Evaluation of an Education Program on Community Orientation among Community Health Nurses in Fiji

AIM

The study objective was to evaluate the effectiveness of an education program to improve community orientation among community health nurses in Fiji. A 1.5-day education program was developed that enabled participants to learn a concept through discussion, as they reviewed their experiences.

DESIGN

This study used mixed methods research.

METHODS

The education program involving 78 community health nurses and supervisors was conducted. The 30-item Community Orientation among Community Health Nurses scale, six-item program evaluation questionnaire, and participant reflection sheets were analyzed using both quantitative and qualitative methods.

RESULTS

Program evaluations demonstrated high satisfaction among participants. The content analysis of participant views on community orientation revealed three categories; utilizing community intelligence in community activities, relationships with community members as a community health nurses, and human resource development tool. Our findings suggest that this education program should be held regularly, in conjunction with on-the-job and off-site training.

Community Orientation Scale among Community Health Nurses in Fiji: Scale development and psychometric evaluation

Aim

To develop and evaluate the reliability and validity of the COSCHN, a scale that aims to measure community orientation among community health nurses in Fiji.

Design

Descriptive cross-sectional design.

Methods

A self-administered questionnaire that included the 51 items in the preliminary COSCHN was distributed to community health nurses in Fiji from April-July 2016.

Results

Exploratory factor analysis of 226 responses (77.4% response rate) to the COSCHN revealed 30 items loading on four factors: Community Initiative Promotion, Consensus Building for Community Needs and Activity Goal, Commitment towards Work and Community Members and Mutually Trusting Relationships with Community Members towards Empowerment. Confirmatory factor analysis with high-order factor modelling revealed a reasonable fit to the data. Cronbach's α values for the COSCHN and the four factors ranged from 0.78-0.94. Weak correlations were noted for concurrent validity, while known-groups validity and time stability were generally satisfactory.

Identifying characteristic features of community orientation among community health nurses in Fiji

AIM

The present study aimed to identify detailed characteristics of community orientation among community health nurses in Fiji.

DESIGN

Qualitative descriptive design using semi-structured individual interviews.

METHODS

Twenty participants including expert nurses, novice nurses, policymakers and representatives from communities were interviewed between July-August 2015 in Fiji. Data were analysed using descriptive qualitative methods.

RESULTS

Three main themes described in detail characteristics of community orientation among community health nurses in Fiji: Trusting Relationships, Commitment and Activity Management. Trusting Relationships and Commitment were interrelated and served as foundations for community orientation that promoted and facilitated Activity Management. Reflection and a sense of self-accomplishment in the CHN experiences during Activity Management further strengthened Commitment and Trusting Relationships. Community orientation leads to superior understanding of community health needs, effective use of resources and increased community participation in activities. Such activity management will contribute to promote health beyond the individual, extending to entire communities.