Challenges and Countermeasures for the Development of Nursing Discipline in China_Chinese Journal of Evidence-Based Medicine

Authors：

WANG Yingqiang ¹ , WEI Shiyou ² ,  LI Youping ¹ , DENG Shaolin ^1,2,3 , LUO Qianqian ⁴ , LI Yan ^1,5

1. Chinese Evidence-Based Medicine Centre, West China Hospital, Sichuan University, Chengdu 610041, China;2. West China Medical School, Sichuan University, Chengdu 610041, China;3. West China Hospital, Sichuan University, Chengdu 610041, China;4. National Chengdu Center for Safety Evaluation of Drugs, West China Hospital, Sichuan University, Chengdu 610041, China;5. School of Political Science, Sichuan University, Chengdu 610065, China;

Corresponding author：

LI Youping, Email: yzmylab@hotmail.com

Keywords：

Nursing; Evidence-based medicine; Competency-based education; Disaster nursing; Nursing education; Quantitative approach

DOI：

10.7507/1672-2531.20130024

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Objective 　Based on the acquirable and optimized evidences at present, to explore the challenge and countermeasures for the development of nursing discipline in China, and to provide suggestions for promoting the construction of nursing discipline, platform, and talent team.
Methods 　The study materials were searched in the following electronic databases including PubMed, EMbase, Web of Science, CNKI, VIP and CBM, as well as in the official websites of World Health Organization (WHO), International Council of Nurses (ICN), World Bank, the Ministry of Health (MOH) and the Ministry of Education (MOE) of China, and the domestic universities, colleges or technical secondary schools. Then the statistical analysis was conducted using SPSS 13.0 and Microsoft Excel software.
Results 　a) By 2012, there were 855 nursing schools, 38 212 nursing undergraduates enrolled in universities, and 130 837 nursing students enrolled in junior colleges and senior vocational schools; b) The doctor-to-nurse ratio was 1 to 0.9 in 2010. The actual demand for doctors was 2.6 million, and there were still lack of 346 000 nurses; c) The age of nurses younger than 35 years old accounted for 50%. Those with primary professional title accounted for 64% to 69%, while less than 2.5% with advanced professional title; d) The training cost for a doctor and nurse/midwife in China only accounted for 2/5 of that in India and 1/5 to 1/4 in the sub-Sahara Africa; and e) To date, only 30.1% of disaster nursing studies in China provided research data, 30.6% were clinical experience and 38.3% were review.
Conclusion 　Education and health systems need to be extensively reformed. It is necessary to train nursing students with core competencies using transformative learning. It is necessary to update textbooks and teaching methods, and funding should be appropriately increased. Nursing should cooperate with other disciplines, and apply evidence-based nursing methods to improve the quality of healthcare services and patient satisfaction.

Citation： WANG Yingqiang,WEI Shiyou,LI Youping,DENG Shaolin,LUO Qianqian,LI Yan. Challenges and Countermeasures for the Development of Nursing Discipline in China. Chinese Journal of Evidence-Based Medicine, 2013, 13(2): 128-136. doi: 10.7507/1672-2531.20130024 Copy

1.	World Bank.2010.Aavailabe at: http://data.worldbank.org/indicator/SP.POP.65UP.TO.ZS.
2.	中华人民共和国卫生部疾病预防控制局. 卫生部等15部门关于印发《中国慢性病防治工作规划(2012-2015年)》的通知. 卫疾控发[2012]34号.2012年. Available at: http://www.moh.gov.cn/publicfiles/business/htmlfiles/mohjbyfkzj/s5878/201205/54755.htm.
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4.	Bunting BP, Murphy SD, O’Neill SM, et al. Lifetime prevalence of mental health disorders and delay in treatment following initial onset: evidence from the Northern Ireland Study of Health and Stress. Psychol Med, 2012, 42(8): 1727-1739.
5.	Vicente B, Saldivia S, de la Barra F, et al. Prevalence of child and adolescent mental disorders in Chile: a community epidemiological study. J Child Psychol Psychiatry, 2012, 53(10): 1026-1035.
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18.	中华人民共和国教育部. 2012年具有普通高等学历教育招生资格的高等学校名单. Available at: http://www.moe.edu.cn/publicfiles/business/htmlfiles/moe/moe_634/201206/137993.html. [Accessed August 10, 2012].
19.	人民卫生出版社有限公司. 2012年. Available at: http://www.pmph.com/Page/list.jsp?cid=1641. [Accessed August 15, 2012].
20.	International Council of Nurses. Nursing workforce profile database summary. 2011. Available at: http://www.icn.ch/images/stories/documents/pillars/sew/DATASHEET_SUMMARY_NURSING_PROFILE_2011.pdf. [Accessed August 10, 2012].
21.	International Council of Nurses. An aging nursing workforce. 2008. Available at: http://www.icn.ch/images/stories/documents/publications/fact_sheets/2a_FS-Ageing_Workforce.pdf. [Accessed August 15, 2012].
22.	Canadian Nurses Association. Nursing Education in Canada Statistics 2008-2009.Ottawa. 2010. Available at: http://www2.cna-aiic.ca/CNA/documents/pdf/publications/Education_Statistics_Report_2008_2009_e.pdf. [Accessed August 10, 2012].
23.	International Council of Nurses. Nursing workforce profile database summary. 2011. Available at: http://www.icn.ch/images/stories/documents/pillars/sew/DATASHEET_SUMMARY_NURSING_PROFILE_2011.pdf. [Accessed August 10, 2012].
24.	International Council of Nurses. Nurse wages and their context Asia workforce forum database summary. 2010. Available at: http://www.icn.ch/images/stories/documents/pillars/sew/sew_asia_workforce_forum_database_summary_2010.pdf. [Accessed August 10, 2012].
25.	李静. 护理学学科体系构建的探索性研究. 上海. 第二军医大学. 2010年.
26.	del Bueno, Dorothy J.R.N.Competency based education. Nurs Educ, 1978, 3(3): 10-14.
27.	Luann MD, Janie BB, Kindy KS. The development of organizing framework to implement AACN Guidelines for nursing education. Journal of Nursing Education, 2002, 41(1): 34-37.
28.	曹梅娟, 姜安丽. 护理本科人才培养整体胜任力标准框架模型的构建. 中华护理杂志, 2009, 44(6): 536-538.
29.	Leung Wai-ching. Competency based medical training: review. BMJ, 2002, 325(28): 693.
30.	Lee JY, Lee SL, Jo MW. Lessons from Healthcare Providers’ Attitudes toward Pay-for-performance: What Should Purchasers Consider in Designing and Implementing a Successful Program? J Prev Med Public Health, 2012, 45(3): 137-147. Doi: 10.3961/jpmph.2012.45.3.137.
31.	Castaldi S, Bodina A, Bevilacqua L, et al. Payment for performance (P4P): any future in Italy? BMC Public Health, 2011, 11: 377.doi:10.1186/1471-2458-11-377.
32.	Emmert M, Eijkenaar F, Kemter H, et al. Economic evaluation of pay-for-performance in health care: a systematic review. Eur J Health Econ, 2011. Doi: 10.1007/s10198-011-0329-8.
33.	孙爱红, 姚雅红. 我院护理人员绩效薪酬改革的做法与成效. 中华护理杂志, 2011, 46(2): 141-143.
34.	马巧焕, 褚洪. 高校社区医院护理人员绩效考核体系的应用. 中华护理杂志, 2012, 47(6): 498-499.
35.	Mortar A, Damberg CL, Sorbero ME, et al. Pay for Performance in the Hospital Setting: What Is the State of the Evidence? Am J Med Qual, 2009, 24(1):19-28. Doi: 10.1177/1062860608326634.
36.	Tsai Y, Wu SW. The relationships between organizational citizenship behaviour, job satisfaction and turnover intention. J Clin Nurs, 2010, 19(23-24): 3564-3574.
37.	Hwang JI, Lou F, Han SS, et al. Professionalism: the major factor influencing job satisfaction among Korean and Chinese nurses. Int Nurs Rev, 2009, 56(3): 313-318.
38.	International Council of Nurses. Positive practice environments. International Centre for Human Resources in Nursing. 2007. Available at: http://www.icn.ch/images/stories/documents/publications/fact_sheets/9d_FS-Positive_Practice_Environments.pdf. [Accessed August 10, 2012].
39.	Aiken LH, Sloane DM, Clarke S, et al. Importance of work environments on hospital outcomes in nine countries. Int Jr Qual Health Care, 2011, 23(4): 357-364. Doi: 10.1093/intqhc/mzr022. [Pubmed: 21561979].
40.	沈建通, 姚乐野, 李幼平, 等. 循证医学学科知识可视化研究之一: 循证医学研究主题图谱. 中国循证医学杂志, 2011, 11(6): 613-621.

1. World Bank.2010.Aavailabe at: http://data.worldbank.org/indicator/SP.POP.65UP.TO.ZS.
2. 中华人民共和国卫生部疾病预防控制局. 卫生部等15部门关于印发《中国慢性病防治工作规划(2012-2015年)》的通知. 卫疾控发[2012]34号.2012年. Available at: http://www.moh.gov.cn/publicfiles/business/htmlfiles/mohjbyfkzj/s5878/201205/54755.htm.
3. 刘善明, 魏赓, 张伟, 等. 西藏自治区四类常见神经精神障碍的流行病学调查. 四川大学学报(医学版), 2012, 43(2): 210-213.
4. Bunting BP, Murphy SD, O’Neill SM, et al. Lifetime prevalence of mental health disorders and delay in treatment following initial onset: evidence from the Northern Ireland Study of Health and Stress. Psychol Med, 2012, 42(8): 1727-1739.
5. Vicente B, Saldivia S, de la Barra F, et al. Prevalence of child and adolescent mental disorders in Chile: a community epidemiological study. J Child Psychol Psychiatry, 2012, 53(10): 1026-1035.
6. International Council of Nurses. Nurse: Patient Ratios. 2003. Available at: http://www.icn.ch/images/stories/documents/publications/fact_sheets/9c_FS-Nurse_Patient_Ratio.pdf. [Accessed August 26, 2012].
7. World health organization. The nursing & midwifery programme at WHO Available at: http://www.who.int/hrh/nursing_midwifery/en/. [Accessed 26 August 2012].
8. World Health Organization. Strategic directions for strengthening nursing and midwifery services 2011-2015. Geneva.2010. Available at: http://www.who.int/nursing_midwifery/en/. [Accessed August 26, 2012].
9. Huicho L, Scherpbier RW, Nkowane AM, et al. How much does quality of child care vary between health workers with differing durations of training? An observational multicountry study. The Lancet, 2008, 372(9642): 910-916. Doi: 10.1016/S0140-6736(08)61401-4.
10. World Health Organization. Global survey monitoring progress in nursing and midwifery. Geneva. 2010. Available at: http://whqlibdoc.who.int/hq/2010/WHO_HRH_HPN_10.4_eng.pdf. [Accessed August 20, 2012].
11. 中华人民共和国卫生部.2010中国卫生统计年鉴. 2010年. Available at: http://www.moh.gov.cn/publicfiles/business/htmlfiles/zwgkzt/ptjnj/year2010/index2010.html. [Accessed August 20, 2012].
12. 中华人民共和国卫生部. 2006中国卫生统计年鉴. 2006年. Available at: http://www.moh.gov.cn/publicfiles/business/htmlfiles/zwgkzt/ptjnj/year2006/index.html. [Accessed August 20, 2012].
13. 中华人民共和国卫生部. 2007-2011年我国卫生事业发展统计公报.2007-2011年. Available at: http://www.moh.gov.cn/publicfiles//business/htmlfiles/zwgkzt/pgb/index.htm. [Accessed August 15, 2012].
14. 中华人民共和国卫生部统计信息中心. 2012中国卫生统计提要. 2012年. Available at: http://www.moh.gov.cn/publicfiles/business/htmlfiles/mohwsbwstjxxzx/s9092/201206/55044.htm. [Accessed August 15, 2012].
15. World Health Organization. World Health Statistics 2011. Geneva. 2011. Available at: http://www.who.int/entity/gho/publications/world_health_statistics/EN_WHS2011_Full.pdf. [Accessed August 10, 2012].
16. Frenk J, Chen L, Bhutta ZA, et al. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. The Lancet, 2010, 376(9756): 1923-1958.
17. 胡锦梁, 郑小华. 2015年四川省医疗机构卫技人员配置标准测算. 中国卫生事业管理, 2009, (5): 292-294.
18. 中华人民共和国教育部. 2012年具有普通高等学历教育招生资格的高等学校名单. Available at: http://www.moe.edu.cn/publicfiles/business/htmlfiles/moe/moe_634/201206/137993.html. [Accessed August 10, 2012].
19. 人民卫生出版社有限公司. 2012年. Available at: http://www.pmph.com/Page/list.jsp?cid=1641. [Accessed August 15, 2012].
20. International Council of Nurses. Nursing workforce profile database summary. 2011. Available at: http://www.icn.ch/images/stories/documents/pillars/sew/DATASHEET_SUMMARY_NURSING_PROFILE_2011.pdf. [Accessed August 10, 2012].
21. International Council of Nurses. An aging nursing workforce. 2008. Available at: http://www.icn.ch/images/stories/documents/publications/fact_sheets/2a_FS-Ageing_Workforce.pdf. [Accessed August 15, 2012].
22. Canadian Nurses Association. Nursing Education in Canada Statistics 2008-2009.Ottawa. 2010. Available at: http://www2.cna-aiic.ca/CNA/documents/pdf/publications/Education_Statistics_Report_2008_2009_e.pdf. [Accessed August 10, 2012].
23. International Council of Nurses. Nursing workforce profile database summary. 2011. Available at: http://www.icn.ch/images/stories/documents/pillars/sew/DATASHEET_SUMMARY_NURSING_PROFILE_2011.pdf. [Accessed August 10, 2012].
24. International Council of Nurses. Nurse wages and their context Asia workforce forum database summary. 2010. Available at: http://www.icn.ch/images/stories/documents/pillars/sew/sew_asia_workforce_forum_database_summary_2010.pdf. [Accessed August 10, 2012].
25. 李静. 护理学学科体系构建的探索性研究. 上海. 第二军医大学. 2010年.
26. del Bueno, Dorothy J.R.N.Competency based education. Nurs Educ, 1978, 3(3): 10-14.
27. Luann MD, Janie BB, Kindy KS. The development of organizing framework to implement AACN Guidelines for nursing education. Journal of Nursing Education, 2002, 41(1): 34-37.
28. 曹梅娟, 姜安丽. 护理本科人才培养整体胜任力标准框架模型的构建. 中华护理杂志, 2009, 44(6): 536-538.
29. Leung Wai-ching. Competency based medical training: review. BMJ, 2002, 325(28): 693.
30. Lee JY, Lee SL, Jo MW. Lessons from Healthcare Providers’ Attitudes toward Pay-for-performance: What Should Purchasers Consider in Designing and Implementing a Successful Program? J Prev Med Public Health, 2012, 45(3): 137-147. Doi: 10.3961/jpmph.2012.45.3.137.
31. Castaldi S, Bodina A, Bevilacqua L, et al. Payment for performance (P4P): any future in Italy? BMC Public Health, 2011, 11: 377.doi:10.1186/1471-2458-11-377.
32. Emmert M, Eijkenaar F, Kemter H, et al. Economic evaluation of pay-for-performance in health care: a systematic review. Eur J Health Econ, 2011. Doi: 10.1007/s10198-011-0329-8.
33. 孙爱红, 姚雅红. 我院护理人员绩效薪酬改革的做法与成效. 中华护理杂志, 2011, 46(2): 141-143.
34. 马巧焕, 褚洪. 高校社区医院护理人员绩效考核体系的应用. 中华护理杂志, 2012, 47(6): 498-499.
35. Mortar A, Damberg CL, Sorbero ME, et al. Pay for Performance in the Hospital Setting: What Is the State of the Evidence? Am J Med Qual, 2009, 24(1):19-28. Doi: 10.1177/1062860608326634.
36. Tsai Y, Wu SW. The relationships between organizational citizenship behaviour, job satisfaction and turnover intention. J Clin Nurs, 2010, 19(23-24): 3564-3574.
37. Hwang JI, Lou F, Han SS, et al. Professionalism: the major factor influencing job satisfaction among Korean and Chinese nurses. Int Nurs Rev, 2009, 56(3): 313-318.
38. International Council of Nurses. Positive practice environments. International Centre for Human Resources in Nursing. 2007. Available at: http://www.icn.ch/images/stories/documents/publications/fact_sheets/9d_FS-Positive_Practice_Environments.pdf. [Accessed August 10, 2012].
39. Aiken LH, Sloane DM, Clarke S, et al. Importance of work environments on hospital outcomes in nine countries. Int Jr Qual Health Care, 2011, 23(4): 357-364. Doi: 10.1093/intqhc/mzr022. [Pubmed: 21561979].
40. 沈建通, 姚乐野, 李幼平, 等. 循证医学学科知识可视化研究之一: 循证医学研究主题图谱. 中国循证医学杂志, 2011, 11(6): 613-621.

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