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目的探寻一种适合于乡村及偏远地区医务人员的指导模式。设计考虑到乡村及偏远地区缺乏医务人员,建议以指导的方式作为人力资源的挽留策略。复习有关指导的相关文献,优先考虑突出指导内容的文献来判定其对乡村及偏远地区医务人员的适用性。方法总共复习了39篇文献,对乡村及偏远地区医务人员指导中的关键因素进行概括。本文对加强乡村及偏远地区医务工作的主要方式及阻碍指导的因素进行确定。由此开发出一种指导乡村及偏远地区医生、学生、学者的模式。结果共确定4种指导模式:复制、培养、友谊、学徒。学徒模式适合于学生,培养模式适用于新入行并定居于乡村及偏远地区的医务工作者,友谊模式用于高年资医务人员/学者。能够加强指导乡村及偏远地区医务人员的影响因素有:高年资医务人员的使命感、员工之间强有力的关系、模糊的工作与社会的界限、层次的缺乏、跨专业执业及技术;阻碍因素有:工作负担、与导师沟通的渠道、某些医务人员的收费系统、可能危及工作及生意关系的冲突、被评价的感受。结论现在已经找到一种乡村及偏远地区医务人员的指导模式。假如乡村及偏远地区医务人力资源有可能得以加强和增加,那么这种模式的尝试就是值得的,其影响尚需评估。
Objective To explore a suitable guidance model for medical workers in rural and remote areas. Given the lack of medical staff in rural and remote areas, the design suggests guiding strategies as retention strategies for human resources. Review relevant literature on guidance and give priority to documents that highlight guidance to determine its applicability to medical workers in rural and remote areas. Methods A total of 39 articles were reviewed to summarize the key factors in the direction of medical staff in rural and remote areas. This article identifies ways to strengthen medical work in rural and remote areas, as well as the factors that hinder the guidance. This led to the development of a model that guides doctors, students and scholars in rural and remote areas. Results A total of four kinds of guidance patterns were identified: replication, cultivation, friendship, apprenticeship. The apprenticeship model is suitable for students. The training model is suitable for new medical workers residing in rural and remote areas. The friendship model is for senior medical staff / scholars. Influencing factors that can guide the medical staff in rural and remote areas include the sense of mission of senior health care workers, strong relationships among employees, vague work and social boundaries, lack of levels, cross-discipline practice and technology; Factors include: work load, channels of communication with mentors, charging systems for certain medical staff, conflicts that may jeopardize work and business relationships, feelings of being evaluated. Conclusions A guideline has been found for medical staff in rural and remote areas. If the medical and human resources in rural and remote areas are likely to be strengthened and increased, then this model of attempt is worth the impact of its assessment needs to be.