| 1 BackgroundIn recent years,public health emergencies have occurred frequently around the world,causing great harm to people’s lives and health.Since the outbreak of COVID19,China has issued a series of policies that clearly indicate the need to improve the construction of public health system and strengthen the training of high-level public health personnel.At present,the special training of public health nursing talents has not yet been carried out in mainland China,and the existing community nurses cannot meet the needs of high-quality public health services,so it is necessary to train public health nurses who meet the national conditions of our country.It is helpful to enrich the reserve of public health talents and improve the ability to deal with public health emergencies.2 ObjectiveOn the basis of literature review,this study used descriptive research method,from the point of view of community nurses and public health physicians,to understand the current situation,real feelings,difficulties of community nurses participating in basic public health services and demand for public health nursing talents during the epidemic of COVID-19.Based on this,Delphi expert consultation method was adopted to construct the evaluation index system of core competence of public health nurses with Chinese mainland characteristics.To test the reliability and validity of the evaluation index system of the core competence of public health nurses,and investigate the status quo of the core competence of community nurses in Guangdong province.3 MethodsThis study adopts a hybrid methodology of exploratory sequence design.(1)Descriptive qualitative study:By using the method of objective sampling,a total of 19 community nurses and public health physicians who met the inclusion and exclusion criteria from Guangzhou and Shenzhen community health service centers were selected for semi-structured interviews to gain an in-depth understanding of the current situation,real feelings,difficulties of community nurses participating in basic public health services and demand for public health nursing talents during the epidemic of COVID-19.Use the content analysis method to analyze the data,and finally,summarize and organize to form the theme.(2)Delphi expert consultation method:Through the previous literature review and the results of semi-structured interview,the core competence evaluation index system of public health nurses was preliminarily formed,and 18 experts in the fields of nursing education,public health education,community nursing and community public health were consulted by Delphi expert consultation method for 2 rounds of expert consultation.The percentage weight method was used to determine the weights of all levels of indicators of the core competence of public health nurses,and the final draft of the evaluation index system of the core competence of public health nurses was formed.(3)Questionnaire survey method:using convenience sampling method,300 community nurses who met the inclusion exclusion criteria in Guangdong Community Health Service Center were selected as the research subjects.Community nurses were investigated by using the public health nursing core competence questionnaire to understand the current situation of public health nursing core competence of community nurses in China,and the reliability and validity of the evaluation index system were tested at the same time.4 Results(1)Current situation of community nurses’ participation in basic public health services and demand for public health nursing talents in Guangzhou and ShenzhenThe study extracted four themes.That is,community nurses’ investment in basic public health services is not sufficient,community nurses are faced with difficulties in participating in basic public health services,public health nurses should have a variety of core competencies,and speeding up the training of public health personnel are the key factors to improve the quality of public health services.(2)Core competency evaluation index system of public health nurses18 questionnaires were sent out in 2 rounds of expert consultation,the effective recovery rate of the questionnaire was 100%,the judgment basis coefficient of the expert was 0.894,the familiarity coefficient was 0.833,and the expert authority coefficient was 0.864,which indicated that the expert authority of this study was high.In the two rounds of expert letters,16 and 12 experts respectively put forward specific opinions and suggestions,accounting for 88.89%and 66.67%respectively,indicating that the experts in this study are more active.The evaluation indicators of core competence of public health nurses constructed in this study include 5 first-level indicators,26 second-level indicators and 79 thirdlevel indicators.The Kendall harmony coefficients of the second round were 0.198～0.422(P<0.001),which were higher than those of the first round(0.172～0.404).The weights of the first-level indicators are 0.215 for basic public health practice,0.205 for project management and implementation,0.210 for emergency response to public health emergencies,0.198 for epidemiological investigation,and 0.181 for leadership.(3)Measurement of evaluation index system of core competence of public health nursesThrough the item analysis,reliability and validity analysis and current situation investigation of the evaluation index system of public health nursing core competence of 300 community nurses in Guangdong Province,the results showed that the differentiation and homogeneity of the items were good,the I-CVI of all index items was 0.78 to 1.00,and the average S-CVI was 0.963.Exploratory factor analysis extracted a total of 8 common factors,and finally merged into 5 common factors,which could explain the variation of 85.398%.The total Cronbach’s coefficient of the questionnaire was 0.993,and the Cronbach’s coefficient of each dimension index was 0.973-0.991,indicating that the reliability and validity of the questionnaire was good.The score of public health nursing core competence of community nurses in Guangdong Province was 157.00(89.25,206.00),which was at a low level.5 Conclusions(1)The participation of community nurses in basic public health services was not good,and the knowledge,skills and enthusiasm of community nurses were insufficient,so it was difficult to meet the needs of basic public health services during the epidemic period.there is an urgent need to train full-time public health nurses in line with China’s national conditions.Public health nurses should have the comprehensive ability to deal with emergencies and daily public health services,master the knowledge and skills adapted to the current health needs,and improve the quality and level of public health services.(2)Through literature review at home and abroad,semi-structured interviews and Delphi expert consultation,the evaluation index system of core competence of public health nurses suitable for the situation of our country was constructed.The evaluation index system of core competence includes five dimensions:basic public health practice ability,basic ability of project management and implementation,emergency response ability of public health emergency,epidemiological investigation ability and leadership ability,with a total of 110 items.It provides a theoretical basis for training high-quality,high-level and compound public health nursing talents under the new situation,which is helpful to enrich the reserve of public health talents and improve the ability to deal with public health emergencies.(3)The evaluation index system of core competence of public health nurses constructed in this study has good reliability and validity,and is scientific and reasonable,which provides a reference for the training and development of public health nurses with Chinese characteristics.At present,the public health nursing core competence of community nurses in Guangdong Province is at a low level,so there is an urgent need to train and develop public health specialist nurses,establish clinical nurse transfer training programs and assessment standards,and improve their public health nursing core competence. |
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