Abstract:

Objective To study the use of policy instruments in nursing and health policies from 1978 to 2020，and to explore the distribution and framework of existing policy instruments，so as to provide references for the formulation and implementation of subsequent policies. Methods Based on Rothwell & Zegveld’s theory of policy instruments，this paper uses the content analysis method to construct a two-dimensional analysis framework of dimension X（basic policy instrument） and dimension Y（policy development stage），collating and quantifying the existing nursing health policy texts. Results 24 policy documents were finally included，and a total of 378 policy items were coded. In the X dimension，supply-oriented，demand-oriented，and environmental-oriented policy instruments accounted for 24.60%，14.02%，and 61.38%，respectively. In the Y dimension，the policy instruments in the budding exploration period，the supplementary improvement period，and the mature promotion period account for 23.02%，31.75%，and 45.24%，respectively. Conclusion At present，the overall use of nursing and health policy instruments in China is not coordinated. Supply-oriented policy instruments pay more attention to personnel training，and scientific and technological research and information construction need to be increased. Demand-oriented policy instruments are less applied and lack effective pulling effect. Environmental policy instruments are used too frequently and the internal ratio needs to be adjusted. It is suggested to further grasp the evolution rules of nursing health policy，improve the effect of policy implementation，and strengthen the integrity of policy.

Key words: Policy Instruments, Health Policy, Policy Analysis, Nursing Administration Research

摘要：

目的 研究1978年—2020年护理卫生政策中政策工具使用情况，探讨现有政策工具的分布情况及框架结构，为后续政策的制定及落实提供参考。 方法 基于Rothwell & Zegveld构建的政策工具分析框架，采用内容分析法，构建X维度（基本政策工具）及Y维度（政策发展阶段）的二维分析框架，对现有护理卫生政策文本进行编码整理和量化分析。 结果 最终纳入24篇政策文件，共整理378条政策分析条目。X维度中，供给型、需求型、环境型政策工具所占比例分别为24.60%、14.02%、61.38%。Y维度中，萌芽探索期、补充完善期、成熟提升期政策工具占比分别为23.02%、31.75%、45.24%。 结论 目前国内护理卫生政策工具总体使用不协调，供给型政策工具较关注人才培养，科技研究和信息化建设有待增加；需求型政策工具应用较少，缺乏有效拉动作用；环境型政策工具使用过于频繁，内部工具比例有待调整。建议可进一步把握护理卫生政策演化的规律性，提升政策实施的实效性，强化政策组合的整体性。

关键词: 政策工具, 卫生政策, 政策分析, 护理管理研究