Configuration of power relations in physicians and nurses' professional practices

Universal healthcare coverage, patients' rights, and nurse-patient communication: a critical review of the evidence

The Sustainable Development Goals adopted by world leaders on September 25, 2015, aimed to end poverty and hunger, promote gender equity, empower women and girls, and ensure human dignity and equality by all human beings in a healthy environment. These development goals were premised on international human rights norms and institutions, thereby acknowledging the relevance of human rights in achieving each goal. Particularly, sustainable development goal 3, whose objective is to achieve universal health coverage, enhance healthy lives, and promote well-being for all, implicitly recognizes the right to health as crucial. Our focus in this paper is to discuss how promoting patients’ rights and enhancing effective nurse-patient communication in the healthcare setting is a significant and necessary way to achieve universal health coverage. Through a critical review of the empirical research evidence, we demonstrated that enhancing patients’ rights and effect nurse-patient communication will promote people-centered care, improve patients’ satisfaction of care outcomes, increase utilization of care services, and empower individuals and families to self-advocate for their health. These steps directly impact primary healthcare strategies and the social determinants of health as core components to achieving universal health coverage. We argue that without paying attention to the human rights dimensions or employing human rights strategies, implementing the other efforts will be inadequate and unsustainable in protecting the poorest and most vulnerable populations in the achievement of goal 3.

Continuity of care for children with chronic conditions after discharge: a constructivist grounded theory

ABSTRACT Objectives: to understand the meaning of continuity of care for children with chronic conditions through transitional care from hospital to home. Methods: this is a qualitative study, conducted from a Constructivist Grounded Theory perspective. Purposive and theoretical sampling were used to recruit 35 participants, including nurses, professionals from the interprofessional hospital team, and actors responsible for healthcare in the home context. The research was conducted at two large hospitals, between March and September 2019. Semi-structured interviews were conducted. Data analysis was carried out using initial and focused coding, according to constructivist grounded theory. Results: the substantive theory that emerged from this study was named “Postponing the next hospitalization”. Eight categories-concepts and 18 elements were derived from the data to support the substantive theory. Final Considerations: transitional care from hospital to home acts as a reminder for the resumption of continuity of care after discharge.

Disciplinary power on daily practices of nurses and physicians in the hospital

To understand power relations, it is important to consider that power is an attribute, and whoever has it at a given moment is in the condition of dominant and whoever is under its exercise is dominated. Moreover, we must consider that these positions are interchangeable, changing when relations of force change. Power relations represent the pursuit of supremacy through knowledge, with struggles for better positioning in the social structure. In this study, we analyze the effects of disciplinary power on daily practices of nurses and physicians in the hospital environment, more specifically in intensive care units. From the perspective of disciplines, power is exercised in a discreet, modest, calculated and permanent way, through the establishment of rules and norms. In this context, despite the strong appreciation of a medical-centered model, it is observed that nurses gain visibility through knowledge and the defense of institutional norms and rules, which can generate tensions in daily professional practices.