Practical study on the qualitative evaluation of the care services in the community

本研究旨在寻找能从社区角度对护理服务进行评价的定性评价指标和方法，指导护理服务质量的提高。进行了以下四项调查，并确定了定性评价模型。调查1;对居家护理护士与公共卫生护士合作的实际合作案例工作流程及居家护理护士对与公共卫生护士合作的认可程度进行了访谈。结果明确了9个需要与初级护理人员合作的对象，以提高护理服务质量。调查2;应护理管理者要求与公共卫生护士的合作情况进行访谈，明确与护理管理者合作的内容。结果明确了12个被试在提高护理服务质量方面与初级护理护士和护理管理人员合作的需求。调查3;中央家庭护理支持中心护士的角色：与护理服务成员的联系。确定了负责提高护理服务质量的角色，居民日常生活的连续性等。调查4;文献回顾：合作活动对社区照护服务品质的评估透过21篇文献的检视，找出合作活动对改善照护服务品质的效果。结论：通过4项调查的结果，建立了定性评价模型。该模型包含主体、行动和结果三个阶段的指标。该模型有助于评价护理对象的护理状况，指导护理人员提高护理质量的行动。此外，还需要对模型进行实际检验。

The purpose of this study was to identify the qualitative evaluation index and the method which enable to evaluate the care services from the community-based viewpoint and to guide the improvement of the quality of care services. Four investigations were conducted as follows and the qualitative evaluation model was identified.Investigation 1; Cooperation with public health nurses requested by home care nursesThe actual cooperative case work process and the recognition of home care nurses on cooperation with public health nurses (PHNs)were interviewed. As the result, 9 subjects became clear which need the cooperation with PHNs, to improve the quality of care services.Investigation 2; Cooperation with public health nurses requested by care managersPHNs were interviewed to make clear the content of cooperation with care managers. As the result,12 subjects became clear which have some needs of the cooperation with PHNs and care managers to improve the quality of care services.Investigation 3; The role of the nurses in the Central home care support centers : Connecting with Care service members.The role to be responsible for the quality improvement of the care services, the continuity of everyday life of the residents and so on were identified.Investigation 4; The review of the literature: Cooperative activities for qualitative evaluation of community care servicesThrough the examination of 21 literatures, the outcome of the cooperative activities to improve the quality of care services were identified.Conclusion :The qualitative evaluation model was built up through the outcome of 4 investigations. The model contained index in 3 phases, such as the subject, the action, and the outcome. It was suggested that this model will be helpful to evaluate the subjects of care condition and to guide the action to improve the quality of care. Furthermore inspection of the model in practice was needed.