The advocacy process in Canadian community health nursing: A collaborative ethnography

AIMS

To shed light on the process of advocacy in the context of community health nursing, through a methodology inspired by the epistemologies of the South.

DESIGN

We conducted a collaborative ethnography in a community health centre in Canada.

METHODS

de Sousa Santos' epistemologies of the South, a typology of advocacy and main themes from historic research informed the methodology. Data were collected between 2016 and 2018 through 420 h of fieldwork observations and three group discussions, including a collective process to co-construct interpretations with participants. Twenty-one nurses participated in the study.

RESULTS

Nurses had sufficient work flexibility to practice advocacy actions focused on individuals and groups. They also engaged in attempts at policy reform in the form of defending access to appropriate care and changing the mode of care organization. However, these were curbed by bureaucracy and administrative rules, resulting in the eventual dismissal of health promotion actions and experiences of moral distress.

CONCLUSION

Despite the political climate of their work environment impeding social justice agendas, nurses' advocacy practices showed a persistence of moral values and ideals in coherence with the regional nursing legacy.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

Acting at the organizational level and involving field nurses in decision making are potential avenues for increasing policy advocacy efficacy.

IMPACT

Examining contexts through another epistemic lens and methods of research drawing on history and anthropology has shed light on a process of advocacy. This research shows that organizations need to equip themselves with mechanisms to promote the sharing of realities between nurses, thereby building collective advocacy.

REPORTING METHOD

The research adheres to the EQUATOR guidelines with SRQR and COREQ methods.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Exploring Strategies for Developing Enabling Environments for People with Chronic Heart Disease: An Ethnographic Study Protocol

The impact of chronic diseases on people's daily lives and the exponential number of people affected is a major public health issue. The consequences on individuals and their families is significant, particularly in terms of quality of life. In the literature, this phenomenon is well described in terms of care policy and cost. Although there is a link between a supportive environment and empowerment, there is little literature describing a supportive environment and the daily lives of people living with cardiovascular disease. The objectives of this study are to identify the strategies people use to develop an enabling environment. It will be a qualitative ethnographic study that will address both human behavior and the notion of culture in a broad sense. In the context of this study, an orientation towards critical ethnography will be considered for its particular interest in vulnerable people and in the power relations that may exist in the socio-cultural system. Data will be collected directly in people's homes through observations and interviews with 10 people with cardiovascular disease. For each person, the data collection will take place over three days and will represent approximately 210 h of observation. This protocol was registered in the Research Register on 30 June 2021 and its number is 6933. This study will explore strategies for developing an enabling environment for people living with heart disease and eventually provide recommendations for nursing practices in terms of support.

Theoretical, methodological and analytical aspects of ethnographic research in obstetric nursing: an integrative review

OBJECTIVE

To characterize ethnographic research in the area of obstetric nursing regarding its theoretical, methodological and analytical aspects.

METHOD

An integrative review performed in the MEDLINE®, LILACS, BDENF and CINAHL databases, as well as the SciELO virtual library.

RESULTS

Thirty (30) articles formed the analytical corpus after screening and reading the primary references in full. The most used methods were ethno-nursing, ethnography and institutional ethnography; the immersion time in the field ranged from 12 visits to 48 months occurring in institutional contexts. The main data collection techniques were observation, individual interviews and training guides for ethno-nursing. The data were organized as themes and subthemes, analyzed through the ethno-nursing analysis guide, implementing the Theory of Diversity and Universality of Cultural Care as theoretical reference.

CONCLUSION

Ethnographic studies in the area of obstetric nursing are within the scope of microethnographies and are operationalized based on theoretical-methodological nursing references, being useful to analyze the complexity of phenomena involving obstetric nursing care, and focusing on the etic (professional) and emic (women) perspectives.

Suffering of Traumatic Amputees in Spain: Meaning, Spirituality, and Biomedicine

Amputation is a traumatic incident that entails a chain of psychological, physical, and social events. The objectives of the study are to describe the beliefs and the philosophies of life related to the experience of suffering of traumatic amputees, analyze the importance of biomedical care, and describe other forms of care used.