ABSTRACT
Scotland has led enactment of the new World Health Organisation (Europe) Family Health Nurse (FHN) concept. This paper presents research which evaluated the initial operation and impact of the role in remote and rural regions of Scotland. Through use of a multiplex research design informed by ideas from realistic evaluation, fourth generation evaluation and case study research, an initial typology of practice was constructed. The new FHN role typically supplemented, rather than supplanted, pre-existing community nursing services. Implications arising from key findings are discussed in relation to Scottish, UK and European nursing and primary care perspectives.
Subject(s)
Family Nursing/organization & administration , Rural Health Services/organization & administration , Attitude of Health Personnel , Consumer Behavior , Humans , Medically Underserved Area , Models, Nursing , Nurse's Role , Pilot Projects , Primary Health Care , Program Evaluation/methods , ScotlandABSTRACT
In 1998 the World Health Organisation (WHO) Europe proposed a new type of community based nurse called the family health nurse (FHN). Although it was initially envisaged that 18 European countries would take part in the development of the FHN role through parallel processes of education and implementation, Scotland has been significantly ahead of other countries in enacting this plan. A pilot project involving community nurses from four remote and rural regions of Scotland was conducted between 2001 and 2003. A Scottish University was commissioned to provide a degree-level course for registered nurses with a minimum of two years post-registration qualifying experience. This paper summarises the main findings and issues arising from an external research evaluation of this educational programme. The programme was found to differ substantially in focus and format from other specialist community nursing programmes available in Scotland. Moreover there were key differences from the curriculum proposed by WHO Europe, in that there was more grounding in North American family nursing models and less focus on management and leadership. This customized degree programme provides a precedent for other educational providers in the UK to reconsider their approach to specialist practice degree level education.
Subject(s)
Community Health Nursing/education , Curriculum/standards , Education, Nursing, Graduate/standards , Family Nursing , Nurse Clinicians/education , Attitude of Health Personnel , Clinical Competence/standards , Community Health Nursing/organization & administration , Faculty, Nursing , Family Nursing/organization & administration , Humans , Leadership , Mentors/psychology , Models, Educational , Models, Nursing , Nurse Clinicians/organization & administration , Nurse Clinicians/psychology , Nurse's Role , Nursing Education Research , Pilot Projects , Program Evaluation , Scotland , Social Support , Surveys and QuestionnairesABSTRACT
I discuss women's work life and the psychological health of women in low-income communities in Northeast Thailand. Previous research has shown that low-income women are part of a disadvantaged group who struggle against several problems in their everyday life, and who work hard to survive. These women worked as either manual laborers in agriculture or factories or as self-employed vendors, and were busy Ha Yoo Ha Kin (working and earning a living). The women's way of life was complex and involved being responsible for their children, husband, extended family, work, and themselves. Understanding women's beliefs and practice relating to work life and health is essential in designing effective intervention programmes to promote the health and well-being of low-income women in Thailand.
