目的 建立门诊护士沟通胜任力结构模型并验证，探讨门诊护士沟通胜任力的结构和内涵，以期为培训和考核提供客观依据。 方法 2021年3月，采用专家函询方式对上海市8所医院的32名专家进行有关门诊护士沟通胜任力要素的开放性问卷调查；同时段采用行为事件访谈法对某院16名门诊护士进行访谈，编码分析访谈资料后，筛选胜任要素，并综合专家函询结果建立初始模型；基于初始模型编制问卷，对8所综合性医院307名门诊护士进行调查，通过探索性因子分析门诊护士沟通胜任力结构要素，采取验证性因子分析验证模型结构。 结果 最终建立门诊护士沟通胜任力结构模型，包括3个一级指标（认知技能、心理素质、人际互动）和14个二级指标，其中医学专业知识、协调解决能力、总结性思考、预知性服务、主动性、同理心等6项为鉴别性沟通胜任力。 结论 构建的门诊护士沟通胜任力结构模型结构科学合理，可为门诊护士综合素质结构评价、培训模式以及绩效评定等方面提供参考。

Objective To construct and verify the communication competence structure model of outpatient nurses,to reveal the structure and connotation of the communication competence of outpatient nurses,and to provide objective basis for training and assessment. Methods In March 2021,an open questionnaire survey on the elements of communication competence of outpatient nurses was conducted among 32 experts from 8 hospitals in Shanghai by correspondence.Meanwhile,behavioral event interview method was used to interview 16 outpatient nurses in a hospital.After coding and analyzing the interview data,the competence elements were screened,and the initial model was established based on the results of expert consultation.A total of 307 outpatient nurses from 8 general hospitals were investigated with the questionnaire based on the initial model.The structure elements of outpatient nurses’ communication competence were analyzed by exploratory factor analysis,and the structure of the model was verified by confirmatory factor analysis. Results The communication competence structure model of outpatient nurses was finally established, including 3 first-class indicators(cognitive skills,personality traits,and interpersonal interaction) and 14 second-class indicators,of which 6 items,including medical professional knowledge,coordination and solving ability,summative thinking,predictive service,initiative,and empathy,were identified as communication competence. Conclusions The communication competence structure model of outpatient nurses is scientific and reasonable,and can be used as a reference for the comprehensive quality structure evaluation,training mode and performance evaluation of outpatient nurses.

R47；R823