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Strus JA, Holmes D, O'Byrne P, Hammond C. Lefebvre's production of space: Implications for nursing. Nurs Philos 2024; 25:e12420. [PMID: 36750689 DOI: 10.1111/nup.12420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 08/23/2022] [Accepted: 01/18/2023] [Indexed: 02/09/2023]
Abstract
In this paper, we argue that nurses need to be aware of how the production of space in specific contexts - including health care systems and research institutions - perpetuates marginalized populations' state of social otherness. Lefebvre's idea regarding spatial triad is mobilized in this paper, as it pertains to two-spirited, lesbian, gay, bisexual, trans and queer populations (2SLGBTQ*). We believe that nurses can create counter-spaces within health care systems and research institutions that challenge normative discourses. Lefebvre's work provides us the necessary tools to understand how various places or environments produce identities. In understanding Lefebvre's principles, we believe that nurses can play an essential role in creating counter-spaces, thereby instigating counter-institutional practices, for those who experience otherness.
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Affiliation(s)
- Jacqueline A Strus
- Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Dave Holmes
- Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Patrick O'Byrne
- Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Chad Hammond
- College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Bergström A, Ehrenberg A, Eldh AC, Graham ID, Gustafsson K, Harvey G, Hunter S, Kitson A, Rycroft-Malone J, Wallin L. The use of the PARIHS framework in implementation research and practice-a citation analysis of the literature. Implement Sci 2020; 15:68. [PMID: 32854718 PMCID: PMC7450685 DOI: 10.1186/s13012-020-01003-0] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 05/20/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The Promoting Action on Research Implementation in Health Services (PARIHS) framework was developed two decades ago and conceptualizes successful implementation (SI) as a function (f) of the evidence (E) nature and type, context (C) quality, and the facilitation (F), [SI = f (E,C,F)]. Despite a growing number of citations of theoretical frameworks including PARIHS, details of how theoretical frameworks are used remains largely unknown. This review aimed to enhance the understanding of the breadth and depth of the use of the PARIHS framework. METHODS This citation analysis commenced from four core articles representing the key stages of the framework's development. The citation search was performed in Web of Science and Scopus. After exclusion, we undertook an initial assessment aimed to identify articles using PARIHS and not only referencing any of the core articles. To assess this, all articles were read in full. Further data extraction included capturing information about where (country/countries and setting/s) PARIHS had been used, as well as categorizing how the framework was applied. Also, strengths and weaknesses, as well as efforts to validate the framework, were explored in detail. RESULTS The citation search yielded 1613 articles. After applying exclusion criteria, 1475 articles were read in full, and the initial assessment yielded a total of 367 articles reported to have used the PARIHS framework. These articles were included for data extraction. The framework had been used in a variety of settings and in both high-, middle-, and low-income countries. With regard to types of use, 32% used PARIHS in planning and delivering an intervention, 50% in data analysis, 55% in the evaluation of study findings, and/or 37% in any other way. Further analysis showed that its actual application was frequently partial and generally not well elaborated. CONCLUSIONS In line with previous citation analysis of the use of theoretical frameworks in implementation science, we also found a rather superficial description of the use of PARIHS. Thus, we propose the development and adoption of reporting guidelines on how framework(s) are used in implementation studies, with the expectation that this will enhance the maturity of implementation science.
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Affiliation(s)
- Anna Bergström
- Department of Women’s and Children’s health, Uppsala Global Health Research on Implementation and Sustainability (UGHRIS), Uppsala, Sweden
- Institute for Global Health, University College London, London, UK
| | - Anna Ehrenberg
- School of Education, Health, and Social Studies, Dalarna University, Falun, Sweden
- Adelaide Nursing School, University of Adelaide, Adelaide, Australia
| | - Ann Catrine Eldh
- Department of Medicine and Health, Linköping University, Linköping, Sweden
- Department of Public Health and Caring Science, Uppsala University, Uppsala, Sweden
| | - Ian D. Graham
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
- Ottawa Hospital Research Institute, Ottawa, Canada
| | - Kazuko Gustafsson
- School of Education, Health, and Social Studies, Dalarna University, Falun, Sweden
- University Library, Uppsala University, Uppsala, Sweden
| | - Gillian Harvey
- Adelaide Nursing School, University of Adelaide, Adelaide, Australia
| | - Sarah Hunter
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Alison Kitson
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
- Green Templeton College, University of Oxford, Oxford, UK
| | - Jo Rycroft-Malone
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancashire, UK
| | - Lars Wallin
- School of Education, Health, and Social Studies, Dalarna University, Falun, Sweden
- Department of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Room Design-A Phenomenological-Hermeneutical Study: A Factor in Creating a Caring Environment. Crit Care Nurs Q 2019; 42:265-277. [PMID: 31135477 DOI: 10.1097/cnq.0000000000000267] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Medical technology has progressed tremendously over the last few decades, but the same development cannot be seen in the design of these intensive care unit environments. Authors report results of a study of evidence-based room design, emphasizing the impact on conveying a caring attitude to patients. Ten nonparticipant observations were conducted in patient rooms with 2 different designs, followed by interviews. The data were analyzed using a phenomenological-hermeneutical approach. The results did not reveal that it was obvious that redesigned spaces resulted in a more caring attitude. The meanings of caring displayed during nursing activities were interpreted by interpreting gazes. Some of the nursing staff had an instrumental gaze, interpreted as caring with a task-orientated approach, while others communicated their caring with an attentive and attuned gaze, where the needs of the patients regulated the working shift. The study findings indicated that caring may not be perceived when nurses use a task-oriented approach. However, when nurses practice a person-centered approach, using an attentive and attuned gaze, caring is conveyed. Caring in intensive care contexts needs to be assisted by a supportive environment design that cultivates the caring approach.
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Lindahl B, Kirk S. When technology enters the home – a systematic and integrative review examining the influence of technology on the meaning of home. Scand J Caring Sci 2018; 33:43-56. [DOI: 10.1111/scs.12615] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 07/29/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Berit Lindahl
- Faculty of Caring Sciences Work Life & Social Welfare University of Borås Borås Sweden
| | - Sue Kirk
- Division of Nursing Midwifery & Social Work University of Manchester Manchester UK
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Hospitals, clinics, and palliative care units: Place-based experiences of formal healthcare settings by people experiencing structural vulnerability at the end-of-life. Health Place 2018; 53:43-51. [DOI: 10.1016/j.healthplace.2018.06.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 06/18/2018] [Accepted: 06/19/2018] [Indexed: 11/23/2022]
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Water T, Wrapson J, Reay S, Ford K. Making space work: Staff socio-spatial practices in a paediatric outpatient department. Health Place 2018; 50:146-153. [DOI: 10.1016/j.healthplace.2018.01.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 01/09/2018] [Accepted: 01/26/2018] [Indexed: 02/05/2023]
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Giesbrecht M, Crooks VA, Castleden H, Schuurman N, Skinner MW, Williams AM. Revisiting the use of 'place' as an analytic tool for elucidating geographic issues central to Canadian rural palliative care. Health Place 2016; 41:19-23. [PMID: 27521815 DOI: 10.1016/j.healthplace.2016.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 05/13/2016] [Accepted: 06/21/2016] [Indexed: 11/16/2022]
Abstract
In 2010, Castleden and colleagues published a paper in this journal using the concept of 'place' as an analytic tool to understand the nature of palliative care provision in a rural region in British Columbia, Canada. This publication was based upon pilot data collected for a larger research project that has since been completed. With the addition of 40 semi-structured interviews with users and providers of palliative care in four other rural communities located across Canada, we revisit Castleden and colleagues' (2010) original framework. Applying the concept of place to the full dataset confirmed the previously published findings, but also revealed two new place-based dimensions related to experiences of rural palliative care in Canada: (1) borders and boundaries; and (2) 'making' place for palliative care progress. These new findings offer a refined understanding of the complex interconnections between various dimensions of place and palliative care in rural Canada.
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Affiliation(s)
- Melissa Giesbrecht
- Department of Geography, Simon Fraser University, 8888 University Drive, Burnaby, British Columbia, Canada V5A 1S6.
| | - Valorie A Crooks
- Department of Geography, Simon Fraser University, 8888 University Drive, Burnaby, British Columbia, Canada V5A 1S6
| | - Heather Castleden
- Department of Geography and Planning, Queen's University, 99 University Avenue, Kingston, Ontario, Canada K7L 3N6
| | - Nadine Schuurman
- Department of Geography, Simon Fraser University, 8888 University Drive, Burnaby, British Columbia, Canada V5A 1S6
| | - Mark W Skinner
- Trent School of the Environment, Trent University, 1600 West Bank Drive, Peterborough, Ontario, Canada K9L 0G2
| | - Allison M Williams
- School of Geography & Earth Sciences, McMaster University, 1280 Main Street West, Hamilton, Ontario, Canada L8S 4M1
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Kyle RG, Atherton IM, Kesby M, Sothern M, Andrews G. Transfusing our lifeblood: Reframing research impact through inter-disciplinary collaboration between health geography and nurse education. Soc Sci Med 2016; 168:257-264. [PMID: 27522601 DOI: 10.1016/j.socscimed.2016.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 06/22/2016] [Accepted: 08/02/2016] [Indexed: 10/21/2022]
Abstract
Geographers have long grappled with how their research can positively impact individuals, communities and society. Demonstrating research impact is an increasingly important aspect of academic life internationally. In this paper we argue that agendas for encouraging 'impact' would be well-served if impact through teaching was identified and stimulated more explicitly, and if academics better recognised and seized the opportunities that already exist for such impact. We take engagement between health geography and nurse education as an example of how social scientists could demonstrate research impact through inter-disciplinary involvement in the education of health care professionals, and specifically student nurses. We begin by showing how the UK's Research Excellence Framework (widely regarded as the key reference point for research performance management regimes internationally) has tended to produce an undervaluation of impact via education in many disciplines. A comprehensive overview of international scholarship at the intersection between geography and nursing is then presented. Here we trace three 'waves of enquiry' that have focused on research interactions before calling for a fourth focused on critical pedagogy. To illustrate the possibilities of this fourth wave, we sketch a case study that outlines how engagement with research around blood donation could help provide a foundation for critical pedagogy that challenges student nurses to practice reflexively, think geographically and act justly. Finally, we call for closer engagement between health geography and nurse education, by encouraging educators to translate, teach, and transfuse ideas and people between health geography and nurse education. In so doing, we argue that work at this interface can be mutually beneficial and demonstrate impact both within and beyond research assessment rubrics. Hence, our ideas are relevant beyond nurse education and geography insofar as this paper serves as an example of how reframing research impact can recover the importance of impact through education.
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Affiliation(s)
- Richard G Kyle
- School of Nursing, Midwifery and Social Care, Edinburgh Napier University, UK.
| | - Iain M Atherton
- School of Nursing, Midwifery and Social Care, Edinburgh Napier University, UK
| | - Mike Kesby
- Department of Geography and Sustainable Development, University of St Andrews, UK
| | - Matthew Sothern
- Department of Geography and Sustainable Development, University of St Andrews, UK
| | - Gavin Andrews
- Department of Health, Aging & Society, McMaster University, Canada
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Andrews GJ. Geographical thinking in nursing inquiry, part one: locations, contents, meanings. Nurs Philos 2016; 17:262-81. [DOI: 10.1111/nup.12133] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Gavin J. Andrews
- Department of Health, Aging and Society McMaster University Hamilton ON Canada
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10
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A practice theory approach to understanding the interdependency of nursing practice and the environment: implications for nurse-led care delivery models. ANS Adv Nurs Sci 2015; 38:96-109. [PMID: 25932817 DOI: 10.1097/ans.0000000000000068] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Nursing has a rich knowledge base with which to develop care models that can transform the ways health is promoted and valued. However, theory linking the environment domain of the nursing metaparadigm with the real-world environments where nurses practice and patients experience their health care is tenuous. Practice theory is used to foreground the generative role of nursing practice in producing environments of care, providing the basis for a metaparadigm relational proposition explicitly linking nursing practice and environment metaparadigm domains. A theoretical and empirical focus on the significance of nursing practice dynamics in producing environments of care that promote health and healing will strengthen present and future nursing care models.
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Persson E, Anderberg P, Ekwall AK. A room of one's own--Being cared for in a hospital with a single-bed room design. Scand J Caring Sci 2014; 29:340-6. [PMID: 25213674 DOI: 10.1111/scs.12168] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2014] [Accepted: 06/26/2014] [Indexed: 11/28/2022]
Abstract
AIM To illuminate patients' experiences of being hospitalised in a hospital with a single-bed room design. INTRODUCTION Many patients seem to prefer single-bed hospital rooms. However, studies have also shown that patients do see the advantages of multiple-bed rooms. METHOD Interviews were conducted with 16 inpatients from a surgical ward in a hospital building with a single-bed room design. A hermeneutical-phenomenological approach guided by van Manen's four life-world existentials was used to analyse the interviews. RESULTS The essential meaning was that patients felt secure because they could create a personal environment without disruptive elements. The room was private, and this implied feelings of homeliness, which allowed patients to focus on themselves and was thought to facilitate the recovery process. The patients preferred staying in their room, and the relationship with the personnel was central. Feelings of loneliness and isolation could occur and could be frightening. Being hospitalised in a single-bed room meant balancing between feeling secure and feeling insecure. The following four themes emerged: A homely environment, The need for company and security, Time as unpredictable and involving waiting and Focus on healing the body. CONCLUSION Patients experienced that a single-bed room allowed them to focus on their recovery, have visitors without disturbing others and create a feeling of homeliness. However, mobilisation is not a natural part of the recovery process when patients have all they need in their rooms. The patients' need for social interaction and confirmation was not satisfied without effort and planning on the part of staff.
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Affiliation(s)
- Eva Persson
- Department of Health Sciences, Lund University, Lund, Sweden
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12
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Huchon C, Arsenault C, Tourigny C, Coulibaly A, Traore M, Dumont A, Fournier P. Obstetric competence among referral healthcare providers in Mali. Int J Gynaecol Obstet 2014; 126:56-9. [PMID: 24800659 DOI: 10.1016/j.ijgo.2014.01.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 12/20/2013] [Accepted: 03/26/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine the factors associated with obstetric competency and clinical practice among obstetric care providers in referral health centers in Mali. METHODS The present cross-sectional study was conducted between March and May 2012 among 140 obstetric care providers (obstetric nurses, midwives, and physicians) working in referral health centers in Mali. Emergency obstetric care knowledge and skills were evaluated with clinical vignettes developed using national Malian guidelines. The vignettes covered 5 areas of emergency obstetric care, and the results were used to generate a competency score. A backward stepwise random-effects model using a maximum likelihood estimator was applied to evaluate variables independently associated with competency score. RESULTS Out of 100, the mean±SD score was 57.8±11.2 for obstetric nurses, 66.4±14.7 for midwifes, and 78.6±13.4 for physicians (P<0.001). Three variables were significantly associated with a higher competency score: professional qualification, working in an urban setting, and working in a health center with a smaller number of obstetric care providers. CONCLUSION Increasing the in-service training of both rural staff and lower-level healthcare workers working in larger health centers via facility-based maternal death reviews might help to improve clinical practice and maternal health outcomes.
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Affiliation(s)
- Cyrille Huchon
- Centre de recherche du CHU Sainte Justine, Montréal, Canada; Axe de Santé Mondiale, CRCHUM, Université de Montréal, Montréal, Canada
| | | | - Caroline Tourigny
- Axe de Santé Mondiale, CRCHUM, Université de Montréal, Montréal, Canada
| | - Aliou Coulibaly
- Axe de Santé Mondiale, CRCHUM, Université de Montréal, Montréal, Canada
| | - Mamadou Traore
- URFOSAME, Faculté de Médecine, Université de Bamako, Bamako, Mali
| | - Alexandre Dumont
- Unité 216, Institut de recherche pour le développement, Paris, France
| | - Pierre Fournier
- Axe de Santé Mondiale, CRCHUM, Université de Montréal, Montréal, Canada.
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Browall M, Koinberg I, Falk H, Wijk H. Patients' experience of important factors in the healthcare environment in oncology care. Int J Qual Stud Health Well-being 2013; 8:20870. [PMID: 23924604 PMCID: PMC3737438 DOI: 10.3402/qhw.v8i0.20870] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/29/2013] [Indexed: 12/30/2022] Open
Abstract
Background and objective The aim of this study was to describe what factors of the healthcare environment are perceived as being important to patients in oncology care. Design A qualitative design was adopted using focus group interviews. Setting and participants The sample was 11 patients with different cancer diagnoses in an oncology ward at a university hospital in west Sweden. Results Analysis of the patients’ perceptions of the environment indicated a complex entity comprising several aspects. These came together in a structure consisting of three main categories: safety, partnership with the staff, and physical space. The care environment is perceived as a complex entity, made up of several physical and psychosocial aspects, where the physical factors are subordinated by the psychosocial factors. It is clearly demonstrated that the patients’ primary desire was a psychosocial environment where they were seen as a unique person; the patients wanted opportunities for good encounters with staff, fellow patients, and family members, supported by a good physical environment; and the patients valued highly a place to withdraw and rest. Conclusions This study presents those attributes that are valued by cancer patients as crucial and important for the support of their well-being and functioning. The results show that physical aspects were subordinate to psychosocial factors, which emerged strongly as being the most important in a caring environment.
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Affiliation(s)
- Maria Browall
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
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Giesbrecht MD, Crooks VA, Stajduhar KI. Examining the language-place-healthcare intersection in the context of Canadian homecare nursing. Nurs Inq 2012. [PMID: 23190192 DOI: 10.1111/nin.12010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Currently, much of the western world is experiencing a shift in the places where care is provided, namely from institutional settings like hospitals to diverse community settings such as the home. However, little is known about how language and the physical and social aspects of place interact to influence how health-care is delivered and experienced in the home environment. Drawing on ethnographic participant observations of homecare nursing visits and semi-structured interviews with Canadian family caregivers, care recipients and nurses, the intersection of language, place and health-care was explored in this secondary analysis. Our findings reveal four themes: homecare nurses view themselves as 'guests'; home environments facilitate the development of nurse-client relationships; nurses adapt healthcare language to each home environment; and storytelling and illness narratives largely prevail during medical interactions in the home. These findings demonstrate the spatiality of language and how the home environment informs decisions regarding language use. Furthermore, these findings exemplify how language and place mutually influence the experiences and delivery of home health-care. We conclude by discussing the importance of considering the language-place-healthcare intersection in order to gain a better understanding of medical exchanges in places and the associated implications for optimizing best nursing practice.
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Affiliation(s)
- Melissa D Giesbrecht
- Department of Geography, Simon Fraser University, Burnaby, BC, CanadaSchool of Nursing and Centre on Aging, University of Victoria, Victoria, BC, Canada
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Falk H, Wijk H, Persson LO, Falk K. A sense of home in residential care. Scand J Caring Sci 2012; 27:999-1009. [PMID: 23170830 DOI: 10.1111/scs.12011] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 09/24/2012] [Indexed: 12/01/2022]
Abstract
Moving into a residential care facility requires a great deal of adjustment to an environment and lifestyle entirely different from that of one's previous life. Attachment to place is believed to help create a sense of home and maintain self-identity, supporting successful adjustment to contingencies of ageing. The purpose of this study was to deepen our understanding of processes and strategies by which older people create a sense of home in residential care. Our findings show that a sense of home in residential care involves strategies related to three dimensions of the environment - attachment to place, to space and attachment beyond the institution - and that the circumstances under which older people manage or fail in creating attachment, consist of psychosocial processes involving both individual and shared attitudes and beliefs. Assuming that attachment is important to human existence regardless of age, attention must be paid to optimize the circumstances under which attachment is created in residential care, and how nursing interventions can help speed up this process due to the frail and vulnerable state of most older residents.
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Affiliation(s)
- Hanna Falk
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
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DeGuzman PB, Kulbok PA. Changing health outcomes of vulnerable populations through nursing's influence on neighborhood built environment: a framework for nursing research. J Nurs Scholarsh 2012; 44:341-8. [PMID: 23062005 DOI: 10.1111/j.1547-5069.2012.01470.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE The purpose of this article is to present a framework for nurses to study the impact of built environment on health, particularly in vulnerable populations. ORGANIZING CONSTRUCT The framework is adapted from Social Determinants of Health and Environmental Health Promotion, a framework describing how physical and social environments interact to influence individual and population health and health disparities via macro, community-level, and interpersonal factors. METHODS The original framework was modified for public health nursing using nursing research evaluating built environment and health, and supplemented with Nightingale's theory of nursing and health. FINDINGS The built environment affects health through regional-, neighborhood-, and individual-level factors. Nursing can affect the health of patients by evaluating the neighborhood built environment where patients reside, and by advocating for changes to the built environment. CONCLUSIONS Through development of built environment research, nurses can provide valuable insight into the pathways linking built environment to health of vulnerable populations, providing evidence for public health nurses to advocate for these changes on a neighborhood, state, and federal level. CLINICAL RELEVANCE This framework can be used by public health clinicians to understand the pathways by which the built environment may be affecting the health of their patients, and by researchers to investigate the pathways, and to design and test community interventions.
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Persson E, Määttä S. To provide care and be cared for in a multiple-bed hospital room. Scand J Caring Sci 2012; 26:663-70. [DOI: 10.1111/j.1471-6712.2012.00976.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Liaschenko J, Peden-McAlpine C, Andrews GJ. Institutional geographies in dying: nurses' actions and observations on dying spaces inside and outside intensive care units. Health Place 2011; 17:814-21. [PMID: 21478045 DOI: 10.1016/j.healthplace.2011.03.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2010] [Revised: 03/06/2011] [Accepted: 03/10/2011] [Indexed: 12/18/2022]
Abstract
This paper articulates the geographies associated with intensive care nursing work with dying patients and their families. Six focus groups were conducted with 27 registered critical care nurses who practice in hospitals in a mid-western city in the United States. The analysis is structured by three emerging themes (i) the importance of a 'good' and 'sacred' place, (ii) the body as mapped by medical specialties, and (iii) problems with procedurally driven suspension of 'do not resuscitate' orders beyond intensive care units (ICUs). Recommendations describe the need for institutional recognition of the moral importance of strong relationships between nurses, clients, and their families, and nurses' wide-ranging roles in bridging the various spatial domains of intensive care.
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Affiliation(s)
- Joan Liaschenko
- University of Minnesota, Center for Bioethics and School of Nursing, 410 Church Street SE, Minneapolis, MN 55455, USA.
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Abstract
Many studies on patient safety are geared towards prevention of adverse events by eliminating causes of error. In this article, I argue that patient safety research needs to widen its analytical scope and include causes of strength as well. This change of focus enables me to ask other questions, like why don't things go wrong more often? Or, what is the significance of time and space for patient safety? The focal point of this article is on the spatial dimension of patient safety. To gain insight into the 'geography' of patient safety and perform a topical analysis, I will focus on one specific kind of space (sterile space), one specific medical procedure (insertion of an intravenous line) and one specific medical ward (neonatology). Based on ethnographic data from research in the Netherlands, I demonstrate how spatial arrangements produce sterility and how sterility work produces spatial orders at the same time. Detailed analysis shows how a sterile line insertion involves the convergence of spatially distributed resources, relocations of the field of activity, an assemblage of an infrastructure of attention, a specific compositional order of materials, and the scaling down of one's degree of mobility. Sterility, I will argue, turns out to be a product of spatial orderings. Simultaneously, sterility work generates particular spatial orders, like open and restricted areas, by producing buffers and boundaries. However, the spatial order of sterility intersects with the spatial order of other lines of activity. Insight into the normative structure of these co-existing spatial orders turns out to be crucial for patient safety. By analyzing processes of spatial fine-tuning in everyday practice, it becomes possible to identify spatial competences and circumstances that enable staff members to provide safe health care. As such, a topical analysis offers an alternative perspective of patient safety, one that takes into account its spatial dimension.
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Affiliation(s)
- Jessica Mesman
- Department of Technology & Society Studies, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, Netherlands.
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Eriksson L, Nga NT, Målqvist M, Persson LÅ, Ewald U, Wallin L. Evidence-based practice in neonatal health: knowledge among primary health care staff in northern Viet Nam. HUMAN RESOURCES FOR HEALTH 2009; 7:36. [PMID: 19393073 PMCID: PMC2678076 DOI: 10.1186/1478-4491-7-36] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2008] [Accepted: 04/24/2009] [Indexed: 05/27/2023]
Abstract
BACKGROUND An estimated four million deaths occur each year among children in the neonatal period. Current evidence-based interventions could prevent a large proportion of these deaths. However, health care workers involved in neonatal care need to have knowledge regarding such practices before being able to put them into action.The aim of this survey was to assess the knowledge of primary health care practitioners regarding basic, evidence-based procedures in neonatal care in a Vietnamese province. A further aim was to investigate whether differences in level of knowledge were linked to certain characteristics of community health centres, such as access to national guidelines in reproductive health care, number of assisted deliveries and geographical location. METHODS This cross-sectional survey was completed within a baseline study preparing for an intervention study on knowledge translation (Implementing knowledge into practice for improved neonatal survival: a community-based trial in Quang Ninh province, Viet Nam, the NeoKIP project, ISRCTN44599712). Sixteen multiple-choice questions from five basic areas of evidence-based practice in neonatal care were distributed to 155 community health centres in 12 districts in a Vietnamese province, reaching 412 primary health care workers. RESULTS All health care workers approached for the survey responded. Overall, they achieved 60% of the maximum score of the questionnaire. Staff level of knowledge on evidence-based practice was linked to the geographical location of the CHC, but not to access to the national guidelines or the number of deliveries at the community level. Two separated geographical areas were identified with differences in staff level of knowledge and concurrent differences in neonatal survival, antenatal care and postnatal home visits. CONCLUSION We have identified a complex pattern of associations between knowledge, geography, demographic factors and neonatal outcomes. Primary health care staff knowledge regarding neonatal health is scarce. This is a factor that is possible to influence and should be considered in future efforts for improving the neonatal health situation in Viet Nam.
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Affiliation(s)
- Leif Eriksson
- International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Nguyen Thu Nga
- International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Vietnam Sweden Uong Bi General Hospital, Quang Ninh, Viet Nam
| | - Mats Målqvist
- International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Lars-Åke Persson
- International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Uwe Ewald
- Neonatology, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Lars Wallin
- International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
- Clinical Research Utilization, Karolinska University Hospital, Stockholm, Sweden
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22
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Lewis S, Andrews G. Climate change and health: Priorities for the CAM community. Complement Ther Clin Pract 2009; 15:1-4. [DOI: 10.1016/j.ctcp.2008.10.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Andrews GJ, Shaw D. Clinical geography: nursing practice and the (re)making of institutional space. J Nurs Manag 2008; 16:463-73. [PMID: 18405263 DOI: 10.1111/j.1365-2834.2008.00866.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM To present a geographical study that highlights the wide ranging spatial features of nursing agency. In turn, illustrate the further potential for geographical research to describe, support, challenge and guide clinical practice - particularly with regard to those 'everyday' activities and actions undertaken on a frequent basis. BACKGROUND To provide a focus, and to anchor the study in existing clinical knowledge and debates, the role of nursing in the (re)making of institutional experiences and life is specifically explored. METHODS In-depth semi-structured interviews were conducted with 15 nurses working in Buckinghamshire and West London, UK. The following specialties were represented: acute care including emergency (n = 3), midwifery (n = 3), children's nursing (n = 2), elderly care (n = 1), rehabilitation (n = 2), mental health (n = 3) and palliative care (n = 1). RESULTS Nurses claimed to actively manipulate, normalize and recreate clinical spaces as part of their everyday therapeutic practice. Specifically, the range of agency employed by them falls under the following six categories: adjusting social composition; introducing 'normal' activities; providing private spaces; seeking private spaces; explaining clinical spaces; spaces for personal escape and wellbeing. IMPLICATIONS FOR NURSING MANAGEMENT It is recommended that nurse leaders - including researchers, managers and clinical educators - explore geography as a source of social scientific evidence that sheds light on the complex nature of everyday professional practice. In this regard, some important disciplinary and structural issues are noted.
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Affiliation(s)
- Gavin J Andrews
- Department of Health, Aging and Society, McMaster University, Hamilton, ON, Canada.
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Andrews GJ. Geography: research and teaching in nurse education. NURSE EDUCATION TODAY 2006; 26:545-54. [PMID: 16545503 DOI: 10.1016/j.nedt.2006.01.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2005] [Revised: 01/23/2006] [Accepted: 01/30/2006] [Indexed: 05/07/2023]
Abstract
This paper outlines how geography might be integrated into nurse education. At one level, researching nurse education geographically could add to the current academic understanding of the many transitional places that make educational experiences and influence outcomes. At another level, as part of a nursing curriculum, teaching geographical concepts and issues to students might provide them with unique insights into core subjects.
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Affiliation(s)
- Gavin J Andrews
- Faculty of Nursing, University of Toronto, 155 College Street, Toronto, Ont., Canada M5T 1P8.
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Andrews GJ, Brodie DA, Andrews JP, Hillan E, Gail Thomas B, Wong J, Rixon L. Professional roles and communications in clinical placements: A qualitative study of nursing students’ perceptions and some models for practice. Int J Nurs Stud 2006; 43:861-74. [PMID: 16380124 DOI: 10.1016/j.ijnurstu.2005.11.008] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2005] [Revised: 09/13/2005] [Accepted: 11/03/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND Research evidence suggests that clinical placements are important to both the perceptions and outcomes of nurse education. Nevertheless, despite this knowledge, research also indicates that many students receive negative experiences whilst attending these 'remote' settings, sometimes resulting in missed opportunities for learning and negative impressions of potential places of employment. OBJECTIVE In this context, this study investigates the experiences and perceptions of students relating to their clinical placements and, in particular, their views on professional structuring. Specifically it addresses the roles of, and communications between, the key academics, clinical professionals and institutions responsible for their organization. METHODS Focus group discussions with students (n=7) and an interview survey of ex-students (n=30) each from two British universities in Southeast England. FINDINGS The research highlights the diverse experiences that student receive on clinical placements, as well as their own suggestions for improvements. Student informed models of worst, minimum, current and best practice are then presented, as well as a cross-setting evaluation feedback model. These highlight responsibilities and communications across health professionals and educational sites. The models include an emphasis on the roles of ward managers, mentors, link tutors and more generally on shared but clearly delineated institutional responsibility for quality assurance mechanisms. They offer the opportunity to improve educational practice in clinically-based education and concurrently to improve student experiences and outcomes. CONCLUSIONS Clinical placements are designed to provide practical learning through a 'slice of practice life'. However, it is necessary to maximize this learning experience. Placements certainly need not be the worst slice.
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MESH Headings
- Attitude of Health Personnel
- Benchmarking
- Clinical Competence
- Communication
- Cooperative Behavior
- Education, Nursing, Baccalaureate/organization & administration
- England
- Faculty, Nursing
- Focus Groups
- Health Knowledge, Attitudes, Practice
- Health Services Needs and Demand
- Humans
- Interinstitutional Relations
- Interprofessional Relations
- Mentors/psychology
- Models, Educational
- Models, Nursing
- Models, Psychological
- Nurse's Role/psychology
- Nursing Education Research
- Nursing Methodology Research
- Nursing Staff, Hospital/psychology
- Qualitative Research
- Students, Nursing/psychology
- Surveys and Questionnaires
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Affiliation(s)
- Gavin J Andrews
- Faculty of Nursing, University of Toronto, 50 St. George Street, Toronto, Ont., Canada M5S3H4.
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Affiliation(s)
- Gavin J Andrews
- Faculty of Nursing, University of Toronto, 155 College Street, Toronto, Ontario, M5T IP8, Canada.
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27
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Abstract
During the last 3 years the interface between geography and nursing has provided fertile ground for research. Not only has a conceptual emphasis on space and place provided nurse researchers with a robust and subtly different way to deconstruct and articulate nursing environments, but also their studies have provided a much needed focus on certain areas of health-care, and in particular clinical practice, not currently prioritized by health geographers. We argue that, as something that is forcing fundamental re-considerations of the nature of both nursing and geography, cyberspace is a particularly important phenomenon that lies comparatively under-researched at this interface. To encourage some interest in researching nursing and cyberspace through a geographical lens, and at least to showcase a range of potentially useful and transportable concepts, we provide an overview of some of the key debates pertaining to cyberspace developed by human geographers, and make some initial and tentative connections to nursing.
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Affiliation(s)
- Gavin J Andrews
- Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
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28
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Brodie DA, Andrews GJ, Andrews JP, Thomas BG, Wong J, Rixon L. Working in London hospitals: Perceptions of place in nursing students’ employment considerations. Soc Sci Med 2005; 61:1867-81. [PMID: 15939515 DOI: 10.1016/j.socscimed.2005.03.042] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2004] [Accepted: 03/23/2005] [Indexed: 11/21/2022]
Abstract
During the past decade, a distinct body of research has started to investigate the dynamics between nursing and place. However, despite attention being paid to a wide-range of nursing subjects, few studies have engaged with the important topic of labour force recruitment. In this context, this study uses a combined questionnaire (n=650), interview (n=30) and focus group (n=7) survey of London-based students, and investigates the complex mix of experiences and perceptions that result in hospitals having varying degrees of popularity as potential workplaces. The findings suggest experiences and perceptions of institutions-often gained on clinical placements-to be important, particularly relating to feeling valued, the quality of patient care, clinical and educational opportunities and team cohesion. These are often combined with experiences and perceptions of locality, relating to factors such as cost of living, travel considerations and sense of personnel safety. The study demonstrates that place is relevant to employment decision-making on multiple scales from wards to regions. Furthermore, that perceptions of potential workplaces result from engagements with complex mixes of cultural, economic and physical features, many of which are the consequences of management. It is argued that in order to effectively unpack workplaces, geographical research of nursing labour may benefit from researching simultaneously both 'inside' institutions, focusing on their dominant cultures of production and sub-cultures, and 'outside', focusing on their local urban or rural contexts.
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Affiliation(s)
- David A Brodie
- Research Centre for Health Studies, Buckinghamshire Chilterns University College, Chalfont Campus, Gorelands Lane, Chalfont St Giles, Buckinghamshire, HP8 4AD, UK
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Andrews GJ, Holmes D, Poland B, Lehoux P, Miller KL, Pringle D, McGilton KS. ‘Airplanes are flying nursing homes’: geographies in the concepts and locales of gerontological nursing practice. J Clin Nurs 2005; 14:109-20. [PMID: 16083493 DOI: 10.1111/j.1365-2702.2005.01276.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
With the geographical literatures and issues outlined in the first paper very much in mind, this paper focuses specifically on the places in the concepts and locales of gerontological nursing practice. Particular attention is paid to the role of nurses in the making of long-term care institutions and to some fundamental priorities of care. Consideration is also given to some broader impacts of neighbourhood and community as an important spatial context to nursing practice based both in institutions and the community. In the final section, the paper makes some observations on how place-sensitive practice and research might contribute to the uptake of evidence for practice. These discussions set the scene for the final paper in this special section focused on the future research agenda for place and older people nursing.
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Affiliation(s)
- Gavin J Andrews
- Faculty of Nursing, University of Toronto, Toronto, ON, Canada.
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