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家访护士工作场所暴力防范培训的范围综述▲
A scoping review on workplace violence prevention training for home visit nurses

内科 页码:81-90

作者机构:1 广西中医药大学护理学院,南宁市 530200;2 广东省深圳市宝安区人民医院,深圳市 518101

基金信息:广东省深圳市科技创新委员会基础研究面上项目(JCYJ20210324110809027) 通信作者:戴利

DOI:10.16121/j.cnki.cn45-1347/r.2026.01.13

  • 中文简介
  • 英文简介
  • 参考文献

目的 通过范围综述方法,系统梳理并分析国内外家访护士工作场所暴力(WPV)防范培训的内容、方法及效果的评价体系,旨在为我国家访护士WPV防范培训的本土化方案构建与持续优化提供循证依据与实践参考。方法 本研究遵循Arksey和O'Malley的范围综述方法学框架。系统检索PubMed、Embase、Web of Science、Cochrane Library、中国知网、万方数据、维普数据库及中国生物医学文献数据库,检索时限为建库至2024年12月。使用“人群-概念-情境”(PCC)模型确定研究问题与纳入、排除标准,采用描述性统计与定性内容分析法对纳入文献进行分析综合。结果 共纳入11篇文献,主要来自北美地区(10/11)。(1)培训内容可归纳为四大核心模块,根据涉及频次排序依次为:理论知识(90.9%)、降级技能(81.8%)、沟通技巧(72.7%)及报告机制(54.5%),显示出对个体认知水平与现场应对技能的高度侧重,而对制度化报告流程的强调相对不足。(2)培训方法呈现多元化,主要可归类为知识传授型、实践互动型及综合任务型,且常组合应用;培训时长呈现显著异质性(51 min至6个月)。(3)培训效果可从两个维度评估:在体验评价维度,参训者普遍认可培训价值并表达了持续需求;在效果评价维度,培训在提升知识、信心(学习层)及降低暴力事件发生率、离职意向(行为/结果层)方面显示出积极效果,但也揭示出机构间培训覆盖率不均、政策执行影响效果等系统性挑战。结论 现有家访护士WPV防范培训在核心内容框架与实践方法上已具雏形,并显示出积极效果,但在内容的全面性与针对性、方法模式的灵活适应性、效果评价的系统性,以及证据的本土适用性方面均存在局限。未来应立足我国文化背景与家访护理工作特点,着力构建包含全面风险覆盖与个性化路径的培训内容体系,发展灵活可持续的培训实施模式,并建立多维度、全过程的科学评价体系,以最终形成并完善一套科学、有效且符合中国国情的家访护士WPV系统化防范培训方案。

Objective To systematically summarize and analyze the content, methods, and effectiveness evaluation systems of workplace violence (WPV) prevention training for home visit nurses in China and abroad with a scoping review approach, so as to provide evidence-based references and practical implications for the development and continuous optimization of localized WPV prevention training programs for home visit nurses in China. Methods This study followed the methodological framework of scoping review by Arksey and O'Malley. Systematic searches were performed in PubMed, Embase, Web of Science, Cochrane Library, CNKI, WanFang Data, VIP Database, and China Biology Medicine disc. The search timeframe was from inception to December 2024. The Population-Concept-Context (PCC) model was used to define the research question and inclusion/exclusion criteria, and descriptive statistics and qualitative content analysis were applied to synthesize the included literature. Results A total of 11 studies were included, most from the North America (10/11). (1) Training content could be summarized into four core modules, ranked by involved frequency: theoretical knowledge (90.9%), de-escalation skills (81.8%), communication skills (72.7%), and reporting mechanisms (54.5%), showing a strong focus on the individual cognition level and on-site response skills, while emphasis on institutional reporting processes was relatively insufficient. (2) Training methods were diverse, mainly categorized as knowledge transmission-oriented, interactive-practical, and task-integrated approaches, often used in combination; training duration was highly heterogeneous (ranging from 51 minutes to 6 months). (3) Training effectiveness can be evaluated from two dimensions: in terms of experiential evaluation dimension, participants generally recognized the value of training and expressed ongoing needs; in terms of outcome evaluation dimension, training showed positive effects in improving knowledge and confidence (learning level) and reducing the incidence of violent incidents and turnover intention (behavior/outcome level). However, systemic challenges were also identified, such as uneven training coverage across institutions and policy implementation affecting effectiveness. Conclusion Current WPV prevention training for home visit nurses has taken shape in its core content framework and practical methods, with positive effects, but limitations exist in content comprehensiveness and relevance, flexibility of delivery methods, systematicness of outcome evaluation, and local applicability of evidence. Future efforts should be grounded in China's cultural context and the specific characteristics of home visit nursing, focusing on establishing a training content system with comprehensive risk coverage and personalized pathways, developing flexible and sustainable training implementation models, and establishing a multidimensional, process-wide scientific evaluation system. The ultimate goal is to form and refine a scientific, effective, systematic, and China-adapted WPV prevention training program for home visit nurses.

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