As examples of nurse practitioners in primary care, Swedish district nurses have been shown, in several studies, to respond well to the general pressure to achieve higher productivity in health care.
Yet they have less frequently been involved in studies of the detailed content of the service they provide.
To maintain total service quality, change should not be brought about only for the sake of efficacy.
This study is divided into an analysis of the basic service provided in district nursing by identifying a typical interaction with a patient ; and an analysis of the daily dilemmas district nurses experience, their consequences, and possible measures for change.
For the consultation study, data were collected from 40 videorecordings of office-hour consultations by a rural district nurse.
Regarding the dilemma situations, a critical incident questionnaire was returned by 153 district nurses in a Swedish county.
The analyses showed that the district nurse practises in an area between self-care on the one hand, and the intersection of the different specialities in health care, on the other.
Both the consultation study and the study of dilemmas in practice showed that the district nurse has to approach the health care organisation from a viewpoint close to that of the patient, which implies that she can, and has to, maintain an overview of the patient's total interaction with social institutions.
This focal localisation of the shared care and co-ordination as...
Mots-clés Pascal : Consultation, Relation soignant soigné, Infirmier, Homme, Pratique professionnelle, Nursing, Qualité, Suède, A domicile, Santé communautaire, Personnel sanitaire, Europe
Mots-clés Pascal anglais : Consultation, Health staff patient relation, Nurse, Human, Professional practice, Nursing, Quality, Sweden, At home, Community health, Health staff, Europe
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0262328
Code Inist : 002B30A05. Création : 199608.