Sharing the Burden of Strife in Chronic Illness: a Praxiological Study of Nursing Practice in a Community Context

<p><b>This inquiry is an in-depth exploration of one middle aged woman’s, Sarah, experience of strife in chronic illness and her nursing care involving four nurses (including myself) in a community context over a three-year period. The study is praxiological in that the understanding achieved is derived from practice within a ‘research as praxis’ methodology positioned in the disciplinary perspective of nursing as a practical human science. Five methodological premises inform the research processes: reflexivity, dialogue, moral comportment, re-presentation in narrative and critique. They emanate from an eclectic ontological praxiology based on the research framework constructed from Gadamerian philosophical hermeneutics, components of other philosophical praxiologies evolved from an exploration of the practical discourse in philosophy and my preferred health and nursing assumptions.</b></p> <p>The research processes include researcher journalling; summaries of Sarah’s nursing record, dialogical meetings with Sarah and the nurse co-participants to collect the research material and then co-construct it into narrative form. The narrative is developed around what Sarah viewed as the overall nursing contribution to her care; the ‘sharing of her burden of illness’. This, she maintained, enabled her to live safely in the community. Finally there occurs a critique of the narrative within a discursive framework.</p> <p>Three themes, embedded in particular discourses, emerged from the narrative both in Sarah’s and the nurses’ experience; paradox, moral meaning and metaphor. Sarah’s experience is interpreted as taking place in the ‘in-between space’ of the disease and health-illness discourses. Two main concepts which depict the tension experienced in this space are the ‘the ontological assault of illness’ and ‘entrapment in the disease discourse’. We, the nurses, ‘pushed the boundaries’ to create a space for the nursing as a caring practice discourse on the margins of nursing as a functional service discourse. Within the nursing as a caring practice space many ‘fine lines’ were walked with Sarah. Walking the ‘fine line’ of an ‘intense relationship’ was seen as advanced nursing practice. The research highlights important implications for a person and/or families who live with chronic illness and practice and educational issues for advanced nurse practitioners. Further, it promotes praxiological methodologies as advantageous for expanding nursing knowledge. This inquiry makes a twofold contribution to the discipline of nursing: it progresses the understanding of living with strife in chronic illness and it expands the practice of praxiological inquiry within nursing.</p>

Sharing the Burden of Strife in Chronic Illness: a Praxiological Study of Nursing Practice in a Community Context

<p><b>This inquiry is an in-depth exploration of one middle aged woman’s, Sarah, experience of strife in chronic illness and her nursing care involving four nurses (including myself) in a community context over a three-year period. The study is praxiological in that the understanding achieved is derived from practice within a ‘research as praxis’ methodology positioned in the disciplinary perspective of nursing as a practical human science. Five methodological premises inform the research processes: reflexivity, dialogue, moral comportment, re-presentation in narrative and critique. They emanate from an eclectic ontological praxiology based on the research framework constructed from Gadamerian philosophical hermeneutics, components of other philosophical praxiologies evolved from an exploration of the practical discourse in philosophy and my preferred health and nursing assumptions.</b></p> <p>The research processes include researcher journalling; summaries of Sarah’s nursing record, dialogical meetings with Sarah and the nurse co-participants to collect the research material and then co-construct it into narrative form. The narrative is developed around what Sarah viewed as the overall nursing contribution to her care; the ‘sharing of her burden of illness’. This, she maintained, enabled her to live safely in the community. Finally there occurs a critique of the narrative within a discursive framework.</p> <p>Three themes, embedded in particular discourses, emerged from the narrative both in Sarah’s and the nurses’ experience; paradox, moral meaning and metaphor. Sarah’s experience is interpreted as taking place in the ‘in-between space’ of the disease and health-illness discourses. Two main concepts which depict the tension experienced in this space are the ‘the ontological assault of illness’ and ‘entrapment in the disease discourse’. We, the nurses, ‘pushed the boundaries’ to create a space for the nursing as a caring practice discourse on the margins of nursing as a functional service discourse. Within the nursing as a caring practice space many ‘fine lines’ were walked with Sarah. Walking the ‘fine line’ of an ‘intense relationship’ was seen as advanced nursing practice. The research highlights important implications for a person and/or families who live with chronic illness and practice and educational issues for advanced nurse practitioners. Further, it promotes praxiological methodologies as advantageous for expanding nursing knowledge. This inquiry makes a twofold contribution to the discipline of nursing: it progresses the understanding of living with strife in chronic illness and it expands the practice of praxiological inquiry within nursing.</p>

International Scientific Conference »Learning to Live and Work Togheter«

University of Maribor Faculty of Health Sciences is organizing the Online International Scientific Conference »LEARNING to Live and Work Together«, held on June 29th 2021. E-proceedings of the conference include most recent findings of domestic and foreign researchers and students in higher education, social work, nursing and health sciences. The conference aims to explore the quality of life for migrant students, transformative action in higher education, advances in nursing research and education as well as advanced nursing practice experience in Slovenian and international arena. It provides an opportunity to promote the development, dissemination and use of knowledge in the field of social work, nursing and health sciences for educators and health practitioners, furthermore they exchange research evidence, models of best practice and innovative ideas.

General practice nurses' experiences of participation in an advanced nursing practice education programme

In the UK, transformation of the nursing workforce, including development of the role of the advanced nurse practitioner within general practice, is essential to meet healthcare demands. This article presents the results of a small, qualitative study conducted among students at one university in Scotland, describing their experiences of participation in advanced practice education. Data were collected through semi-structured interviews to generate in-depth descriptions and to identify the facilitators and barriers to learning. The study identified that a shared responsibility for patient care creates opportunities for learning. The facilitators to learning were identified as foundation level education in history taking and clinical examination, finance, having a supportive network and mentorship. Barriers included pressure of work and a lack of clarity about roles and training needs. Given the key role that these nurses will have in future healthcare models, there is a requirement for a national education standard. It is recommended that the Nursing and Midwifery Council leads on defining advanced nurse practitioner in general practice programme learning outcomes. The overall aim of such courses is to enhance the experience for future nurses to encourage recruitment and transform the nursing workforce.

Advanced Nursing Practice: International Experiences and Future Direction for Nursing in Slovenia, Book of Abstracts

First international Advanced Nursing Practice conference in Slovenia brought world leading academic scholars to exchange and share their experiences on Advance Nursing Practice (ANP) education and practice. Special emphasis will be put on presentation of competencies, roles and scope of practice. Aim of our conference was to bring ANP education and especially the nature of ANP practice closer to an academic and clinical environment as well to decision making bodies in government and other professional groups in Slovenia. Numerous studies have shown that advanced practice nurses can provide quality patient care by role extension or expansion, contribute to efficacy, cost efficiency, patient satisfaction, reduced (re)hospitalizations, and reduced mortality. Experts from countries where ANP is well established and experts from countries where ANP is in the beginning stages of development participated in round table discussion. Conclusions of the round table discussion produced future direction for development of ANP in Slovenia.

Betreuung durch ein Advanced Nursing Practice-Team – Erfahrungen Lymphombetroffener und ihrer Angehörigen

Zusammenfassung. Hintergrund: Patient_innen mit Lymphomen, die mit Hochdosis-Chemotherapie (HDC) und autologer Stammzelltransplantation (ASZT) behandelt werden, sind mit einer lebensbedrohlichen Krankheit und einer stressvollen Therapie konfrontiert. Durch den Einsatz eines Advanced Nursing Practice (ANP)-Teams sollte diesen Patient_innen und ihren Angehörigen am Inselspital, Universitätsspital Bern eine kontinuierliche und bedarfsgerechte Betreuung über den ganzen Therapieverlauf geboten werden. Zu Erfahrungen von Betroffenen mit ANP ist wenig bekannt. Ziel: Mit dieser Studie wurde deshalb untersucht, wie diese Patient_innen und ihre Angehörigen die Betreuung durch das ANP-Team erlebten. Methode: Die qualitative Studie orientierte sich am Forschungsansatz “Interpretive Description”. Acht Paarinterviews mit Patient_innen und Angehörigen wurden durchgeführt und mittels reflexiver thematischer Analyse ausgewertet. Ergebnisse: Die Teilnehmenden erlebten eine kontinuierliche Begleitung durch die Pflegeberaterinnen über den ganzen Therapieverlauf hinweg, erfuhren fachliche, administrative und emotionale Unterstützung und fühlten sich kompetent informiert und beraten. Sie hatten eine gut erreichbare Ansprechperson für Fragen, zu der sie eine emotionale Beziehung aufbauten. Dadurch fühlten sich Patient_innen und Angehörige nicht nur ermutigt und bestärkt, sondern auch sicher und gut aufgehoben. Schlussfolgerung: Der Einsatz eines ANP-Angebots wird für Betroffene empfohlen, da die kontinuierliche Begleitung durch eine fachkompetente, mitfühlende, vertraute und engagierte Ansprechperson für sie unerlässlich war.