干旱区生态环境知识资源中心(Arid): The delivery of Primary Health Care in remote communities: A Grounded Theory study of the perspective of nurses

Arid

DOI	10.1016/j.ijnurstu.2019.103474
	The delivery of Primary Health Care in remote communities: A Grounded Theory study of the perspective of nurses
	McCullough, Kylie 1; Whitehead, Lisa 1,2; Bayes, Sara 1; Williams, Anne 1,3,4; Cope, Vicki 3
通讯作者	McCullough, Kylie
来源期刊	INTERNATIONAL JOURNAL OF NURSING STUDIES
ISSN	0020-7489
EISSN	1873-491X
出版年	2020
卷号	102
英文摘要	Background: Australia has vast areas of desert, wilderness and offshore islands where nurses provide the majority of health care services. The residents of Australia's remote communities generally have poorer health status than their metropolitan counterparts. Despite recognition of Primary Health Care as a comprehensive model of acute and preventative care well suited to areas of high health and social need, there is little known about how nurses employ the Primary Health Care model in practice. Objectives: This study described and explained from the perspective of nurses, the actions and interactions involved in the delivery of Primary Health Care in remote communities. Design: This study was conducted from a Constructivist Grounded Theory perspective. Settings: The setting was community health centres or Aboriginal Medical Services located in 'remote' or 'very remote' areas. Communities with inpatient health services were excluded. Participants: Twenty four Nurse Practitioners, Registered Nurses and nursing academics participated. Participants had worked or were working, in a variety of remote communities across Australia. Length of service ranged from three months to over 15 years nursing in remote areas. Methods: Data were collected through 23 telephone interviews and an expert reference group. Theoretical sampling and constant comparative analysis were used to reach theoretical saturation. Results: The core issue participants faced was the inability to provide Primary Health Care. Four conditions impacted on the core issue: understanding the social world of the remote community, availability of resources, clinical knowledge and skill and, shared understanding and support. The process of doing the best you can with what you have, emerged as the way participants dealt with the inability to provide Primary Health Care. The process involved four primary activities: facilitating access to health care, continually learning, seeking understanding, and home-making in a work environment. The outcome of this process was considered to be making compromises to provide Primary Health Care. Conclusions: This study describes the substantive theory: making compromises to provide Primary Health care services in the remote Australian setting. Understanding the process of making compromises could direct employers and educators in their efforts to improve the provision of Primary Health Care in a variety of settings. Increased attention to the education, resources and support of nurses is likely to increase access to safe, quality care for remote communities. (C) 2019 The Authors. Published by Elsevier Ltd.
英文关键词	Advanced practice nursing Community nursing Constructivist Grounded Theory Health promotion Indigenous health Nurse practitioners Primary Health Care Primary Care Remote Area Nurse
类型	Article
语种	英语
国家	Australia ; New Zealand
开放获取类型	Green Published, hybrid
收录类别	SCI-E ; SSCI
WOS记录号	WOS:000515209000012
WOS关键词	REGISTERED NURSES ; OCCUPATIONAL STRESS ; MANAGEMENT ; COMPROMISE ; AUSTRALIA
WOS类目	Nursing
WOS研究方向	Nursing
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/314781
作者单位	1.Edith Cowan Univ, Sch Nursing & Midwifery, 270 Joondalup Dr, Joondalup, WA 6027, Australia; 2.Univ Otago, Ctr Postgrad Nursing Studies, Dunedin, New Zealand; 3.Murdoch Univ, Coll Sci Hlth Engn & Educ, Discipline Nursing, 90 South St, Murdoch, WA 6150, Australia; 4.Sir Charles Gairdner Hosp, Ctr Nursing Res, Hosp Ave, Perth, WA 6009, Australia
推荐引用方式 GB/T 7714	McCullough, Kylie,Whitehead, Lisa,Bayes, Sara,et al. The delivery of Primary Health Care in remote communities: A Grounded Theory study of the perspective of nurses[J],2020,102.
APA	McCullough, Kylie,Whitehead, Lisa,Bayes, Sara,Williams, Anne,&Cope, Vicki.(2020).The delivery of Primary Health Care in remote communities: A Grounded Theory study of the perspective of nurses.INTERNATIONAL JOURNAL OF NURSING STUDIES,102.
MLA	McCullough, Kylie,et al."The delivery of Primary Health Care in remote communities: A Grounded Theory study of the perspective of nurses".INTERNATIONAL JOURNAL OF NURSING STUDIES 102(2020).