scholarly journals Reflections on the Experience of Community Health Nurses in Palliative Care: A Qualitative Approach

2021 ◽  
Vol 27 ◽  
pp. 330-335
Author(s):  
R. Siva ◽  
V. Sadan ◽  
G. Alexander ◽  
S. Immanuel ◽  
Priyadharishini Joy

There is a major demographic shift with increase in non-communicable diseases even in low- and middle-income countries. Many self-limiting illnesses are burdensome to people when they have limited access to health care system and poor family support. The aim of the study explores experiences of community health nurses in palliative care delivery in a primary health care setting. The study was conducted in Community Health Nursing Department, College of Nursing, CMC, Vellore. A qualitative research using a grounded theory approach was done which included in-depth interviews and focus group discussions from community health nursing faculty. This study used a deductive and inductive approach that stressed the process rather than the meaning of the studied phenomenon. The in-depth interviews lasted for 45 min–1 ½ h for each participant; focus group discussions were held in two sessions lasting for 2 ½ h. The group interviews were transcribed to verbatim. All transcripts were read multiple times to ensure correctness of the transcription by the authors to get an overall impression of the material before the initial coding. Authenticity, credibility, critical appraisal and integrity were demonstrated throughout the study. This study enlightens the experiences of the health care providers on palliative care delivery at the primary care setting and explores barriers, challenges and facilitators for delivery of good palliative home care. Totally, 15 subthemes were grouped under five major themes; community support, family support, acceptance of services, barriers and gaps in care. The in-depth interviews provided an insight into the experiences of the participants on successful collaborative services, caregivers fatigue and the barriers in providing services in the home care setting. Focus group discussion showed that a holistic approach to patient care in primary care setting is possible by community health nurses and a collaborative care from the secondary and tertiary care settings will bring down the non-compliance to the therapeutic regimen.

2010 ◽  
Vol 33 (8) ◽  
pp. 1047-1068 ◽  
Author(s):  
Ruth Schofield ◽  
Rebecca Ganann ◽  
Sandy Brooks ◽  
Jennifer McGugan ◽  
Kim Dalla Bona ◽  
...  

As health care is shifting from hospital to community, community health nurses (CHNs) are directly affected. This descriptive qualitative study sought to understand priority issues currently facing CHNs, explore development of a national vision for community health nursing, and develop recommendations to shape the future of the profession moving toward the year 2020. Focus groups and key informant interviews were conducted across Canada. Five key themes were identified: community health nursing in crisis now, a flawed health care system, responding to the public, vision for the future, and CHNs as solution makers. Key recommendations include developing a common definition and vision of community health nursing, collaborating on an aggressive plan to shift to a primary health care system, developing a comprehensive social marketing strategy, refocusing basic baccalaureate education, enhancing the capacity of community health researchers and knowledge in community health nursing, and establishing a community health nursing center of excellence.


2017 ◽  
Vol 13 (1) ◽  
pp. 77-87
Author(s):  
Tuti Surtimanah ◽  
Yanti Herawati

Background of this research was the still high number of infant mortality and high use of Traditional Birth Attendants (TBAs). The This study aims aimed to determine TBAs positioning on the effort of strengthening partnership with midwives. A number of pregnant women, TBAs, and midwives become became informants, through in-depth interviews and focus group discussions. The results showed positioning TBAs still needed with different roles but side by side with midwife role, used by primi and multi pregnant women before and during pregnancy, during and after birth. The requirement forrequirement for TBAs was derived from parents as a cultural heritage, whereas the requirement for midwife obtained was from formal and non- formal information. The TBAs services toward maintain family health care including include cultural events. The midwife is givingserved professional servicescare. The partnership includes clients registration, motivation, abnormalities early detection. There has had been an unwritten financing unwritten agreement. The TBAs midwife partnership needs to be strengthened through legislation and , communication to diverse audiences in order to form the right positioning.


2021 ◽  
Author(s):  
Ramlah Kisut ◽  
Hajah Jamilah Haji Awang Sulaiman ◽  
Hanif Abdul Rahman ◽  
Khadizah H. Abdul-Mumin

Abstract Background: General Practice setting in the Primary Health Care Services are the utmost visited by the public. It is important that the nurses’ competencies in this area be assessed to ensure provision of safe and quality services.Aim/objective: To explore perceptions and experiences of competencies assessment tool for community health nurses working at the General Practice setting in the Primary Health Care Services.Methods: An exploratory qualitative study utilizing focus group discussions were conducted on purposive sample of 12 officers with expertise in competency assessment and community health nursing from higher nursing education institutions, the Nursing Training and Development Centre, the Nursing Board and the Community Health Nursing Services in Brunei Darussalam. The existing competencies assessment tool was revised, the participants were divided into two groups of expert panel review team and two focus group discussions were held with each team. The focus group discussions encompassed components and methods of assessment; methods of grading; and overall organization and structure of the revised competency assessment tool. Findings: Four themes emerged: 1) International equivalent core competencies components; 2) Multi-methods approach to assessment; 3) Definitive guidelines as framework for assessment; and 4) Understanding and acceptability of the competency assessment tool. Conclusions/Implications to practice: The expert panel reviews provide practical input that were inculcated in the preliminary developed competencies assessment tool. Identification of eligible assessors were recommended based on standardized criteria, and socialization and training held to set direction and guidance for implementing the utilization of the competencies assessment tool. Further studies are deemed important to critically evaluate and validate the preliminary competencies assessment tool for development of a more robust assessment instrument.


2015 ◽  
Vol 16 (2) ◽  
pp. 98-111 ◽  
Author(s):  
H Khunga ◽  
K J Okop ◽  
Thandi Puoane

Each year, malnutrition accounts for about 50% of the deaths of under-fives in developing countries. In Zambia, about 45% of children under the age of five exhibit stunted growth, mainly due to malnutrition. Early detection of cases by health workers and prompt health-seeking practices at household and community levels can improve the identification and management of malnutrition, and prevent unnecessary deaths. The study provides insights into the perceptions of mothers, caregivers, community members and community health workers regarding the detection, referral and health-seeking practices of malnourished children in Kalomo district of Zambia. This was a qualitative study which explored perceptions and challenges of detection and prompt treatment of malnutrition (kwashiorkor and marasmus) in children under five years of age in the community. Focus group discussions using pictographs were conducted with purposely selected mothers and caregivers of children attending immunization clinics in rural health centres in Zambia. In-depth interviews were also conducted with purposely selected grandparents, community health workers and nutrition advisors to validate the findings obtained from focus group discussions. Data were analysed using thematic analysis. Malnutrition, particularly marasmus, was linked to HIV infection. Barriers to seeking health care for severely malnourished children included beliefs about causes of malnutrition, failure to link malnutrition to poor feeding practices, distance to health care facilities and lack of free feeding schemes for malnourished children. Mothers’ decisions to seek care for malnourished children were influenced largely by grandparents. Increasing awareness about causes, signs and symptoms of malnutrition in this community is needed to improve detection and treatment of malnourished children.


2020 ◽  
Vol 4 (1) ◽  
pp. e000822
Author(s):  
Robert C Hughes ◽  
Patricia Kitsao-Wekulo ◽  
Sunil Bhopal ◽  
Elizabeth W Kimani-Murage ◽  
Zelee Hill ◽  
...  

IntroductionThe early years are critical. Early nurturing care can lay the foundation for human capital accumulation with lifelong benefits. Conversely, early adversity undermines brain development, learning and future earning.Slums are among the most challenging places to spend those early years and are difficult places to care for a child. Shifting family and work structures mean that paid, largely informal, childcare seems to be becoming the ‘new normal’ for many preschool children growing up in rapidly urbanising Africa. However, little is known about the quality of this childcare.AimsTo build a rigorous understanding what childcare strategies are used and why in a typical Nairobi slum, with a particular focus on provision and quality of paid childcare. Through this, to inform evaluation of quality and design and implementation of interventions with the potential to reach some of the most vulnerable children at the most critical time in the life course.Methods and analysisMixed methods will be employed. Qualitative research (in-depth interviews and focus group discussions) with parents/carers will explore need for and decision-making about childcare. A household survey (of 480 households) will estimate the use of different childcare strategies by parents/carers and associated parent/carer characteristics. Subsequently, childcare providers will be mapped and surveyed to document and assess quality of current paid childcare. Semistructured observations will augment self-reported quality with observable characteristics/practices. Finally, in-depth interviews and focus group discussions with childcare providers will explore their behaviours and motivations. Qualitative data will be analysed through thematic analysis and triangulation across methods. Quantitative and spatial data will be analysed through epidemiological methods (random effects regression modelling and spatial statistics).Ethics and disseminationEthical approval has been granted in the UK and Kenya. Findings will be disseminated through journal publications, community and government stakeholder workshops, policy briefs and social media content.


Human Affairs ◽  
2011 ◽  
Vol 21 (4) ◽  
Author(s):  
Olayinka Akanle ◽  
Olanrewau Olutayo

AbstractUnderstanding the selves, situations and actions of Africans can never be comprehended outside kinship. Local and foreign worldviews are first pigeonholed into culture and defined within kinship realities in Nigeria and Africa. There have been studies on kinship in Africa. However, the findings from such studies portrayed the immutability of African kinship. Thus, as an important contribution to the on-going engagement of kinship in the twenty-first century as an interface between the contemporary Diaspora, this article engaged kinship within international migration. This is a major behavioural and socio-economic force in Nigeria. Methodological triangulation was adopted as part of the research design and primary data were collected through in-depth interviews (IDIs), and life histories of international migrants were documented and focus group discussions (FGDs) were held with kin of returnees. The article found and concluded that while returnees continued to appreciate local kinship infrastructures, the infrastructures were liable to reconstruction primarily determined by dominant support situations in the traditional African kinship networks.


2021 ◽  
Vol 80 (1) ◽  
pp. 49-60
Author(s):  
Justin Raycraft

This paper addresses how Makonde Muslim villagers living on the Swahili coast of southern Tanzania conceptualize and discuss environmental change. Through narratives elicited during in-depth interviews and focus group discussions, I show that respondents associate various forms of environmental change—ecological, climatic, political, and socioeconomic—with God’s plan. Respondents had a sound grasp of the material workings of their lived realities and evoked religious causality to fill in the residual explanatory gaps and find meaning in events that were otherwise difficult to explain. Such narratives reveal both a culturally engrained belief system that colors people’s understandings of change and uncertainty and a discursive idiom for making sense of social suffering. On an applied note, I submit that social science approaches to studying environmental change must take into account political and economic contexts relative to local cosmologies, worldviews, and religious faiths, which may not disaggregate the environment into distinct representational categories.


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