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Laari L, Duma SE. Health advocacy role performance of nurses in underserved populations: A grounded theory study. Nurs Open 2023; 10:6527-6537. [PMID: 37315173 PMCID: PMC10415994 DOI: 10.1002/nop2.1907] [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: 12/21/2022] [Revised: 04/25/2023] [Accepted: 06/05/2023] [Indexed: 06/16/2023] Open
Abstract
AIM Nurses' health advocacy (HA) role requires them to speak up for patients, clients, and communities in relation to healthcare. Various studies report the importance of the HA role of the nurse in healthcare. However, nurses' performance in this role is not clear yet. The present study aims to identify and explain how nurses perform their HA role in underserved populations. DESIGN Qualitative grounded theory by Strauss and Corbin. METHODS Data were gathered from three regional hospitals in Ghana with 24 registered nurses and midwives as participants through purposive and theoretical sampling techniques. Face-to-face in-depth semi-structured interviews were conducted from August 2019 to February 2020. The data were analysed using Strauss and Corbin's method and Nvivo software. The reporting follows Consolidated Criteria for Reporting Qualitative Research guidelines. FINDINGS The HA role performance theory emerged from data with role enquiry, role dimension, role context, role influence, role reforms and role performance as building blocks. Data analysis showed that the main concerns of the nurses during their daily practice were mediating, speaking up, and negotiating. Among others, the intervening conditions were clientele influence and interpersonal barriers, whereas the outcome was a balance between role reforms and role performance. CONCLUSION Although some nurses proactively initiated biopsychosocial assessment and performed the HA role, most of them relied on clients' requests to perform the role. Stakeholders should prioritise critical thinking during training and intensify mentoring programmes in the clinical areas. RELEVANCE FOR CLINICAL PRACTICE The present study explains the process by which nurses perform their roles as health advocates in their daily activities as nurses. The findings can be used to teach and guide clinical practice for the HA role in nursing and other health care fields. There was no patient or public contribution.
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Affiliation(s)
- Luke Laari
- School of Nursing and Midwifery, College of Health SciencesUniversity of GhanaAccraGhana
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Adams C, Hooker L, Taft A. A systematic review and qualitative meta-synthesis of the roles of home-visiting nurses working with women experiencing family violence. J Adv Nurs 2022; 79:1189-1210. [PMID: 35285982 DOI: 10.1111/jan.15224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 02/03/2022] [Accepted: 02/10/2022] [Indexed: 11/28/2022]
Abstract
AIMS To systematically review and synthesize qualitative research exploring home-visiting nurses' roles and identify the challenges for nurses working with women experiencing family violence. DESIGN We undertook a thematic synthesis of qualitative studies, focusing on the family violence work of nurse home visitors. DATA SOURCES A systematic search of four scientific databases (ProQuest Central, CINAHL, MEDLINE, EMBASE) was undertaken in August 2021. Grey literature was searched, including government and non-government research documents, theses, clinical guidelines, policy documents and practice frameworks. REVIEW METHODS Inclusion criteria included research from high-income countries, peer-reviewed qualitative studies in English published from 1985 to 2021, and included research on home-visiting nurse family violence practice. The first author conducted the data search and the initial screening. The first and second authors independently reviewed the full text of 115 papers, identifying 26 for inclusion in the thematic synthesis (Figure 1-PRISMA flowchart). RESULTS The thematic synthesis identified two themes: (1) relationship building-with the client, with services and with colleagues/self; and (2) family violence practice-ask/screen, validate/name, assess risk/safety plan and safeguard children. CONCLUSION The thematic synthesis confirmed the multiple roles fulfilled by home-visiting nurses and enabled insight into the challenges they face as they undertake complex and demanding work. The roles of the home-visiting nurse have evolved, with the initial focus on safeguarding children leading to broader family violence nursing practice roles, including the identification of family violence and safety planning discussions with women. IMPACT Our meta-synthesis has confirmed the high-level communication and rapport-building skills required by nurses undertaking complex and conflicting roles. Nurses need support and supervision to undertake emotionally demanding work. Integrated health systems, clinical practice guidelines and tools, and training programmes need to encompass the breadth and complexity of the roles of these specialist practitioners.
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Affiliation(s)
- Catina Adams
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | - Leesa Hooker
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia.,Department of Rural Nursing and Midwifery, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Angela Taft
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
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Fuller AM, Kaplun C, Short AE. The application of the Music Therapy Visual Schedule Approach (MT-ViSA) within a group music therapy program. NORDIC JOURNAL OF MUSIC THERAPY 2021. [DOI: 10.1080/08098131.2021.1938642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Allison M. Fuller
- School of Humanities and Communication Arts, Western Sydney University, Sydney, Australia
- MusicConnect, Music Therapy Services, Sydney, Australia
| | - Catherine Kaplun
- Transforming Early Education and Child Health (TeEACH), Western Sydney University, Sydney, Australia
- Translational Health Research Institute, Western Sydney University, Sydney, Australia
- Affiliate of the Ingham Institute for Applied Medical Research, Sydney, Australia
| | - Alison E. Short
- School of Humanities and Communication Arts, Western Sydney University, Sydney, Australia
- Translational Health Research Institute, Western Sydney University, Sydney, Australia
- MARCS Institute for Brain, Behaviour & Development, Western Sydney University, Sydney, Australia
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Mapelli LD, Sabino FHO, Costa LCR, Silva JLD, Ferriani MDGC, Carlos DM. Inter-sectoral network to face violence against children and adolescents in a rural context. ACTA ACUST UNITED AC 2020; 41:e20190461. [PMID: 33237224 DOI: 10.1590/1983-1447.2020.20190461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 05/05/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To analyze the Primary Health Care inter-sectoral network in a rural context to face domestic violence against children and adolescents. METHOD A qualitative research study, with the Paradigm of Complexity as theoretical and methodological framework. Eighteen health professionals from two rural Family Health Units in a municipality in the state of São Paulo were the participants. Data was collected through minimum maps of the institutional network and focus groups in May and June 2019. Data was analyzed through thematic analysis. RESULTS Two categories emerged, entitled "It's not nonexistent, but it's complicated" and "We're always on the firing line". The existence of a weakened network; assistance based on biomedical bias; and care fragmentation were characteristics present in the care provided to the families. FINAL CONSIDERATIONS The absence of network care was evident, with isolation and overload of the Primary Health Care unit that is enhanced by the characteristics of rurality.
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Affiliation(s)
- Lina Domenica Mapelli
- Universidade Federal de São Carlos (UFSCar), Centro de Ciências Biológicas e da Saúde, Departamento de Enfermagem. São Carlos, São Paulo, Brasil
| | - Fabiano Henrique Oliveira Sabino
- Universidade Federal de São Carlos (UFSCar), Centro de Ciências Biológicas e da Saúde, Departamento de Enfermagem. São Carlos, São Paulo, Brasil
| | - Luiza Cesar Riani Costa
- Universidade Federal de São Carlos (UFSCar), Centro de Ciências Biológicas e da Saúde, Departamento de Enfermagem. São Carlos, São Paulo, Brasil
| | - Jorge Luiz da Silva
- Universidade de Franca (UNIFRAN), Programa de Mestrado e Doutorado em Promoção de Saúde. Franca, São Paulo, Brasil
| | - Maria das Graças Carvalho Ferriani
- Universidade de São Paulo (USP), Escola de Enfermagem de Ribeirão Preto, Departamento de Enfermagem Materno-Infantil e Saúde Pública. Ribeirão Preto, São Paulo, Brasil
| | - Diene Monique Carlos
- Universidade Federal de São Carlos (UFSCar), Centro de Ciências Biológicas e da Saúde, Departamento de Enfermagem. São Carlos, São Paulo, Brasil
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Cheng H, Eames-Brown R, Tutt A, Laws R, Blight V, McKenzie A, Rossiter C, Campbell K, Sim K, Fowler C, Seabury R, Denney-Wilson E. Promoting healthy weight for all young children: a mixed methods study of child and family health nurses' perceptions of barriers and how to overcome them. BMC Nurs 2020; 19:84. [PMID: 32943981 PMCID: PMC7488672 DOI: 10.1186/s12912-020-00477-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 08/27/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Childhood obesity is a global health concern. Early intervention to help parents adopt best practice for infant feeding and physical activity is critical for maintaining healthy weight. Australian governments provide universal free primary healthcare from child and family health nurses (CFHNs) to support families with children aged up to five years and to provide evidence-based advice to parents. This paper aims to examine factors influencing the child obesity prevention practices of CFHNs and to identify opportunities to support them in promoting healthy infant growth. METHODS This mixed methods study used a survey (n = 90) and semi-structured interviews (n = 20) with CFHNs working in two local health districts in Sydney, Australia. Survey data were analysed descriptively; interview transcripts were coded and analysed iteratively. Survey and interview questions examined how CFHNs addressed healthy infant feeding practices, healthy eating, active play and limiting sedentary behaviour during routine consultations; factors influencing such practices; and how CFHNs could be best supported. RESULTS CFHNs frequently advised parents on breastfeeding, introducing solid foods, and techniques for settling infants. They spent less time providing advice on evidence-based formula feeding practices or encouraging physical activity in young children. Although nurses frequently weighed and measured children, they did not always use growth charts to identify those at risk of becoming overweight or obese. Nurses identified several barriers to promoting healthy weight gain in infants and young children, including limited parental recognition of overweight in their children or motivation to change diet or lifestyle; socioeconomic factors (such as the cost of healthy food); and beliefs and attitudes about infant weight and the importance of breastfeeding and physical activity amongst parents and family members. CONCLUSIONS CFHNs require further education and support for their role in promoting optimal child growth and development, especially training in behaviour change techniques to increase parents' understanding of healthy infant weight gain. Parent information resources should be accessible and address cultural diversity. Resources should highlight the health effects of childhood overweight and obesity and emphasise the benefits of breastfeeding, appropriate formula feeding, suitable first foods, responsiveness to infant feeding cues, active play and limiting screen time.
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Affiliation(s)
- Heilok Cheng
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Rosslyn Eames-Brown
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Alison Tutt
- Child and Family Health Nursing, South Western Sydney Local Health District, NSW Health, Sydney, Australia
| | - Rachel Laws
- Institute of Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Melbourne, Australia
| | - Victoria Blight
- Child and Family Health Nursing, South Western Sydney Local Health District, NSW Health, Sydney, Australia
| | - Anne McKenzie
- Child and Family Health Nursing, South Western Sydney Local Health District, NSW Health, Sydney, Australia
| | - Chris Rossiter
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Karen Campbell
- Institute of Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Melbourne, Australia
| | - Kyra Sim
- Sydney Local Health District, NSW Health, Sydney, Australia
| | - Cathrine Fowler
- Centre for Midwifery, Child and Family Health, School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Rochelle Seabury
- Centre for Population Health, NSW Ministry of Health, Sydney, Australia
| | - Elizabeth Denney-Wilson
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Sydney Local Health District, NSW Health, Sydney, Australia
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Carlos DM, Silva LMP, Beserra MA, Aragão ADS, Gregory A, Ferriani MDGC. Social support network of family members of abused children and adolescents: Perspectives and possibilities. J Clin Nurs 2018; 28:814-827. [PMID: 30184282 DOI: 10.1111/jocn.14665] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 08/20/2018] [Accepted: 08/28/2018] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To analyse the network of care and social support from the perspectives of family members of children and adolescents who have been abused. BACKGROUND The theoretical-methodological background of the ecological model for understanding violence and the Paradigm of Complexity provide a broad perspective of violence. The paradigm considers all aspects that constitute a phenomenon as well as particular features. DESIGN Qualitative research based on the Paradigm of Complexity, developed by Edgar Morin, the primary philosopher. We have adhered to the COREQ Checklist guidelines for qualitative research. METHODS Data were collected through Minimal Maps of Personal Social Networks, and semi-structured interviews were held with 15 families who were assisted by a nongovernmental organisation in a Brazilian city. The notions of comprehension and contextualisation guided the data analysis. RESULTS Two categories emerged from the data analyses: "Social isolation" and "Affective relationships needs." The maps revealed a weakened and limited network with low-density, homogeneous bonds and few significant bonds. Therefore, the network provided predominantly instrumental and material social support with few important effective relationships. The participants disclosed some strategies to empower their lives. CONCLUSIONS We conclude that it is urgent to develop strategies in a broad manner to promote family empowerment, especially on education and employment dimension, and to construct supportive and respectful relationships between services and families as well. RELEVANCE TO CLINICAL PRACTICE The present study contributes to international clinical nursing, especially in low- and middle-income countries, by discussing (a) looking at and caring for family members of children and adolescents who have been abused in a contextualised manner; (b) family empowerment, which enables them to have access to healthier environments and to educational/employment opportunities; and (c) broad comprehension of health care among the family members, which provides perspectives not only for looking at violence but also for strengthening supportive social relationships.
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Affiliation(s)
| | | | | | | | - Alison Gregory
- Centre for Academic Primary Care, University of Bristol, Bristol, UK
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Esposito S, Bianchini S, Tagliabue C, Umbrello G, Madini B, Di Pietro G, Principi N. Impact of a website based educational program for increasing vaccination coverage among adolescents. Hum Vaccin Immunother 2018; 14:961-968. [PMID: 28853975 PMCID: PMC5893194 DOI: 10.1080/21645515.2017.1359453] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Data regarding the use of technology to improve adolescent knowledge on vaccines are scarce. The main aim of this study was to evaluate whether different web-based educational programmes for adolescents might increase their vaccination coverage. Overall, 917 unvaccinated adolescents (389 males, 42.4%; mean age ± standard deviation, 14.0 ± 2.2 years) were randomized 1:1:1 into the following groups: no intervention (n = 334), website educational program only (n = 281), or website plus face to face lesson (n = 302) groups. The use of the website plus the lesson significantly increased the overall knowledge of various aspects of vaccine-preventable disease and reduced the fear of vaccines (p < 0.001). A significant increase in vaccination coverage was observed for tetanus, diphtheria, acellular pertussis and conjugated meningococcal ACYW vaccines in the 2 groups using the website (p < 0.001), and better results were observed in the group that had also received the lesson; in this last group, significant results were observed in the increase in vaccination coverage for meningococcal B vaccine (p < 0.001). Overall, the majority of the participants liked the experience of the website, although they considered it important to further discuss vaccines with parents, experts and teachers. This study is the first to evaluate website based education of adolescents while considering all of the vaccines recommended for this age group. Our results demonstrate the possibility of increasing vaccination coverage by using a website based educational program with tailored information. However, to be most effective, this program should be supplemented with face-to-face discussions of vaccines at school and at home. Thus, specific education should also include teachers and parents so that they will be prepared to discuss with adolescents what is true and false in the vaccination field.
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Affiliation(s)
- Susanna Esposito
- a Pediatric Clinic, Università degli Studi di Perugia , Perugia , Italy
| | - Sonia Bianchini
- b Department of Pathophysiology and Transplantation , Pediatric Highly Intensive Care Unit, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milan , Italy
| | - Claudia Tagliabue
- b Department of Pathophysiology and Transplantation , Pediatric Highly Intensive Care Unit, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milan , Italy
| | - Giulia Umbrello
- b Department of Pathophysiology and Transplantation , Pediatric Highly Intensive Care Unit, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milan , Italy
| | - Barbara Madini
- b Department of Pathophysiology and Transplantation , Pediatric Highly Intensive Care Unit, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milan , Italy
| | - Giada Di Pietro
- b Department of Pathophysiology and Transplantation , Pediatric Highly Intensive Care Unit, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milan , Italy
| | - Nicola Principi
- b Department of Pathophysiology and Transplantation , Pediatric Highly Intensive Care Unit, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milan , Italy
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Austin J, Holt S. Responding to the support needs of front-line public health nurses who work with vulnerable families and children: a qualitative study. Contemp Nurse 2017; 53:524-535. [PMID: 28504060 DOI: 10.1080/10376178.2017.1330661] [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] [Indexed: 10/19/2022]
Abstract
BACKGROUND This paper reports on a research study to inform the development of a specialist role to support front line public health nurses (PHNs) working with vulnerable families and at risk children in Ireland. AIMS This study aimed to investigate the position of a leading role and explore the implications of such change. METHODS Focus group and semi-structured individual interviews were conducted with ten purposively selected participants in public health nursing, social work and a non-governmental children's organisation working in disadvantaged areas in Dublin. RESULTS Assistant directors of public health nursing are in a key position to inform decisions regarding the children's services. CONCLUSION Access to support and appropriate supervision are fundamental resource requirements for PHNs who work with vulnerable families and at risk children. The introduction of a specialist-leading role to support these PHN's is essential to sustaining best practice.
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Affiliation(s)
- Jackie Austin
- a Mary Mercers Health Centre , Fortunestown Road, Jobstown, Dublin 12 , Ireland
| | - Stephanie Holt
- b School of Social Work & Social Policy , University of Dublin, Trinity College , Dublin 2 , Ireland
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