Exploring The Role Of Community Nurses In Continuous Rehabilitation Of Stroke Patients

ObjectivesTo explore the role of community nurses according to our national conditions and working mode of multi-disciplinary team in community, in order to define their role and the work content in the multidisciplinary team and ensure the development of continuous rehabilitation of community stroke patients.MethodsThis study was divided into three parts.The first part was about the chinesization of community nurse role questionnaire.The community nurse role questionnaire in the multidisciplinary team caring for clients with chronic conditions(CNRQ) was translated and revised, and community nurses from Community Health Service Centers in Zhengzhou were investigated with the Chinese version of CNRQ to test its reliability and validity.The second part was about current situation research.It included both questionnaire investigation and semi-structured interview. First,using CNRQ as a research tool, community nurses working in Zhengzhou community health service centers were selected for the survey, to comprehend their views on thecommunity nurses role in stroke continuous rehabilitation and their performance of the role. Using semi structure interview and interview outline as a guide, 14 community nurses and doctors working in Community Health Service Center in Zhengzhou were selected to find out their view and expectation on community nurses role.The third part is the definition of role and work content of community nurses in continuous rehabilitation of stroke patients.Based on the ARN rehabilitation nurse competency model and the results of current situation research, role and work content of community nurses in the continuous rehabilitation of stroke patients were comprehensively defined.ResultsThe result of the questionnaire showed that the Chinese version of CNRQ has been proved to be reliable and valid. It includes 38 items and 5 dimensions. The Cronbach’s α coefficient for the overall 38-item Chinese questionnaire is 0.963, and the coefficient of 5 factors ranged from 0.630 to 0.923. It can be used to measure community nurse role in continuous rehabilitation of stroke patients.Contents with high level(> 80%) of recognition and enforcement were mainly included of educating the carer and client, listening to the client, evaluating the case of the client and liaising with the GP. High recognition but low execution were mainly included engaging with other health professionals to acquire support and input,liaising with the continuing care coordinators and working in partnership with secondary specialist nursing services(CNC/CNS), low level(>80%) of recognition and enforcement were mainly included(<70%) gives guidance to other multidisciplinary team members and provides psycho-social support to the carer.Qualitative research results showed that there were six major roles perceived by community nurses and doctors: educator, coordinator, assessor, supporter,administrator and researcher.According to the preliminary results of quantitative research and qualitative research, combined with ARN Competency Model, role and work content ofcommunity nurses in the continuous rehabilitation of stroke patients were comprehensively defined.ConclusionsA prototype of continuous stroke rehabilitation role of community nurses was built on the basis of literature analysis and current understanding. Combined with ARN professional rehabilitation nurse competency model with the results of quantitative and qualitative research, the role of community nurses in continuous stroke patients contained seven aspects: educator, coordinator, team number, assessor,supporter, administrator and researcher. It validated and enriched the prototype, has strong applicability, provides significance guidance for nursing training program and certain policy.