Social meanings and understandings in patient-nurse interaction in the community practice setting: a grounded theory study

Provisional: Background: The patient-nurse relationship is a traditional concern of healthcare research. However, patient-nurse interaction is under examined from a social perspective. Current research focuses mostly on specific contexts of care delivery and experience related to medical condition or illness, or to nurses' speciality. Consequentially, this paper is about the social meanings and understandings at play within situated patient-nurse interaction in the community practice setting in a transforming healthcare service. Methods: Grounded theory methodology was used and the research process was characterised by principles of theoretical sensitivity and constant comparative analysis. The field of study was four health centres in the community. The participants were patients and nurses representative of those attending or working in the health centres and meeting there by scheduled appointment. Data collection methods were observations, informal interviews and semi-structured interviews. Results: Key properties of 'Being a good patient, being a good nurse', 'Institutional experiences' and 'Expectations about healthcare' were associated with the construction of a category entitled 'Experience'. Those key properties captured that in an evolving healthcare environment individuals continually re-constructed their reality of being a patient or nurse as they endeavoured to perform appropriately; articulation of past and present healthcare experiences was important in that process. Modus operandi in role as patient was influenced by past experiences in healthcare and by those in non-healthcare institutions in terms of engagement and involvement (or not) in interaction. Patients' expectations about interaction in healthcare included some uncertainly as they strived to make sense of the changing roles and expertise of nurses and, differentiating between the roles and expertise of nurses and doctors. Conclusions: The importance of social meanings and understandings in patient-nurse interaction is not fully apparent to nurses, but important in the patient experience. Seeking understanding from a social perspective makes a contribution to enhancing knowledge about patient-nurse interaction with subsequent impact on practice, in particular the development of the patient-nurse relationship. The implications are that the meanings and understandings patients and nurses generate from experiences beyond and within their situated interaction are pivotal to the development of their relationship in the transforming community healthcare environment

Migration of women from the Philippines: Implications for healthcare delivery

Filipinos have been an important part of the global workforce since the first half of the twentieth century. The initial migration of primarily men has shifted to an increasing numbers of women in recent decades. These changes are primarily attributed to a high demand for domestic workers, nurses and occupations that are female dominated. In 2005, about 70% of the international labour migrants are women from the Philippines. Living in a foreign land, these women face challenges that affect their physical, emotional and social well being. Especially on their first year living abroad, these women experience significant stress which affects their health as they adjust to a new work environment, culture, social norms, diet, and weather. The emotional strain can be greater for those who have left their families behind in the Philippines and aggravated by the financial need to send money to them. Striking examples, such as the homicide rate of Filipino women married to Australian men being 5.6 times higher than that of Australian-born women, underscores the importance of supportive health care environments and appreciating socio-cultural factors. In the delivery of healthcare services to migrant women, it is critical to consider the unique socio-cultural background of women as well as health beliefs and practices. © 2011 Royal College of Nursing, Australia

An Integrative Review of Home Visiting Programs for Mothers and Infants from Birth to 12 Months in Developed and Underdeveloped Countries

Objectives. To investigate home visiting for mothers and young infants, age birth-To-12 months, program goals, interventions used, home visitor characteristics and qualifications, and the program content and outcomes. Methods. Electronic databases PubMed, CINAHL, ScienceDirect, and Sagepub were used. Eleven studies investigating home visiting from 2011-To-2016 were included. Studies were included if they: 1) were a primary study; 2) commenced during the antepartum or early postpartum period for mothers and finished before or when the infant was 12 months old; 3) and provided a description of home visiting program in terms of goal, type of home visitor, content, length, and outcomes. Data extraction included goals, activities, home visitor characteristics and qualificati ons, and outcomes. A descriptive approach was used to synthesize data. Results. Home visiting impacted birth preparedness, newborn care practices, breastfeeding practices, and home environment necessary for maternal wellness and child health and development. Conclusion. Home visits in developed and underdeveloped countries create positive outcomes for mothers and infants. It is important to understand the process in order to make it more effective