国内长期照护护理队伍建设现行政策分析

doi:10.3761/j.issn.0254-1769.2025.06.014

摘要/Abstract

摘要：

目的探讨2008年1月—2024年6月国内长期照护护理队伍建设现行政策，分析现行政策工具的偏好方向与结构比例，以期为后续政策的制订及体系优化提供参考。方法基于McDonnell & Elmore政策工具与队伍建设要素构建二维分析框架，对国内长期照护护理队伍建设相关政策进行编码整理与量化分析。结果最终纳入63篇政策文件，对355条政策进行分析整理。政策工具类型维度中命令性工具、激励性工具、能力建设工具、权威重组工具、劝告工具所占比例分别为48.45%、11.55%、5.35%、11.27%、23.38%。队伍建设要素维度中岗位管理、教育培训、权利保障、任职聘用、专业发展所占比例分别为27.04%、22.25%、11.27%、10.70%和28.73%。结论目前国内长期照护背景下涉及护理队伍建设的政策工具存在应用不均衡、条目多为目标规划的情况，建议不断优化各类政策工具比例关系，切实保障政策细节的落实。长期照护护理队伍体系建设有待完善，护理人员权利保障有待增强，应制订具体可行、特色化且有针对性的策略。

关键词: 政策工具, 队伍建设, 长期照护, 文本分析, 护理管理研究

Abstract:

Objective To explore the status quo of domestic long-term care nursing team construction policy in January 2008—June 2024，analyze the favored direction and structure proportion of existing policy tools，so as to provide references for the follow-up policy and system optimization. Methods Based on McDonnell & Elmore policy tools and construction elements to two-dimensional analysis framework，the coding policy arrangement and quantitative analysis were conducted on the related policies of long-term care nursing team construction. Results Finally，63 policy documents were included，and the 355 pieces of policy were analyzed. In the policy instrument dimension，the proportions of mandate tools，incentive tools，capacity building tools，authority reorganization tools，and counseling tools were 48.45%，11.55%，5.35%，11.27%，and 23.38%，respectively. Team-building dimension in the post management，education training，rights management，post employment，professional development，respectively accounted for 27.04%，22.25%，11.27%，10.70% and 28.73%. Conclusion At present，there is uneven application of the policy tools related to nursing team building in the context of long-term care in China，and most of the entries are for goal planning. It is recommended that the ratio of the various policy tools should be optimised continuously，so as to ensure that the details of the policies are effectively implemented. The construction of the long-term care nursing team system needs to be improved，and the protection of the rights of nursing staff needs to be strengthened；specific，feasible，special and targeted strategies should be formulated.

Key words: Policy Tool, Team Building, Long-Term Care, Textual Studies, Nursing Administration Research

朱雨涵, 李文佳, 祝雪花. 国内长期照护护理队伍建设现行政策分析[J]. 中华护理杂志, 2025, 60(6): 729-735.

ZHU Yuhan, LI Wenjia, ZHU Xuehua. Textual studies of domestic long-term care nursing workforce policies from the perspective of policy tools[J]. Chinese Journal of Nursing, 2025, 60(6): 729-735.

图/表 4

表1 纳入政策文件的基本特征（部分）

Table 1 Basic features of included policies（part）

表2 政策工具类型及内容分布（n=355）

Table 2 Distribution of types and content of policy tools（n=355）

表3 队伍建设要素及内容分布（n=355）

Table 3 Distribution of team-building elements and content（n=355）

表4 不同类型政策工具中队伍建设要素分布（n=355，条）

Table 4 Distribution of team building factors in different types of policy tools（n=355，piece）

参考文献 26

[26]	Yang JY, Wang XY. Ten-year action of preschool teachers’ team construction from the perspective of policy tools—based on the quantitative analysis of 33 policy texts since the implementation of the outline of education planning[J]. J Chin Soc Educ, 2021(2):88-92.
[27]	缪苗, 陈建俞, 王琳. 长期护理保险背景下护理服务实施现状[J]. 护理学杂志, 2020, 35(6):108-111.
	Miao M, Chen JY, Wang L. Present status of nursing services under the background of long-term care insurance:a literature review[J]. J Nurs Sci, 2020, 35(6):108-111.
[1]	国家统计局. 国家统计局信息公开:人口总量有所下降人口高质量发展取得成效[EB/OL].(2024-01-18)[2024-03-28]. https://www.stats.gov.cn/xxgk/jd/sjjd2020/202401/t20240118_1946711.html.
	National Bureau of Statistics. Information disclosure of Natio-nal Bureau of Statistics:quality population development has achieved results[EB/OL].(2024-01-18)[2024-03-28]. https://www.stats.gov.cn/xxgk/jd/sjjd2020/202401/t20240118_1946711.html.
[2]	李欣, 邱卓英, 杨剑, 等. 康复2030:扩大康复规模以满足日益增长的康复需求[J]. 中国康复理论与实践, 2017, 23(4):380-384. DOI
	Li X, Qiu ZY, Yang J, et al. Rehabilitation 2030:meeting ever-increasing rehabilitation needs[J]. Chin J Rehabil Theory Pract, 2017, 23(4):380-384.
[3]	Morris R. Long term care:principles,programs,and policies[J]. J Public Health Policy, 1988, 9(4):568-571.
[4]	皮红英, 彭培培, 苏清清, 等. 失能老年人长期照护质量评价指标体系的构建[J]. 中华护理杂志, 2018, 53(9):1110-1114.
	Pi HY, Peng PP, Su QQ, et al. A study on long-term care of quality evaluation index system for the disabled elderly[J]. Chin J Nurs, 2018, 53(9):1110-1114.
[5]	周兰姝. 护理学科发展现状与展望[J]. 军事护理, 2023, 40(1):1-4.
	Zhou LS. Current situation and prospect of the development of nursing discipline[J]. Mil Nurs, 2023, 40(1):1-4.
[6]	马跃如, 易丹, 胡斌. 养老护理员工作幸福感的随机突变机理[J]. 系统管理学报, 2021, 30(3):526-538.
	Ma YR, Yi D, Hu B. Analysis of stochastic catastrophe me-chanism of occupational well-being of nursing practitioner servicing for the elderly[J]. J Syst Manag, 2021, 30(3):526-538.
[7]	颜国祥, 颜瑾, 袁文星. 人口老龄化背景下老老照护面临的挑战与对策[J]. 护理学杂志, 2023, 38(10):117-120.
	Yan GX, Yan J, Yuan WX. The challenges and countermeasures of elderly care in the context of aging population[J]. J Nurs Sci, 2023, 38(10):117-120.
[8]	叶晓力, 徐培鑫, 蔡敬民. 我国省域高校分类发展政策工具使用偏好与优化策略研究[J]. 当代教育论坛, 2023(5):33-43.
	Ye XL, Xu PX, Cai JM. Research on usage preference and optimization strategy of classified development policy tools of provincial universities in China[J]. Forum Contemp Educ, 2023(5):33-43.
[9]	Rothwell R, Zegveld W. Industrial innovation and public poli-cy:preparing for the 1980s and the 1990s[M]. London: France Printer,1981.
[10]	The World Bank. What matters most for teacher policies:a framework paper[J]. SABER Working Paper Series Number, 2013:13-23.
[11]	全国老龄工作委员会, 发展改革委员会, 教育部, 等. 关于全面推进居家养老服务工作的意见[EB/OL].(2008-01-29)[2024-09-04]. https://www.gov.cn/zwgk/2008-02/25/content_899738.htm.
	National Aging Commission Office, Development and Reform Commission,Ministry of Education, Ministry of Education,et al. et al. Work on comprehen-sively advancing home endowment service opinion[EB/OL]. (2008-01-29)[2024-09-04]. https://www.gov.cn/zwgk/2008-02/25/content_899738.htm.
[12]	吴杨. 大数据政策文本与现实的偏差及完善路径研究[J]. 公共管理学报, 2020, 17(1):31-46.
	Wu Y. Research on the deviation between big data policy text and reality and the improvement path[J]. J Public Manag, 2020, 17(1):31-46.
[13]	杨亚荣. 我国养老机构护理员队伍建设研究——以天津市为例[D]. 天津: 天津财经大学, 2018.
	Yang YR. Study on the construction of nursing workforce in China’s elderly institutions-taking Tianjin as an example[D]. Tianjin:Tianjin university of finance and economics, 2018.
[14]	王婧玲. 贵阳市失能老人长期照护服务社区照顾模式构建研究[D]. 贵阳: 贵州大学, 2023.
	Wang JL. Study on the construction of community care model of long-term care service for the disabled elderly in Guiyang city[D]. Guiyang: Guizhou University, 2023.
[15]	国家卫生健康委员会. 关于印发《全国护理事业发展规划(2021—2025年)》的通知[EB/OL].(2022-04-29)[2024-09-04]. https://www.gov.cn/zhengce/zhengceku/2022-05/09/content_568-9354.htm.
	National Health Commission. Issuance of the “national nurs-ing development plan(2021-2025)”[EB/OL].(2022-04-29)[2024-09-04]. https://www.gov.cn/zhengce/zhengceku/2022-05/09/content_5689354.htm.
[16]	张薷, 周晓英, 裴俊良, 等. 我国突发公共卫生事件应急信息管理政策工具的量化分析[J]. 情报资料工作, 2021, 42(3):44-51.
	Zhang R, Zhou XY, Pei JL, et al. Quantitative analysis of our country’s public health emergencies emergency information ma-nagement policy tools[J]. Inf Docu Serv, 2021, 42(3):44-51.
[17]	莱斯特·M萨拉蒙. 政府工具:新治理指南[M]. 北京: 北京大学出版社, 2016.
	Lester M Salamon. Government tools:a new governance guide[M]. Beijing: Peking University Press, 2016.
[18]	国务院. 关于加强新时代老龄工作的意见[EB/OL]. (2021-11-08)[2024-09-04]. https://www.gov.cn/gongbao/content/2021/content_5659511.htm.
	The State Council. Opinions on Strengthening the Work of the Elderly in the New Era[EB/OL]. (2021-11-08)[2024-09-04]. https://www.gov.cn/gongbao/content/2021/content_5659511.htm.
[19]	国务院. 关于印发“十四五”国家老龄事业发展和养老服务体系规划的通知[EB/OL].(2022-02-21)[2024-09-04]. https://www.gov.cn/zhengce/content/2022-02/21/content_5674844.htm.
	The State Council. Notice on issuing the 14th Five-Year Plan for the development of the national cause for aging and the planning of the elderly service system[EB/OL].(2022-02-21)[2024-09-04]. https://www.gov.cn/zhengce/content/2022-02/21/content_5674844.htm.
[20]	吴捷, 章雅青, 张媛媛, 等. 新护士和护理管理者双视角下新护士护理能力研究进展[J]. 护理研究, 2024, 38(4):630-634.
	Wu J, Zhang YQ, Zhang YY, et al. Research progress on nursing competence of newly graduated nurse from dual perspective of newly graduated nurses and nursing managers[J]. Chin Nurs Res, 2024, 38(4):630-634.
[21]	赖先进. 变“内卷”为边界外拓:行政审批制度改革边际递减效应与再创新策略[J]. 浙江社会科学, 2022(4):63-69.
	Lai XJ. Changing “internal volume” into boundary extension:marginal decreasing effect of administrative examination and approval system reform and re-innovation strategy[J]. Zhejiang Soc Sci, 2022(4):63-69.
[22]	刘晓辉, 赵庆华, 肖明朝. 护理院失能老年人长期照护服务质量评价指标体系的构建[J]. 中华护理杂志, 2019, 54(6):902-907. DOI
	Liu XH, Zhao QH, Xiao MZ. Construction of service quality evaluation index system for long-term care of disabled elderly in nursing home based on service quality gap model[J]. Chin J Nurs, 2019, 54(6):902-907. DOI
[23]	人力资源社会保障部,国家医疗保障局. 关于颁布健康照护师(长期照护师)国家职业标准的通知[EB/OL].(2024-02-02)[2024-09-04]. https://www.gov.cn/zhengce/zhengceku/202402/content_6934989.htm.
	Ministry of Human Resources and Social Security,National Health Insurance Bureau. Circular on the promulgation of the national occupational standard for health care workers(long-term care workers)[EB/OL].(2024-02-02)[2024-09-04]. https://www.gov.cn/zhengce/zhengceku/202402/content_6934989.htm.
[24]	张瀚文, 杨颖秀. 新时代我国引智政策建设的历史回溯与未来展望:基于历史制度主义的分析[J]. 东北师大学报(哲学社会科学版), 2022(2):154-161,174.
	Zhang HW, Yang YX. Historical retrospect and future development of China’s talent introduction policy in the new era:analysis based on historical institutionalism[J]. J Nor-theast Norm Univ Philos Soc Sci, 2022(2):154-161,174.
[25]	张思锋, 张泽滈. 中国养老服务的人力资源困境与智能养老选择[J]. 西安交通大学学报(社会科学版), 2023, 43(6):152-163.
	Zhang SF, Zhang ZH. Human resource dilemma and intelligent choice of elderly care service in China[J]. J Xi’an Jiaotong Univ Soc Sci, 2023, 43(6):152-163.
[26]	杨继英, 王小英. 政策工具视角下幼儿教师队伍建设的十年行动:基于《教育规划纲要》实施以来33份政策文本的计量分析[J]. 中国教育学刊, 2021(2):88-92.