Structural Dialectic Model of Care: A Guide to Beliefs, Scenarios and Social Actors Analysis in Nursing Research

The structural dialectic model of care provides a data analysis method that facilitates the identification of beliefs and structural and functional characteristics. To demonstrate the relevance of the structural dialectic model of care for data analysis integrating beliefs, scenarios and social actors. The characteristics and functions of the model are described and explained through an analysis of its application in fifteen doctoral theses (2009-2017). This model has three structures, the functional unit (beliefs), the functional element (social agents), and the functional framework (scenarios). The Structural Dialectic Model of Care constitutes a useful methodological tool for studies of nursing, organizing analysis of the data according to the dynamic and dialectical nature of their structures.

Nursing in the 21st century: results of a pilot survey on attitudes towards nurses and nursing

Nursing is one of the most trusted professions, yet it is poorly defined. There are many definitions and characterisations of nursing. This study sought to pilot a survey exploring the views of nursing in the 21st century.

METHODS

This study piloted an electronic survey with open and closed questions. Descriptive statistics were collated for closed questions using Excel. Open-ended questions were analysed using the text analysis program Linguistic Inquiry and Word Count (LIWC) for tone, emotion and criticality.

RESULTS

This pilot study recruited 72 participants from professional and non-professional backgrounds. Respondents displayed diversity in their perceptions of nursing, the role of nurses and the role that nurses perform.

CONCLUSION

Nursing is a complex, multifaceted profession. The view of nursing was generally positive and authentic although not easy to define. Nursing was felt to be an inclusive profession; however, it is extremely diverse in nature. Further research is required to explore these concepts in greater depth.

Looking back moving forward: The history of midwifery in Western Australia

PROBLEM

To date there is has been very little research into midwifery in Western Australia (WA), therefore this paper addresses a significant gap in the literature. The aim of this paper was to gain insight into the history of midwifery in WA.

BACKGROUND

Since the beginning of recorded history midwives have assisted women in childbirth. Midwifery is recognised as one of the oldest professions; midwives are mentioned in ancient Hindu texts, featured on Egyptian papyrus and in The Bible. Up until the seventeenth century childbirth was the responsibility of midwives, but the gradual emergence of barber-surgeons, then man-midwives and obstetricians heralded a shift from women-led and community-supported birth to a patriarchal and medical model. Throughout the twentieth century childbirth practices in the Western World have continued to change, leading to a move from midwifery-led care at home to doctor-led care in the hospital.

DISCUSSION

The first non-Indigenous Australian midwives were not formally trained; they came on ships bringing convicts to Australia and are described as 'accidental' midwives, as assistance in childbirth came from whoever was available at the time. This period was followed by what was called the 'Aunt Rubina' period where older married women helped younger women in childbirth. Throughout the early 1800s untrained or 'lay' midwifery care continued alongside the more formally trained midwives who had arrived with the colonists. From the early 20th century, when birth moved into the hospital, midwives in WA have been incorporated into the hierarchy of the professions with obstetrics as the lead profession and midwifery considered a speciality of nursing. The role of the midwife has been subordinated, initially controlled by medicine and then incorporated into the institutions and nursing. The increase in legislative and training requirements for midwives throughout Australia and the move from home to the hospital, gradually led to the decrease in autonomous midwives working within the community, impacting women's choice of birth attendant and place of birth.

CONCLUSION

The historical suppression of midwifery in Australia has impacted the understanding of the role of the midwife in the contemporary setting. Understanding the development and evolution of the midwifery profession in Australia can help future directions of the profession.

The construction of contemporary nursing identity from narrative accounts of practice and professional life

OBJECTIVE

To explore the contemporary narrative of nursing identity in Spain.

METHOD

This qualitative study was conducted between 2018 and 2020. Eleven registered nurses were interviewed. The conversations were recorded in audio, were semistructured, and held in a mental health clinic affiliated with a Catholic institution. Narrative analysis of the data was carried out.

FINDINGS

Two themes were identified: How do I construct my professional life?, with the subthemes 'Training and initiation in care practice', 'Ways of living the professional care experience', 'The sculpting of care' and 'Self-image and future projection'; and What do I know about my practice?, with the subthemes 'Nursing experience: shift, days, years', 'Strategy in the field of nursing care', 'Some foundations of caregiving practice', 'The specificity of the gesture of care' and 'Voice and recognition of nursing within the institution'.

CONCLUSION

Contemporary nursing identity is built in reflections on the epistemology of care, confronting the weight of tradition and breaking into new modes of self-image where the profession is legitimized and projected from historical consciousness. This claim can be used to support reflective practice in academic and healthcare settings as well as to promote a paradigm shift.

The construction of contemporary nursing identity from narrative accounts of practice and professional life

OBJECTIVE

To explore the contemporary narrative of nursing identity in Spain.

METHOD

This qualitative study was conducted between 2018 and 2020. Eleven registered nurses were interviewed. The conversations were recorded in audio, were semistructured, and held in a mental health clinic affiliated with a Catholic institution. Narrative analysis of the data was carried out.

FINDINGS

Two themes were identified: How do I construct my professional life?, with the subthemes 'Training and initiation in care practice', 'Ways of living the professional care experience', 'The sculpting of care' and 'Self-image and future projection'; and What do I know about my practice?, with the subthemes 'Nursing experience: shift, days, years', 'Strategy in the field of nursing care', 'Some foundations of caregiving practice', 'The specificity of the gesture of care' and 'Voice and recognition of nursing within the institution'.

CONCLUSION

Contemporary nursing identity is built in reflections on the epistemology of care, confronting the weight of tradition and breaking into new modes of self-image where the profession is legitimized and projected from historical consciousness. This claim can be used to support reflective practice in academic and healthcare settings as well as to promote a paradigm shift.

The White/Black hierarchy institutionalizes White supremacy in nursing and nursing leadership in the United States

BACKGROUND

Black/African American nurses (BAANs) in the United States (US) experience barriers to career advancement.

AIM

The specific aims of this study were to a) explore how the perception of racism or racial bias affects the motivation of Black/African American nurses (BAANs) in the United States (US) to seek and apply for nursing leadership and faculty positions, and b) to characterize the racism-related barriers that BAANs perceive that prevent them from moving forward with their careers in academia and nursing leadership.

METHOD

As part of a qualitative focused ethnographic study, 30 nurses who self-identified as BAAN, had a bachelor's degree or higher, and had at least five years of nursing experience were interviewed. Qualitative data underwent thematic analysis.

RESULT

Although five themes were identified, four were established in the literature, and one - Nursing Leadership Dynamics (NLD) - was novel. A complex network of NLDs that served to both prevent the success of BAANs as well as threaten their job security and health was identified.

CONCLUSION

This study identified a multi-faceted, tightly-woven system of NLDs that serves to continually institutionalize and enforce a white/black hierarchy and white supremacy in nursing at all levels in the US, including education.

Nurses' occupational health as a driver for curriculum change emphasising health promotion: an historical research study

BACKGROUND

Reasons stated for curriculum change in nursing education are usually shifts in knowledge, care delivery, roles, regulatory standards and population health needs. In New Zealand in the 1930s, a curriculum change was driven instead by the need to protect and promote nurses' health. Tuberculosis was an international occupational health risk among nurses. Mary Lambie, New Zealand's chief nurse, considered nursing a "hazardous profession". One remedy she instituted was curriculum change in the national nurse training programme to emphasise health promotion among nurses. Global nursing issues today also impact on nurses' health. Curriculum changes again address this by promoting self-care and resilience.

OBJECTIVE

To examine how international and national concern for nurses' occupational health drove a curriculum change in New Zealand nurse training in the 1930s.

DESIGN

Historical Research

METHODS

International occupational health reports (1930s), Lambie's annual reports (1932-1950), and questions and examiners' comments in a new state examination (1940s-1950s), were analysed to identify the reasons for and direction of the curriculum change. Findings were interpreted within international and national concerns and measures related to occupational health in nursing.

RESULTS

Lambie used the political leverage of international and national worry over tuberculosis as a nursing occupational health risk to protect nurses' health more generally. In 1933 she revised the first year of the three-year national nursing curriculum to emphasise personal hygiene and bacteriology related to cross-infection, and in 1938 introduced a State Preliminary Examination at the end of the first year of training to test this knowledge. Analysis of examinations, 1940s-1950s, confirms that the curriculum change driver was a concern to make nursing a less "hazardous profession".

CONCLUSION

Nurse educators today should be aware of the variety of factors that can lead to curriculum change in nursing. In addition, concern for nurses' health today demonstrates the continuing need for health promotion in nursing curricula.