Navigating conflicting value systems: a grounded theory of the process of public health equity work in the context of mental health promotion and prevention of harms of substance use

Expert patients leading activities on social justice: towards patient-centered education

BACKGROUND

Social justice is recognized by reputable international organizations as a professional nursing value. However, there are serious doubts as to whether it is embodied in Catalan nursing education.

OBJECTIVES

To explore what nursing students take away from two teaching activities led by expert patients (one presentation and three expert patient illness narratives) on the topics of social justice, patient rights, and person-centered care.

RESEARCH DESIGN

Qualitative study using a content analysis approach. The research plan included (1) think-pair-share activities (additional faculty-assisted presentation and three faculty-assisted, semi-structured scripted narratives); (2) paired reflections; (3) focus groups; and (4) content analysis of paired reflections and focus groups.

PARTICIPANTS AND RESEARCH CONTEXT

Fourth-year nursing degree students at the Autonomous University of Barcelona (UAB), Spain. Convenience sampling was used.

ETHICAL CONSIDERATIONS

The UAB Research Ethics Committee did not deem it necessary to apply any specific measures. We fully explained to patients that they could decide what medical information they would share with the students that was relevant to their learning, and we provided students with guidelines about patient confidentiality, dignity, and respect.

FINDINGS/RESULTS

The students engaged in reflection about their education (recognizing that it had been centered on the professional and not the patient) and their relationship with the patient, in which they reproduced low-involvement patient care by modeling behaviors of their nurse educator. Moreover, they valued a person-centered care model with an emphasis on the emotional part but left out decision-making as an individual right of people.

CONCLUSIONS

The think-pair-share activities were useful to spark self-reflection among students, who identified aspects to change in their own practice, and reflected about their own education process, both of which promote change.

Mental health promotion practice in Aotearoa New Zealand: findings from a qualitative study

Mental health promotion (MHP) is integral to improving the overall health and well being of individuals, communities, and populations. However, knowledge and reporting about MHP which occurs throughout Aotearoa New Zealand (NZ) is limited. This article reports findings from a qualitative study that sought to understand NZ health promotion practitioners' (HPPs) MHP practice. Semi-structured interviews were undertaken with 15 HPPs employed at various health promotion organizations. Thematic analysis of interview transcripts identified three key themes. Two themes (planning and evaluation) related to practice directly and included various subthemes: needs assessment; principles/approaches/frameworks; operationalizing equity and te Tiriti o Waitangi; collaborative approaches; planning for evaluation; process evaluation domination; and evaluation challenges. The third theme related to the context of practice and encompassed various system influences restricting HPPs from practising as they wished. These were represented in four subthemes: contractual agreements; field fragmentation; in the shadows of mental ill-health and workforce capacity. Study findings highlight several opportunities to improve MHP practice in NZ. Most pertinently, the need for system-level action to address the factors restricting HPPs' practice.