Abstract:

Objective To understand the feelings and experiences of nurses in family medical team in the process of implementing contracted services，in order to provide a reference for effectively exerting the function of nursing in contracted services，and promoting and optimizing the contracted services in China. Methods Using phenomenological research methods，14 team nurses from 3 community health service centers in Beijing were interviewed with semi-structured interviews. The content analysis method was used to analyze the data. Results 3 themes were extracted in the nurses’ experiences and feelings during the implementation of the contracted services，personal growth and benefit，and the need to optimize the work. 3 sub-themes were extracted in work experiences and feelings，namely sense of optimization of nursing philosophy，sense of changing focus of nursing，improvement of nurse and patient bond. 4 sub-themes were extracted in personal growth and benefits，namely increasing job responsibility and accomplishment，forming a sense of teamwork，greater understanding and respecting for patients. 5 sub-themes were extracted in the optimization of contracted service needs，namely clarifying the position of team nurses，improving the bidirectional referrals，improving the contracted team management and assessment mechanisms，strengthening the support of the policy on home care，and providing opportunities for continuing education and training. Conclusion In practicing contracted services，team nurses have gained recognition of their profession and continuous self-growth. The government should continue to improve the support of contracting-related policies to meet the needs of team nurses’ career development，optimize contracted services，and attract more nurses into the practice of contracted services.

Key words: Family Medical Team, Team Nurses, Work Experience, Qualitative Research, Community Nursing

摘要：

目的 了解家庭签约护士在实施签约服务过程中的感受和体验，为有效发挥护理在签约服务中的功能、推进并优化国内社区家庭签约服务提供参考。方法 2022年1月—11月，采用现象学研究方法，对北京市3所社区卫生服务中心的14名签约护士进行半结构式访谈，采用内容分析法进行资料分析。结果 提炼出3个主题，包括签约模式下的工作体验和感受；签约模式下的个人成长和获益；家庭签约团队工作需求。在工作体验和感受方面提炼出了护理工作理念优化、护理工作重心变迁、护患联系紧密3个亚主题；在个人成长和获益方面，提炼出工作责任心提升、工作成就感增强、形成团队工作意识、更加尊重和理解患者4个亚主题；在家庭签约团队工作需求方面，提炼出明确签约护士定位、完善医院与社区间的双向转诊、完善签约团队管理与考核机制、加强居家护理政策支持、提供继续教育培训机会5个亚主题。结论 签约护士在签约服务实践中，获得了对自身职业的认可和自我的不断成长。相关部门应该不断完善签约政策，满足签约护士职业发展的需求，不断优化签约服务，吸引更多护士投入到签约服务实践中。

关键词: 家庭签约团队, 签约护士, 工作体验, 质性研究, 社区护理