Article(id=1322931654938993337, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322931549481599694, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.12.008, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1775059200000, receivedDateStr=2026-04-02, revisedDate=1780416000000, revisedDateStr=2026-06-03, acceptedDate=null, acceptedDateStr=null, onlineDate=1793341085418, onlineDateStr=2026-10-30, pubDate=1782316800000, pubDateStr=2026-06-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793341085418, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793341085418, creator=13701087609, updateTime=1793341085418, updator=13701087609, issue=Issue{id=1322931549481599694, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='12', pageStart='2001', pageEnd='2192', issueExtLink='null', onlineDate='null', pubDate='1782316800000', pubDateStr='2026-06-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793341060276, creator='13701087609', updateTime=1793343118019, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322940180335829530, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322931549481599694, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322940180335829531, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322931549481599694, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=2067, endPage=2071, ext={EN=ArticleExt(id=1322931656696406714, articleId=1322931654938993337, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Optimization and preliminary application of a training program for nutrition support nurses, columnId=1220689484526572183, journalTitle=Chinese Nursing Research, columnName=Original Articles, runingTitle=null, highlight=null, articleAbstract=
Objective

Based on family nurse diet theory and the competency model,to optimize the training program for nutrition support nurses in China,and to verify its scientific validity and practical applicability through a preliminary application,thereby to provide basis for improving the training system.

Methods

A preliminary draft of the training program was developed through literature review and semi-structured interviews.A modified Delphi method was used to consult 29 experts over two rounds.The final program was revised based on their opinions.A preliminary application was conducted in Shanxi province.Data on core competencies were collected from 57 nutrition support nurses before and after the training to evaluate the training effect.

Results

The response rates for the two rounds of expert consultation were 85.29% and 100.00% respectively.The expert authority coefficients were 0.876 and 0.907,respectively.The final program consisted of four parts:training objectives,training content,training process,and assessment and evaluation.Core contents included nutrition-related knowledge,whole-process management of nutrition support,competency development,and clinical practice.The preliminary application showed that the post-training core competency score of the nutrition support nurses was significantly higher than the pre-training score (P<0.05).

Conclusion

The training program for nutrition support nurses,to optimize based on the family nurse diet theory and the competency model,is highly scientific and feasible.It can provide a reference for improving the training system for Nutrition Support Nurses in China.

, authors=Jing ZHANG1, Hongfang SHAO1, Dandan GUO1, Ruolan LI2, Linping SHANG1, 3, Shifan HAN1, 3, 4, 5, 6, Ruifang ZHU1, 3, authorsList=Jing ZHANG, Hongfang SHAO, Dandan GUO, Ruolan LI, Linping SHANG, Shifan HAN, Ruifang ZHU, authorCompany=null, correspAuthors=Ruifang ZHU, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322931657463964347, articleId=1322931654938993337, tenantId=1146029695717560320, journalId=1220038315760373764, language=CN, title=营养支持专科护士培养方案的优化及初步应用, columnId=1220689484681761433, journalTitle=护理研究, columnName=科研论著, runingTitle=null, highlight=null, articleAbstract=
目的

基于家庭护士食疗理论与胜任力模型,优化我国营养支持专科护士培养方案,并通过初步应用验证其科学性与实用性,为完善培养体系提供依据。

方法

通过文献回顾与半结构化访谈拟定培养优化方案初稿,采用改良德尔菲法对29名专家进行函询,根据专家意见修订形成最终方案。在山西省开展初步应用,收集57名营养支持专科护士培训前后数据,检验培训效果。

结果

共进行了2轮专家函询,问卷回收率分别为85.29%和100.00%,专家权威系数分别为0.876和0.907。最终方案涵盖培养目标、内容、过程、考核与评价4部分,包括营养相关知识、全程管理、胜任力培养及临床实践等核心内容。初步应用显示,培训后营养支持专科护士核心能力得分明显高于培训前(P<0.05)。

结论

基于家庭护士食疗理论与胜任力模型优化的营养支持专科护士培养方案具有较高的科学性与可行性,可为完善我国营养支持专科护士的培养体系提供参考。

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张静,硕士研究生在读

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朱瑞芳,E-mail:
ZHU Ruifang, E-mail:
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unstructuredReference=胡美玲,刘红梅,刘航呈,等.基于Miller金字塔模型的静脉治疗专科护士培训方案的构建及应用[J].当代护士,2025,32(28):146-151., articleTitle=基于Miller金字塔模型的静脉治疗专科护士培训方案的构建及应用, refAbstract=null), Reference(id=1322931666829845272, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931654938993337, doi=null, pmid=null, pmcid=null, year=2021, volume=50, issue=7, pageStart=1247, pageEnd=1251, url=null, language=null, rfNumber=19, rfOrder=18, authorNames=田仁萍, 任懿, 徐永柱, journalName=重庆医学, refType=null, unstructuredReference=田仁萍,任懿,徐永柱.重庆市住院医师规范化培训效果评价及影响因素分析[J].重庆医学,2021,50(7):1247-1251., articleTitle=重庆市住院医师规范化培训效果评价及影响因素分析, refAbstract=null), Reference(id=1322931666934702873, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931654938993337, doi=null, pmid=null, pmcid=null, year=2024, volume=8, issue=8, pageStart=587, pageEnd=591, url=null, language=null, rfNumber=20, rfOrder=19, authorNames=何甘霖, 陈淑英, 何穗智, journalName=中国毕业后医学教育, refType=null, 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Coefficient of coordination from two rounds of expert consultations

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轮次 项目Kendall's W值χ2值P
第1轮重要程度0.330558.478<0.001
相关性0.334517.546<0.001
第2轮重要程度0.246427.541<0.001
相关性0.259481.449<0.001
), ArticleFig(id=1322931662128030464, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931654938993337, language=CN, label=表1, caption=

2轮专家函询的协调系数

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轮次 项目Kendall's W值χ2值P
第1轮重要程度0.330558.478<0.001
相关性0.334517.546<0.001
第2轮重要程度0.246427.541<0.001
相关性0.259481.449<0.001
), ArticleFig(id=1322931662249665281, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931654938993337, language=EN, label=Table 2, caption=

Results of expert inquiry

, figureFileSmall=null, figureFileBig=null, tableContent=
项目条目重要程度相关性
得分(x±s,分)变异系数得分(x±s,分)变异系数
A培养目标A1基础目标4.80±0.560.116 94.80±0.560.116 9
A2进阶目标4.53±0.640.141 24.47±0.830.186 6
B培养内容B1营养基础知识4.93±0.260.052 34.80±0.560.116 9
B1.1营养学基础4.73±0.700.148 84.67±0.900.192 7
B1.2营养相关理论4.60±0.510.110 24.53±0.640.141 3
B1.3营养发展历程3.73±0.880.237 03.73±0.880.237 0
B1.4相关政策法律4.20±0.940.224 14.20±0.940.224 1
B2营养全程管理4.93±0.260.052 34.80±0.410.086 3
B2.1健康及亚健康人群营养管理4.80±0.410.086 34.73±0.800.168 9
B2.2患病人群营养管理4.87±0.520.106 04.87±0.520.106 0
B2.3慢性病及康复期人群的营养管理4.87±0.520.106 04.80±0.560.116 9
B3营养核心胜任力培养4.67±0.720.155 04.27±0.960.225 1
B3.1营养评估与干预能力4.73±0.460.096 84.53±0.920.202 0
B3.2护理教学能力4.53±0.740.164 04.27±0.960.225 1
B3.3护理管理能力3.93±0.960.244 53.80±0.860.226 8
B3.4护理领导能力4.07±0.960.236 13.93±0.880.224 9
B3.5人际交往与沟通能力4.67±0.900.192 74.40±0.910.206 8
B3.6知识综合能力4.60±0.740.160 24.47±0.830.186 6
B3.7评判性思维能力4.40±0.910.206 84.07±0.960.236 1
C培养过程C1学员入选要求4.47±1.060.237 14.33±0.900.207 9
C2师资安排4.67±0.720.155 04.33±1.050.241 8
C3培养形式4.60±1.120.243 74.53±1.130.248 3
C4授课方法4.80±0.770.161 54.80±0.780.161 5
D培养考核与评价D1胜任力表现评估体系(CPAs,课堂教学效果的评价)4.60±0.510.110 24.47±0.640.143 2
D2胜任力表现测验体系(CPEs,临床教学效果的评价)4.67±0.620.132 14.40±0.740.167 5
D3学术继教4.13±0.830.201 94.13±0.830.201 9
), ArticleFig(id=1322931662333551362, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931654938993337, language=CN, label=表2, caption=

专家函询结果

, figureFileSmall=null, figureFileBig=null, tableContent=
项目条目重要程度相关性
得分(x±s,分)变异系数得分(x±s,分)变异系数
A培养目标A1基础目标4.80±0.560.116 94.80±0.560.116 9
A2进阶目标4.53±0.640.141 24.47±0.830.186 6
B培养内容B1营养基础知识4.93±0.260.052 34.80±0.560.116 9
B1.1营养学基础4.73±0.700.148 84.67±0.900.192 7
B1.2营养相关理论4.60±0.510.110 24.53±0.640.141 3
B1.3营养发展历程3.73±0.880.237 03.73±0.880.237 0
B1.4相关政策法律4.20±0.940.224 14.20±0.940.224 1
B2营养全程管理4.93±0.260.052 34.80±0.410.086 3
B2.1健康及亚健康人群营养管理4.80±0.410.086 34.73±0.800.168 9
B2.2患病人群营养管理4.87±0.520.106 04.87±0.520.106 0
B2.3慢性病及康复期人群的营养管理4.87±0.520.106 04.80±0.560.116 9
B3营养核心胜任力培养4.67±0.720.155 04.27±0.960.225 1
B3.1营养评估与干预能力4.73±0.460.096 84.53±0.920.202 0
B3.2护理教学能力4.53±0.740.164 04.27±0.960.225 1
B3.3护理管理能力3.93±0.960.244 53.80±0.860.226 8
B3.4护理领导能力4.07±0.960.236 13.93±0.880.224 9
B3.5人际交往与沟通能力4.67±0.900.192 74.40±0.910.206 8
B3.6知识综合能力4.60±0.740.160 24.47±0.830.186 6
B3.7评判性思维能力4.40±0.910.206 84.07±0.960.236 1
C培养过程C1学员入选要求4.47±1.060.237 14.33±0.900.207 9
C2师资安排4.67±0.720.155 04.33±1.050.241 8
C3培养形式4.60±1.120.243 74.53±1.130.248 3
C4授课方法4.80±0.770.161 54.80±0.780.161 5
D培养考核与评价D1胜任力表现评估体系(CPAs,课堂教学效果的评价)4.60±0.510.110 24.47±0.640.143 2
D2胜任力表现测验体系(CPEs,临床教学效果的评价)4.67±0.620.132 14.40±0.740.167 5
D3学术继教4.13±0.830.201 94.13±0.830.201 9
), ArticleFig(id=1322931662543266563, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931654938993337, language=EN, label=Table 3, caption=

Comparison of scores changes before and after training for nutrition support specialty nurses based on different demographic and occupational characteristics(x±s)

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项目分类人数培训前后得分差值统计值P
医院等级三级甲等4410.84±6.33t=1.9890.052
其他136.92±5.89
职称初级/中级5210.25±6.48t=1.1540.253
高级56.80
是否持有营养相关证书无5110.14±6.66t=0.6500.519
有68.33±3.45
最高学历本科549.74±6.48t=-1.0350.305
硕士研究生313.67
年龄25~34岁2113.48±7.57F=6.2100.004
35~44岁298.21±4.59
≥45岁76.57±4.61
临床工作年限<5年518.00F=6.2210.004
5~10年1411.14±6.32
>10年388.45±4.67
近1年培训次数无329.88±4.68F=0.0630.979
1次1210.08±10.23
2次610.83±7.91
≥3次79.29±4.89
), ArticleFig(id=1322931662631346948, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931654938993337, language=CN, label=表3, caption=

不同人口学及职业特征营养支持专科护士能力培训前后得分变化比较(x±s)

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分类人数培训前后得分差值统计值P
医院等级三级甲等4410.84±6.33t=1.9890.052
其他136.92±5.89
职称初级/中级5210.25±6.48t=1.1540.253
高级56.80
是否持有营养相关证书无5110.14±6.66t=0.6500.519
有68.33±3.45
最高学历本科549.74±6.48t=-1.0350.305
硕士研究生313.67
年龄25~34岁2113.48±7.57F=6.2100.004
35~44岁298.21±4.59
≥45岁76.57±4.61
临床工作年限<5年518.00F=6.2210.004
5~10年1411.14±6.32
>10年388.45±4.67
近1年培训次数无329.88±4.68F=0.0630.979
1次1210.08±10.23
2次610.83±7.91
≥3次79.29±4.89
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营养支持专科护士培养方案的优化及初步应用
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张静 1 , 邵红芳 1 , 郭丹丹 1 , 李若兰 2 , 商临萍 1, 3 , 韩世范 1, 3, 4, 5, 6 , 朱瑞芳 1, 3, *, *
护理研究 | 科研论著 2026,40(12): 2067-2071
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护理研究 |科研论著 2026 , 40 (12) : 2067 -2071
营养支持专科护士培养方案的优化及初步应用
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张静1, 邵红芳1, 郭丹丹1, 李若兰2, 商临萍1, 3, 韩世范1, 3, 4, 5, 6, 朱瑞芳1, 3, *, *
作者信息
  • 1山西医科大学护理学院,山西 030001
  • 2山西医学期刊社有限责任公司
  • 3山西医科大学第一医院
  • 4山西医科大学食疗科技研究中心
  • 5山西省食疗和农产品处方产业技术创新战略联盟
  • 6山西省大健康产教融合重大平台载体与实训基地
通讯作者:
朱瑞芳,E-mail:
ZHU Ruifang, E-mail:
作者简介:

张静,硕士研究生在读

Optimization and preliminary application of a training program for nutrition support nurses
Jing ZHANG1, Hongfang SHAO1, Dandan GUO1, Ruolan LI2, Linping SHANG1, 3, Shifan HAN1, 3, 4, 5, 6, Ruifang ZHU1, 3
Affiliations
  • 1Nursing College of Shanxi Medical University, Shanxi 030001 China
  • 2Shanxi Medical Periodical Press Co., Ltd.
  • 3First Hospital of Shanxi Medical University
  • 4Dietotherapy Science and Technology Research Center,Shanxi Medical University
  • 5Shanxi Province Food Therapy and Agricultural Products Prescription Industry Technology Innovation Strategic Alliance
  • 6Major Platform Carrier and Training Base for the Integration of Health Industry and Education in Shanxi Province
出版时间: 2026-06-25 doi: 10.12102/j.issn.1009-6493.2026.12.008
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目的

基于家庭护士食疗理论与胜任力模型,优化我国营养支持专科护士培养方案,并通过初步应用验证其科学性与实用性,为完善培养体系提供依据。

方法

通过文献回顾与半结构化访谈拟定培养优化方案初稿,采用改良德尔菲法对29名专家进行函询,根据专家意见修订形成最终方案。在山西省开展初步应用,收集57名营养支持专科护士培训前后数据,检验培训效果。

结果

共进行了2轮专家函询,问卷回收率分别为85.29%和100.00%,专家权威系数分别为0.876和0.907。最终方案涵盖培养目标、内容、过程、考核与评价4部分,包括营养相关知识、全程管理、胜任力培养及临床实践等核心内容。初步应用显示,培训后营养支持专科护士核心能力得分明显高于培训前(P<0.05)。

结论

基于家庭护士食疗理论与胜任力模型优化的营养支持专科护士培养方案具有较高的科学性与可行性,可为完善我国营养支持专科护士的培养体系提供参考。

营养支持  /  专科护士  /  培养方案  /  护理
Objective

Based on family nurse diet theory and the competency model,to optimize the training program for nutrition support nurses in China,and to verify its scientific validity and practical applicability through a preliminary application,thereby to provide basis for improving the training system.

Methods

A preliminary draft of the training program was developed through literature review and semi-structured interviews.A modified Delphi method was used to consult 29 experts over two rounds.The final program was revised based on their opinions.A preliminary application was conducted in Shanxi province.Data on core competencies were collected from 57 nutrition support nurses before and after the training to evaluate the training effect.

Results

The response rates for the two rounds of expert consultation were 85.29% and 100.00% respectively.The expert authority coefficients were 0.876 and 0.907,respectively.The final program consisted of four parts:training objectives,training content,training process,and assessment and evaluation.Core contents included nutrition-related knowledge,whole-process management of nutrition support,competency development,and clinical practice.The preliminary application showed that the post-training core competency score of the nutrition support nurses was significantly higher than the pre-training score (P<0.05).

Conclusion

The training program for nutrition support nurses,to optimize based on the family nurse diet theory and the competency model,is highly scientific and feasible.It can provide a reference for improving the training system for Nutrition Support Nurses in China.

nutritional support  /  specialist nurse  /  training program  /  nursing
张静, 邵红芳, 郭丹丹, 李若兰, 商临萍, 韩世范, 朱瑞芳. 营养支持专科护士培养方案的优化及初步应用. 护理研究, 2026 , 40 (12) : 2067 -2071 . DOI: 10.12102/j.issn.1009-6493.2026.12.008
Jing ZHANG, Hongfang SHAO, Dandan GUO, Ruolan LI, Linping SHANG, Shifan HAN, Ruifang ZHU. Optimization and preliminary application of a training program for nutrition support nurses[J]. Chinese Nursing Research, 2026 , 40 (12) : 2067 -2071 . DOI: 10.12102/j.issn.1009-6493.2026.12.008
在老龄化加剧和慢性病负担不断上升的背景下,营养支持专科护士在慢性病防治和人群营养管理中的作用日益凸显[1-4]。我国营养支持专科护士培训起步较晚,关于营养支持专科护士的培训体系尚不成熟,中华护理学会目前进行了多次营养支持专科护士培训,但对于完善、标准、全面的培养方案仍在摸索中[5]。现有营养支持专科护士培训多以知识与技能传授为主,在能力结构整合、全程营养管理理念以及系统评价机制等方面仍存在不足,难以全面支撑营养支持专科护士在复杂临床与社区情景中的角色发挥[6]。针对上述问题,本研究在系统梳理国内外营养支持专科护士培养方案的基础上,参考国外较为成熟的培养内容与实践经验,结合我国家庭护士食疗理论的实践特点[7],引入非营养素及全程营养管理等理念[8],并以胜任力结果与绩效评估模型作为整体结构框架[9],对现有培养方案进行整合与优化。同时,充分考虑学习者需求,对培养内容与培养过程进行调整,以期为我国营养支持专科护士培养方案的完善提供理论依据与实践参考。此外,本研究经过初步应用验证优化方案的科学性与可行性。
系统检索中国知网、万方数据库、PubMed、MedLine、Cochrane Library等数据库以及国内外相关机构网站。检索时限为建库至2025年3月1日。中文检索词为:“营养支持专科护士”“营养护理专家”“营养护士”“培养”“培训”等,英文检索词为:“specialist nurse”“advanced practice nurse”“nutritional support”“nutrition nurse”“training”等。根据检索内容拟定半结构化访谈提纲,主要包括:对当前培养课程设置的满意度及具体体现;培训内容与临床工作的契合度及主要工作任务;对岗位胜任力的自我评价及进一步学习需求;培训后的临床角色转变或个人成长;对培训方案的改进建议。采用目的性抽样法,于2025年3月—4月选取取得中华护理学会营养支持专科护士培训证书的17名护士进行半结构访谈。访谈数据通过NVivo 15.0软件进行管理和分析,采用Colaizzi现象学资料7步分析法进行分析[10],以确保结果的真实性与准确性。通过小组讨论、分析,初步拟定培养优化方案初稿。
专家纳入标准:在营养相关领域具有10年及以上工作经验;副高级及以上职称;本科及以上学历;对本研究知情同意并能够积极参与。在充分考虑函询内容、专家的权威性和可及性、专家的专业领域等基础上,选择了来自北京、上海、河北、山西、四川、云南、内蒙古等地的29名专家进行函询,其中临床营养专家12人,包括临床营养师以及来自营养科、胃肠外科、消化内科等科室的医学营养专家;护理专家13人,包括护理管理者、取得营养支持专科证书的专科护士以及护理教育专家等;中医专家2人,食疗专家2人;20年及以上工作经验占72.41%;25名专家具备硕士研究生及以上学历,占86.21%;所有专家职称均为副高级及以上,担任研究生导师的专家占51.72%。
专家咨询问卷分为3部分:第1部分是专家咨询知情同意书,在介绍研究的目的和意义之后,征询专家是否同意参加此研究。第2部分是专家信息表、判断依据表、专家对表格各项信息熟悉程度评价表。第3部分为咨询问卷的主体内容,说明优化后的营养支持专科护士培养方案的基本框架和各部分的具体内容等,同时还设有增加建议栏和修改意见栏,以便专家填写建议。
本次函询调查通过面对面、微信、邮件等渠道发放专家函询问卷。每轮函询的指标筛选标准为同时满足重要性均分>3.50分、变异系数(CV)<0.25[11]。第1轮专家函询问卷收回后,整理有效信息并对有效意见进行处理分析后回访专家,向专家反映回访结果,将修订后的问卷按照相同的方式进行第2轮专家咨询,将第2轮专家函询问卷整理分析后得到函询最终结果。
采用Microsoft Excel和SPSS 26.0对营养支持专科护士培养优化方案专家咨询表内容进行统计学处理,得出专家对咨询问卷中每个选项的重视程度、相关性赋分结果后分别计算每个选项均分、标准差、变异系数、肯德尔系数。根据回收有效问卷的比例和提出意见的比例得出专家积极系数;根据专家判断依据及熟悉程度自评表统计得出咨询专家的权威系数;根据专家信息登记表统计咨询专家基本信息。
采用自身前后对照试验,在培训前完成基线调查,培训结业当天完成干预后调查。通过比较培训前后核心能力得分变化,评价培训效果。采用便利抽样法,于2025年7月—8月选取山西省营养支持专科护士培训班的57名学员为研究对象。纳入标准:具有护士执业证书,且注册在有效期内;从事临床护理工作5年及以上,其中在重症医学科、普外科、肿瘤科、老年科等相关科室工作3年及以上;具备本科及以上学历,护理专业或相关医学专业;自愿参加本研究并签署知情同意书。排除标准:因病假、事假或其他原因在培训期间无法完成全部培训的护士。
研究者在系统文献回顾基础上自行编制营养支持专科护士核心能力现状与培训需求调查问卷,问卷包括3部分内容。1)一般资料调查表:收集性别、年龄、学历、医院等级、职称、工作年限等资料;2)核心能力评估量表:包括6个维度,共17个条目,采用Likert 5级评分法,总分17~85分,得分越高,表示核心能力越强,该量表信效度良好;3)开放性问题,用于收集学员建议,以促进培养方案持续改进。
以问卷星的方式通过现场发放问卷和微信发放问卷,分别于培训开始前和培训结束后进行问卷填写与数据收集。培训前共回收有效问卷61份,有效回收率为100%,培训后回收有效问卷57份,有效回收率为93%。
采用Excel、SPSS 25.0软件进行数据整理及统计分析。符合正态分布的定量资料以均数±标准差(x±s)表示,采用独立样本t检验;不符合正态分布的定量资料以中位数(四分位数)[M(P25,P75)]表示,采用 Welch校正检验。定性资料用频数、百分比(%)表示。所有统计检验均为双侧检验,以P<0.05为差异有统计学意义。
研究期间严格把控问卷的质量,遵守伦理学原则,调查对象知情同意并自愿参与。本次调查采用匿名方法,对医护人员资料保密,其相关信息仅用于本次研究,本研究已通过山西医科大学第一医院伦理委员会审查(编号:KYLL-2025-158)。
专家的积极系数指的是专家的参与度,通过有效问卷的回收率衡量,回收率>70%认为专家参与程度较高。本研究共进行了2轮专家函询,2轮问卷回收率分别为85.29%和100.00%,表明专家的参与度较高。专家权威程度通过权威系数(Cr)表示,用来评判专家意见的可信度与权重,以保证专家意见的科学性与有效性。Cr的计算公式为:Cr=[判断系数(Ca)+熟悉系数(Cs)]/2[12-13]。根据2轮专家咨询的判断系数和熟悉系数结果计算得权威系数分别为0.876和0.907,均>0.70,表明专家函询结果较为可靠。
专家的协调程度是衡量专家群体对某一问题是否达成共识的指标,用变异系数和肯德尔协调系数(Kendall's W)表示[14]。2轮函询协调系数均有统计学意义(P<0.001),提示专家意见存在高度一致的趋势。第2轮协调系数较第1轮略有下降,可能是第1轮函询后剔除专家分歧较大的条目,优化问卷结构所致,整体仍保持良好的专家意见一致性,无须开展第3轮函询,研究结果可靠。见表1。
根据重要性均分和变异系数要求对各条目进行筛选。根据函询结果,所有条目均符合上述条件,且专家意见较为统一。根据2轮专家的函询结果和意见,得到了营养支持专科护士培养优化方案终稿,包括培养目标、培养内容、培养过程、培养考核与评价4部分,见表2。
最终纳入57名营养支持专科护士,均为女性,年龄35~44岁占52.63%;临床工作年限>10年者占71.93%。采用配对样本t检验分析培训前后学员核心能力得分变化,培训后总分为(65.42±8.69)分,培训前总分为(45.16±13.73)分,培训前后得分比较差异有统计学意义(P<0.05)。
以培训前后总分差值作为培训效果指标,对不同人口学及职业特征护士得分变化进行分析,结果见表3。
目前,我国营养支持专科护士培养方案虽已具备行业规范和实践基础,但在培养目标分层、能力导向结构整合及临床培养方面仍有进一步优化的空间。本研究在系统梳理现有方案的基础上,通过文献分析、半结构化访谈及改良德尔菲专家函询,对培养目标、培养内容、结构框架、临床实践等多方面进行针对性优化,构建了以胜任力模型为核心框架的培养方案。在方案构建过程中,本研究以现有培养方案为基础,查阅国内外相关文献、网站,参考实践标准,如《营养支持护士的实践标准》《营养支持和全科护士的营养护理实践标准和专业表现》《专科护士培训大纲》[15]等,明确当前培养方案的内容框架及实施现状。结合半结构化访谈,参考一线护理人员、实践专家与管理者的意见,并创新性地融入本课题组前期形成的家庭护士食疗理论及非营养素相关知识,同时引入胜任力模型作为整体结构框架,形成培养方案初稿。随后采用2轮改良德尔菲专家函询法对方案进行修订与完善。参与函询的专家均具有较高的学术水平和丰富的实践经验,在相关研究领域具有一定代表性,能够从不同角度提出专业性和建设性意见。专家参与积极性较高,意见具有较高可信度,协调程度较高、分歧较小。综上所述,通过文献分析、质性研究及专家函询,本研究构建的培养方案在内容设置和结构框架上具有较好的科学性与可靠性,为后续方案的实施与评价提供了坚实的方法学基础。
核心能力是指营养支持专科护士从事护理工作应具有的能力,是护士知识、技能、态度的综合表现[16-17]。本研究结果显示,培训后营养支持专科护士核心能力得分明显高于培训前(P<0.05),这一结果与胡美玲等[18]在静脉治疗专科护士培训中的结果相一致,说明系统的培养有助于提高营养支持专科护士的核心能力。营养支持专科护士培养方案突出了对非营养素知识、慢性病食疗处方制定、多学科合作和营养评估工具等的培养,说明综合性、针对性的课程设置可以很好地弥补专业知识更新和综合分析应用能力上的不足。另外,本研究结果还显示,年轻的低年资护士进步培训后提升更明显,学历、职称、参加培训经历影响均不明显,说明培训效果可能更多决定于培训老师的培训水平、培训时间长短、培训内容、培训考核标准[19-20]等因素。
本研究通过文献回顾、质性研究及德尔菲专家函询,对我国营养支持专科护士培养方案进行了系统优化,以家庭护士食疗理论为指导,结合胜任力模型,贴近临床实际需求,得出了一个更加完善的培养优化方案。尽管研究本身存在不足,如自我评量方法的局限性、评估短期效果等,但本研究形成的训练培养方案利于提高专科护士核心能力,有一定的可行性与有效性,可为改善类似训练培养模式提供参考。

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doi: 10.12102/j.issn.1009-6493.2026.12.008
  • 接收时间:2026-04-02
  • 首发时间:2026-10-30
  • 出版时间:2026-06-25
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  • 收稿日期:2026-04-02
  • 修回日期:2026-06-03
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    1山西医科大学护理学院,山西 030001
    2山西医学期刊社有限责任公司
    3山西医科大学第一医院
    4山西医科大学食疗科技研究中心
    5山西省食疗和农产品处方产业技术创新战略联盟
    6山西省大健康产教融合重大平台载体与实训基地

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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
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属
Genus
种数
Number of
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Percentage of total
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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