Value-Sensitive Clinical Accompaniment in Community Nursing Science

ABSTRACT

Clinical community health facilities where undergraduate students are placed for their practical work in community nursing science are dynamic and have undergone major transformation over the past few years. In the clinical field; community nurses and undergraduate students are representative of the different races and language and ethnic groups in the South African population; with each group espousing different value systems. Both parties - students and community nurses - report that; due to these differences; value conflicts are experienced during clinical accompaniment and that this has negative effects on clinical learning in community nursing science. The goal of this study was to explore and describe the experiences of students with regard to value-sensitive clinical accompaniment in the community nursing environment. An exploratory; descriptive and contextual design was used. Interactions between community nurses and students during clinical accompaniment were explored for value sensitivity by means of video recordings; participant observation and focus group interviews. Data were collected by means of video recordings; participant observation and focus group interviews. The data were analysed and coded by the researcher and the external coder; using an inductive descriptive method to identify important segments of the regularity of behaviour. The focus group interviews were transcribed; analysed and coded by the researcher and the external coder; using Tesch's steps of analysis (Creswell 1994155-156). Lincoln and Guba's criteria (1985290) for trustworthiness were applied to the study. The general findings indicate that clinical accompaniment in community nursing is not value sensitive and; as a result; guidelines for value-sensitive clinical accompaniment need to be developed for undergraduate students in the community nursing environment. The following values (values for which guidelines need to be developed) were identified respect during clinical accompaniment; value-sensitive communication and sensitivity to the quality of clinical accompaniment. People's thoughts often focus on the suicide victim immediately after a completed suicide. Yet; the real victims of such an event are those individuals who are left behind to cope with the aftermath of the suicide. This phenomenological psychological study explored the lived experiences of lateadolescent suicide survivors; particularly those negative experiences that seemed to worsen in the weeks and months after a significant other's completed suicide. The research participants were five female late-adolescents (aged 17-22 years) who were recruited by means of purposive sampling at a South African tertiary institution and at youth camps. Data collection consisted of collagefacilitated; face-to-face phenomenological interviews. In addition; some participants provided documentary material in the form of personal diaries; letters and poems. The data analysis was conducted according to Giorgi's phenomenological method. The following salient experiences emerged during the data analysis: guilt; self-blame; blaming others or God; anger; loss or restriction of 'self'; depression; suboptimal behavioural coping patterns; changes in relationship dynamics; and suicidality. The results of this study can be used by mental health professionals and caregivers to support adolescent suicide survivors effectively; in the midst of their mourning