursing practice in community.It can provide reference for the plan of clinical practice towards the mater of nursing specialist in community nursing in China.There is of great significance for improving the effects of community health nurses' cultivation,the quality of services provided by community nurses,and the development of community health care nursing discipline.It should be added that the contents of the clinical practice system need to be continuously adjusted and updated with the development of the community health service system in China and the expansion of the scope of advanced nursing practice. |
PDF Full Text Request