Focus on community: directions for nursing knowledge development

Nursing science and public health: contributions to the discipline of nursing

This column highlights the unique relationship of nursing science and public health in the broader context of the discipline of nursing and healthcare. An integrated framework is used to illustrate that nursing knowledge is the product of interaction and interdependence of four domains -the discipline and science of nursing, the philosophy of nursing, the nursing profession, and nursing practice. In the context of the integrated framework, knowledge specific to public health nursing is shown to inform the discipline of nursing and other health disciplines. Ongoing challenges related to clarifying and describing unique contributions to nursing and public health are explored. In addition, under utilization of theoretical and conceptual nursing knowledge from public health nursing for the advancement nursing science in education, practice, and research is addressed.

Being and doing politics: an outdated model or 21st century reality?

AIM

This paper presents a discussion of how critical social theory can be used as a tool for research, reflection and exploration of the political role of the nurse.

BACKGROUND

Sociological theory can be used to examine ideologies within nursing systems in order to contribute to the future development of the profession. The importance of critical social theory has been identified in the literature as being directly relevant to holism which is central to the nature of nursing.

DATA SOURCES

Texts published in English were identified from 1990 to 2008 using the keywords critical social theory, community nursing, political advocacy, social justice, sociological theory, health inequalities, health democracy, equity and inequality.

DISCUSSION

Critical social theory can be used as a tool to highlight ethical ways to practise nursing. One reason for examination of the community nurse's political role is a shift in focus from the individual as patient to communities experiencing health inequalities. Nursing needs to decide whether the profession will work at the political level, and where advocacy and citizenship are located within a community role.

CONCLUSION

Nurse educators must prepare nurses for political participation, and nurse managers need to focus on national and local contexts in order to encourage policy analysis and community engagement within nursing practice. An understanding of critical social theory can aid decision-making in relation to global and local policy, enable the nursing profession to respond to social injustice, and permit nurses to work with communities in the pursuit of community health.

Sustaining a healthy work force in the 21st century--a model for collaborating through reciprocation

Occupational health nurses are positioned to restore and maintain worker health, well-being, and safety, thereby increasing productivity. A model of practice is needed that provides a comprehensive worker-environment perspective. A model that incorporates reciprocation and collaboration increases workers' engagement in their own health action plan. It empowers workers and provides a broader multidimensional perspective on factors affecting or influencing their health. The Reciprocation Model has been designed using the nursing process; it incorporates reciprocation and collaboration to assist occupational health nurses improve or maintain worker health and safety, as well as achieve corporate goals of reducing on-the-job lost time and increasing productivity.

Home and border: the contradictions of community

If community is the theory and locale for much of nursing in the 21st century, complex thinking about community is required. In creating unified identities to form community, differences are suppressed and border communities are built. This article examines the contradictory, complicated, and unending processes of producing home (a space of comfort and commonality) and border (a space of discomfort and difference) communities. The construction of border communities in terms of class and race/ethnicity are considered through exemplars from research on the meaning of community. A deeper understanding of community calls for us to live with uncertainty and unfamiliarity.

From theory to practice: community health nursing in a public health neighborhood team

An interdisciplinary team in a local public health district tested its ability to implement the core public health functions of assessment, policy development, and assurance by changing its practice to a community-driven model of building partnerships for health with groups and communities in a designated locale. Evaluation of this innovation revealed that the public health nurse members of the team enacted their community health nursing knowledge to strengthen agency to cocreate health. Interdisciplinary collaboration was essential to the team's community mobilization efforts. Additional findings suggested that this organizational innovation was associated with developing a more participatory organizational climate, increasing system effectiveness, and building community capacity.

Take-a-village (TAV): a metaphorical model for health promotion

Because of the emerging minority concept in American society, nursing in the new millennium is committed to designing culturally appropriate community health nursing models. The purpose of this article is to build one metaphorical model for health promotion inductively from substantive data obtained in a qualitative research. In one study, the take-a-village (TAV) construct was conceptualized as a kin and a social network system. TAV was born out of a popular African adage that "it takes a village to raise one single child." The TAV model emerged during the analysis phase of the study. This model-building exercise explored the tenets of the TAV construct for use in building a community health practice model for health promotion.

Concepts of health: implications for public health work

This article explores the health concepts of community health care (CHC) nurses in relation to their potential roles as public health workers. On examining Ewen's (1998) study of CHC nurses' role perceptions, it is evident that an individualized, person-centred, holistic approach to care continues to dominate practice. The public health role within CHC nursing remains underdeveloped and is equated with primary prevention with the well population. A 'community-as-foreground' model is proposed as a useful way of redefining CHC nursing practice to incorporate public health. The discussion revolves around the need for a broader view of health to include a political and social dimension, and considers the role of education and practice in achieving this.